{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T11:23:30Z","timestamp":1785065010039,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004421","name":"World Bank Group","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004421","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Autism Research"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Use of autism diagnosing standards in low\u2010income countries (LICs) are restricted due to the high price and unavailability of trained health professionals. Furthermore, these standards are heavily skewed towards developed countries and LICs are underrepresented. Due to such constraints, many LICs use their own ways of assessing autism. This is the first retrospective study to analyze such local practices in Sri Lanka. The study was conducted at Ward 19B of Lady Ridgeway Hospital (LRH) using the clinical forms filled for diagnosing ASD. In this study, 356 records were analyzed, from which 79.5% were boys and the median age was 33\u2009months. For each child, the clinical form together with the Childhood Autism Rating Scale (CARS) value were recorded. In this study, a Clinically Derived Autism Score (CDAS) is obtained from the clinical forms. Scatter plot and Pearson product moment correlation coefficient were used to benchmark CDAS with CARS, and it was found CDAS to be positively and moderately correlated with CARS. In identifying the significant variables, a logistic regression model was built based on clinically observed data and it evidenced that \u201cEye Contact,\u201d \u201cInteraction with Others,\u201d \u201cPointing,\u201d \u201cFlapping of Hands,\u201d \u201cRequest for Needs,\u201d \u201cRotate Wheels,\u201d and \u201cLine up Things\u201d variables as the most significant variables in diagnosing autism. Based on these significant predictors, the classification tree was built. The pruned tree depicts a set of rules, which could be used in similar clinical environments to screen for autism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Lay Summary<\/jats:title><jats:p>Screening and diagnosing autism in low\u2010income countries such as Sri Lanka has always been a challenge due to limited resources and not being able to afford global standards. Due to these challenges, locally developed clinical forms have been used. This study is the first to analyze a clinical record set for autism in Sri Lanka to benchmark the local clinic form with a global standard. Furthermore, this study identifies the most significant diagnostic symptoms for children and based on these significant features, a simple set of IF\u2013THEN rules are derived which could be used for screening autism in a similar clinical environment by health officials in the absence of consultants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/aur.2765","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T07:51:43Z","timestamp":1655365903000},"page":"1358-1367","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Diagnosing autism in low\u2010income countries: Clinical record\u2010based analysis in Sri Lanka"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4721-9881","authenticated-orcid":false,"given":"Hashan","family":"Peiris","sequence":"first","affiliation":[{"name":"Department of Statistics University of Sri Jayewardenepura  Nugegoda Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6958-9667","authenticated-orcid":false,"given":"Darshana Chitraka","family":"Wickramarachchi","sequence":"additional","affiliation":[{"name":"Department of Statistics University of Sri Jayewardenepura  Nugegoda Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6908-3017","authenticated-orcid":false,"given":"Pradeepa","family":"Samarasinghe","sequence":"additional","affiliation":[{"name":"Faculty of Computing Sri Lanka Institute of Information Technology  Malabe Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2189-3608","authenticated-orcid":false,"given":"Philip","family":"Vance","sequence":"additional","affiliation":[{"name":"Intelligent Systems Research Centre University of Ulster  Londonderry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1740-2183","authenticated-orcid":false,"given":"Dulangi","family":"Dahanayake","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Colombo  Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7079-3841","authenticated-orcid":false,"given":"Veerandi","family":"Kulasekara","sequence":"additional","affiliation":[{"name":"Faculty of Computing Sri Lanka Institute of Information Technology  Malabe Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7312-1984","authenticated-orcid":false,"given":"Madhuka","family":"Nadeeshani","sequence":"additional","affiliation":[{"name":"Faculty of Computing Sri Lanka Institute of Information Technology  Malabe Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Missing data","author":"Allison P. 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