Screening and surveillance for autism and pervasive developmental disorders

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Abstract
The review by Hall1 in Health for all children concluded that most screening tests that set out to identify neurodevelopmental disorders do not meet the stringent criteria outlined by Cochrane and Holland2 and Wilson and Jungner.3 In some conditions, for example language disorders, this is because there is uncertainty about “caseness” and tests tend to have low sensitivity and specificity.4 5 This is particularly the case for screening tests that attempt to identify a specific condition rather than general developmental delay, and for the identification of relatively rare disorders. In the latter case, even when the sensitivity and specificity of a screen remain constant, the positive predictive value (the proportion of children with a positive screen result and who have the disorder) is lower the rarer a disorder is within the population.6