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Diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in chidren aged 2–9 years

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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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Authors and Affiliations

  1. Department of Pediatrics, Kalawati Saran Children’s Hospital, Bangla Sahib Road, New Delhi, 110 001, India

    Sharmila Banerjee Mukherjee, Manoj Kumar Malhotra & Satinder Aneja

  2. Department of Psychiatry, Pt. BD Sharma PGIMS, Rohtak, Haryana, India

    Satabdi Chakraborty

  3. Department of Psychiatry, PGIMER — Dr. Ram Manohar Lohia Hospital, New Delhi, India

    Smita Deshpande

Authors
  1. Sharmila Banerjee Mukherjee
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  2. Manoj Kumar Malhotra
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  3. Satinder Aneja
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  4. Satabdi Chakraborty
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  5. Smita Deshpande
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Correspondence to Sharmila Banerjee Mukherjee.

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Mukherjee, S.B., Malhotra, M.K., Aneja, S. et al. Diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in chidren aged 2–9 years. Indian Pediatr 52, 212–216 (2015). https://doi.org/10.1007/s13312-015-0608-z

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  • DOI: https://doi.org/10.1007/s13312-015-0608-z

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