Klug Marilyn G, O'Connell Ann Marie, Palme Amanda, Kobrinsky Nathan, Burd Larry
Department of Population Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA.
Alcohol Clin Exp Res. 2021 Apr;45(4):765-772. doi: 10.1111/acer.14570. Epub 2021 Apr 3.
The initial confirmatory factor analysis of the Alcohol Related Neurodevelopmental Disorder Behavioral Checklist (ABC) utilized a population of 203 children. The analysis identified 10 independent measures (executive functioning, attention and concentration, cognition, memory, confabulation, gullibility, communication skills, academic skills, living/social skills, and juvenile justice). The 10 measures differentiated children with FASD from non-FASD controls. In this study, we present a validity study of the ABC using a different population of children with FASD and non-FASD controls.
A chart review identified 224 children with ABC checklist scores who had been evaluated for FASD. From this sample, we implemented a case-control study of 76 children diagnosed with FASD and 76 non-FASD controls who were matched by gender and closest age in years (mean age was 8.5 years).
The averages of the total score and individual domain scores were compared between the 2 data sets and then between children with FASD and non-FASD controls. Children with FASD had significantly higher scores on all 10 measures than the non-FASD controls. There were very high sensitivity and specificity scores for the total score cutoff and for all 10 of the individual measures.
In an independent sample, we found minimal differences between the previous data and the current validation study on measures of average total score cutoffs, scores for the 10 measures and correlations. Combining the 2 samples yielded robust differences in scores between children with FASD and non-FASD controls. The sensitivity, specificity and accuracy estimates were also very high. The ABC Screen appears to have acceptable epidemiologic performance data to support its use as a screening tool and as an initial step in differentiating children with FASD from those who do not have FASD.
酒精相关神经发育障碍行为清单(ABC)的初始验证性因素分析使用了203名儿童。该分析确定了10项独立指标(执行功能、注意力与专注力、认知、记忆、虚构、易受骗性、沟通技巧、学术技能、生活/社交技能以及青少年司法相关)。这10项指标能够区分患有胎儿酒精谱系障碍(FASD)的儿童与非FASD对照儿童。在本研究中,我们使用不同的患有FASD的儿童群体及非FASD对照儿童对ABC进行了效度研究。
通过图表回顾确定了224名有ABC清单评分且接受过FASD评估的儿童。从该样本中,我们实施了一项病例对照研究,选取了76名被诊断为FASD的儿童和76名非FASD对照儿童,他们在性别和年龄上最为接近(平均年龄为8.5岁)。
比较了两个数据集之间以及FASD儿童与非FASD对照儿童之间的总分及各个领域分数的平均值。FASD儿童在所有10项指标上的得分均显著高于非FASD对照儿童。总分临界值及所有10项个体指标的敏感性和特异性得分都非常高。
在一个独立样本中,我们发现先前数据与当前关于平均总分临界值、10项指标得分及相关性的验证研究之间差异极小。将两个样本合并后,FASD儿童与非FASD对照儿童在得分上产生了显著差异。敏感性、特异性和准确性估计值也非常高。ABC筛查似乎具有可接受的流行病学表现数据,以支持其作为一种筛查工具以及作为区分患有FASD的儿童与未患FASD儿童的初始步骤。