101
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Juárez AP, Weitlauf AS, Nicholson A, Pasternak A, Broderick N, Hine J, Stainbrook JA, Warren Z. Early Identification of ASD Through Telemedicine: Potential Value for Underserved Populations. J Autism Dev Disord 2019. [PMID: 29527626 DOI: 10.1007/s10803-018-3524-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Increasing access to diagnostic services is crucial for identifying ASD in young children. We therefore evaluated a telemedicine assessment procedure. First, we compared telediagnostic accuracy to blinded gold-standard evaluations (n = 20). ASD cases identified via telemedicine were confirmed by in-person evaluation. However, 20% of children diagnosed with ASD in-person were not diagnosed via telemedicine. Second, we evaluated telediagnostic feasibility and acceptability in a rural catchment. Children (n = 45) and caregivers completed the telemedicine procedure and provided feedback. Families indicated high levels of satisfaction. Remote diagnostic clinicians diagnosed 62% of children with ASD, but did not feel capable of ruling-in or out ASD in 13% of cases. Findings support preliminary feasibility, accuracy, and clinical utility of telemedicine-based assessment of ASD for young children.
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Affiliation(s)
- A Pablo Juárez
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy S Weitlauf
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy Nicholson
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anna Pasternak
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Neill Broderick
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeffrey Hine
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J Alacia Stainbrook
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zachary Warren
- Vanderbilt Kennedy Center/Treatment and Research Institute for Autism Spectrum Disorders, Vanderbilt University Medical Center, Nashville, TN, USA. .,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. .,Department of Psychiatry & Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. .,Department of Special Education, Vanderbilt University, Nashville, TN, USA.
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102
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Abstract
Early diagnosis of autism spectrum disorder (ASD) in children enables earlier access to services and better ability to predict subsequent development. A vast body of literature consistently shows discrepancies in the age of diagnosis between children from varying socio-economic levels, cultural and ethnic backgrounds. The present study examines the effect of sociodemographic factors on age of ASD diagnosis among the three primary ethnic sectors in Jerusalem region: secular and modern religious Jews, ultra-Orthodox Jews and Arabs. Findings indicate minimal differences in age of diagnosis prior to the age of six, although Arab children of this age were largely minimally verbal. After age six, no Arab children were referred for an evaluation.
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103
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Schelly D, González PJ, Solís PJ. Barriers to an Information Effect on Diagnostic Disparities of Autism Spectrum Disorder in Young Children. Health Serv Res Manag Epidemiol 2019; 6:2333392819853058. [PMID: 31211181 PMCID: PMC6547173 DOI: 10.1177/2333392819853058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives: Autism spectrum disorder (ASD) is underdiagnosed in children from minority and low
socioeconomic status families, and reports indicate that parental “lack of awareness” of
symptoms is a factor, which implicates the adoption of the category globally. However,
parental knowledge of ASD has failed to explain emerging clusters of cases. The
objective of the present research was to identify and describe barriers to an
“information effect” in diagnosis. Methods: Interviews were conducted with the parents of 54 children with ASD in Costa Rica, many
living within clusters that appeared after a genetic study conducted an information
campaign for recruitment. The interviews explored factors influencing symptom
recognition and help-seeking behaviors. Several barriers were identified that prevent
information about ASD or exposure to diagnosed cases from influencing parents’
help-seeking behaviors. Results: Early symptoms in most children gave parents no reason to suspect ASD. Later, parents’
understanding of ASD depended on caricatures of the disorder. Parents often received
unsolicited advice from strangers, although rarely from family, and it was always seen
as critical of their parenting; furthermore, the advice was too late to influence the
referral process, which was well underway by the time classical symptoms of ASD
appeared, if they did at all. Postdiagnosis, the interviewees occasionally gave advice
to other parents, mostly strangers, but none had apparently been diagnosed. Conclusions: The results implicate efforts to educate parents about symptoms of ASD, where a focus
on generic developmental delays and neurodevelopmental disorders in general may be more
effective than ASD-specific information.
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Affiliation(s)
- David Schelly
- Department of Occupational Therapy, Clarkson University, Potsdam, NY, USA
| | - Patricia Jiménez González
- Hospital Nacional de Niños "Dr Sáenz Herrera," CCSS, Child Developmental and Behavioral Unit, San José, Costa Rica
| | - Pedro J Solís
- Department of Humanities, University of Costa Rica, Alajuela, Costa Rica
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104
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An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework. J Autism Dev Disord 2019; 48:2148-2163. [PMID: 29423605 PMCID: PMC5948258 DOI: 10.1007/s10803-018-3482-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.
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105
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Cohen SR, Miguel J, Wishard Guerra A. Child-rearing routines among Mexican-heritage children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:80-94. [PMID: 31096778 DOI: 10.1177/1362361319849244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study examined the daily routines and activities of Mexican-heritage mothers and their children with autism spectrum disorder. Experienced sampling methods were used to capture families' current daily routines and activities, how parents valued those activities, and whether the activity was part of the child's autism spectrum disorder intervention. A total of 32 mothers were texted five times per day over five consecutive days for a total of 721 observations. Mothers frequently engaged in Self-Care (e.g. showering), General Caregiving (e.g. cooking), and House Chores (e.g. laundry). Children engaged in activities in which interventions could easily be integrated (e.g. Academics, Self-Care, and Playing with Others). Families spent less than one-third (26.1%) of their activities participating in interventions. Mothers and children jointly spent time in General Caregiving, Playing with Others, and Using Electronics. Practitioners should focus on integrating evidence-based interventions into daily joint routine activities.
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106
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Parent and Provider Perspectives on the Diagnosis and Management of Autism in a Chinese Immigrant Population. J Dev Behav Pediatr 2019; 40:257-265. [PMID: 30908425 PMCID: PMC6499700 DOI: 10.1097/dbp.0000000000000660] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Minority families experience disparities in the diagnosis and management of autism spectrum disorder (hereafter "autism"). To date, the experiences of Chinese immigrant families in the United States have not been explored. Utilizing parent and provider perspectives, this research sought to identify barriers and facilitators to the diagnosis and management of autism among Chinese immigrant children. METHODS We conducted semistructured qualitative interviews with 16 parents of Chinese children diagnosed with autism and 16 providers who assist in the diagnosis and management of autism. Participant characteristics were analyzed utilizing descriptive statistics. Interviews were audiorecorded, transcribed, translated, and independently coded by 2 researchers until consensus was reached. Coded data were analyzed using a modified grounded therapy approach. RESULTS Parents and providers both identified cultural beliefs as an influence on the understanding and acceptance of autism as a diagnosis. There was a high degree of alignment in themes related to barriers to health care access and parent-provider communication. Recommendations to improve the system of care include (1) supporting communication, (2) cultural sensitivity, and (3) care coordination programming. CONCLUSION Findings reinforce that diagnosis and treatment of autism should take into account culturally specific beliefs about child developmental norms and should address systems-, provider-, and family-level barriers.
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107
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Miller KL, Re Cruz A, Ala’i-Rosales S. Inherent Tensions and Possibilities: Behavior Analysis and Cultural Responsiveness. BEHAVIOR AND SOCIAL ISSUES 2019. [DOI: 10.1007/s42822-019-00010-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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108
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Gillespie-Lynch K, Daou N, Sanchez-Ruiz MJ, Kapp SK, Obeid R, Brooks PJ, Someki F, Silton N, Abi-Habib R. Factors underlying cross-cultural differences in stigma toward autism among college students in Lebanon and the United States. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1993-2006. [PMID: 30939906 DOI: 10.1177/1362361318823550] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Although stigma negatively impacts autistic people globally, the degree of stigma varies across cultures. Prior research suggests that stigma may be higher in cultures with more collectivistic orientations. This study aimed to identify cultural values and other individual differences that contribute to cross-cultural differences in autism stigma (assessed with a social distance scale) between college students in Lebanon (n = 556) and those in the United States (n = 520). Replicating prior work, stigma was lower in women than men and in the United States relative to Lebanon. Heightened autism knowledge, quality of contact with autistic people, openness to experience, and reduced acceptance of inequality predicted lower stigma. Collectivism was not associated with heightened stigma. Findings highlight the need to address structural inequalities, combat harmful misconceptions, and foster positive contact to combat stigma.
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Affiliation(s)
- Kristen Gillespie-Lynch
- College of Staten Island, City University of New York, USA.,The Graduate Center, City University of New York, USA
| | - Nidal Daou
- American University of Beirut, Lebanon.,McNeese State University, USA
| | | | - Steven K Kapp
- University of California, Los Angeles, USA.,University of Exeter, UK
| | - Rita Obeid
- College of Staten Island, City University of New York, USA.,The Graduate Center, City University of New York, USA
| | - Patricia J Brooks
- College of Staten Island, City University of New York, USA.,The Graduate Center, City University of New York, USA
| | - Fumio Someki
- College of Staten Island, City University of New York, USA
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109
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Ali Y, Anderson LN, Smile S, Chen Y, Borkhoff CM, Koroshegyi C, Lebovic G, Parkin PC, Birken CS, Szatmari P, Maguire JL. Prospective cohort study of vitamin D and autism spectrum disorder diagnoses in early childhood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:584-593. [PMID: 38321697 DOI: 10.1177/1362361318756787] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Several studies have suggested an association between vitamin D in childhood and autism spectrum disorder. No prospective studies have evaluated whether lower vitamin D levels precede ASD diagnoses - a necessary condition for causality. The objective of this study was to prospectively evaluate whether vitamin D serum levels in early childhood was associated with incident physician diagnosed ASD. A prospective cohort study was conducted using data from preschool-aged children in the TARGet Kids! practice-based research network in Toronto, Canada, from June 2008 to July 2015. 25-hydroxyvitamin D concentration was measured through blood samples and vitamin D supplementation from parent report. Autism spectrum disorder diagnosis was determined from medical records at follow-up visits. Covariates included age, sex, family history of autism spectrum disorder, maternal ethnicity, and neighborhood household income. Unadjusted and adjusted relative risks and 95% confidence intervals were estimated using Poisson regression with a robust error variance. In this study, 3852 children were included. Autism spectrum disorder diagnosis was identified in 41 children (incidence = 1.1%) over the observation period (average follow-up time = 2.5 years). An association between 25-hydroxyvitamin D concentration and autism spectrum disorder was not identified in the unadjusted (relative risk = 1.04, 95% confidence interval: 0.97, 1.11 per 10 nmol/L increase in 25-hydroxyvitamin D concentration) or adjusted models (adjusted relative risk = 1.06; 95% confidence interval: 0.95, 1.18). An association between vitamin D supplementation in early childhood and autism spectrum disorder was also not identified (adjusted relative risk = 0.86, 95% confidence interval: 0.46, 1.62). Vitamin D in early childhood may not be associated with incident physician diagnoses of autism spectrum disorder.
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Affiliation(s)
- Yamna Ali
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Laura N Anderson
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Sharon Smile
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Yang Chen
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Hospital for Sick Children Research Institute, Toronto, Canada
| | | | - Gerald Lebovic
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Catherine S Birken
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
| | | | - Jonathon L Maguire
- Li Ka Thing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Hospital for Sick Children Research Institute, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
- Department of Nutritional Sciences, University of Toronto, Toronto, Canada
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110
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Imm P, White T, Durkin MS. Assessment of racial and ethnic bias in autism spectrum disorder prevalence estimates from a US surveillance system. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1927-1935. [PMID: 30892923 DOI: 10.1177/1362361319827510] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study assessed potential under-ascertainment of autism spectrum disorder due to missing administrative information for Hispanic and non-Hispanic Black children within the Autism and Developmental Disabilities Monitoring Network. We analyzed data from two Network sites (Colorado and Wisconsin) for surveillance years 2012 and 2014 to determine whether children excluded from autism spectrum disorder prevalence estimates due to missing residency and other information differed from those included by race and ethnicity. We used multiple approaches to impute missing information to evaluate impacts on racial and ethnic disparities in autism spectrum disorder prevalence. Compared with confirmed autism spectrum disorder cases, those excluded due to missing residency were more than twice as likely to be Hispanic (19% vs 44%; p < 0.002), yet the number of cases excluded due to missing residency information was too small to account for prevalence differences. Confirmation of autism spectrum disorder case status was more likely for children with relevant health records than for those with school records only. Moreover, relevant health records were more likely to be missing for Black and Hispanic children than for White children. Observed disparities in autism spectrum disorder prevalence were not accounted for by missing demographic data, but may reflect disparities in healthcare access for developmental evaluations.
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Affiliation(s)
| | - Tiffany White
- Colorado Department of Public Health and Environment, USA
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111
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Maynard DW, Turowetz J. Doing Abstraction: Autism, Diagnosis, and Social Theory. SOCIOLOGICAL THEORY 2019; 37:89-116. [PMID: 31156290 PMCID: PMC6541456 DOI: 10.1177/0735275119830450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Recent decades have witnessed a dramatic upsurge in the prevalence of autism spectrum disorder (ASD). As researchers have investigated the responsible sociohistorical conditions, they have neglected how clinicians determine the diagnosis in local encounters in the first place. Articulating a position "between Foucault and Goffman," we ask how the interaction order of the clinic articulates with larger-scale historical forces affecting the definition and distribution of ASD. First, we show how the diagnostic process has a narrative structure. Second, case data from three decades show how narrative practices accommodate to different periods in the history of the disorder, including changing diagnostic nomenclatures. Third, we show how two different forms of abstraction-Type A, which is categorical, and Type B, which is concrete and particular-inhabit the diagnostic process. Our analysis contributes to the sociology of autism, the sociology of diagnosis, the sociology of abstraction, and social theory.
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Affiliation(s)
| | - Jason Turowetz
- Universitat Siegen, Siegen, Nordrhein-Westfalen, Germany
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112
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Trends in concept and nosology of autism spectrum disorder: A review. Asian J Psychiatr 2019; 40:92-99. [PMID: 30776666 DOI: 10.1016/j.ajp.2019.01.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/31/2019] [Accepted: 01/31/2019] [Indexed: 11/23/2022]
Abstract
Autism Spectrum Disorder is a neurodevelopmental disorder characterized by persistent deficits in social communication, social interaction and restricted, repetitive patterns of behavior, interests or activities. The concept of autism has changed since its inception, from childhood schizophrenia to neuro-variation. These changes in concept have been accompanied by changes in the diagnostic threshold through which the 'case' of autism is identified. The occurrence of multiple changes in its diagnostic criteria over last 80 odd years opens up the possibility of challenges being posed to the existence of the disorder as it is today, with a possibility of newer conceptualization of autism coming up in the future. The potential consequences of the changes in its nosology and concept, such as those on the management and on prevalence estimation are some of the essential issues which need attention. In the current paper, we evaluate the evolution of the concept and nosology of autism with an overview of the accompanying impact of these changes.
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113
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Blacher J, Stavropoulos K, Bolourian Y. Anglo-Latino differences in parental concerns and service inequities for children at risk of autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1554-1562. [PMID: 30612447 DOI: 10.1177/1362361318818327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In an evaluation of Anglo and Latina mothers and their children at risk of autism, this study compared mother-reported child behavioral concerns to staff-observed symptoms of autism. Within Latina mothers, the impact of primary language (English/Spanish), mothers' education, and child age on ratings of developmental concerns was examined. Participants were 218 mothers (Anglo = 85; Latina = 133) of children referred to a no-cost autism screening clinic. Mothers reported on behavioral concerns, autism symptomology, and services received; children were administered the Autism Diagnostic Observation Schedule by certified staff. Results revealed that Anglo and Latino children did not differ by autism symptoms or classification. However, Anglo mothers reported significantly more concerns than Latina mothers. Within the Latina group, analyses revealed significant interaction effects of language and child age; Spanish-speaking mothers of preschoolers endorsed fewer concerns, while Spanish-speaking mothers of school-aged children endorsed more concerns. Despite these reports, Anglo children with a classification of autism spectrum disorder were receiving significantly more services than Latino children with autism spectrum disorder, suggesting early beginnings of a service divide as well as the need for improved parent education on child development and advocacy for Latino families.
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Affiliation(s)
- Jan Blacher
- 1 University of California, Riverside, USA.,2 University of California, Los Angeles (UCLA), USA
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114
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Kogan MD, Vladutiu CJ, Schieve LA, Ghandour RM, Blumberg SJ, Zablotsky B, Perrin JM, Shattuck P, Kuhlthau KA, Harwood RL, Lu MC. The Prevalence of Parent-Reported Autism Spectrum Disorder Among US Children. Pediatrics 2018; 142:peds.2017-4161. [PMID: 30478241 PMCID: PMC6317762 DOI: 10.1542/peds.2017-4161] [Citation(s) in RCA: 204] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2018] [Indexed: 12/27/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5839990273001PEDS-VA_2017-4161Video Abstract OBJECTIVES: To estimate the national prevalence of parent-reported autism spectrum disorder (ASD) diagnosis among US children aged 3 to 17 years as well as their treatment and health care experiences using the 2016 National Survey of Children's Health (NSCH). METHODS The 2016 NSCH is a nationally representative survey of 50 212 children focused on the health and well-being of children aged 0 to 17 years. The NSCH collected parent-reported information on whether children ever received an ASD diagnosis by a care provider, current ASD status, health care use, access and challenges, and methods of treatment. We calculated weighted prevalence estimates of ASD, compared health care experiences of children with ASD to other children, and examined factors associated with increased likelihood of medication and behavioral treatment. RESULTS Parents of an estimated 1.5 million US children aged 3 to 17 years (2.50%) reported that their child had ever received an ASD diagnosis and currently had the condition. Children with parent-reported ASD diagnosis were more likely to have greater health care needs and difficulties accessing health care than children with other emotional or behavioral disorders (attention-deficit/hyperactivity disorder, anxiety, behavioral or conduct problems, depression, developmental delay, Down syndrome, intellectual disability, learning disability, Tourette syndrome) and children without these conditions. Of children with current ASD, 27% were taking medication for ASD-related symptoms, whereas 64% received behavioral treatments in the last 12 months, with variations by sociodemographic characteristics and co-occurring conditions. CONCLUSIONS The estimated prevalence of US children with a parent-reported ASD diagnosis is now 1 in 40, with rates of ASD-specific treatment usage varying by children's sociodemographic and co-occurring conditions.
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Affiliation(s)
- Michael D. Kogan
- Health Resources and Services Administration,
Maternal and Child Health Bureau, Rockville, Maryland
| | - Catherine J. Vladutiu
- Health Resources and Services Administration,
Maternal and Child Health Bureau, Rockville, Maryland
| | - Laura A. Schieve
- National Center on Birth Defects and Developmental
Disabilities and
| | - Reem M. Ghandour
- Health Resources and Services Administration,
Maternal and Child Health Bureau, Rockville, Maryland
| | - Stephen J. Blumberg
- National Center for Health Statistics, Centers for
Disease Control and Prevention, Hyattsville, Maryland
| | - Benjamin Zablotsky
- National Center for Health Statistics, Centers for
Disease Control and Prevention, Hyattsville, Maryland
| | - James M. Perrin
- Department of Pediatrics, Harvard Medical School,
Harvard University and MassGeneral Hospital for Children, Boston,
Massachusetts
| | - Paul Shattuck
- AJ Drexel Autism Institute, School of Public Health,
Drexel University, Philadelphia, Pennsylvania; and
| | - Karen A. Kuhlthau
- Department of Pediatrics, Harvard Medical School,
Harvard University and MassGeneral Hospital for Children, Boston,
Massachusetts
| | - Robin L. Harwood
- Health Resources and Services Administration,
Maternal and Child Health Bureau, Rockville, Maryland
| | - Michael C. Lu
- Office of the Dean, Milken Institute School of Public
Health, George Washington University, Washington, District of Columbia
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115
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Zhang W, Eshghi M. Brief Report: Regional Variations in Characteristics of ASD Hospitalizations in the U.S. J Autism Dev Disord 2018; 49:1289-1297. [PMID: 30443701 DOI: 10.1007/s10803-018-3826-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Regional differences in ASD inpatient care remain understudied. We used the Nationwide Inpatient Sample to examine contributory causes and potential determinants associated with regional variations in ASD hospitalizations. We performed univariate and multivariate analyses to identify differences in ASD hospitalizations across four U.S. Census Bureau-defined regions. Our results revealed considerable variations in ASD hospitalizations across U.S. regions. Compared with patients in the Northeast, those in the Midwest, South, and West were less likely to be hospitalized for ASD. Significant differences were observed among regions with regard to the effect of health insurance type, hospital length of stay, hospital bed size, hospital location and teaching status on ASD hospitalizations. The region-specific analysis provides direction for further investigation.
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Affiliation(s)
- Wanqing Zhang
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27599-7122, USA.
| | - Marziye Eshghi
- Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27599-7122, USA.,Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
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116
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Durkin MS, Yeargin-Allsopp M. Socioeconomic Status and Pediatric Neurologic Disorders: Current Evidence. Semin Pediatr Neurol 2018; 27:16-25. [PMID: 30293586 PMCID: PMC8340602 DOI: 10.1016/j.spen.2018.03.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Socioeconomic status (SES) is an important risk factor for many neurological disorders and a determinant of health outcomes and quality of life, especially for individuals with neurologic disorders and developmental disabilities. This article focuses on the relationship between SES and pediatric epilepsy, cerebral palsy, autism spectrum disorder, and intellectual disability. Disparities in the prevalence and long-term impact of SES on functioning in persons with disabilities are observed worldwide. Clinicians can use the information presented in the article to target early identification and interventions for improving outcomes in populations most at risk for these disorders and for poor health, social, and economic outcomes.
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Affiliation(s)
- Maureen S Durkin
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
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117
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Stainbrook JA, Weitlauf AS, Juárez AP, Taylor JL, Hine J, Broderick N, Nicholson A, Warren Z. Measuring the service system impact of a novel telediagnostic service program for young children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1051-1056. [PMID: 30112912 DOI: 10.1177/1362361318787797] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As prevalence of autism spectrum disorder continues to increase, so too does the need for timely, accessible diagnostic consultation. The present work extends from a previous study which provided preliminary evidence for the feasibility of expert clinicians to utilize telemedicine to triage autism spectrum disorder risk in young children. However, it did not examine whether a telediagnostic model had a demonstrable impact on tertiary care center referrals and usage. We therefore examined whether the introduction of telemedicine-based diagnostic consultation for families served by a rural medical facility affected referrals overall as well as to a metropolitan tertiary care diagnostic center. Results suggest that telemedicine diagnostic consultation in partnership with a referring early intervention system may positively impact referrals for diagnostic evaluation as well as the ability of families to schedule and attend appointments.
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Social Function and Autism Spectrum Disorder in Children and Adults with Neurofibromatosis Type 1: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2018; 28:317-340. [DOI: 10.1007/s11065-018-9380-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/10/2018] [Indexed: 12/27/2022]
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Brief Report: Texas School District Autism Prevalence in Children from Non-English-Speaking Homes. J Autism Dev Disord 2018; 50:1411-1417. [PMID: 29974313 DOI: 10.1007/s10803-018-3676-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Previous studies have implicated migration and ethnicity as possible risk factors for autism spectrum disorder (ASD) in developed countries. Using Texas education data, we calculated district-reported ASD prevalence stratified by geographic region, with reported home language as a proxy for immigration. Prevalence ratios were also stratified by race. Prevalence estimates were significantly lower for White children from homes speaking Spanish and other non-English languages compared to those from English-speaking homes. This is the first study, to our knowledge, that investigates ASD prevalence of children from non-English-speaking households in a large sample. Barriers in identification of children of immigrants with ASD indicate that the increased district-reported prevalence seen in our study may only be a small indicator of a potentially larger prevalence.
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Moseley RL, Hitchiner R, Kirkby JA. Self-reported sex differences in high-functioning adults with autism: a meta-analysis. Mol Autism 2018; 9:33. [PMID: 29796237 PMCID: PMC5960195 DOI: 10.1186/s13229-018-0216-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/30/2018] [Indexed: 12/21/2022] Open
Abstract
Background Sex differences in autistic symptomatology are believed to contribute to the mis- and missed diagnosis of many girls and women with an autism spectrum condition (ASC). Whilst recent years have seen the emergence of clinical and empirical reports delineating the profile of young autistic girls, recognition of sex differences in symptomatology in adulthood is far more limited. Methods We chose here to focus on symptomatology as reported using a screening instrument, the Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R). In a meta-analysis, we pooled and analysed RAADS-R data from a number of experimental groups. Analysis of variance (ANOVA) searched for the presence of main effects of Sex and Diagnosis and for interactions between these factors in our sample of autistic and non-autistic adults. Results In social relatedness and circumscribed interests, main effects of Diagnosis revealed that as expected, autistic adults reported significantly greater lifetime prevalence of symptoms in these domains; an effect of Sex, in circumscribed interests, also suggested that males generally reported more prevalent symptoms than females. An interaction of Sex and Diagnosis in language symptomatology revealed that a normative sex difference in language difficulties was attenuated in autism. An interaction of Sex and Diagnosis in the sensorimotor domain revealed the opposite picture: a lack of sex differences between typically developing men and women and a greater prevalence of sensorimotor symptoms in autistic women than autistic men. Conclusions We discuss the literature on childhood sex differences in relation to those which emerged in our adult sample. Where childhood sex differences fail to persist in adulthood, several interpretations exist, and we discuss, for example, an inherent sampling bias that may mean that only autistic women most similar to the male presentation are diagnosed. The finding that sensorimotor symptomatology is more highly reported by autistic women is a finding requiring objective confirmation, given its potential importance in diagnosis. Electronic supplementary material The online version of this article (10.1186/s13229-018-0216-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R L Moseley
- Department of Psychology, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - R Hitchiner
- Department of Psychology, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB UK
| | - J A Kirkby
- Department of Psychology, Bournemouth University, Fern Barrow, Poole, Dorset, BH12 5BB UK
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Janvier YM, Coffield CN, Harris JF, Mandell DS, Cidav Z. The Developmental Check-In: Development and initial testing of an autism screening tool targeting young children from underserved communities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:689-698. [PMID: 29716386 DOI: 10.1177/1362361318770430] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children with autism spectrum disorder from low-income, minority families or those with limited English proficiency are diagnosed at a later age, or not at all, compared with their more advantaged peers. The Developmental Check-In is a new tool that could potentially be used to screen for autism that uses pictures to illustrate target behaviors. It was developed to enhance early identification of autism spectrum disorder in low literacy groups. The Developmental Check-In was tested in a sample of 376 children between the ages of 24 and 60 months, from underserved communities. It showed good ability to discriminate autism spectrum disorder from non-autism spectrum disorder (area-under-the-curve = 0.75) across the full age range represented in the sample. Twenty-six of the 28 Developmental Check-In items predicted the presence of autism spectrum disorder. Findings suggest that this pictorial tool may reduce linguistic and health literacy demands when screening for autism among vulnerable populations.
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Affiliation(s)
| | | | - Jill F Harris
- 3 Children's Specialized Hospital - Mountainside, USA
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Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, Kurzius-Spencer M, Zahorodny W, Robinson Rosenberg C, White T, Durkin MS, Imm P, Nikolaou L, Yeargin-Allsopp M, Lee LC, Harrington R, Lopez M, Fitzgerald RT, Hewitt A, Pettygrove S, Constantino JN, Vehorn A, Shenouda J, Hall-Lande J, Van Naarden Braun K, Dowling NF. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES (WASHINGTON, D.C. : 2002) 2018; 67:1-23. [PMID: 29701730 PMCID: PMC5919599 DOI: 10.15585/mmwr.ss6706a1] [Citation(s) in RCA: 2010] [Impact Index Per Article: 335.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
PROBLEM/CONDITION Autism spectrum disorder (ASD). PERIOD COVERED 2014. DESCRIPTION OF SYSTEM The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance system that provides estimates of the prevalence of autism spectrum disorder (ASD) among children aged 8 years whose parents or guardians reside within 11 ADDM sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). ADDM surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by professional service providers in the community. Staff completing record review and abstraction receive extensive training and supervision and are evaluated according to strict reliability standards to certify effective initial training, identify ongoing training needs, and ensure adherence to the prescribed methodology. Record review and abstraction occurs in a variety of data sources ranging from general pediatric health clinics to specialized programs serving children with developmental disabilities. In addition, most of the ADDM sites also review records for children who have received special education services in public schools. In the second phase of the study, all abstracted information is reviewed systematically by experienced clinicians to determine ASD case status. A child is considered to meet the surveillance case definition for ASD if he or she displays behaviors, as described on one or more comprehensive evaluations completed by community-based professional providers, consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) diagnostic criteria for autistic disorder; pervasive developmental disorder-not otherwise specified (PDD-NOS, including atypical autism); or Asperger disorder. This report provides updated ASD prevalence estimates for children aged 8 years during the 2014 surveillance year, on the basis of DSM-IV-TR criteria, and describes characteristics of the population of children with ASD. In 2013, the American Psychiatric Association published the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which made considerable changes to ASD diagnostic criteria. The change in ASD diagnostic criteria might influence ADDM ASD prevalence estimates; therefore, most (85%) of the records used to determine prevalence estimates based on DSM-IV-TR criteria underwent additional review under a newly operationalized surveillance case definition for ASD consistent with the DSM-5 diagnostic criteria. Children meeting this new surveillance case definition could qualify on the basis of one or both of the following criteria, as documented in abstracted comprehensive evaluations: 1) behaviors consistent with the DSM-5 diagnostic features; and/or 2) an ASD diagnosis, whether based on DSM-IV-TR or DSM-5 diagnostic criteria. Stratified comparisons of the number of children meeting either of these two case definitions also are reported. RESULTS For 2014, the overall prevalence of ASD among the 11 ADDM sites was 16.8 per 1,000 (one in 59) children aged 8 years. Overall ASD prevalence estimates varied among sites, from 13.1-29.3 per 1,000 children aged 8 years. ASD prevalence estimates also varied by sex and race/ethnicity. Males were four times more likely than females to be identified with ASD. Prevalence estimates were higher for non-Hispanic white (henceforth, white) children compared with non-Hispanic black (henceforth, black) children, and both groups were more likely to be identified with ASD compared with Hispanic children. Among the nine sites with sufficient data on intellectual ability, 31% of children with ASD were classified in the range of intellectual disability (intelligence quotient [IQ] <70), 25% were in the borderline range (IQ 71-85), and 44% had IQ scores in the average to above average range (i.e., IQ >85). The distribution of intellectual ability varied by sex and race/ethnicity. Although mention of developmental concerns by age 36 months was documented for 85% of children with ASD, only 42% had a comprehensive evaluation on record by age 36 months. The median age of earliest known ASD diagnosis was 52 months and did not differ significantly by sex or race/ethnicity. For the targeted comparison of DSM-IV-TR and DSM-5 results, the number and characteristics of children meeting the newly operationalized DSM-5 case definition for ASD were similar to those meeting the DSM-IV-TR case definition, with DSM-IV-TR case counts exceeding DSM-5 counts by less than 5% and approximately 86% overlap between the two case definitions (kappa = 0.85). INTERPRETATION Findings from the ADDM Network, on the basis of 2014 data reported from 11 sites, provide updated population-based estimates of the prevalence of ASD among children aged 8 years in multiple communities in the United States. The overall ASD prevalence estimate of 16.8 per 1,000 children aged 8 years in 2014 is higher than previously reported estimates from the ADDM Network. Because the ADDM sites do not provide a representative sample of the entire United States, the combined prevalence estimates presented in this report cannot be generalized to all children aged 8 years in the United States. Consistent with reports from previous ADDM surveillance years, findings from 2014 were marked by variation in ASD prevalence when stratified by geographic area, sex, and level of intellectual ability. Differences in prevalence estimates between black and white children have diminished in most sites, but remained notable for Hispanic children. For 2014, results from application of the DSM-IV-TR and DSM-5 case definitions were similar, overall and when stratified by sex, race/ethnicity, DSM-IV-TR diagnostic subtype, or level of intellectual ability. PUBLIC HEALTH ACTION Beginning with surveillance year 2016, the DSM-5 case definition will serve as the basis for ADDM estimates of ASD prevalence in future surveillance reports. Although the DSM-IV-TR case definition will eventually be phased out, it will be applied in a limited geographic area to offer additional data for comparison. Future analyses will examine trends in the continued use of DSM-IV-TR diagnoses, such as autistic disorder, PDD-NOS, and Asperger disorder in health and education records, documentation of symptoms consistent with DSM-5 terminology, and how these trends might influence estimates of ASD prevalence over time. The latest findings from the ADDM Network provide evidence that the prevalence of ASD is higher than previously reported estimates and continues to vary among certain racial/ethnic groups and communities. With prevalence of ASD ranging from 13.1 to 29.3 per 1,000 children aged 8 years in different communities throughout the United States, the need for behavioral, educational, residential, and occupational services remains high, as does the need for increased research on both genetic and nongenetic risk factors for ASD.
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Durkin MS, Imm P. Durkin and Imm Respond. Am J Public Health 2018; 108:e16-e17. [DOI: 10.2105/ajph.2017.304272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Maureen S. Durkin
- Maureen S. Durkin is with the Department of Population Health Sciences at the University of Wisconsin School of Medicine and Public Health, and both authors are with the Waisman Center of the University of Wisconsin–Madison
| | - Pamela Imm
- Maureen S. Durkin is with the Department of Population Health Sciences at the University of Wisconsin School of Medicine and Public Health, and both authors are with the Waisman Center of the University of Wisconsin–Madison
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Tsai MN, Wu CL, Tseng LP, An CP, Chen HC. Extraversion Is a Mediator of Gelotophobia: A Study of Autism Spectrum Disorder and the Big Five. Front Psychol 2018. [PMID: 29515481 PMCID: PMC5826254 DOI: 10.3389/fpsyg.2018.00150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Previous research has shown that individuals with autism are frequently mocked in their childhood and are consequently more anxious about being ridiculed. Research has also shown that autistic individuals have a higher level of gelotophobia (fear of being laughed at) compared to typically developed individuals. However, recent studies have also found that gelotophobia is strongly related to personality, which suggests that personality is a factor that helps to create a higher level of gelotophobia in autistic individuals. To investigate whether this is the case, we recruited 279 Taiwanese high school students, 123 with autism spectrum disorder (ASD) and 156 typically developed students as a control group. Self-reporting questionnaires were used to gather data on the Big Five personality traits and on the gelotophobia-related traits of gelotophobia, gelotophilia, and katagelasticism. The results were analyzed and the two groups were compared for differences in gelotophobia and personality. The ASD group was found to have a higher level of gelotophobia than the typically developed group, but lower levels of gelotophilia and katagelasticism. Additionally, the ASD group was found to have lower levels of extraversion and agreeableness than the typically developed group, but no significant difference was found between the two groups in terms of conscientiousness, openness, and emotional stability. We then investigated the possible correlations between gelotophobia-related traits and the Big Five, and consequently the mediation effect of the Big Five on gelotophobia. The results show, firstly, that extraversion rather than ASD is a direct factor in gelotophobia. Secondly, the level of gelotophilia was partly influenced by autism but also to a certain extent by the level of extraversion. Lastly, the results indicate that autism and the level of agreeableness are in conflict when predicting the level of katagelasticism.
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Affiliation(s)
- Meng-Ning Tsai
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Ching-Lin Wu
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Lei-Pin Tseng
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Chih-Pei An
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Hsueh-Chih Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
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125
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Characterizing Health Disparities in the Age of Autism Diagnosis in a Study of 8-Year-Old Children. J Autism Dev Disord 2018; 48:2396-2407. [DOI: 10.1007/s10803-018-3500-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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126
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Cohen SR, Miguel J. Amor and Social Stigma: ASD Beliefs Among Immigrant Mexican Parents. J Autism Dev Disord 2018; 48:1995-2009. [DOI: 10.1007/s10803-017-3457-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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127
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He P, Guo C, Wang Z, Chen G, Li N, Zheng X. Socioeconomic status and childhood autism: A population-based study in China. Psychiatry Res 2018; 259:27-31. [PMID: 29028520 DOI: 10.1016/j.psychres.2017.08.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/23/2017] [Accepted: 08/19/2017] [Indexed: 10/19/2022]
Abstract
There is limited evidence on the association between socioeconomic status (SES) and autism in developing nations. The aim of this study was to examine this association among children aged 0-17 years in China. We obtained data from the Second National Sample Survey on Disability, and selected 616,940 children for analysis. Autism was ascertained according to the International Statistical Classification of Diseases, Tenth Revision. Multiple logistic regressions allowing for weights showed that children in middle-income and high-income families were less likely than their low-income peers to have autism, with an odds ratio of 0.60 (95%CI: 0.39, 0.93) and 0.44 (95%CI: 0.27, 0.72), respectively. Children in middle-education families had 63% (95%CI: 41%, 95%) odds of autism relative to their counterparts in low-education families. Stratified analyses found that all observed associations were only in male children, not in female children. In conclusion, children in families with socioeconomic disadvantage, in the form of lower family income and education, had greater risk of childhood autism.
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Affiliation(s)
- Ping He
- Institute of Population Research, Peking University, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China
| | - Zhenjie Wang
- Institute of Population Research, Peking University, Beijing, China
| | - Gong Chen
- Institute of Population Research, Peking University, Beijing, China
| | - Ning Li
- Institute of Population Research, Peking University, Beijing, China
| | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing, China; WHO Collaborating Center on Reproductive Health and Population Science, Beijing, China.
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Mahdi S, Viljoen M, Yee T, Selb M, Singhal N, Almodayfer O, Granlund M, de Vries PJ, Zwaigenbaum L, Bölte S. An international qualitative study of functioning in autism spectrum disorder using the World Health Organization international classification of functioning, disability and health framework. Autism Res 2017; 11:463-475. [PMID: 29226604 PMCID: PMC5900830 DOI: 10.1002/aur.1905] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 11/23/2017] [Accepted: 11/25/2017] [Indexed: 01/30/2023]
Abstract
This is the third in a series of four empirical studies designed to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The present study aimed to describe functioning in ASD (as operationalized by the ICF) derived from the perspectives of diagnosed individuals, family members, and professionals. A qualitative study using focus groups and semi-structured interviews were conducted with 19 stakeholder groups (N = 90) from Canada, India, Saudi Arabia, South Africa, and Sweden. Meaningful concepts from the focus groups and individual interviews were linked to ICF categories using a deductive qualitative approach with standardized linking procedures. The deductive qualitative content analysis yielded meaningful functioning concepts that were linked to 110 ICF categories across all four ICF components. Broad variation of environmental factors and activities and participation categories were identified in this study, while body functions consisted mainly of mental functions. Body structures were sparsely mentioned by the participants. Positive aspects of ASD included honesty, attention to detail, and memory. The experiences provided by international stakeholders support the need to understand individuals with ASD in a broader perspective, extending beyond diagnostic criteria into many areas of functioning and environmental domains. This study is part of a larger systematic effort that will provide the basis to define ICF Core Sets for ASD, from which assessment tools can be generated for use in clinical practice, research, and health care policy making. Autism Res 2018, 11: 463-475. © 2017 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY The study findings support the need to understand the living experiences of individuals with Autism Spectrum Disorder (ASD) from a broader perspective, taking into account many areas of an individual's functioning and environment. The ICF can serve as foundation for exploring these living experiences more extensively by offering tools that enable wide variety of individual difficulties and strengths to be captured along with important environmental influences. As such, these tools can facilitate interventions that meet the needs and goals of the individual.
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Affiliation(s)
- Soheil Mahdi
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
| | - Marisa Viljoen
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Tamara Yee
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Melissa Selb
- ICF Research Branch, a cooperation partner within the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Nidhi Singhal
- Action for Autism, The National Centre for Autism, New Delhi, India
| | - Omar Almodayfer
- Mental Health Department, KAMC-R, MNGHA, Riyadh, Saudi Arabia
| | - Mats Granlund
- CHILD, SIDR, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | | | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
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Magán-Maganto M, Bejarano-Martín Á, Fernández-Alvarez C, Narzisi A, García-Primo P, Kawa R, Posada M, Canal-Bedia R. Early Detection and Intervention of ASD: A European Overview. Brain Sci 2017; 7:brainsci7120159. [PMID: 29194420 PMCID: PMC5742762 DOI: 10.3390/brainsci7120159] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/20/2017] [Accepted: 11/28/2017] [Indexed: 01/13/2023] Open
Abstract
Over the last several years there has been an increasing focus on early detection of Autism Spectrum Disorder (ASD), not only from the scientific field but also from professional associations and public health systems all across Europe. Not surprisingly, in order to offer better services and quality of life for both children with ASD and their families, different screening procedures and tools have been developed for early assessment and intervention. However, current evidence is needed for healthcare providers and policy makers to be able to implement specific measures and increase autism awareness in European communities. The general aim of this review is to address the latest and most relevant issues related to early detection and treatments. The specific objectives are (1) analyse the impact, describing advantages and drawbacks, of screening procedures based on standardized tests, surveillance programmes, or other observational measures; and (2) provide a European framework of early intervention programmes and practices and what has been learnt from implementing them in public or private settings. This analysis is then discussed and best practices are suggested to help professionals, health systems and policy makers to improve their local procedures or to develop new proposals for early detection and intervention programmes.
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Affiliation(s)
- María Magán-Maganto
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
| | - Álvaro Bejarano-Martín
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
| | - Clara Fernández-Alvarez
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
| | | | | | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warszawa, Poland.
| | - Manuel Posada
- IIER, Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Ricardo Canal-Bedia
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
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Kelly B, Williams S, Collins S, Mushtaq F, Mon-Williams M, Wright B, Mason D, Wright J. The association between socioeconomic status and autism diagnosis in the United Kingdom for children aged 5–8 years of age: Findings from the Born in Bradford cohort. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:131-140. [DOI: 10.1177/1362361317733182] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
There has been recent interest in the relationship between socioeconomic status and the diagnosis of autism in children. Studies in the United States have found lower rates of autism diagnosis associated with lower socioeconomic status, while studies in other countries report no association, or the opposite. This article aims to contribute to the understanding of this relationship in the United Kingdom. Using data from the Born in Bradford cohort, comprising 13,857 children born between 2007 and 2011, it was found that children of mothers educated to A-level or above had twice the rate of autism diagnosis, 1.5% of children (95% confidence interval: 1.1%, 1.9%) compared to children of mothers with lower levels of education status 0.7% (95% confidence interval: 0.5%, 0.9%). No statistically significant relationship between income status or neighbourhood material deprivation was found after controlling for mothers education status. The results suggest a substantial level of underdiagnosis for children of lower education status mothers, though further research is required to determine the extent to which this is replicated across the United Kingdom. Tackling inequalities in autism diagnosis will require action, which could include increased education, awareness, further exploration of the usefulness of screening programmes and the provision of more accessible support services.
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Affiliation(s)
- Brian Kelly
- Bradford Teaching Hospitals NHS Foundation Trust, UK
| | | | | | | | | | | | - Dan Mason
- Bradford Teaching Hospitals NHS Foundation Trust, UK
| | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust, UK
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131
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Abstract
Individuals with autism spectrum disorder (ASD) experience increased morbidity and decreased life expectancy compared to the general population, and these disparities are likely exacerbated for those individuals who are otherwise disadvantaged. We conducted a review to ascertain what is known about health and health system quality (e.g., high quality care delivery, adequate care access) disparities in ASD. Nine studies met final inclusion criteria. Seven studies identified racial disparities in access to general medical services for children with ASD. No studies examined disparities in health outcomes or included older adults. We present a model of health disparities (Fundamental Causes Model) that guides future research. Additional work should examine health disparities, and their causal pathways, in ASD, particularly for older adults.
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Affiliation(s)
- Lauren Bishop-Fitzpatrick
- School of Social Work, University of Wisconsin-Madison, Madison, WI, USA.
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA.
| | - Amy J H Kind
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- VA Geriatrics Research Education and Clinical Center (GRECC), Madison, WI, USA
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Durkin MS, Maenner MJ, Baio J, Christensen D, Daniels J, Fitzgerald R, Imm P, Lee LC, Schieve LA, Van Naarden Braun K, Wingate MS, Yeargin-Allsopp M. Autism Spectrum Disorder Among US Children (2002-2010): Socioeconomic, Racial, and Ethnic Disparities. Am J Public Health 2017; 107:1818-1826. [PMID: 28933930 PMCID: PMC5637670 DOI: 10.2105/ajph.2017.304032] [Citation(s) in RCA: 175] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To describe the association between indicators of socioeconomic status (SES) and the prevalence of autism spectrum disorder (ASD) in the United States during the period 2002 to 2010, when overall ASD prevalence among children more than doubled, and to determine whether SES disparities account for ongoing racial and ethnic disparities in ASD prevalence. METHODS We computed ASD prevalence and 95% confidence intervals (CIs) from population-based surveillance, census, and survey data. We defined SES categories by using area-level education, income, and poverty indicators. We ascertained ASD in 13 396 of 1 308 641 8-year-old children under surveillance. RESULTS The prevalence of ASD increased with increasing SES during each surveillance year among White, Black, and Hispanic children. The prevalence difference between high- and low-SES groups was relatively constant over time (3.9/1000 [95% CI = 3.3, 4.5] in 2002 and 4.1/1000 [95% CI = 3.6, 4.6] in the period 2006-2010). Significant racial/ethnic differences in ASD prevalence remained after stratification by SES. CONCLUSIONS A positive SES gradient in ASD prevalence according to US surveillance data prevailed between 2002 and 2010, and racial and ethnic disparities in prevalence persisted during this time among low-SES children.
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Affiliation(s)
- Maureen S Durkin
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Matthew J Maenner
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Jon Baio
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Deborah Christensen
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Julie Daniels
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Robert Fitzgerald
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Pamela Imm
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Li-Ching Lee
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Laura A Schieve
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Kim Van Naarden Braun
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Martha S Wingate
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
| | - Marshalyn Yeargin-Allsopp
- Maureen S. Durkin is with the Department of Population Health Sciences of the University of Wisconsin School of Medicine and Public Health and the Waisman Center of the University of Wisconsin-Madison. Matthew J. Maenner, Jon Baio, Deborah Christensen, Laura A. Schieve, Kim Van Naarden Braun, and Marshalyn Yeargin-Allsopp are with the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Julie Daniels is with the Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill. Robert Fitzgerald is with the Department of Psychiatry, Washington University, St Louis, MO. Pamela Imm is with the Waisman Center of the University of Wisconsin-Madison. Li-Ching Lee is with the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Martha S. Wingate is with the Department of Health Care Organization and Policy, University of Alabama at Birmingham School of Public Health
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Madsen KB, Hohwü L, Zhu JL, Olsen J, Obel C. Social selection in cohort studies and later representation of childhood psychiatric diagnoses: The Danish National Birth Cohort. Scand J Public Health 2017; 48:207-213. [PMID: 28810815 DOI: 10.1177/1403494817726619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: This study aimed to estimate the relative representation of childhood psychiatric diagnoses and use of psychotropic medication in the Danish National Birth Cohort (DNBC) compared to the general population. Methods: The general population was identified as all childbirths in Denmark during 1998-2002 (N=344,160). Linking the DNBC (N=91,442) and the general population to the Danish national health registries, all children were followed until they received an ICD-10 psychiatric diagnosis, had a prescription of psychotropic medication or to the end of follow-up in 2013. The prevalence ratios (PRs) with corresponding 95% confidence intervals (CI) were estimated for each psychiatric diagnosis and by sex. Age at first diagnosis presented as means were compared using the one-sample t-test. Results: In the DNBC, the selected childhood psychiatric diagnoses were underrepresented by 3% (PR=0.97, 95% CI 0.94-0.99), ranging from a 20% underrepresentation for schizophrenia (PR=0.80, 95% CI 0.59-1.09) to a 6% over-representation for anxiety disorder or obsessive-compulsive disorder (PR=1.06, 95% CI 0.97-1.17). The majority of the specific diagnoses were modestly underrepresented in the DNBC compared to the general population, while use of psychotropic medication had similar representation. Girls were generally more underrepresented than boys. Depression was on average diagnosed 0.4 years earlier in the DNBC than in the general population (p=0.023). Conclusions: These findings suggest that the social selection may influence the prevalence of diagnosed childhood psychiatric disorders in the DNBC.
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Affiliation(s)
| | - Lena Hohwü
- Department of Public Health, Aarhus University, Denmark
| | - Jin Liang Zhu
- Department of Public Health, Aarhus University, Denmark
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - Carsten Obel
- Department of Public Health, Aarhus University, Denmark.,Center for Collaborative Health, Aarhus University, Denmark
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134
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Phenotypic Characteristics of Autism Spectrum Disorder in a Diverse Sample of Somali and Other Children. J Autism Dev Disord 2017; 47:3150-3165. [DOI: 10.1007/s10803-017-3232-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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135
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Varcin KJ, Alvares GA, Uljarević M, Whitehouse AJO. Prenatal maternal stress events and phenotypic outcomes in Autism Spectrum Disorder. Autism Res 2017; 10:1866-1877. [DOI: 10.1002/aur.1830] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/20/2017] [Accepted: 06/05/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Kandice J. Varcin
- Telethon Kids Institute, University of Western Australia; Perth Western Australia Australia
| | - Gail A. Alvares
- Telethon Kids Institute, University of Western Australia; Perth Western Australia Australia
- Cooperative Research Centre for Living with Autism (Autism CRC); Long Pocket Brisbane, Queensland Australia
| | - Mirko Uljarević
- Cooperative Research Centre for Living with Autism (Autism CRC); Long Pocket Brisbane, Queensland Australia
- Olga Tennison Autism Research Centre; School of Psychology and Public Health, La Trobe University; Victoria Australia
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136
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Bussanich P, Hartley SL, Bolt D. Parental attributions for positive behaviours in children with autism spectrum disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:643-655. [PMID: 28332245 PMCID: PMC7380566 DOI: 10.1111/jir.12373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 01/30/2017] [Accepted: 02/20/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND The present study examined parental attributions for positive child behaviour in children with Autism Spectrum Disorder (ASD) and their association with parent outcomes. METHOD In total, 175 couples who had a child with ASD (5-12 years) completed measures about the child's positive behaviour, ASD symptoms, functional skills and negative behaviour problems, and their own positive and negative affect and closeness in the parent-child relationship. A comparison group of 170 couples who had a child without a neurodevelopmental disability also completed measures. RESULTS Dyadic multilevel models were conducted. Parents of children with ASD believed that their child's positive behaviour was due to factors less internal to the child, less stable and less controllable by the child than the comparison group. Beliefs about stability were associated with closeness in the parent-child relationship. Child age and level of impairment and parent education were associated with parental attributions. CONCLUSIONS Interventions that alter parental attributions may offer pathways to increase closeness in the parent-child relationship.
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Affiliation(s)
- P Bussanich
- Human Development and Family Studies and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - S L Hartley
- Human Development and Family Studies and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - D Bolt
- Educational Psychology and Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
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137
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Abstract
Autism spectrum disorders (ASDs) are neurodevelopmental disorders whose core features of impaired social communication and atypical repetitive behaviors and/or restrictions in range of interests emerge in toddlerhood and carry significant implications at successive stages of development. The ability to reliably identify most cases of the condition far earlier than the average age of diagnosis presents a novel opportunity for early intervention, but the availability of such an intervention is disparate across US communities, and its impact is imperfectly understood. New research may transform the clinical approach to these conditions in early childhood.
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Affiliation(s)
- John N Constantino
- Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St Louis, MO 63110, USA.
| | - Natasha Marrus
- Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St Louis, MO 63110, USA
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138
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Kamimura-Nishimura K, Froehlich T, Chirdkiatgumchai V, Adams R, Fredstrom B, Manning P. Autism spectrum disorders and their treatment with psychotropic medications in a nationally representative outpatient sample: 1994-2009. Ann Epidemiol 2017; 27:448-453.e1. [PMID: 28789776 DOI: 10.1016/j.annepidem.2017.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 04/12/2017] [Accepted: 06/20/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE No prior studies have assessed change in health care provider-coded rates of Autism spectrum disorder (ASD) diagnoses over time, and few have investigated sociodemographic factors associated with having an ASD diagnosis, having behavioral conditions comorbid with ASD, or using psychotropic medications for this group. METHODS We used data from the 1994-2009 National (Hospital) Ambulatory Medical Care Surveys for children aged 2-18 years (n = 158,488). RESULTS Rates of visits with coded-ASD per 100 outpatient medical visits increased from 0.04% to 0.82% from 1994 to 2009. Factors associated with an ASD diagnosis included male gender, lack of private insurance, white race, and later study period. The most frequent comorbid behavioral diagnoses were ADHD, anxiety, disruptive behavior, and mood disorders. Older age was linked to an increased likelihood of having a comorbid behavioral diagnosis and using psychotropic medications. Geographic region was also associated with having a comorbid behavioral diagnosis, and psychotropic use was linked to have a behavioral comorbidity. Comorbidities with the highest rates of psychotropic use were ADHD, mood, and anxiety disorders. CONCLUSIONS Pediatric outpatient visits with an ASD diagnosis have increased dramatically from 1994 to 2009. Further study is needed to determine the reasons for the observed sociodemographic disparities in ASD diagnosis.
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Affiliation(s)
- Kelly Kamimura-Nishimura
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
| | - Tanya Froehlich
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | - Ryan Adams
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Bridget Fredstrom
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Patty Manning
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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139
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Gibbs VD. Detection and Treatment of Autism Spectrum Disorder by Occupational Therapy Practitioners: Addressing Racial Disparity in Diagnosis. Am J Occup Ther 2017; 71:7103360010p1-7103360010p4. [PMID: 28422642 DOI: 10.5014/ajot.2017.016303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
As the prevalence of autism spectrum disorder (ASD) continues to rise, racial disparities remain in age of diagnosis and initiation of treatment. Therefore, occupational therapy practitioners should examine cultural perceptions related to disparities in ASD diagnosis. This article investigates the role that practitioners may play in this disparity by asking, "Are occupational therapy practitioners contributing to the late diagnosis of children with ASD who are members of particular racial or ethnic groups?" Correlations among practitioners' detection of symptoms, parents' perceptions, and evaluator influences are investigated. By examining these factors, practitioners may gain better insight into these disparities and therefore provide more effective advocacy regarding early diagnosis and treatment access.
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Affiliation(s)
- Varleisha D Gibbs
- Varleisha D. Gibbs, OTD, OTR/L, is Associate Professor and Chair and Director, Master's of Occupational Therapy Program, Wesley College, Dover, DE;
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140
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Hickey EJ, Dubois L, Hartley SL. Positive and negative social exchanges experienced by fathers and mothers of children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:469-478. [PMID: 28326797 DOI: 10.1177/1362361316687117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
When faced with child-related challenges associated with autism spectrum disorder, positive and negative social exchanges may be critical to parents' psychological well-being. This study examined the types and sources of positive and negative social exchanges reported by mothers and fathers of children with autism spectrum disorder and their association with parental depressive symptoms in 176 families of children (5-12 years; 85% male) with autism spectrum disorder. One-way repeated measure multivariate analyses of variance and multilevel modeling were used. Results indicated that informational was the most frequent type, and one's spouse was the primary source, of both positive and negative social exchanges. Fathers reported fewer positive, and also fewer negative, social exchanges with family, friends, and health professionals than mothers. Positive and negative social exchanges with one's spouse were most strongly associated with depressive symptoms. Findings have implications for interventions designed to foster optimal outcomes in families of children with autism spectrum disorder.
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141
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Lyall K, Croen L, Daniels J, Fallin MD, Ladd-Acosta C, Lee BK, Park BY, Snyder NW, Schendel D, Volk H, Windham GC, Newschaffer C. The Changing Epidemiology of Autism Spectrum Disorders. Annu Rev Public Health 2017; 38:81-102. [PMID: 28068486 PMCID: PMC6566093 DOI: 10.1146/annurev-publhealth-031816-044318] [Citation(s) in RCA: 555] [Impact Index Per Article: 79.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition with lifelong impacts. Genetic and environmental factors contribute to ASD etiology, which remains incompletely understood. Research on ASD epidemiology has made significant advances in the past decade. Current prevalence is estimated to be at least 1.5% in developed countries, with recent increases primarily among those without comorbid intellectual disability. Genetic studies have identified a number of rare de novo mutations and gained footing in the areas of polygenic risk, epigenetics, and gene-by-environment interaction. Epidemiologic investigations focused on nongenetic factors have established advanced parental age and preterm birth as ASD risk factors, indicated that prenatal exposure to air pollution and short interpregnancy interval are potential risk factors, and suggested the need for further exploration of certain prenatal nutrients, metabolic conditions, and exposure to endocrine-disrupting chemicals. We discuss future challenges and goals for ASD epidemiology as well as public health implications.
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Affiliation(s)
- Kristen Lyall
- A.J. Drexel Autism Institute, Philadelphia, Pennsylvania 19104;
| | - Lisa Croen
- Kaiser Permanente Division of Research, Oakland, California 94612
| | - Julie Daniels
- Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill, North Carolina 27599
| | - M Daniele Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Christine Ladd-Acosta
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Brian K Lee
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania 19104
- Department of Medical Epidemiology and Biostatistics and Department of Public Health Sciences, Karolinska Institute, SE 171-77 Stockholm, Sweden
| | - Bo Y Park
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
| | | | - Diana Schendel
- Department of Economics and Business, National Centre for Register-Based Research, Aarhus University, DK-8210 Aarhus, Denmark
- Department of Public Health, Section for Epidemiology, Aarhus University, DK-8000 Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Heather Volk
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Gayle C Windham
- California Department of Public Health, Division of Environmental and Occupational Disease Control, Richmond, California 94805
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Karimi P, Kamali E, Mousavi SM, Karahmadi M. Environmental factors influencing the risk of autism. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2017; 22:27. [PMID: 28413424 PMCID: PMC5377970 DOI: 10.4103/1735-1995.200272] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/06/2016] [Accepted: 11/30/2016] [Indexed: 12/16/2022]
Abstract
Autism is a developmental disability with age of onset in childhood (under 3 years old), which is characterized by definite impairments in social interactions, abnormalities in speech, and stereotyped pattern of behaviors. Due to the progress of autism in recent decades, a wide range of studies have been done to identify the etiological factors of autism. It has been found that genetic and environmental factors are both involved in autism pathogenesis. Hence, in this review article, a set of environmental factors involved in the occurrence of autism has been collected, and finally, some practical recommendations for reduction of the risk of this devastating disease in children are represented.
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Affiliation(s)
- Padideh Karimi
- Division of Genetics, Department of Biology, Faculty of Science, Tarbiat Modares University, Tehran, Iran
| | - Elahe Kamali
- Division of Genetics, Department of Biology, Faculty of Science, Isfahan University, Isfahan, Iran
| | - Seyyed Mohammad Mousavi
- Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Genetic and Identification Lab, Legal Medicine Center, Isfahan, Iran
| | - Mojgan Karahmadi
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Noor Hospital, Isfahan, Iran
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143
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Deal LS, DeMuro C, DiBenedetti D, Lewis S. Development of the Observable Behaviors of Autism Spectrum Disorder Scale. Ther Innov Regul Sci 2017; 51:372-379. [PMID: 30231702 DOI: 10.1177/2168479016680258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The objective of this research was to develop a caregiver-reported clinical outcome assessment (COA) measure designed to assess observable behaviors of children, ages 4 to 12 years, with autism spectrum disorder (ASD) for supporting labeling claims of treatment benefit. METHODS Development of the measure included a review of the literature and existing instruments, conceptual disease model development, concept elicitation focus groups, item generation, and cognitive debriefing interviews. RESULTS Predominant characteristics and behaviors of ASD identified by the literature and instrument reviews included sociability, communication deficits, stereotypy, inattention and hyperactivity, irritability, anxiety, and familial impact. In each of the 10 instruments reviewed, evidence of content validity was limited or nonexistent. Predominant themes arose across 8 major categories during concept elicitation. A total of 27 concepts were identified through focus group feedback and formed the basis for item development and cognitive pre-testing. Revisions to the items yielded a final version of a daily diary containing 21 items assessing observable behaviors and characteristics of ASD in children 4 to 12 years old. CONCLUSIONS The Observable Behaviors of ASD Scale (OBAS) was developed as a self-administered, caregiver-reported measure containing 8 predominant themes. Items are scored on one of two 5-point ordinal categorical response scales, and the recall period for each item is "the past 24 hours." This research provides evidence that the OBAS is content valid for assessing treatment benefit, which was found to be lacking in other instruments.
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Affiliation(s)
| | - Carla DeMuro
- 2 RTI Health Solutions, Research Triangle Park, NC, USA
| | | | - Sandy Lewis
- 2 RTI Health Solutions, Research Triangle Park, NC, USA
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144
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Keller-Bell YD. Disparities in the Identification and Diagnosis of Autism Spectrum Disorder in Culturally and Linguistically Diverse Populations. ACTA ACUST UNITED AC 2017. [DOI: 10.1044/persp2.sig14.68] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Early identification and intervention services play a critical role in determining the degree of communication development in children with autism spectrum disorder (ASD). However, researchers have reported that African-American and Hispanic populations are less likely to be diagnosed with ASD, often receive the initial diagnosis at later ages, and experience differences in access to services in comparison to other racial and ethnic groups. Studies have also documented lower participation rates of minorities in research studies of ASD. These differences have contributed to disparities in services for children with autism from culturally, linguistically, and economically diverse backgrounds. The purpose of this article is to discuss disparities in the identification and diagnosis of children with ASD from diverse backgrounds. It will discuss the clinical implications for speech-language pathologists (SLPs) in addressing potential barriers and strategies to facilitate services.
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145
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Zablotsky B, Colpe LJ, Pringle BA, Kogan MD, Rice C, Blumberg SJ. Age of Parental Concern, Diagnosis, and Service Initiation Among Children With Autism Spectrum Disorder. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:49-61. [PMID: 28095057 PMCID: PMC5568529 DOI: 10.1352/1944-7558-122.1.49] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Children with autism spectrum disorder (ASD) require substantial support to address the core symptoms of ASD and co-occurring behavioral/developmental conditions. This study explores the early diagnostic experiences of school-aged children with ASD using survey data from a large probability-based national sample. Multivariate linear regressions were used to examine age when parent reported developmental concern to doctor, received ASD diagnosis, and first obtained services. Children whose parents had concerns about their child's verbal communication reported earlier ages for all outcomes when compared to children of parents who did not have verbal communication concerns. Children whose parents had concerns about their child's nonverbal communication or unusual gestures/movements received an earlier diagnosis than children whose parents did not have these specific concerns.
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Affiliation(s)
| | - Lisa J Colpe
- Lisa J. Colpe; Beverly A. Pringle, National Institute of Mental Health
| | - Beverly A Pringle
- Lisa J. Colpe; Beverly A. Pringle, National Institute of Mental Health
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146
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Dickerson AS, Rahbar MH, Pearson DA, Kirby RS, Bakian AV, Bilder DA, Harrington RA, Pettygrove S, Zahorodny WM, Moyé LA, Durkin M, Slay Wingate M. Autism spectrum disorder reporting in lower socioeconomic neighborhoods. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:470-480. [DOI: 10.1177/1362361316650091] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Utilizing surveillance data from five sites participating in the Autism and Developmental Disabilities Monitoring Network, we investigated contributions of surveillance subject and census tract population sociodemographic characteristics on variation in autism spectrum disorder ascertainment and prevalence estimates from 2000 to 2008 using ordinal hierarchical models for 2489 tracts. Multivariable analyses showed a significant increase in ascertainment of autism spectrum disorder cases through both school and health sources, the optimal ascertainment scenario, for cases with college-educated mothers (adjusted odds ratio = 1.06, 95% confidence interval = 1.02–1.09). Results from our examination of sociodemographic factors of tract populations from which cases were drawn also showed that after controlling for other covariates, statistical significance remained for associations between optimal ascertainment and percentage of Hispanic residents (adjusted odds ratio = 0.93, 95% confidence interval = 0.88–0.99) and percentage of residents with at least a bachelor’s degree (adjusted odds ratio = 1.06, 95% confidence interval = 1.01–1.11). We identified sociodemographic factors associated with autism spectrum disorder prevalence estimates including race, ethnicity, education, and income. Determining which specific factors influence disparities is complicated; however, it appears that even in the presence of education, racial and ethnic disparities are still apparent. These results suggest disparities in access to autism spectrum disorder assessments and special education for autism spectrum disorder among ethnic groups may impact subsequent surveillance.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lemuel A Moyé
- The University of Texas Health Science Center at Houston, USA
| | - Maureen Durkin
- University of Wisconsin School of Medicine and Public Health, USA
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147
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Page J, Constantino JN, Zambrana K, Martin E, Tunc I, Zhang Y, Abbacchi A, Messinger D. Quantitative autistic trait measurements index background genetic risk for ASD in Hispanic families. Mol Autism 2016; 7:39. [PMID: 27606047 PMCID: PMC5013609 DOI: 10.1186/s13229-016-0100-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 08/11/2016] [Indexed: 01/14/2023] Open
Abstract
Background Recent studies have indicated that quantitative autistic traits (QATs) of parents reflect inherited liabilities that may index background genetic risk for clinical autism spectrum disorder (ASD) in their offspring. Moreover, preferential mating for QATs has been observed as a potential factor in concentrating autistic liabilities in some families across generations. Heretofore, intergenerational studies of QATs have focused almost exclusively on Caucasian populations—the present study explored these phenomena in a well-characterized Hispanic population. Methods The present study examined QAT scores in siblings and parents of 83 Hispanic probands meeting research diagnostic criteria for ASD, and 64 non-ASD controls, using the Social Responsiveness Scale-2 (SRS-2). Ancestry of the probands was characterized by genotype, using information from 541,929 single nucleotide polymorphic markers. Results In families of Hispanic children with an ASD diagnosis, the pattern of quantitative trait correlations observed between ASD-affected children and their first-degree relatives (ICCs on the order of 0.20), between unaffected first-degree relatives in ASD-affected families (sibling/mother ICC = 0.36; sibling/father ICC = 0.53), and between spouses (mother/father ICC = 0.48) were in keeping with the influence of transmitted background genetic risk and strong preferential mating for variation in quantitative autistic trait burden. Results from analysis of ancestry-informative genetic markers among probands in this sample were consistent with that from other Hispanic populations. Conclusions Quantitative autistic traits represent measurable indices of inherited liability to ASD in Hispanic families. The accumulation of autistic traits occurs within generations, between spouses, and across generations, among Hispanic families affected by ASD. The occurrence of preferential mating for QATs—the magnitude of which may vary across cultures—constitutes a mechanism by which background genetic liability for ASD can accumulate in a given family in successive generations.
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Affiliation(s)
- Joshua Page
- Department of Psychiatry and Pediatrics, Washington University School of Medicine, 4444 Forest Park Ave, St. Louis, MO USA
| | - John Nicholas Constantino
- Department of Psychiatry and Pediatrics, Washington University School of Medicine, 4444 Forest Park Ave, St. Louis, MO USA
| | - Katherine Zambrana
- Department of Psychology, University of Miami, P.O. Box 248185-0751, Coral Gables, FL USA
| | - Eden Martin
- The Center for Genetic Epidemiology and Statistical Genetics, University of Miami School of Medicine, 1501 NW 10th Avenue, Miami, FL USA
| | - Ilker Tunc
- Division of Intramural Research, National Heart Lung and Blood Institute, NIH, 31 Center Dr., Bethesda, MD USA
| | - Yi Zhang
- Department of Psychiatry and Pediatrics, Washington University School of Medicine, 4444 Forest Park Ave, St. Louis, MO USA
| | - Anna Abbacchi
- Department of Psychiatry and Pediatrics, Washington University School of Medicine, 4444 Forest Park Ave, St. Louis, MO USA
| | - Daniel Messinger
- Department of Psychology, University of Miami, P.O. Box 248185-0751, Coral Gables, FL USA
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148
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Emerson ND, Morrell HER, Neece C. Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity. J Autism Dev Disord 2016; 46:127-138. [PMID: 26280401 DOI: 10.1007/s10803-015-2555-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Having a consistent source of medical care may facilitate diagnosis of autism spectrum disorders (ASD). This study examined predictors of age of ASD diagnosis using data from the 2011-2012 National Survey of Children's Health. Using multiple linear regression analysis, age of diagnosis was predicted by race, ASD severity, having a consistent source of care (CSC), and the interaction between these variables after controlling for birth cohort, birth order, poverty level, parental education, and health insurance. While African American children were diagnosed earlier than Caucasians, this effect was moderated by ASD severity and CSC. Having a CSC predicted earlier diagnosis for Caucasian but not African American children. Both physician and parent behaviors may contribute to diagnostic delays in minority children.
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Affiliation(s)
- Natacha D Emerson
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Loma Linda, CA, 92354, USA.
| | - Holly E R Morrell
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Loma Linda, CA, 92354, USA
| | - Cameron Neece
- Department of Psychology, Loma Linda University, 11130 Anderson Street, Loma Linda, CA, 92354, USA
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149
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Mandell D, Mandy W. Should all young children be screened for autism spectrum disorder? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 19:895-6. [PMID: 26734703 DOI: 10.1177/1362361315608323] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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150
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Dickerson AS, Rahbar MH, Bakian AV, Bilder DA, Harrington RA, Pettygrove S, Kirby RS, Durkin MS, Han I, Moyé LA, Pearson DA, Wingate MS, Zahorodny WM. Autism spectrum disorder prevalence and associations with air concentrations of lead, mercury, and arsenic. ENVIRONMENTAL MONITORING AND ASSESSMENT 2016; 188:407. [PMID: 27301968 DOI: 10.1007/s10661-016-5405-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/02/2016] [Indexed: 06/06/2023]
Abstract
Lead, mercury, and arsenic are neurotoxicants with known effects on neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder apparent by early childhood. Using data on 4486 children with ASD residing in 2489 census tracts in five sites of the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, we used multi-level negative binomial models to investigate if ambient lead, mercury, and arsenic concentrations, as measured by the US Environmental Protection Agency National-Scale Air Toxics Assessment (EPA-NATA), were associated with ASD prevalence. In unadjusted analyses, ambient metal concentrations were negatively associated with ASD prevalence. After adjusting for confounding factors, tracts with air concentrations of lead in the highest quartile had significantly higher ASD prevalence than tracts with lead concentrations in the lowest quartile (prevalence ratio (PR) = 1.36; 95 '% CI: 1.18, 1.57). In addition, tracts with mercury concentrations above the 75th percentile (>1.7 ng/m(3)) and arsenic concentrations below the 75th percentile (≤0.13 ng/m(3)) had a significantly higher ASD prevalence (adjusted RR = 1.20; 95 % CI: 1.03, 1.40) compared to tracts with arsenic, lead, and mercury concentrations below the 75th percentile. Our results suggest a possible association between ambient lead concentrations and ASD prevalence and demonstrate that exposure to multiple metals may have synergistic effects on ASD prevalence.
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Affiliation(s)
- Aisha S Dickerson
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA.
| | - Mohammad H Rahbar
- Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA
- Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
- Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Amanda V Bakian
- Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Deborah A Bilder
- Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Rebecca A Harrington
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Sydney Pettygrove
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA
| | - Russell S Kirby
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, 33612, USA
| | - Maureen S Durkin
- Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA
| | - Inkyu Han
- Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA
| | - Lemuel A Moyé
- Division of Biostatistics, University of Texas School of Public Health at Houston, Houston, TX, 77030, USA
| | - Deborah A Pearson
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, TX, 77054, USA
| | - Martha Slay Wingate
- Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35205, USA
| | - Walter M Zahorodny
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
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