Schwenck Christina, Freitag Christine M
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University, Frankfurt am Main, Germany,
Atten Defic Hyperact Disord. 2014 Sep;6(3):221-9. doi: 10.1007/s12402-014-0147-9. Epub 2014 Jun 26.
The differentiation of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) poses a clinical challenge. In children, overlap of psychopathological and cognitive findings has been found for both disorders. In addition, some children suffer from both disorders. The Social Communication Questionnaire (SCQ) is a screening instrument for ASD symptoms which indicates the presence of ASD in a rapid and economic way. However, validity to differentiate ASD and ADHD as differential or comorbid diagnoses has not been studied. Here, the differential validity was compared in groups of children with ASD, ADHD, ASD + ADHD, and typically developing (TD) children and IQ > 70. ROC analyses indicated an excellent differentiation between ASD and TD with ROC-AUC = .941 and between ASD + ADHD with ROC-AUC = .993. The optimal cutoff was below the originally recommended one of 15. The differentiation between children with ASD with (ROC-AUC = .982) or without ADHD (ROC-AUC = .864) and ADHD alone also showed acceptable differential validity, and here, the optimal cutoff corresponded to the recommended. Taken together, the SCQ can be recommended as a screening instrument for a first differentiation between children with ASD and typically developing children as well as children with ADHD.
注意缺陷多动障碍（ADHD）与自闭症谱系障碍（ASD）的鉴别诊断是一项临床挑战。在儿童中，已发现这两种疾病在精神病理学和认知方面存在重叠。此外，一些儿童同时患有这两种疾病。社交沟通问卷（SCQ）是一种用于筛查ASD症状的工具，它能以快速且经济的方式表明ASD的存在。然而，尚未研究其在鉴别ASD和ADHD作为不同诊断或共病诊断方面的有效性。在此，对患有ASD、ADHD、ASD + ADHD的儿童组以及智商>70的正常发育（TD）儿童组进行了鉴别效度比较。ROC分析表明，ASD与TD之间的鉴别效果极佳，ROC-AUC = 0.941；ASD + ADHD与TD之间的鉴别效果也极佳，ROC-AUC = 0.993。最佳临界值低于最初推荐的15分。ASD合并ADHD（ROC-AUC = 0.982）或不合并ADHD（ROC-AUC = 0.864）的儿童与单纯ADHD儿童之间的鉴别也显示出可接受的鉴别效度，且此处的最佳临界值与推荐值相符。综上所述，SCQ可作为一种筛查工具，用于初步鉴别患有ASD的儿童与正常发育儿童以及患有ADHD的儿童。
