Related Experiment Video
Updated: Oct 16, 2025
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
The Autism Detection in Early Childhood Tool: Level 2 autism spectrum disorder screening in a NICU Follow-up program
Darrah N Haffner1, Lindsay R Bartram2, Daniel L Coury2
1Department of Pediatrics, Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, OH, USA; Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Insights
The Autism Detection in Early Childhood (ADEC) tool effectively identifies autism spectrum disorder (ASD) risk in preterm infants. This autism-specific screening tool shows higher accuracy than the Child Behavior Checklist (CBCL) in NICU follow-up settings.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Child psychology
Background:
- Children born preterm face a higher risk of developing autism spectrum disorder (ASD).
- Conventional screening tools for ASD have limited reliability in preterm populations, complicating early diagnosis.
- Accurate identification of ASD risk in high-risk infants is crucial for timely intervention and support.
Purpose of the Study:
- To evaluate the effectiveness of the Autism Detection in Early Childhood (ADEC) and Child Behavior Checklist (CBCL) in identifying ASD risk in infants from a Neonatal Intensive Care Unit (NICU) Follow-up program.
- To determine if these tools can facilitate earlier referral for formal ASD evaluations in this vulnerable population.
Main Methods:
- Children aged 18-36 months from a NICU Follow-up program were assessed.
- Screening for ASD risk was conducted using the ADEC and CBCL, with referrals for diagnostic evaluation triggered by 'at-risk' scores.
- Diagnostic ASD evaluations were performed on referred children based on DSM-5 criteria.
Main Results:
- Out of 69 preterm infants (median gestational age 28 weeks), 18 were identified as 'at risk' for ASD.
- The ADEC tool showed high performance (sensitivity 89%, specificity 98%), while the CBCL was less sensitive (sensitivity 50%, specificity 90%).
- Nine children received a formal ASD diagnosis after undergoing evaluation.
Conclusions:
- The ADEC tool demonstrated strong performance in detecting ASD risk within a high-risk NICU cohort.
- The ADEC offers added value as an autism-specific screening instrument compared to using the CBCL alone in this population.
- Early and accurate screening using tools like ADEC is vital for timely ASD diagnosis and intervention in preterm infants.
Objective:
Children born preterm are at increased risk for autism spectrum disorder (ASD). However, early diagnosis of ASD is challenging because conventional screening Level 1 tools are less reliable in this population. We sought to determine whether the Autism Detection in Early Childhood (ADEC) and Child Behavior Checklist (CBCL) could accurately identify children at risk for ASD in a NICU Follow-up setting and thus facilitate referral for formal ASD evaluation.
Method:
Children aged 18-36 months were recruited from a NICU Follow-up program. All children received presumptive diagnoses based on DSM-5 criteria and were screened for ASD risk with the ADEC and CBCL. Children scoring in the "at risk" range on either tool were referred for a full diagnostic ASD evaluation.
Results:
Sixty-nine patients (median birth weight 1140 g; median gestational age 28 weeks) were included with 18 designated "at risk" for ASD. Nine (13 %) scored "at risk" on the ADEC and 12 (17 %) on the CBCL. Thirteen children underwent diagnostic ASD evaluation with 9 receiving a formal diagnosis of ASD. The ADEC demonstrated the best performance (sensitivity 89 %, specificity 98 %). The CBCL was less sensitive (sensitivity 50 %, specificity 90 %). Requiring elevated scores on both the CBCL and ADEC was specific but not sensitive (sensitivity 33 %, specificity 100 %).
Conclusion:
The ADEC performed well in identifying children at risk for ASD within this high-risk NICU cohort, adding benefit as an autism-specific screening tool over the CBCL alone.
More Related Videos
11:14A Novel Experimental and Analytical Approach to the Multimodal Neural Decoding of Intent During Social Interaction in Freely-behaving Human Infants
Published on: October 4, 2015
09:16Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers
Published on: March 14, 2018
