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Predictive properties of the A-TAC inventory when screening for childhood-onset neurodevelopmental problems in a population-based sample

Journal article
Authors Tomas Larson
Sebastian Lundström
Thomas Nilsson
Eva Norén Selinus
Maria Råstam
Paul Lichtenstein
Clara Hellner Gumpert
Henrik Anckarsäter
Nora Kerekes
Published in BMC Psychiatry
Volume 13
Issue 233
ISSN 1471-244X
Publication year 2013
Published at Institute of Neuroscience and Physiology
Centre for Ethics, Law, and Mental Health
Language en
Keywords Autism; Tics; AD/HD, and other Co-morbidities inventory; A-TAC; Screening; Mental disorders diagnosed in childhood; Co-morbidity; Cohort studies; Predictive value of tests; Sensitivity and specificity
Subject categories Child and adolescent psychiatry


Background Identifying children with childhood-onset neurodevelopmental problems (NDPs, defined here as autism spectrum disorders [ASDs], attention-deficit/hyperactivity disorder [AD/HD], tic disorders [TDs], learning disorders [LDs] and development coordination disorder), using easily administered screening instruments, is a prerequisite for epidemiological research. Such instruments are also clinically useful to prioritize children for comprehensive assessments, to screen risk groups, and to follow controls. Autism–Tics, ADHD, and other Co-morbidities inventory (A-TAC) was developed to meet these requirements; here the A-TAC’s prospective and psychometric properties are examined, when used in a population-based, epidemiological setting. Methods Since 2004, parents of all Swedish twins have been asked to take part in an ongoing, nation-wide twin study (The Child and Adolescent Twin Study in Sweden). The study includes the A-TAC, carried out as a telephone interview with parents of twins aged 9 or 12. In the present study, screen-positive twins from three birth year cohorts (1993–1995) were invited to a comprehensive clinical follow-up (blinded for previous screening results) together with their co-twins and randomly selected, healthy controls at age 15 (Total N = 452). Results Sensitivity and specificity of A-TAC scores for predicting later clinical diagnoses were good to excellent overall, with values of the area under the receiver operating characteristics curves ranging from 0.77 (AD/HD) to 0.91 (ASDs). Among children who were screen-positive for an ASD, 48% received a clinical diagnosis of ASDs. For AD/HD, the corresponding figure was also 48%, for LDs 16%, and for TDs 60%. Between 4% and 35% of screen-positive children did not receive any diagnosis at the clinical follow-up three years later. Among screen-negative controls, prevalence of ASDs, AD/HD, LDs, and TDs was 0%, 7%, 4%, and 2%, respectively. Conclusions The A–TAC appeared to be a valid instrument to assess NDPs in this population-based, longitudinal study. It has good-to-excellent psychometric properties, with an excellent ability to distinguish NDPs (mainly ASDs) from non-NDPs at least three years after the screening evaluations, although specific diagnoses did not correspond closely to actual clinical diagnoses.

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