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Performance of the Australian Developmental Screening Test in a clinical setting

Authors

  • Joanne Morris,

    1. Department of Community Child Health, Royal Children's Hospital
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  • Deborah Perkins,

    1. Department of Community Child Health, Royal Children's Hospital
    2. School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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  • Vanessa Sarkozy,

    1. Department of Community Child Health, Royal Children's Hospital
    2. School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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  • Adrienne Moline,

    1. Department of Community Child Health, Royal Children's Hospital
    2. School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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  • Karen Zwi,

    1. Department of Community Child Health, Royal Children's Hospital
    2. School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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  • Katrina Williams

    Corresponding author
    1. Department of Community Child Health, Royal Children's Hospital
    2. School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
      Professor Katrina Williams, Royal Children's Hospital, University of NSW, Sydney Children's Community Health Centre, Corner Avoca and Barker Streets, Randwick, Sydney, NSW 2031, Australia. Fax: +61 2 9382 8188; email: katrina.williams@rch.org.au
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  • Conflict of interest: None declared.

Professor Katrina Williams, Royal Children's Hospital, University of NSW, Sydney Children's Community Health Centre, Corner Avoca and Barker Streets, Randwick, Sydney, NSW 2031, Australia. Fax: +61 2 9382 8188; email: katrina.williams@rch.org.au

Abstract

Aims:  The study aims to assess the sensitivity and specificity of the Australian Developmental Screening Test (ADST) in a clinical setting in detecting developmental concerns that warrant further assessment or treatment.

Methods:  Clients referred to an inner Sydney Community Health Centre with developmental concerns were initially assessed using the ADST, followed within 12 weeks by an assessment using the Griffiths Mental Developmental Scales (GMDS) as the gold standard.

Results:  Of the 65 eligible children, 46 (71%) had results indicating further assessment (42) or follow-up (4) was needed (using the criteria recommended in the ADST manual). However, of these only 21 (46%) had an abnormal GMDS. This gave a sensitivity of 95% but a specificity of only 52%.

New threshold criteria for further assessment were developed and applied to three age groups. If children aged under 2 years are assessed using the standard ADST threshold, and children 2 years or older are assessed using the new ADST cut-off, then the tool has a sensitivity of 95%, a specificity of 82%, a positive likelihood ratio of 5.24 (95% CI 2.78, 9.88) and negative likelihood ratio of 0.06 (0.01, 0.40).

Conclusions:  Modified criteria for the ADST developed in this study showed good specificity and sensitivity for detection of developmental problems in this population, referred because of developmental concerns. Further testing to see if these new criteria perform well in a different population is now needed.

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