A possible role of the Infant/Toddler Sensory Profile in screening for autism: a proof-of-concept study in the specific sample of prematurely born children with birth weights <1,500 g

Abstract

Objective: The objective of this study was to explore the potential of the Infant/Toddler Sensory Profile (ITSP) as a screening tool for autism spectrum disorders (ASD) in prematurely born children.

Methods: Parents of 157 children with birth weights <1,500 g (aged 2 years, corrected for prematurity; 88 boys, 69 girls) completed a screening battery that included the ITSP, Modified Checklist for Autism in Toddlers (M-CHAT), and the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-DP-ITC). Children with known disabilities were excluded. All the children who were screened positive on any of the screening tools subsequently underwent clinical examination including the Autism Diagnostic Observation Schedule.

Results: We used classification trees to answer the question whether ITSP (or some of its subscales) could be combined with the M-CHAT and/or the CSBS-DP-ITC or its subscales into an effective ASD screening tool. Using the CSBS-DP-ITC, overall score, and the Sensation Seeking subscale of the ITSP, we obtained a screening tool that was able to identify all of the ASD children in our sample (confirmed by cross-validation). The proposed screening tool is scored as follows: 1) if the overall CSBS-DP-ITC value is <45.5, then the screening is positive; 2) if the overall CSBS-DP-ITC value is ≥45.5 and the z-score of the Sensation Seeking subscale of ITSP is ≥1.54, then the screening is positive; 3) otherwise, the screening is negative.

Conclusion: The use of CSBS-DP-ITC in combination with the Sensation Seeking subscale of the ITSP improved the accuracy of autism screening in preterm children.

Keywords: Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist; Infant/Toddler Sensory Profile; Modified Checklist for Autism in Toddlers; autism spectrum disorders; preterm children; screening.

Figure 1

Proposed classification tree. Notes: The first two branches are defined by the total score of the CSBS-DP-ITC (ITC sum). The screening outcome is positive (denoted by 1) for an ITC sum <45.5 (first classification rule). The branch for ITC sum ≥45.5 is further split into two sub-branches based on the z-score of the Sensation Seeking scale of the ITSP (SP senseek SD) relative to the value of 1.54. In this branch of the classification tree SP senseek SDs ≥1.54 result in a positive screening outcome (denoted by 1) and SP senseek SDs <1.54 in a negative screening outcome (denoted by 0). Abbreviations: CSBS-DP-ITC, Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist; ITSP, Infant/Toddler Sensory Profile; SD, standard deviation.

Figure 2

Visualization of the effect of the suggested screening tool on the data sample. Notes: Vertical green line represents screening rule (1), horizontal green line represents screening rule (2). Red dots are children with ASD, and blue circles are children without ASD. The “ITC sum” axis represents the total CSBS-DP-ITC score, the “SP senseek SD” axis represents the z-score of the Sensation Seeking scale of the ITSP. Abbreviations: ASD, autism spectrum disorder; CSBS-DP-ITC, Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist; ITSP, Infant/Toddler Sensory Profile.