Sensitivity of the autism behavior checklist in Indian autistic children.

Objective: The autism behavior checklist (ABC) has potential utility for evaluation of autistic children in resource-poor settings. Although the original total cutoff score has been described as 67, lower cutoffs have been suggested. We evaluated the sensitivity of ABC in the diagnosis of autism in Indian children.

Methods: This study was conducted over 2 years in the Child Development Clinic of a tertiary care hospital. Children diagnosed with autistic disorder as per the DSM-IV criteria were included. Children with comorbid motor, visual, and hearing deficits were excluded. Each child was evaluated using the Childhood Autism Rating Scale and ABC.

Results: Fifty-one children were enrolled in the study. The mean age was 3.28 +/- 1.89 years. The ratio of boys to girls was 2.2:1. The mean Childhood Autism Rating Scale score was 44.7 +/- 6.22, with all children having scores in the autistic range. The mean ABC score was 72.4, with a standard deviation of 14.2. By using the originally suggested cutoff score of 67, only 40 children in this study were diagnosed with autism. When lower cutoffs were used, the sensitivity increased, with a sensitivity of 98% and a cutoff of 45.

Conclusion: The ABC cutoff needs to be lowered to increase its sensitivity for diagnosis of autistic disorder.