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Validation of existing diagnosis of autism in mainland China using standardised diagnostic instruments.


Type

Article

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Authors

Sun, Xiang 
Auyeung, Bonnie 
Zhang, Zhixiang 
Matthews, Fiona E 

Abstract

Research to date in mainland China has mainly focused on children with autistic disorder rather than Autism Spectrum Conditions and the diagnosis largely depended on clinical judgment without the use of diagnostic instruments. Whether children who have been diagnosed in China before meet the diagnostic criteria of Autism Spectrum Conditions is not known nor how many such children would meet these criteria. The aim of this study was to evaluate children with a known diagnosis of autism in mainland China using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised to verify that children who were given a diagnosis of autism made by Chinese clinicians in China were mostly children with severe autism. Of 50 children with an existing diagnosis of autism made by Chinese clinicians, 47 children met the diagnosis of autism on the Autism Diagnostic Observation Schedule algorithm and 44 children met the diagnosis of autism on the Autism Diagnostic Interview-Revised algorithm. Using the Gwet's alternative chance-corrected statistic, the agreement between the Chinese diagnosis and the Autism Diagnostic Observation Schedule diagnosis was very good (AC1 = 0.94, p < 0.005, 95% confidence interval (0.86, 1.00)), so was the agreement between the Chinese diagnosis and the Autism Diagnostic Interview-Revised (AC1 = 0.91, p < 0.005, 95% confidence interval (0.81, 1.00)). The agreement between the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised was lower but still very good (AC1 = 0.83, p < 0.005).

Description

Keywords

China, autism spectrum disorders, diagnosis, validation, Autistic Disorder, Child, Child, Preschool, China, Female, Humans, Interview, Psychological, Male, Psychiatric Status Rating Scales, Reproducibility of Results, Sensitivity and Specificity

Journal Title

Autism

Conference Name

Journal ISSN

1362-3613
1461-7005

Volume Title

19

Publisher

SAGE Publications
Sponsorship
Medical Research Council (G0600977)
X.S. was supported by the Waterloo Foundation, Cambridge Commonwealth Trust, Clare Hall of the University of Cambridge and Great Britain-China Educational Trust during initial writing up and then funded by the International Development Fund Cambridge- CUHK Collaboration on Autism Research in Hong Kong and China during the later writing up of this article. C.A., S.B.C. and B.A. were supported by the MRC UK. This study was conducted in association with the NIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation Trust. FM was supported by UK Medical Research Council programme grant U105292687.