1
|
Washington-Nortey M, Anum A, Serpell Z, Xu Y. Expectations for Children with Autism Spectrum Disorders or Intellectual Disabilities in Ghana: A Comparison Between Service Providers and Parents. J Autism Dev Disord 2024; 54:3516-3532. [PMID: 37530915 PMCID: PMC11362313 DOI: 10.1007/s10803-023-06073-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Abstract
Little is known about care providers' expectations for children with autism spectrum disorders (ASD) and intellectual disabilities (ID) in Ghana. This study used group concept mapping (n = 9) and a quantitative survey (n = 128) to explore and compare service providers' and parents' expectations for children with ASD or ID. Data were analyzed using hierarchical clustering procedures and Multivariate Analysis of Variance (MANOVA). Concept mapping results revealed several expectation clusters, including independence, love and acceptance, equal social rights and opportunities, and professional and caregiver training. MANOVA results revealed significant differences between parents, teachers, and healthcare providers in their perceptions of the importance and likelihood of a child achieving these expectations. Results are discussed in reference to the cultural context, and implications are outlined.
Collapse
Affiliation(s)
| | - Adote Anum
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Zewelanji Serpell
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | - Yaoying Xu
- Department of Counseling and Special Education, Virginia Commonwealth University, Richmond, USA
| |
Collapse
|
2
|
Lockwood Estrin G, Mason L, Arora R, Bhavnani S, Dasgupta J, Gulati S, Gliga T, Johnson MH. Attention control in autism: Eye-tracking findings from pre-school children in a low- and middle-income country setting. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:43-57. [PMID: 36700615 DOI: 10.1177/13623613221149541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
LAY ABSTRACT The development of cognitive processes, such as attention control and learning, has been suggested to be altered in children with a diagnosis of autism spectrum disorder. However, nearly all of our understanding of the development of these cognitive processes comes from studies with school-aged or older children in high-income countries, and from research conducted in a controlled laboratory environment, thereby restricting the potential generalisability of results and away from the majority of the world's population. We need to expand our research to investigate abilities beyond these limited settings. We address shortcomings in the literature by (1) studying attention control and learning in an understudied population of children in a low- and middle-income country setting in India, (2) focusing research on a critical younger age group of children and (3) using portable eye-tracking technology that can be taken into communities and healthcare settings to increase the accessibility of research in hard-to-reach populations. Our results provide novel evidence on differences in attention control and learning responses in groups of children with and without a diagnosis of autism spectrum disorder. We show that learning responses in children that we assessed through a portable eye-tracking task, called the 'antisaccade task', may be specific to autism. This suggests that the methods we use may have the potential to identify and assess autism-specific traits across development, and be used in research in low-resource settings.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Mark H Johnson
- Birkbeck, University of London, UK
- University of Cambridge, UK
| |
Collapse
|
3
|
Rabot J, Rødgaard EM, Joober R, Dumas G, Bzdok D, Bernhardt B, Jacquemont S, Mottron L. Genesis, modelling and methodological remedies to autism heterogeneity. Neurosci Biobehav Rev 2023; 150:105201. [PMID: 37116771 DOI: 10.1016/j.neubiorev.2023.105201] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
Diagnostic criteria used in autism research have undergone a shift towards the inclusion of a larger population, paralleled by increasing, but variable, estimates of autism prevalence across clinical settings and continents. A categorical diagnosis of autism spectrum disorder is now consistent with large variations in language, intelligence, comorbidity, and severity, leading to a heterogeneous sample of individuals, increasingly distant from the initial prototypical descriptions. We review the history of autism diagnosis and subtyping, and the evidence of heterogeneity in autism at the cognitive, neurological, and genetic levels. We describe two strategies to address the problem of heterogeneity: clustering, and truncated-compartmentalized enrollment strategy based on prototype recognition. The advances made using clustering methods have been modest. We present an alternative, new strategy for dissecting autism heterogeneity, emphasizing incorporation of prototypical samples in research cohorts, comparison of subgroups defined by specific ranges of values for the clinical specifiers, and retesting the generality of neurobiological results considered to be acquired from the entire autism spectrum on prototypical cohorts defined by narrow specifiers values.
Collapse
Affiliation(s)
| | - Eya-Mist Rødgaard
- Department of Psychology, Copenhagen University, Copenhagen, Denmark,.
| | - Ridha Joober
- Neurological Institute and Hospital, McGill University, Montreal, Quebec, H4H 1R3, Canada,.
| | - Guillaume Dumas
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, Mila - Quebec Artificial Intelligence Institute, Montreal, QC, Canada,.
| | - Danilo Bzdok
- Mila - Quebec Artificial Intelligence Institute, Montreal, Canada, Department of Biomedical Engineering, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, H3A 2B4, QC, Canada,.
| | - Boris Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, McGill University, Montreal, QC, H3A 2B4, Canada,.
| | - Sebastien Jacquemont
- Department of Pediatrics, University of Montreal, Montréal, Quebec, H3T 1C5, Canada,.
| | - Laurent Mottron
- Department of Psychiatry & Addictology, University of Montreal, Montreal, QC, H3T 1C5, Canada, CIUSSS-NIM, Research Center, Montréal, QC, H1E 1A4, Canada,.
| |
Collapse
|
4
|
Fujii Y, Matsumura H, Shirasu A, Nakakura H, Yamazaki S, Kanazawa T, Saito N, Hirano H, Azuma H, Nozu K, Ashida A. Unexpected cause of repeated peritoneal dialysis-related complications: a case study of autism spectrum disorder with normal intelligence quotient in an adolescent. RENAL REPLACEMENT THERAPY 2023. [DOI: 10.1186/s41100-023-00470-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Abstract
Background
Autism spectrum disorder (ASD) is a common communication disorder, with an incidence rate of 3%. In most cases, clinicians can diagnose ASD in a single outpatient visit. However, in the case of ASD patients without intellectual disability, clinicians are sometimes unaware for a prolonged period that a patient has ASD. In such cases, delayed diagnosis can lead to serious complications.
Case presentation
An 18-year-old boy had repeated severe complications of peritoneal dialysis. At the age of 9, the patient presented with proteinuria, and 5 years later, he developed end-stage kidney disease. Percutaneous renal biopsy and the clinical symptoms revealed focal segmental glomerulosclerosis with Charcot-Marie-Tooth disease due to a gene mutation in INF2. Peritoneal dialysis was initiated at the age of 14, but led to many related complications, including peritonitis, hypertensive retinopathy and encephalopathy, and acute heart failure. Initially, we were unaware of his developmental characteristics and autism spectrum disorder without intellectual disability, but through lengthy observations by various healthcare professionals, his unique characteristics were noticed. Because the patient often displayed a discrepancy between behavior and speech, we cautiously studied his thoughts and behaviors, and developed a special approach to ensure safe peritoneal dialysis.
Conclusions
When many peritoneal dialysis-related complications occur in a patient with normal intelligence quotient, autism spectrum disorder should be considered as a possible cause.
Collapse
|
5
|
Chang X, Sun L, Li R. Application of symbolic play test in identification of autism spectrum disorder without global developmental delay and developmental language disorder. BMC Psychiatry 2023; 23:138. [PMID: 36879230 PMCID: PMC9990336 DOI: 10.1186/s12888-023-04647-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Children with autism spectrum disorders (ASD) usually experience difficulty regarding symbolic play. However, studies on whether symbolic play test (SPT) can differentiate between ASD and other developmental disorders are inconsistent, and evaluating the application value of the SPT in the identification of ASD without global developmental delay (GDD) and developmental language disorder (DLD) is necessary. METHODS A total of 200 children were selected as the research participants. There were 100 cases of ASD without GDD and 100 cases of DLD. All children were tested by SPT and Children Neuropsychological and Behavioral Scale-Revision (CNBS-R2016). Binomial logistic regression was used for multivariate analysis. The receiver operating characteristic (ROC) curve was used to evaluate the value of SPT in identifying ASD without GDD and DLD. RESULTS SPT equivalent age was lower than chronological age in the two groups, the difference between the ASD without GDD group was greater than that in the DLD group, and the proportion of SPT equivalent age retardation was higher than that in the DLD group; the differences were statistically significant. Logistic regression analysis showed that there was a difference in SPT equivalent age between DLD and ASD without GDD. When the cut-off value of the SPT was 8.5, the largest area under the ROC curve was 0.723, and the sensitivity and specificity for the diagnosis of ASD without GDD were 0.720 and 0.620 respectively. CONCLUSIONS Symbolic play ability in ASD children is worse than that of DLD children at comparable development levels. SPT may be helpful to distinguish ASD without GDD from children with DLD.
Collapse
Affiliation(s)
- Xuening Chang
- Department of Child Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Lingli Sun
- Department of Child Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Ruizhen Li
- Department of Child Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China.
| |
Collapse
|
6
|
Leader G, Hogan A, Chen JL, Maher L, Naughton K, O'Rourke N, Casburn M, Mannion A. Age of Autism Spectrum Disorder Diagnosis and Comorbidity in Children and Adolescents with Autism Spectrum Disorder. Dev Neurorehabil 2022; 25:29-37. [PMID: 33934683 DOI: 10.1080/17518423.2021.1917717] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AIM Research is required to study the relationship between age of autism spectrum disorder (ASD) diagnosis and the presence of comorbidities. METHOD The Gastrointestinal Symptom Inventory, Autism Spectrum Disorder-Comorbid for Children, Behavior Problem Inventory-Short Form and Social Communication Questionnaire were completed by parents of 129 children and adolescents with a diagnosis of ASD. RESULTS Results revealed significant relationships between the age of ASD diagnosis, the presence of comorbidities and intellectual disability. Significant correlations were found between the age of ASD diagnosis and self-injurious and stereotyped behavior. Comorbid psychopathology significantly predicted the presence of GI symptoms. In addition, the relationship between comorbid psychopathology and challenging behavior in this study was reported as bi-directional as both comorbidities predicted one another in the sample. CONCLUSION Future research needs to consider the role of comorbidities in relation to ASD diagnosis.
Collapse
Affiliation(s)
- Geraldine Leader
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Amy Hogan
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - June L Chen
- Department of Special Education, Faculty of Education, East China Normal University, Shanghai, China
| | - Leanne Maher
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Katie Naughton
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Nathan O'Rourke
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Mia Casburn
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| | - Arlene Mannion
- Irish Centre for Autism and Neurodevelopmental Research, School of Psychology, National University of Ireland, Galway, Ireland
| |
Collapse
|
7
|
Lenart A, Pasternak J. Resources, Problems and Challenges of Autism Spectrum Disorder Diagnosis and Support System in Poland. J Autism Dev Disord 2021; 53:1629-1641. [PMID: 34345979 PMCID: PMC10066150 DOI: 10.1007/s10803-021-05142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/30/2022]
Abstract
The article refers to resources, problems and challenges of autism diagnosis and support system in Poland. The resources include: the increasing number of specialists, diagnostic and therapeutic centres, well-established course of education for people working with youths, standardised and normalised diagnostic tools. The diagnostic process is not without some areas in need of our focus: the tendency of some specialists to make unauthorised diagnosis, overshadowing; underestimation of comorbidity of ASD with other disorders. The challenges refer to introducing an effective system of monitoring the services provided in form of certification and control in order to prevent their abuse, initiating category of temporary diagnosis; paying more attention on individual's resources, better cooperation among specialists, teachers and families, developing and unifying diagnostic standards.
Collapse
Affiliation(s)
- Anna Lenart
- College of Social Sciences, Institute of Pedagogy, Department of Psychology, University of Rzeszow, ul. Ks. Jalowego 24, 35-010, Rzeszow, Poland
| | - Jacek Pasternak
- College of Social Sciences, Institute of Pedagogy, Department of Psychology, University of Rzeszow, ul. Ks. Jalowego 24, 35-010, Rzeszow, Poland.
| |
Collapse
|
8
|
Washington-Nortey PM, Serpell Z. Parental expectations for children with intellectual disability or autism in Ghana and Zambia: A concept mapping study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103989. [PMID: 34049230 DOI: 10.1016/j.ridd.2021.103989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 05/01/2021] [Accepted: 05/09/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Parent expectations have an important impact on children's outcomes. Despite a wealth of research on the familial experience of children with disabilities in African countries, very few studies have examined expectations these children's parents hold for them. AIMS This study explores parental expectations for children with intellectual disability, or autism and assesses their perceived importance and likelihood of attainment. METHODS AND PROCEDURES Concept mapping methodology with focus groups comprised of parents of children with intellectual disability or autism were employed. OUTCOMES AND RESULTS Results revealed several expectation themes: independence, acceptance and inclusion, public awareness, education, governmental assistance, resources, and healthcare. Whereas some expectations were congruent with themes in the broader literature, nuances within themes reflected cultural and societal conditions. Themes unique to each country also emerged, and importance and likelihood ratings revealed some cultural variation across the two countries. Expectations and the value placed on them differ across countries. IMPLICATIONS This study represents an important first step in efforts to understand the developmental contexts of children with disabilities on the African continent. Findings inform future research and potential strategies for policy and practice.
Collapse
|
9
|
Mitchell RA, Barton SM, Harvey AS, Ure AM, Williams K. Factors associated with autism spectrum disorder in children with tuberous sclerosis complex: a systematic review and meta-analysis. Dev Med Child Neurol 2021; 63:791-801. [PMID: 33432576 DOI: 10.1111/dmcn.14787] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 12/21/2022]
Abstract
AIM To investigate associations between clinical factors and the development of autism spectrum disorder (ASD) in children with tuberous sclerosis complex (TSC), specifically seizures, electroencephalogram abnormalities, tubers and other neurostructural abnormalities, and genetic factors. METHOD MEDLINE, Embase, PubMed, the Cochrane Library, and Web of Science were searched until January 2019. Studies that considered the predefined factors for development of ASD in children with TSC were included, following PRISMA-P guidelines. Two authors independently reviewed titles, abstracts, and full texts, extracted data, and assessed risk of bias. RESULTS Forty-two studies with 3542 children with TSC were included. ASD was associated with a history of seizures (odds ratio [OR] 3.79, 95% confidence interval [CI] 1.77-8.14), infantile spasms compared with other seizure types (OR 3.04, 95% CI 2.17-4.27), onset of any seizure type during infancy (OR 2.65, 95% CI 1.08-6.54), and male sex (OR 1.62, 95% CI 1.23-2.14). There was no association with tuber number, tuber location, or genotype. INTERPRETATION While a causal link between seizures and ASD in children with TSC cannot be inferred, a strong association between seizures and ASD in children with TSC, particularly with seizure onset during infancy and specifically infantile spasms, is present. Children with TSC and infant-onset seizures should be monitored for emerging features of ASD. What this paper adds Seizures and autism spectrum disorder (ASD) strongly associate in children with tuberous sclerosis complex (TSC). Infant-onset seizures and infantile spasms are particularly strongly associated with ASD in TSC.
Collapse
Affiliation(s)
- Rebecca A Mitchell
- Department of Neurodevelopment and Disability, The Royal Children's Hospital, Parkville, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Sarah M Barton
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Neurology, The Royal Children's Hospital, Parkville, VIC, Australia
| | - A Simon Harvey
- Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Neurology, The Royal Children's Hospital, Parkville, VIC, Australia
| | - Alexandra M Ure
- Department of Paediatrics, The University of Melbourne, Parkville, VIC, Australia.,Murdoch Children's Research Institute, Parkville, VIC, Australia.,Mental Health, The Royal Children's Hospital, Parkville, VIC, Australia.,Paediatrics and Education Research, Monash University, Clayton, VIC, Australia
| | - Katrina Williams
- Department of Neurodevelopment and Disability, The Royal Children's Hospital, Parkville, VIC, Australia.,Paediatrics and Education Research, Monash University, Clayton, VIC, Australia.,Monash Health, Monash Children's Hospital, Clayton, VIC, Australia
| |
Collapse
|
10
|
Avlund SH, Thomsen PH, Schendel D, Jørgensen M, Carlsen AH, Clausen L. Factors Associated with a Delayed Autism Spectrum Disorder Diagnosis in Children Previously Assessed on Suspicion of Autism. J Autism Dev Disord 2021; 51:3843-3856. [PMID: 33392868 DOI: 10.1007/s10803-020-04849-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2020] [Indexed: 12/30/2022]
Abstract
This study aimed to investigate factors associated with a delayed autism spectrum (ASD) diagnosis when compared to children with either no or early ASD diagnosis. Among 893 children assessed for ASD before age 8, 39% had no ASD at baseline, of which 21% received a later ASD diagnosis. Autism symptoms, diagnostic history of other developmental disorders, cognitive ability, and socioeconomic factors were associated with delayed ASD. Autism Diagnostic Observation Schedule (ADOS) scores in delayed ASD fell between early and no ASD. Other developmental disorders, time and clinical trends like ADOS use and low parental education distinguished delayed and early ASD, whereas higher frequency of IQ < 70 at baseline and a diagnosis of emotional disorders during follow-up distinguished delayed and no ASD.
Collapse
Affiliation(s)
- Sara Højslev Avlund
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Aarhus N, Denmark. .,Department of Clinical Medicine, Aarhus University, Incuba Skejby, Bldg 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark.
| | - Per Hove Thomsen
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Incuba Skejby, Bldg 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Diana Schendel
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Fuglsangs Allé 4, Bldg 2640/R, 8210, Aarhus V, Denmark.,Department of Public Health, Institute of Epidemiology and Social Medicine, Aarhus University, Bartholins Allé 2, Bldg 1260, 8000, Aarhus C, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglsangs Allé 4, Bldg 2640/R, 8210, Aarhus V, Denmark
| | - Meta Jørgensen
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Aarhus N, Denmark.,Special Area Autism, Central Denmark Region, Samsøvej 33, 8383, Hinnerup, Denmark
| | - Anders Helles Carlsen
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Incuba Skejby, Bldg 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Loa Clausen
- Research Unit, Department of Child- and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Palle Juul-Jensens Boulevard 175, Entrance K, 8200, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Incuba Skejby, Bldg 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark.,Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Fuglsangs Allé 4, Bldg 2640/R, 8210, Aarhus V, Denmark
| |
Collapse
|
11
|
De Giacomo A, Craig F, Palermo G, Coppola A, Margari M, Campanozzi S, Margari L, Turi M. Differential Diagnosis in Children with Autistic Symptoms and Subthreshold ADOS Total Score: An Observational Study. Neuropsychiatr Dis Treat 2021; 17:2163-2172. [PMID: 34262276 PMCID: PMC8274229 DOI: 10.2147/ndt.s300452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/23/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) share some symptoms with children with other neurodevelopmental disorders (ie, intellectual disability or communication disorders or language disorders). These similarities can make difficult to obtain an accurate diagnosis, which is essential to give targeted treatments to the patients. We aim to verify in our study if children with autistic traits who undergo to Autism Diagnostic Observation Schedule had specific clinical diagnosis. PATIENTS AND METHODS We selected 73 children tested with ADOS-G or ADOS-2, for the presence of autistic symptoms. The whole sample did not reach the cut-off of ADOS and did not receive the ASD diagnosis, according to DSM-5. RESULTS Results of this study showed that in order of frequency and early diagnosis, communication disorders (CD), mild intellectual disability (mID) and the attention deficit hyperactivity disorders (ADHD) represent the most common final clinical diagnosis in children with autistic traits. CONCLUSION Our results showed as the CD was the common diagnosis of these children and that often associated with younger age. Moreover, analyses of ADOS domains and the difference of individual items between groups did not show the capacity to differentiate between different neurodevelopmental disorders in terms of differential diagnosis, and this confirms the need for integrating multiple sources of information during the diagnostic process.
Collapse
Affiliation(s)
- Andrea De Giacomo
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Francesco Craig
- Department of Cultures, Education and Society, University of Calabria, Rende, Italy
| | | | - Annamaria Coppola
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Mariella Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Stella Campanozzi
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Lucia Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Marco Turi
- Fondazione Stella Maris Mediterraneo, Potenza, Italy
| |
Collapse
|
12
|
Shulman C, Rice CE, Morrier MJ, Esler A. The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:605-628. [PMID: 33126998 DOI: 10.1016/j.psc.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.
Collapse
Affiliation(s)
- Cory Shulman
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel.
| | - Catherine E Rice
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Michael J Morrier
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Amy Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota 2540 Riverside Ave S., RPB 550, Minneapolis, MN 55454, USA
| |
Collapse
|
13
|
Cha JY, Min SK, Yoon TH, Jee YS. Gross motor function and health fitness in adults with autistic spectrum disorder and intellectual disability: single-blind retrospective trial. J Exerc Rehabil 2020; 16:258-264. [PMID: 32724783 PMCID: PMC7365725 DOI: 10.12965/jer.2040270.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 11/29/2022] Open
Abstract
This study aimed at providing an exercise program for each type of disability after analyzing the exercise program performed by adults with intellectual disability (ID) or autistic spectrum disorder (ASD). Twenty-nine male adults voluntarily took part in this study, whose age ranged from 19 to 28 years and with an average body mass index of 23.98± 4.02 kg/m2. The sample was divided into two groups as follows: ASD group (ASDG; n=15) and ID group (IDG, n=14). The selected tests used to measure gross motor function (GMF, locomotion and object control skills) and health fitness (body composition, flexibility, strength, muscle endurance, and cardiopulmonary endurance) were also used in previous studies. The GMF and health fitness between ASDG and IDG showed no significant differences. This study indicates that exercise programs could provide similar effects, even with other disorder types having similar symptoms.
Collapse
Affiliation(s)
- Jun-Youl Cha
- Division of Martial Arts∙Guard, Howon University, Gunsan, Korea.,Research Institute of Sports and Industry Science (RISIS), Hanseo University, Seosan, Korea
| | - Su-Kyung Min
- Department of Physical Education, Chungbuk National University, Chungju, Korea.,Research Institute of Sports and Industry Science (RISIS), Hanseo University, Seosan, Korea
| | - Tae-Hyun Yoon
- Research Institute of Sports and Industry Science (RISIS), Hanseo University, Seosan, Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science (RISIS), Hanseo University, Seosan, Korea
| |
Collapse
|
14
|
Avlund SH, Thomsen PH, Schendel D, Jørgensen M, Clausen L. Time Trends in Diagnostics and Clinical Features of Young Children Referred on Suspicion of Autism: A Population-Based Clinical Cohort Study, 2000–2010. J Autism Dev Disord 2020; 51:444-458. [DOI: 10.1007/s10803-020-04555-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
15
|
A framework for an evidence-based gene list relevant to autism spectrum disorder. Nat Rev Genet 2020; 21:367-376. [PMID: 32317787 DOI: 10.1038/s41576-020-0231-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2020] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder (ASD) is often grouped with other brain-related phenotypes into a broader category of neurodevelopmental disorders (NDDs). In clinical practice, providers need to decide which genes to test in individuals with ASD phenotypes, which requires an understanding of the level of evidence for individual NDD genes that supports an association with ASD. Consensus is currently lacking about which NDD genes have sufficient evidence to support a relationship to ASD. Estimates of the number of genes relevant to ASD differ greatly among research groups and clinical sequencing panels, varying from a few to several hundred. This Roadmap discusses important considerations necessary to provide an evidence-based framework for the curation of NDD genes based on the level of information supporting a clinically relevant relationship between a given gene and ASD.
Collapse
|
16
|
The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan. Child Adolesc Psychiatr Clin N Am 2020; 29:275-299. [PMID: 32169263 DOI: 10.1016/j.chc.2020.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.
Collapse
|
17
|
Bondár RZ, di Fronso S, Bortoli L, Robazza C, Metsios GS, Bertollo M. The effects of physical activity or sport-based interventions on psychological factors in adults with intellectual disabilities: a systematic review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:69-92. [PMID: 31833138 DOI: 10.1111/jir.12699] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 10/10/2019] [Accepted: 10/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Inactivity is a major factor contributing to adverse health in people with intellectual disabilities (IDs). While it is generally agreed that physical activity (PA)/sport-based interventions promote cognitive and social development in the general population, little is known about their specific benefits in adults with ID. The aims of this systematic review were (a) to examine the effects of PA/sport-based interventions on intention, motivation and attitude regarding PA/sport participation in adults with ID and (b) to investigate the influence of these psychological factors on behavioural change (e.g. PA level) and quality of life. METHODS A systematic review has been conducted searching four electronic databases (i.e. SCOPUS, Web of Science, PubMed and Cochrane Library). Studies were included if written in English, peer reviewed, had primary research data, and measured intention, motivation, attitude, behavioural outcomes or quality of life. RESULTS Thirteen articles met our inclusion criteria of which 10 explored the effects of PA/sport as part of a multi-component intervention. Most investigated outcomes were exercise self-efficacy and quality of life. Five studies measured exercise self-efficacy, and four of them found significant changes. One study found a significant improvement in quality of life and another study in life satisfaction. We observed lack of sport-based interventions, few data about people with severe ID and limited psychological measures. CONCLUSIONS Personal and environmental factors are key components of behavioural change. Support of caregivers and individualised instructions may benefit exercise self-efficacy. There is lack of information about the effects of psychological factors on behavioural change and quality of life in adults with ID.
Collapse
Affiliation(s)
- R Z Bondár
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - S di Fronso
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - L Bortoli
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - C Robazza
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| | - G S Metsios
- Institute of Sport, Faculty of Education Health and Wellbeing, University of Wolverhampton, Walsall, UK
- Health Exercise and Activity Therapy (HEAT) Institution, Birmingham, UK
| | - M Bertollo
- BIND-Behavioral Imaging and Neural Dynamics Center, Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti-Pescara, Italy
| |
Collapse
|
18
|
Fernandes CS, Tomazelli J, Girianelli VR. Diagnóstico de autismo no século XXI: evolução dos domínios nas categorizações nosológicas. PSICOLOGIA USP 2020. [DOI: 10.1590/0103-6564e200027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Resumo Os critérios que subsidiaram o diagnóstico do autismo passaram por diversas mudanças ao longo dos anos, acompanhando os pressupostos conceituais hegemônicos no período. O objetivo deste estudo é analisar a evolução do diagnóstico do autismo no século XXI, a partir dos domínios e subdomínios em que se baseiam as categorizações nosológicas. Adicionalmente, são sinalizados instrumentos auxiliares utilizados e algumas tecnologias diagnósticas em desenvolvimento, além de modelos conceituais que tratam do perfil neuropsicológico. Trata-se de pesquisa documental, tendo como referência os manuais diagnósticos existentes no período. Os domínios de interação social, comunicação e padrão restrito e repetitivo de comportamento foram mantidos nos diferentes manuais diagnósticos abordados. Os subdomínios de interação social e comunicação foram reduzidos, enquanto o padrão restrito e repetitivo teve consolidação no DSM-5. Compreender a evolução dos critérios diagnósticos tende a promover o desenvolvimento da clínica, potencializando a antecipação do diagnóstico e as intervenções necessárias para um melhor prognóstico.
Collapse
Affiliation(s)
| | - Jeane Tomazelli
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Brasil
| | | |
Collapse
|
19
|
Richard AE, Hodges EK, Carlson MD. Differential Diagnosis of Autism Spectrum Disorder Versus Language Disorder in Children Ages 2 to 5 Years: Contributions of Parent-Reported Development and Behavior. Clin Pediatr (Phila) 2019; 58:1232-1238. [PMID: 31349758 DOI: 10.1177/0009922819865794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Early diagnosis of autism spectrum disorder (ASD) has focused on differentiating children with ASD from neurotypical children. However, many children presenting with concern for ASD are ultimately diagnosed with language disorder (LD). This study aimed to identify differences in parent-rated development and behavior among children ages 2 to 5 years presenting with concern for ASD who were diagnosed with either ASD or LD. Children with ASD were rated as more socially withdrawn and more delayed in social development and self-help skills than those with LD. Parent-rated developmental delays were positively correlated with scores on an autism screening measure and with social withdrawal and pervasive developmental problems among children with ASD. Among those with LD, parent-rated social and self-help development were positively correlated with social withdrawal and attention problems. Thus, parent ratings of social withdrawal and development of social and self-help skills may facilitate differential diagnosis of ASD and LD in children ages 2 to 5 years.
Collapse
|
20
|
Shea LL, Field R, Xie M, Marcus S, Newschaffer C, Mandell D. Transition-Age Medicaid Coverage for Adolescents With Autism and Adolescents With Intellectual Disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 124:174-185. [PMID: 30835524 PMCID: PMC10726726 DOI: 10.1352/1944-7558-124.2.174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Although the majority of adolescents with autism spectrum disorder (ASD) rely on healthcare coverage through Medicaid during their transition into adulthood, little is known about their continuing eligibility. This study used Medicaid Analytic Extract (MAX) data to examine Medicaid coverage in a national sample using a cohort of adolescents with ASD ( n = 4,179) and a like-aged cohort with intellectual disability (ID, n = 21,844) over 5 years using survival analysis and Cox regression models. More than 1 in 4 adolescents with ASD lost coverage and fewer than half subsequently regained it. They were more likely to disenroll than adolescents with ID. Similarities in overall patterns among the 2 groups suggest that the experience of adolescents with ASD was characteristic of more general aspects of behavioral health coverage and indicate the need for programmatic reforms.
Collapse
Affiliation(s)
- Lindsay L Shea
- Lindsay L. Shea and Robert Field, Drexel University; Ming Xie and Steven Marcus, University of Pennsylvania; Craig Newschaffer, Drexel University; and David Mandell, University of Pennsylvania
| | - Robert Field
- Lindsay L. Shea and Robert Field, Drexel University; Ming Xie and Steven Marcus, University of Pennsylvania; Craig Newschaffer, Drexel University; and David Mandell, University of Pennsylvania
| | - Ming Xie
- Lindsay L. Shea and Robert Field, Drexel University; Ming Xie and Steven Marcus, University of Pennsylvania; Craig Newschaffer, Drexel University; and David Mandell, University of Pennsylvania
| | - Steven Marcus
- Lindsay L. Shea and Robert Field, Drexel University; Ming Xie and Steven Marcus, University of Pennsylvania; Craig Newschaffer, Drexel University; and David Mandell, University of Pennsylvania
| | - Craig Newschaffer
- Lindsay L. Shea and Robert Field, Drexel University; Ming Xie and Steven Marcus, University of Pennsylvania; Craig Newschaffer, Drexel University; and David Mandell, University of Pennsylvania
| | - David Mandell
- Lindsay L. Shea and Robert Field, Drexel University; Ming Xie and Steven Marcus, University of Pennsylvania; Craig Newschaffer, Drexel University; and David Mandell, University of Pennsylvania
| |
Collapse
|
21
|
|