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Accuracy Of Autism Diagnostic Interview-Revised (ADI-R) In Categorizing Egyptian Children With Pervasive Developmental Disorders By Heba Elsayed Gaber Ass. lecturer at Faculty of Medicine, Alexandria university Supervised by: Y.Aboras , H. Azouz , T. Molokhia and M.ElBanna.
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Accuracy Of Autism Diagnostic Interview-Revised (ADI-R) In Categorizing Egyptian Children With Pervasive Developmental DisordersByHeba Elsayed Gaber Ass. lecturer at Faculty of Medicine, Alexandria universitySupervised by: Y.Aboras, H. Azouz, T. Molokhia and M.ElBanna
Introduction Pervasive developmental disorders (PDDs) are complex neurodevelopmental disorders characterized by core deficits in three major domains
Introduction Autism It is characterized by qualitative behavioral abnormalities in the domains of communication, reciprocal social interaction and interests, and activities that are repetitive, restricted and stereotyped, that appear before 3 years of age
Introduction It shares the social-relatedness impairment and the presence of restricted interest and/or repetitive behavior, but requires that the child have no delay in language development. Asperger’s Syndrome
Introduction It is a clinical syndrome characterized by disintegration of mental functions and regression of acquired language and intellectual functions after a period of normal development up to 3-4 years in children Childhood disintegrative disorder
Introduction The diagnosis of PDD-NOS is made in individuals with some, but not all features of autistic disorder (either quantitatively or qualitatively). Social deficits are always present, along with some degree of impaired communication or restricted interests/repetitive behaviors. Pervasive developmental disorder not otherwise specified
Introduction It is a rare disorder occurring almost exclusively in females. There is an initial period of normal development followed by regression in social and language skills that can be confused with autism. Rett’s syndrome
Introduction Symptoms of PDDs
Aim Of The Work This study is designed to formulate and apply Autism Diagnostic Interview (Lord et al, 1994) as a tool for evaluating Egyptian children with pervasive developmental disorders in order to detect its accuracy in quantifying the autistic features among different subtypes of these disorders.
Subjects • The study was applied on 80 children with age ranging from 2 to 6 years. They were divided into 3 groups: • Group I: (PDD): 35 children referred with a diagnostic query regarding possible PDDs, with exclusion of children suffering from sensory deprivation and brain damage. • Group II: (normal children): 25 children. • Group III: (mentally retarded): 20 children with exclusion of children suffering from sensory deprivation and brain damage.
Methods Each child was subjected to the protocol of evaluationfordelayed language development which consists of three levels of evaluation
Methods 1) The background questions about the subject’s family and education as well as on the diagnosis that have been applied and the medication that has been used. 2) This is followed by introductory questions, which are designed to provide a general picture of the subject’s behavior. This is necessary in order to provide an adequate framework for the further detailed questioning that follows. This includes item 1(current concerns about the child) 3) The third section provides an account of early developmental milestones (item 2 through 8) 4) This is followed by questioning on the age at which key language skills were acquired and on the question as to whether there has been any period involving a loss of language skills after they have been acquired, or a general loss of other skills (item 9 through 28). 5) Language and communication functioning (items 29 to 49). 6) Social development and play (items 50 to 66). 7) Interests and behaviors (items 67 to 79). 8) The last section (items 80 to 93) deals with a range of general behaviors that are of clinical importance – such as aggression, self injury, the occurrence of possible epileptic features.
Results • Mean age in months for the 3 groups.
Results • Sex distribution in the 3 groups.
Results • Comparison between means of the 3 groups as regards Stanford BinetIntelligence
Results • Comparison between means of the 3 groups as regards CARS, GARS, VSMS
Results Correlation studies • Correlation of ADI-R score with CARS • Correlation of ADI-R score with CARS as regards mental age
Results Correlation studies • Correlation of ADI-R scores with GARS
Results Correlation studies • Correlation of ADI-R with TACS
Results • Comparing means in between groups in domain A
Results • Comparing means in between groups in domain B
Results • Comparing means in between groups in domain C
Results • Comparing mean scores: Domain A
Results • Comparing mean scores: Domain A
Results • Comparing mean scores: Domain B
Results • Comparing mean scores: Domain B
Results • Comparing mean scores: Domain C
Results • Comparing mean scores: Domain C
Results Reliability • Correlation between domains A, B, C and total ADI-R score. • Correlation between domains
Results Reliability • Correlation between each sub domain to its main domain.
Results • Comparison between the original cutoff values and the new cutoffs NV: non verbal, V: verbal
Results Differential diagnosis: • The number of children who crossed cutoff values in all domains in group I (PDD) was 26 and were diagnosed as autism. The number of children who crossed cutoff in domain A, B were 5 (suspected to be PDD-NOS ), 2 crossed cutoff in domain B only and 2 didn’t cross cutoffs in all domains.
