Diagnostic Accuracy of Indian Scale for Assessment of Autism (ISAA) in Chidren Aged 2-9 Years.
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Date
2015-03
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Abstract
Objective: To determine the diagnostic accuracy of Indian Scale
for Assessment of Autism (ISAA) in children aged 2-9 year at high
risk of autism, and to ascertain the level of agreement with
Childhood Autism Rating Scale (CARS).
Design: Diagnostic Accuracy study
Setting: Tertiary-level hospital.
Participants: Children aged between 2 and 9 year and
considered to be at a high risk for autism (delayed development,
and age-inappropriate cognition, speech, social interaction,
behavior or play) were recruited. Those with diagnosed Hearing
impairment, Cerebral palsy, Attention deficit hyperactivity disorder
or Pervasive developmental disorders (PDD) were excluded.
Methods: Eligible children underwent a comprehensive
assessment by an expert. The study group comprising of PDD,
Global developmental delay (GDD) or Intellectual disability was
administered ISAA by an investigator after one week. Both
evaluators were blinded. ISAA results were compared to the
Expert’s diagnosis and CARS scores.
Results: Out of 102 eligible children, 90 formed the study group
(63 males, mean age 4.5y). ISAA had a sensitivity 93.3,
specificity of 97.4, positive and negative likelihood ratios 85.7 and
98.7 and positive and negative predictive values of 35.5 and 0.08,
respectively. Reliability was good and validity sub-optimal (r low, in
4/6 domains). The optimal threshold point demarcating Autism
from ‘No autism’ according to Receiver Operating Characteristic
curve was ISAA score of 70. Level of agreement with CARS
measured by Kappa coefficient was low (0.14).
Conclusions: The role of ISAA in 3-9 year old children at high risk
for Autism is limited to identifying and certifying Autism at ISAA
score of 70. It requires re-examination in 2-3 year olds.
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Keywords
Autism spectrum disorder, Certification, Diagnosis, Pervasive Developmental disorders
Citation
Mukherjee Sharmila Banerjee, Malhotra Manoj Kumar, Aneja Satinder, Chakraborty Satabdi, Deshpande Smita. Diagnostic Accuracy of Indian Scale for Assessment of Autism (ISAA) in Chidren Aged 2-9 Years. Indian Pediatrics. 2015 Mar; 52(3): 212-216.