[Landon-pediatric-foundation-telemedicine-listserv] New resources for treatment of Autism

Mon Dec 15 11:33:54 PST 2008

Below is a new report on Broadband Developmental-Behavioral Screening for
Children likely to have Autism Spectrum Disorder.

Also attached is a report on an Autism Workshop held at Ventura County
Medical Center by Rachelle Tyler, M.D., Associate Professor of Pediatrics,
David Geffen School of Medicine at UCLA and a copy of the powerpoint
presentation by Dr. Tyler.

All materials will be available on the Littlesteps web site this week for
you to review as needed.

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Can a Broadband Developmental-Behavioral Screening Test Identify
Children Likely to Have Autism Spectrum Disorder?
Frances Page Glascoe, PhD
Department of Pediatrics, Vanderbilt University, Nashville, Tennessee,
Frances.P.Glascoe at Vanderbilt.edu

Michelle M. Macias, MD

Department of Pediatrics, Medical University of South Carolina,
Charleston, South Carolina

Lynn M. Wegner, MD

Department of Pediatrics, University of North Carolina at Chapel Hill,
Chapel Hill, North Carolina

Nicholas S. Robertshaw

Forepath.org, Washington, DC

Because services for children with autism spectrum disorder (ASD) are
scarce, when children fail a broadband screening measure, providers need
to carefully discern which children need ASD evaluations and which do
not. This research considers how well a broadband screening test sorts
those with and without probable ASD. The subjects were 427 children
between 18 and 59 months of age with elevated risk scores on broadband
screening, ie, Parents' Evaluation of Developmental Status (PEDS), a
10-item measure eliciting parents' concerns. Parents also completed the
Modified Checklist of Autism in Toddlers (M-CHAT), an autism specific
screen. The results showed that of the 427 children at risk on PEDS, 34%
(N = 144) passed the M-CHAT. To determine whether these potential
overreferrals could be reduced, parents' concerns on PEDS were used to
predict M-CHAT results. Three or more discrete types of concerns,
varying by age, characterized children who failed the M-CHAT while fewer
than 3 were associated with passing. This reduced overreferrals by 70%
while maintaining high levels of sensitivity (81%). Although compliance
with the American Academy of Pediatrics recommendations for both
broadband and autism-specific screening at 18 and 24 months is still
recommended, viewing performance patterns on a broadband screening test
can substantially reduce overreferrals to autism specialty services.

Key Words: parents' concerns ● autism ● child development ●
developmental screening

Simple questionnaire useful screening tool for postpartum depression

Published on Sep 16, 2008

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Article Tools:

Clinical

Simple questionnaire useful screening tool for postpartum depression

Last Updated: 2008-09-04 8:30:43 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A condensed version of the 10-item
Edinburgh Postpartum Depression Scale (EPDS) is useful in screening for
postpartum depression in primary care settings, according to a report in
the September issue of Pediatrics.

Dr. Karolyn Kabir, from the University of Colorado in Denver, and
colleagues examined three subscales of the 10-item EPDS as ultrabrief
alternatives to screening with the full test. The EPDS-3 included three
questions focusing on anxiety, EPDS-7 featured seven focusing on
depression, and EPDS-2 included two resembling those found in the
Patient Health Questionnaire.

The study included 41 mothers, between 14 and 26 years of age, who were
referred for assessment of possible postpartum depression. The screening
performance of the EPDS-2, EPDS-3, and EPDS-7 were compared to that of
the full 10-item EPDS.

The EPDS-3 performed the best as a screening tool with a sensitivity of
95% and a negative predictive value of 98%. Compared with the full test,
the EPDS-3 identified 16% more subjects as being depressed.

For the EPDS-3, women are asked to respond to these statements:

--I have blamed myself unnecessarily when things went wrong;

--I have felt scared or panicky for no very good reason;

--I have been anxious or worried for no good reason.

The EPDS-2 had the worst performance with a raw score sensitivity and
negative predictive value of 48% and 88%, respectively. This test was
also unreliable for mothers without a history of depression. EPDS-7 had
a sensitivity of 59% and a ne
gative predictive value of 90%.

"Our findings strongly suggest that healthcare providers who do not
have time to administer the full EPDS should consider incorporating the
EPDS-3 into their health maintenance visits with new mothers," Dr.
Kabir's team concludes.

Pediatrics 2008;122:e696-e702.

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Timothy Tyndall
List manager
timothy at rain.org

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