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<DIV> </DIV>
<DIV>Below is a new report on Broadband Developmental-Behavioral Screening for Children likely to have Autism Spectrum Disorder.</DIV>
<DIV> </DIV>
<DIV>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.</DIV>
<DIV> </DIV>
<DIV>All materials will be available on the Littlesteps web site this week for you to review as needed.</DIV>
<DIV> </DIV>
<DIV>===============================================================================================</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV>Can a Broadband Developmental-Behavioral Screening Test Identify</DIV>
<DIV>Children Likely to Have Autism Spectrum Disorder?</DIV>
<DIV>Frances Page Glascoe, PhD</DIV>
<DIV>Department of Pediatrics, Vanderbilt University, Nashville, Tennessee,</DIV>
<DIV><A href="mailto:Frances.P.Glascoe@Vanderbilt.edu">Frances.P.Glascoe@Vanderbilt.edu</A></DIV>
<DIV> </DIV>
<DIV>Michelle M. Macias, MD</DIV>
<DIV> </DIV>
<DIV>Department of Pediatrics, Medical University of South Carolina,</DIV>
<DIV>Charleston, South Carolina</DIV>
<DIV> </DIV>
<DIV>Lynn M. Wegner, MD</DIV>
<DIV> </DIV>
<DIV>Department of Pediatrics, University of North Carolina at Chapel Hill,</DIV>
<DIV>Chapel Hill, North Carolina</DIV>
<DIV> </DIV>
<DIV>Nicholas S. Robertshaw</DIV>
<DIV> </DIV>
<DIV>Forepath.org, Washington, DC</DIV>
<DIV> </DIV>
<DIV>Because services for children with autism spectrum disorder (ASD) are</DIV>
<DIV>scarce, when children fail a broadband screening measure, providers need</DIV>
<DIV>to carefully discern which children need ASD evaluations and which do</DIV>
<DIV>not. This research considers how well a broadband screening test sorts</DIV>
<DIV>those with and without probable ASD. The subjects were 427 children</DIV>
<DIV>between 18 and 59 months of age with elevated risk scores on broadband</DIV>
<DIV>screening, ie, Parents' Evaluation of Developmental Status (PEDS), a</DIV>
<DIV>10-item measure eliciting parents' concerns. Parents also completed the</DIV>
<DIV>Modified Checklist of Autism in Toddlers (M-CHAT), an autism specific</DIV>
<DIV>screen. The results showed that of the 427 children at risk on PEDS, 34%</DIV>
<DIV>(N = 144) passed the M-CHAT. To determine whether these potential</DIV>
<DIV>overreferrals could be reduced, parents' concerns on PEDS were used to</DIV>
<DIV>predict M-CHAT results. Three or more discrete types of concerns,</DIV>
<DIV>varying by age, characterized children who failed the M-CHAT while fewer</DIV>
<DIV>than 3 were associated with passing. This reduced overreferrals by 70%</DIV>
<DIV>while maintaining high levels of sensitivity (81%). Although compliance</DIV>
<DIV>with the American Academy of Pediatrics recommendations for both</DIV>
<DIV>broadband and autism-specific screening at 18 and 24 months is still</DIV>
<DIV>recommended, viewing performance patterns on a broadband screening test</DIV>
<DIV>can substantially reduce overreferrals to autism specialty services.</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV>Key Words: parents' concerns ● autism ● child development ●</DIV>
<DIV>developmental screening</DIV>
<DIV> </DIV>
<DIV>Simple questionnaire useful screening tool for postpartum depression</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV>Published on Sep 16, 2008</DIV>
<DIV> </DIV>
<DIV> </DIV>
<DIV>--------------------------------------------------------------------------------</DIV>
<DIV> </DIV>
<DIV>Article Tools:</DIV>
<DIV> </DIV>
<DIV>Clinical</DIV>
<DIV> </DIV>
<DIV>Simple questionnaire useful screening tool for postpartum depression</DIV>
<DIV> </DIV>
<DIV>Last Updated: 2008-09-04 8:30:43 -0400 (Reuters Health)</DIV>
<DIV> </DIV>
<DIV>NEW YORK (Reuters Health) - A condensed version of the 10-item</DIV>
<DIV>Edinburgh Postpartum Depression Scale (EPDS) is useful in screening for</DIV>
<DIV>postpartum depression in primary care settings, according to a report in</DIV>
<DIV>the September issue of Pediatrics.</DIV>
<DIV> </DIV>
<DIV>Dr. Karolyn Kabir, from the University of Colorado in Denver, and</DIV>
<DIV>colleagues examined three subscales of the 10-item EPDS as ultrabrief</DIV>
<DIV>alternatives to screening with the full test. The EPDS-3 included three</DIV>
<DIV>questions focusing on anxiety, EPDS-7 featured seven focusing on</DIV>
<DIV>depression, and EPDS-2 included two resembling those found in the</DIV>
<DIV>Patient Health Questionnaire.</DIV>
<DIV> </DIV>
<DIV>The study included 41 mothers, between 14 and 26 years of age, who were</DIV>
<DIV>referred for assessment of possible postpartum depression. The screening</DIV>
<DIV>performance of the EPDS-2, EPDS-3, and EPDS-7 were compared to that of</DIV>
<DIV>the full 10-item EPDS.</DIV>
<DIV> </DIV>
<DIV>The EPDS-3 performed the best as a screening tool with a sensitivity of</DIV>
<DIV>95% and a negative predictive value of 98%. Compared with the full test,</DIV>
<DIV>the EPDS-3 identified 16% more subjects as being depressed.</DIV>
<DIV> </DIV>
<DIV>For the EPDS-3, women are asked to respond to these statements:</DIV>
<DIV> </DIV>
<DIV>--I have blamed myself unnecessarily when things went wrong;</DIV>
<DIV> </DIV>
<DIV>--I have felt scared or panicky for no very good reason;</DIV>
<DIV> </DIV>
<DIV>--I have been anxious or worried for no good reason.</DIV>
<DIV> </DIV>
<DIV>The EPDS-2 had the worst performance with a raw score sensitivity and</DIV>
<DIV>negative predictive value of 48% and 88%, respectively. This test was</DIV>
<DIV>also unreliable for mothers without a history of depression. EPDS-7 had</DIV>
<DIV>a sensitivity of 59% and a ne</DIV>
<DIV>gative predictive value of 90%.</DIV>
<DIV> </DIV>
<DIV>"Our findings strongly suggest that healthcare providers who do not</DIV>
<DIV>have time to administer the full EPDS should consider incorporating the</DIV>
<DIV>EPDS-3 into their health maintenance visits with new mothers," Dr.</DIV>
<DIV>Kabir's team concludes.</DIV>
<DIV> </DIV>
<DIV>Pediatrics 2008;122:e696-e702.</DIV>
<DIV> </DIV>
<DIV>==============================================================================================</DIV>
<DIV> </DIV>
<DIV>Timothy Tyndall</DIV>
<DIV>List manager</DIV>
<DIV><A href="mailto:timothy@rain.org">timothy@rain.org</A></DIV>
<DIV> </DIV>
<DIV> </DIV>
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