A-TAC

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About the A-TAC

The A-TAC (Autism-Tics, ADHD and other Comorbidities) is a telephone interview developed by Christopher Gillberg and his group at the University of Gothenburg for use in the CATSS (Child and Adolescent Twin Study in Sweden). It can be used by non-child-psychiatrists. It provides good proxies for several ESSENCE diagnostic categories (including autism, ADHD, DCD, and learning disability), but cannot be used as a stand-alone diagnostic instrument. There have been many studies published reporting results from the CATSS using A-TAC and also a number of clinical validation studies, including the original publication in the British Journal of Psychiatry (Hansson et al, 2006). Cut-offs for various diagnostic category proxies can be found in these publications.

The A-TAC consists of a number of modules which, either individually or cumulatively, indicate a potential screening diagnosis. The A-TAC has seen a few changes over the years, but the gate questions form the basis of the validations. The gate questions are the numbered questions e.g., 1, 2, 3 etc. For example, question 1 for module A and questions 2-6 for module B etc. The questions that start with a letter are of clinical interest but do not add anything in terms of the statistical prediction of a diagnosis. Modules C and D constitute ADHD and modules H, I and J constitute autism. If a person answers “No”, this is scored as 0, “Yes, to some extent” is scored as 0.5 and “Yes” is scored as 1.

The validations are based on A-TAC-interviews where laymen (in one case psychology students) have asked parents the questions verbatim over the phone, after which the concordance has been calculated through clinical studies or registry follow-ups. Note that the validations are primarily based on A-TAC interviews with parents whose children were either nine or twelve years old, and always over the phone. The A-TAC has not only been validated in Sweden; a Spanish research group has also carried out an external validation of the autism module. References to validation studies are included below.

Different conditions have different cut-offs. The table below shows that autism, ADHD, learning difficulties and developmental coordination disorder have both a high and a low cut-off, depending on which level of sensitivity and specificity one wishes to apply. Note that these are based on the gate questions (see above), where each question is scored as 0 for “No”, 0.5 for “Yes, to some extent” and 1 for “Yes”. The cut-offs only serve as indications but can provide an overview of the individual’s constellations of problems.

  • Hansson SL, Svanström Röjvall A, Rastam M, Gillberg C, Gillberg C, Anckarsäter H. Psychiatric telephone interview with parents for screening of childhood autism – tics, attention-deficit hyperactivity disorder and other comorbidities (A-TAC): preliminary reliability and validity. British Journal of Psychiatry. 2005;187:262-7.

2023

  • Jonsson L, Martin J, Lichtenstein P, Magnusson PKE, Lundström S, Westberg L, et al. Examining neurodevelopmental problems in 15q11.2 (BP1-BP2) copy number variation carriers at ages 9/12 and 18 in a Swedish twin sample. Molecular Genetics and Genomic Medicine. 2023;11(8):e2191.

2022

  • Nilsson G, Lundström S, Fernell E, Gillberg C. Neurodevelopmental problems in children with febrile seizures followed to young school age: A prospective longitudinal community-based study in Sweden. Acta Paediatrica. 2022;111(3):586-92.
  • Mårland C, Nilsson T, Larsson H, Gillberg C, Lubke G, Lundström S. Measuring autism in males and females with a differential item functioning approach: Results from a nation-wide population-based study. Psychiatry Research. 2022;314:114674.
  • 2021
  • Kaltenegger HC, Doering S, Gillberg C, Wennberg P, Lundström S. Low prevalence of risk drinking in adolescents and young adults with autism spectrum problems. Addictive Behaviors. 2021;113:106671.

2019

  • Mårland C, Lubke G, Degl’Innocenti A, Råstam M, Gillberg C, Nilsson T, et al. The development of a brief screener for autism using item response theory. BMC Psychiatry. 2019;19(1):337.
  • Lundström S, Mårland C, Kuja-Halkola R, Anckarsäter H, Lichtenstein P, Gillberg C, et al. Assessing autism in females: The importance of a sex-specific comparison. Psychiatry Research. 2019;282:112566.

2017

  • Mårland C, Lichtenstein P, Degl’Innocenti A, Larson T, Råstam M, Anckarsäter H, et al. The Autism-Tics, ADHD and other Comorbidities inventory (A-TAC): previous and predictive validity. BMC Psychiatry. 2017;17(1):403.
  • Barnevik Olsson M, Holm A, Westerlund J, Lundholm Hedvall Å, Gillberg C, Fernell E. Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age. Neuropsychiatric Disease and Treatment. 2017;13:2519-26.

2016

  • Eriksson JM, Lundström S, Lichtenstein P, Bejerot S, Eriksson E. Effect of co-twin gender on neurodevelopmental symptoms: a twin register study. Molecular Autism. 2016;7:8.
  • Barnevik Olsson M, Lundström S, Westerlund J, Giacobini MB, Gillberg C, Fernell E. Preschool to School in Autism: Neuropsychiatric Problems 8 Years After Diagnosis at 3 Years of Age. Journal of Autism and Developmental Disorders. 2016;46(8):2749-55.

2015

  • Pettersson E, Sjölander A, Almqvist C, Anckarsäter H, D’Onofrio BM, Lichtenstein P, et al. Birth weight as an independent predictor of ADHD symptoms: a within-twin pair analysis. Journal of Child Psychology and Psychiatry. 2015;56(4):453-9.
  • Olsson MB, Westerlund J, Lundström S, Giacobini M, Fernell E, Gillberg C. “Recovery” from the diagnosis of autism – and then? Neuropsychiatric Disease and Treatment. 2015;11:999-1005.
  • Kerekes N, Tajnia A, Lichtenstein P, Lundström S, Anckarsäter H, Nilsson T, et al. Neurodevelopmental problems and extremes in BMI. PeerJ. 2015;3:e1024.

2014

  • Larson T, Kerekes N, Selinus EN, Lichtenstein P, Gumpert CH, Anckarsäter H, et al. Reliability of Autism-Tics, AD/HD, and other Comorbidities (A-TAC) inventory in a test-retest design. Psychological Reports. 2014;114(1):93-103.
  • Gustafsson P, Kerekes N, Anckarsäter H, Lichtenstein P, Gillberg C, Råstam M. Motor function and perception in children with neuropsychiatric and conduct problems: results from a population based twin study. Journal of Neurodevelopmental Disorders 2014;6(1):11.

2013

  • Larson T, Lundström S, Nilsson T, Selinus EN, Råstam M, Lichtenstein P, et al. Predictive properties of the A-TAC inventory when screening for childhood-onset neurodevelopmental problems in a population-based sample. BMC Psychiatry. 2013;13:233.
  • Kerekes N, Brändström S, Lundström S, Råstam M, Nilsson T, Anckarsäter H. ADHD, autism spectrum disorder, temperament, and character: phenotypical associations and etiology in a Swedish childhood twin study. Comprehensive Psychiatry. 2013;54(8):1140-7.
  • Garcia D, Anckarsäter H, Lundström S. Self-directedness and cooperativeness, psychosocial dysfunction and suffering in ESSENCE.The ScientificWorldJournal. 2013;2013:416981.

2012

  • Losh M, Esserman D, Anckarsäter H, Sullivan PF, Lichtenstein P. Lower birth weight indicates higher risk of autistic traits in discordant twin pairs. Psychological Medicine. 2012;42(5):1091-102.

2011

  • Cubo E, Sáez Velasco S, Delgado Benito V, Ausín Villaverde V, García Soto XR, Trejo Gabriel YGJM, et al. [Psychometric attributes of the Spanish version of A-TAC screening scale for autism spectrum disorders]. Anales de Pediatrica (Barc). 2011;75(1):40-50.

2010

  • Larson T, Anckarsäter H, Gillberg C, Ståhlberg O, Carlström E, Kadesjö B, et al. The autism–tics, AD/HD and other comorbidities inventory (A-TAC): further validation of a telephone interview for epidemiological research. BMC Psychiatry. 2010;10:1.
  • Halleröd SL, Larson T, Ståhlberg O, Carlström E, Gillberg C, Anckarsäter H, et al. The Autism–Tics, AD/HD and other Comorbidities (A-TAC) telephone interview: convergence with the Child Behavior Checklist (CBCL). Nordic Journal of Psychiatry. 2010;64(3):218-24.

2009

  • Rydén E, Johansson C, Blennow K, Landén M. Lower CSF HVA and 5-HIAA in bipolar disorder type 1 with a history of childhood ADHD. Journal of Neural Transmission (Vienna). 2009;116(12):1667-74.

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