![]() ![]() Of these instruments, the AQ and the SRS-A appear to be the most commonly used in the Netherlands. ![]() 2011), the Social Responsiveness Scale Adult version (SRS-A Constantino and Todd 2005), and the Social Communication Questionnaire (SCQ Rutter et al. 2001), the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R Ritvo et al. Various ASD questionnaires for adults are used in clinical practice, including the Autism-spectrum Quotient (AQ Baron-Cohen et al. Depending on the specific use of the questionnaire, a choice must be made concerning which values are to be assigned the most weight. In practice, however, high sensitivity often comes at the expense of specificity, and vice versa. Ideally, all of these predictive values of a questionnaire should be as high as possible. Conversely, if an individual scores below the cut-off point on a questionnaire, it is important to know the accuracy of the estimate that the individual actually does not have the condition (NPV) or that the result is a missed patient (false negative = 1 − NPV). If an individual scores above the cut-off point on a questionnaire, it is important to know the accuracy of the estimate that the individual actually does have the condition (PPV) or that the result is a false alarm (false positive = 1 − PPV). After all, when a questionnaire is used for such purposes it is primarily important to know how much value can be assigned to the results of the questionnaire (given that the diagnosis is not yet known). The latter two properties nevertheless seem quite relevant to clinical practice, especially when it comes to using questionnaires as part of screening or diagnosing. It is interesting to note that, while sensitivity and specificity are often mentioned in research on the predictive value of questionnaires, PPV and NPV are much less commonly mentioned. Patients are thus taken as the source for calculating sensitivity and specificity, while test results are taken as the source for calculating PPV and NPV. From a different perspective, PPV refers to the percentage of people with the condition among the positive test results, and NPV refers to the percentage of people without the condition among the negative test results. Specificity refers to the percentage of negative test results among people without the condition. Sensitivity refers to the percentage of positive test results among the people with the condition. With regard to the predictive power of questionnaires concerning the ultimate diagnosis, the concepts of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) play an important role (Parikh et al. ![]() Questionnaires can play a role in decisions concerning whether a referral for ASD assessment is needed (i.e., for screening purposes), as well as in support of formal ASD assessment (i.e., for diagnostic purposes). Additionally, questionnaires may be used. Also, a thorough (early) developmental history is assessed with a relative (preferably the primary caregiver) and possibly an interview with another informant (e.g. For adults without cognitive disabilities, this consists of a general psychiatric examination of the characteristics of ASD and possible co-morbidity. 2014).įollowing (inter) national guidelines, the diagnostics of ASD requires a comprehensive assessment (Kan et al. 2016), and increased financial costs (Horlin et al. When ASD remains undetected, it regularly leads to secondary problems (e.g., depression, anxiety, and burn-out), reduced quality of life (Bargiela et al. 2017) also make it difficult to recognize the symptoms of ASD (Bargiela et al. Above-average intelligence, an optimal environment, and acquired camouflaging behaviors (masking, compensation, and assimilation Hull et al. Explanations include the often wider diversity of reasons for referring to such departments, the likelihood that ASD is concealed by co-morbid psychopathology (diagnostic overshadowing), and greater subtlety in the manifestations of ASD. We suspect that ASD cases are more frequently missed in the more general departments, as clinicians in these facilities are, on average, less sensitive to recognizing ASD. The diagnostics of ASD take place in specialized departments, as well as in more general departments within the mental healthcare system. 2018), which is partly due to differing autism survey methodologies (Fombonne 2018). For children, this figure has recently been adjusted upward and ranges from 1.68% (Baio et al. Epidemiological research shows that autism spectrum disorder (ASD) occurs in approximately 1% of the adult population (Brugha et al. ![]()
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