TY - JOUR
T1 - Combining developmental and sleep health measures for autism spectrum disorder screening
T2 - an ECHO study
AU - for the ECHO Cohort Consortium
AU - Shuffrey, Lauren C.
AU - Rennie, Brandon
AU - Li, Xiuhong
AU - Galai, Noya
AU - Pini, Nicolò
AU - Akbaryan, Anahid
AU - Alshawabkeh, Akram
AU - Aschner, Judy
AU - Vargas, Julianna Collazo
AU - Costello, Lauren
AU - D’Sa, Viren
AU - Deoni, Sean
AU - Dunlop, Anne
AU - Elliott, Amy J.
AU - Fifer, William P.
AU - Hash, Jonica
AU - Koinis-Mitchell, Daphne
AU - Lai, Jin Shei
AU - Leventhal, Bennett L.
AU - Lewis, Johnnye
AU - Lucchini, Maristella
AU - McArthur, Kristen L.
AU - Morales, Santiago
AU - Nozadi, Sara S.
AU - O’Connor, Thomas G.
AU - O’Shea, T. Michael
AU - Page, Grier P.
AU - Propper, Cathi
AU - Sania, Ayesha
AU - Shuster, Coral
AU - Zimmerman, Emily
AU - Margolis, Amy E.
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2024.
PY - 2024/6/12
Y1 - 2024/6/12
N2 - Background: Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses. Methods: Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses. Results: The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis. Conclusion: While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. Impact: Parental-reported sleep problems are common in autism spectrum disorder (ASD). We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism. We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance.
AB - Background: Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses. Methods: Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses. Results: The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis. Conclusion: While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. Impact: Parental-reported sleep problems are common in autism spectrum disorder (ASD). We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism. We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance.
UR - http://www.scopus.com/inward/record.url?scp=85195934019&partnerID=8YFLogxK
U2 - 10.1038/s41390-024-03306-0
DO - 10.1038/s41390-024-03306-0
M3 - Article
C2 - 38867029
AN - SCOPUS:85195934019
SN - 0031-3998
JO - Pediatric Research
JF - Pediatric Research
ER -