A Validation Study of the Alcohol Related Neurodevelopmental Disorders Behavioral Checklist

Abstract

Background: 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.Methods: 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).Results: 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.Conclusions: 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.

Development and validation of a postnatal risk score that identifies children with prenatal alcohol exposure

“…Additionally, a hierarchical decision tree model using similar measures as described herein had accuracy rates of 79.5% to 84.7% (Goh et al, 2016). Although some of these previous studies have higher accuracy and sensitivity rates compared with the findings from the current study, the previous identification tools required subjects to complete a battery of neuropsychological assessments (Klug et al, 2021; Mattson et al, 2010b, 2013), measures of intellectual functioning (Goh et al, 2016), required maternal information (Burd et al, 2010), or were created for use with adults only (Widder et al, 2021). In comparison, the risk score that we developed could be simply deployed in a clinical setting and therefore has significant clinical potential as an early screening tool.…”

“…Although some of these previous studies have higher accuracy and sensitivity rates compared with the findings from the current study, the previous identification tools required subjects to complete a battery of neuropsychological assessments (Klug et al, 2021;Mattson et al, 2010bMattson et al, , 2013, measures of intellectual functioning (Goh et al, 2016), required maternal information (Burd et al, 2010), or were created for use with adults only (Widder et al, 2021). In compari-…”

“…Studies aimed at developing a neurobehavioral profile for FASD have previously reported the overall classification accuracy rates ranging between 71.5% and 84.7% (Mattson et al, 2010b(Mattson et al, , 2013. Studies assessing the utility of other FASD screening tools have reported accuracy rates of 71.3% to 89.6% (Klug et al, 2021) and 78.4% to 82% (Burd et al, 2010), and sensitivity rates of 86% (Widder et al, 2021). Additionally, a hierarchical decision tree model using similar measures as described herein had accuracy rates of 79.5% to 84.7% (Goh et al, 2016).…”

“…Furthermore, recruitment procedures limited our understanding of the child's environment which, as discussed above, can influence outcomes. Finally, although the risk score has improved clinical utility compared with those previously developed (Klug et al, 2021;Mattson et al, 2010bMattson et al, , 2013,…”

“…Therefore, the development of improved screening tools that can be used to identify children who may have been affected by prenatal alcohol exposure is essential. Some clinical tools have shown promise in their ability to aid in the identification of individuals with prenatal alcohol exposure (Burd et al, 2010;Klug et al, 2021;Mattson et al, 2010bMattson et al, , 2013Widder et al, 2021). However, these tools require a large amount of information which may not be readily available, including neurobehavior and intelligence quotient (IQ) data, maternal characteristics, and birth records.…”