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ESSENCE-Q - used as a screening tool for neurodevelopmental problems in public health checkups for young children in south Japan

Journal article
Authors Yuhei Hatakenaka
H. Ninomiya
Eva Billstedt
Elisabeth Fernell
Christopher Gillberg
Published in Neuropsychiatric Disease and Treatment
Volume 13
Pages 1271-1280
ISSN 1178-2021
Publication year 2017
Published at Institute of Neuroscience and Physiology
Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry
Gillberg Neuropsychiatry Centre
Pages 1271-1280
Language en
Keywords ESSENCE, questionnaire, public health nurse, receiver operating characteristic, ROC, area under the, autism spectrum disorder, parents concerns, diagnosis, age, surveillance
Subject categories Neurosciences


Background: Screening for developmental disorders is an important task for Child Health Care. The concept of ESSENCE (early symptomatic syndromes eliciting neurodevelopmental clinical examinations) was created to cover all types of early developmental disorders and the ESSENCE-Questionnaire (ESSENCE-Q containing 12 questions with possible total scores ranging from 0 to 22) was developed as a tool for early detection of these disorders. The aim of this study was to perform a validation study in a public health situation in Japan. Methods: The psychometric properties of the ESSENCE-Q, completed by mothers, public health nurses (PHNs), and psychologists at 18-month (n=143 children) and 36-month (n=149 children) checkups were evaluated in a small city of Japan. Results were validated against clinical ESSENCE diagnoses. Receiver operating characteristic curves were generated and compared by using the area under the curve (AUC). Optimal cutoff values were explored. Results: At the 18-month checkup, AUC by mothers was 0.72, by PHNs 0.86, and by psychologists 0.82. An optimal cutoff was 3 with a high negative predictive value (NPV). At the 36-month checkup, AUC by mothers was 0.57, by PHNs 0.82, and by psychologists 0.87. Optimal cutoff was 2 with high NPV. Conclusion: The ESSENCE-Q completed by PHNs and psychologists had good diagnostic validity. The results suggested that almost all children scoring under cutoff would not have any ESSENCE problems/diagnoses.

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