Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #115398

Catherine E. Rice, PhD¹, Lisa S. Wiggins, MS¹, Jon E. Baio, EdS¹, Michael J. Morrier, MA², and Catherine Lord, PhD³. (1) National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, 404-498-3847, crice@cdc.gov, (2) Emory University School of Medicine, Emory Autism Center, 1551 Shoup Court, Atlanta, GA 30322, (3) Autism and Communication Disorders Center (UMACC), University of Michigan, 1111 East Catherine St., Ann Arbor, MI 48109

In an ongoing effort to monitor prevalence of Autism Spectrum Disorders (ASDs), the Centers for Disease Control and Prevention (CDC) has developed a record review methodology for ASD case ascertainment. Over time, data from the surveillance system will enable a more comprehensive understanding of trends and risk factors associated with ASD. The established methodology is based on screening and abstraction of records from multiple sources. Records are selected for children in a specific population as defined by study year, catchment area, and target age. Evaluation files are screened at data sources for behavioral or diagnostic triggers and abstracted if triggers are present. Trained clinicians review the files and apply a standardized coding scheme to determine ASD case status. Reliability standards were defined for initial training and ongoing monitoring of inter-rater agreement. Based on preliminary results from the 2000 study year, CDC clinician reviewers demonstrated 91% agreement (Kappa = .76) on final ASD case status in a random sample of 64 records reviewed by two clinicians. Agreement on presence or absence of DSM-IV criteria was 85% for impairments in social interaction, 89% for impairments in communication, and 88% for restricted interests and stereotyped behaviors. Reviewers also reached 93% agreement on coding developmental delay less than 3 years of age, 88% agreement on behaviors considered hallmark features of ASD, and 87% agreement on other associated features. Results suggest that the established methodology was consistently applied among trained clinicians and continues to be an effective tool for monitoring the prevalence of ASD.

Learning Objectives:

• Discuss elements of a model surveillance case definition for the autism spectrum disorders
• Describe statistical techniques used in measuring inter-rater reliability
• Apply this knowledge in public health program evaluation

Keywords: Surveillance, Evaluation

Related Web page: www.cdc.gov/ncbddd/autism/

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation