Autism screening at 18 months of age: a comparison of the Q-CHAT-10 and M-CHAT screeners

Background Autism screening is recommended at 18- and 24-month pediatric well visits. The Modified Checklist for Autism in Toddlers—Revised (M-CHAT-R) authors recommend a follow-up interview (M-CHAT-R/F) when positive. M-CHAT-R/F may be less accurate for 18-month-olds than 24-month-olds and accuracy for identification prior to two years is not known in samples that include children screening negative. Since autism symptoms may emerge gradually, ordinally scoring items based on the full range of response options, such as in the 10-item version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-10), might better capture autism signs than the dichotomous (i.e., yes/no) items in M-CHAT-R or the pass/fail scoring of Q-CHAT-10 items. The aims of this study were to determine and compare the accuracy of the M-CHAT-R/F and the Q-CHAT-10 and to describe the accuracy of the ordinally scored Q-CHAT-10 (Q-CHAT-10-O) for predicting autism in a sample of children who were screened at 18 months. Methods This is a community pediatrics validation study with screen positive (n = 167) and age- and practice-matched screen negative children (n = 241) recruited for diagnostic evaluations completed prior to 2 years old. Clinical diagnosis of autism was based on results of in-person diagnostic autism evaluations by research reliable testers blind to screening results and using the Autism Diagnostic Observation Schedule—Second Edition (ADOS-2) Toddler Module and Mullen Scales of Early Learning (MSEL) per standard guidelines. Results While the M-CHAT-R/F had higher specificity and PPV compared to M-CHAT-R, Q-CHAT-10-O showed higher sensitivity than M-CHAT-R/F and Q-CHAT-10. Limitations Many parents declined participation and the sample is over-represented by higher educated parents. Results cannot be extended to older ages. Conclusions Limitations of the currently recommended two-stage M-CHAT-R/F at the 18-month visit include low sensitivity with minimal balancing benefit of improved PPV from the follow-up interview. Ordinal, rather than dichotomous, scoring of autism screening items appears to be beneficial at this age. The Q-CHAT-10-O with ordinal scoring shows advantages to M-CHAT-R/F with half the number of items, no requirement for a follow-up interview, and improved sensitivity. Yet, Q-CHAT-10-O sensitivity is less than M-CHAT-R (without follow-up) and specificity is less than the two-stage procedure. Such limitations are consistent with recognition that screening needs to recur beyond this age.

ANALISIS ESTIMASI KEMAMPUAN SISWA DENGAN PENDEKATAN ITEM RESPONSE THEORY PENSKORAN DIKOTOMUS DAN POLITOMUS

This study compares students' abilities using the Item Response Theory (IRT) approach to dichotomous and polytomous scoring. This research is quantitative descriptive. The research subjects were 1175 high school students in class XI spread across West Java and Banten provinces, consisting of 450 male students and 725 female students. Response data with dichotomous scoring were analyzed using the item response theory approach with the BILOG-MG program, while the polytomous scoring was analyzed using the GPCM approach using the R program. The results of the model fit test showed that the items most fit with the 2PL model. The instrument used is a work and energy material test instrument tested for validity d, reliability, distinguishing power, and difficulty level. The results showed that the average ability with a polytomous score was greater than that of a dichotomous, even though compared to having almost the same ability but with a relatively different distribution. The distribution of students' abilities with polytomous scoring is closer to the normal curve than the dichotomous scoring. The relationship between students' ability scores with these two scoring approaches is shown by a correlation coefficient score of 0.990 and a determination index of 0.9808 with a prediction line y= 0.9735 x +0.0036.

Examining Chemistry Students’ Perceptions Toward Multiple-Choice Assessment Tools that Vary in Feedback and Partial Credit

Multiple-choice testing with dichotomous scoring is one of the most common assessment methods utilized in undergraduate education. Determining students’ perceptions toward different types of multiple-choice testing formats is important for effective assessment. The present study compared two alternative multiple-choice testing formats used in a second-year required chemistry course: (1) The Immediate Feedback Assessment Technique (IFAT®) and (2) Personal Point Allocation (PPA). Both testing methods allow for partial credit but only the IFAT® provides immediate feedback on students’ responses. Both survey and interview data indicated that, overall, most students preferred IFAT® to the PPA testing method. These positive ratings were related to potential increase in reward, ease of use, and confidence. IFAT® was also perceived to be less stress producing, and anxiety provoking than PPA. Interview data supported these findings but also indicated individual differences in preference for each of these two methods. Additionally, students’ feedback on strategies used for either testing method and suggestions on how to improve the methods are discussed.

Autism Screening at 18 Months of Age: a Comparison of the Q-CHAT and the M-CHAT

Background: Autism screening is recommended at 18 and 24-month pediatric well visits. The M-CHAT-R screen requires a follow-up interview (M-CHAT-R/F) when positive. M-CHAT-R/F may be less accurate for 18- than 24-month-olds and accuracy for identification prior to two years is not known in samples including children passing screens. Since autism symptoms may emerge gradually, items with ordinal responses, such as Q-CHAT-10, might better capture autism signs than the dichotomous (i.e., yes/no) items in M-CHAT-R. The objective of this study was to determine the accuracy of the M-CHAT-R/F and the Q-CHAT-10 for predicting autism in a sample of children who screen positive or negative at 18 months old.Methods: This is a community pediatrics validation study with screen positive (96) and age and practice-matched screen negative children (314) recruited for diagnostic evaluations completed prior to two years old.Clinical diagnosis of autism based on results of in-person diagnostic autism evaluations by research reliable testers blind to screening results and using the ADOS-2 Toddler module, Mullen Scales of Early Learning (MSEL) per standard guidelines, and ADOS-T algorithm.Results: While the M-CHAT-R/F had higher specificity and PPV compared to M-CHAT-R as expected, performance characteristics, including improved sensitivity with similar PPV, favored Q-CHAT-10 (scoring adjusted to capture the full range of frequency items). Limitations: Many parents declined participation and the sample skewed toward higher educated parents. Results cannot be extended to older ages. Conclusions: The limitations of the M-CHAT-R/F at the 18-month-visit include low sensitivity with minimal balancing benefit of improved PPV from the follow-up interview. The Q-CHAT-10 shows advantages over M-CHAT-R/F including requiring half the number of items and no follow-up interview, yet it did not improve the low PPV at 18 months. Ordinal, rather than dichotomous, scoring of autism screening items appears to be beneficial at this age. The Q-CHAT-10 with adjusted scoring is thus a better alternative to the M-CHAT at the 18-month-visit, providing better detection of children who can be diagnosed at this age even though psychometrics of both approaches still fall below recommended standards, consistent with growing recognition that screening needs to also occur repeatedly beyond this age.

Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician’s perspective

Purpose To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study. Methods The AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval. The results of the developmental process were analyzed using descriptive statistics, the reliability per parameter using Kappa statistics, inter-rater rater agreement using intraclass correlation coefficient (ICC), and internal consistency using Cronbach’s α. Results The AOSpine CROST was developed and consisted of 10 parameters, 2 of which are only applicable for surgically treated patents (‘Wound healing’ and ‘Implants’). A dichotomous scoring system (‘yes’ or ‘no’ response) was incorporated to express expected problems for the short term and long term. In the reliability study, 16 (84.2%) participated in the first round and 14 (73.7%) in the second. Intra-rater reliability was fair to good for both time points (κ = 0.40–0.80 and κ = 0.31–0.67). Results of inter-rater reliability were lower (κ = 0.18–0.60 and κ = 0.16–0.46). Inter-rater agreement for total scores showed moderate results (ICC = 0.52–0.60), and the internal consistency was acceptable (α = 0.76–0.82). Conclusions The AOSpine CROST, an outcome tool for the surgeons, was developed using an iterative process. An initial reliability analysis showed fair to moderate results and acceptable internal consistency. Further clinical validation studies will be performed to further validate the tool.

What does the analysis of C-test gaps tell us about the construct of a C-test? A comparison of foreign and heritage language learners’ performance

In view of the ubiquitous increase in the use of C-tests, which are almost unanimously believed to measure general language proficiency, this study investigates whether the aspects of language proficiency tapped into by the C-test format are the same when the test is taken by a learner population other than that of foreign language learners. Specifically, we conducted a differential functioning analysis and compared the types of mistakes that 113 foreign language learners of Russian made when completing C-test gaps, with the performance of 89 heritage language learners on the same C-test. The results showed that almost half of the C-test gaps are biased towards either learner group. In addition, the error analysis for a number of the biased items demonstrated that, although heritage language learners seem to have an advantage in reconstructing the meaning of C-test gaps, they fail to translate their recognition skills into producing the right form. Furthermore, the study reveals a possible sensitivity of the C-test construct to the traditionally used dichotomous scoring method. We conclude with a discussion that includes the implications of the results regarding the construct measured by the C-test and the possible consequences for its actual use.

Influence of Corporate Attributes on Magnitude of Disclosure by Private Commercial Banks in Bangladesh

The study reports the results of an empirical investigation of the magnitude of disclosure by listed Private Commercial Banks (PCBs) in Bangladesh and the attributes influencing it. For the purpose of the study, samples were taken following the purposive sampling approach covering about 21 percent of the population. A researcher developed unweighted disclosure checklist containing 247 information items divided into ten groups, were utilized. Applying the Dichotomous scoring procedure, the study found an average disclosure of 75.76 percent with a constant growth during the study period. Significant differences were found while comparing the disclosure level among the years and among the sample banks under study. Out of the eight variables, the regression model used in the study found Log total assets, Return on Equity (ROE), and EPS as three influential contributors to disclosure; while other five variables were found to have insignificant influence on disclosure of PCBs in Bangladesh.Journal of Business and Technology (Dhaka) Vol.11(1-2) 2016; 111-118

Empirical Option Weights Improve the Validity of a Multiple-Choice Knowledge Test

Standard dichotomous scoring of multiple-choice test items grants no partial credit for partial knowledge. Empirical option weighting is an alternative, polychotomous scoring method that uses the point-biserial correlation between option choices and total score as a weight for each answer alternative. Extant studies demonstrate that the method increases reliability of multiple-choice tests in comparison to conventional scoring. Most previous studies employed a correlational validation approach, however, and provided mixed findings with regard to the validity of empirical option weighting. The present study is the first investigation using an experimental approach to determine the reliability and validity of empirical option weighting. To obtain an external validation criterion, we experimentally induced various degrees of knowledge in a domain of which participants had no knowledge. We found that in comparison to dichotomous scoring, empirical option weighting increased both reliability and validity of a multiple-choice knowledge test employing distractors that were appealing to test takers with different levels of knowledge. A potential application of the present results is the computation and publication of empirical option weights for existing multiple-choice knowledge tests that have previously been scored dichotomously.