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Au AHC, Shum KKM, Cheng Y, Tse HMY, Wong RMF, Li J, Au TKF. Autism spectrum disorder screening in preschools. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:516-528. [PMID: 33153314 PMCID: PMC7874379 DOI: 10.1177/1362361320967529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
LAY ABSTRACT With professional training and regular opportunities to observe children interacting with their peers, preschool teachers are in a good position to notice children's autism spectrum disorder symptomatology. Yet even when a preschool teacher suspects that a child may have autism spectrum disorder, fear of false alarm may hold the teacher back from alerting the parents, let alone suggesting them to consider clinical assessment for the child. A valid and convenient screening tool can help preschool teachers make more informed and hence more confident judgment. We set out to develop a screening tool that capitalizes on peer interaction as a naturalistic "stress test" to identify children more likely than their peers to have autism spectrum disorder. A total of 304 3- to 4-year-olds were observed at school with an 84-item preliminary checklist; data-driven item reduction yielded a 13-item Classroom Observation Scale. The Classroom Observation Scale scores correlated significantly with Autism Diagnostic Observation Schedule-2 scores. To validate the scale, another 322 2- to 4-year-olds were screened using the Classroom Observation Scale. The screen-positive children and randomly selected typically developing peers were assessed for autism spectrum disorder 1.5 years later. The Classroom Observation Scale as used by teachers and researchers near preschool onset predicted autism spectrum disorder diagnoses 1.5 years later. This user-friendly 13-item Classroom Observation Scale enables teachers and healthcare workers with little or no clinical training to identify, with reliable and valid results, preschoolers more likely than their peers to have autism spectrum disorder.
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Carmassi C, Bertelloni CA, Salarpi G, Diadema E, Avella MT, Dell'Oste V, Dell'Osso L. Is There a Major Role for Undetected Autism Spectrum Disorder with Childhood Trauma in a Patient with a Diagnosis of Bipolar Disorder, Self-Injuring, and Multiple Comorbidities? Case Rep Psychiatry 2019; 2019:4703795. [PMID: 31249714 PMCID: PMC6556326 DOI: 10.1155/2019/4703795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/10/2019] [Accepted: 05/16/2019] [Indexed: 12/27/2022] Open
Abstract
This case report highlights the relevance of the consequences of trauma in a female patient with an undetected autism spectrum disorder (ASD) affected by bipolar disorder (BD) with multiple comorbidities. A 35-year-old woman with BD type II, binge eating disorder and panic disorder was admitted in the Inpatient Unit of the Psychiatric Clinic of the University of Pisa because of a recrudescence of depressive symptomatology, associated with increase of anxiety, noticeable ruminations, significant alteration in neurovegetative pattern, and serious suicide ideation. During the hospitalization, a diagnosis of ASD emerged besides a history of childhood trauma and affective dysregulation, marked impulsivity, feeling of emptiness, and self-harm behavior. The patient was assessed by the Autism-Spectrum Quotient (AQ), Ritvo Autism and Asperger Diagnostic Scale (RAADS-R), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), Trauma and Loss Spectrum (TALS-SR), and Ruminative Response Scale (RRS). Total scores of 38/50 in the AQ, 146/240 in the RAADS-R, 99/160 in the AdAS Spectrum emerged, compatible with ASD, 47/116 in the TALS-SR, and 64/88 in the RRS. We discuss the implications of the trauma she underwent during her childhood, in the sense that caused a complex posttraumatic disorder, a lifelong disease favored and boosted by the rumination tendency of high functioning ASD.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Gianluca Salarpi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisa Diadema
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Maria Teresa Avella
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Dunfield KA, Best LJ, Kelley EA, Kuhlmeier VA. Motivating Moral Behavior: Helping, Sharing, and Comforting in Young Children With Autism Spectrum Disorder. Front Psychol 2019; 10:25. [PMID: 30728793 PMCID: PMC6351476 DOI: 10.3389/fpsyg.2019.00025] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 01/07/2019] [Indexed: 11/13/2022] Open
Abstract
This exploratory study examined the role of social-cognitive development in the production of moral behavior. Specifically, we explored the propensity of children with Autism Spectrum Disorders (ASD) to engage in helping, sharing, and comforting acts, addressing two specific questions: (1) Compared to their typically developing (TD) peers, how do young children with ASD perform on three prosocial tasks that require the recognition of different kinds of need (instrumental, material, and emotional), and (2) are children with ASD adept at distinguishing situations in which an adult needs assistance from perceptually similar situations in which the need is absent? Children with ASD demonstrated low levels of helping and sharing but provided comfort at levels consistent with their TD peers. Children with ASD also tended to differentiate situations where a need was present from situations in which it was absent. Together, these results provided an initial demonstration that young children with ASD have the ability to take another's perspective and represent their internal need states. However, when the cost of engaging in prosocial behavior is high (e.g., helping and sharing), children with ASD may be less inclined to engage in the behavior, suggesting that both the capacity to recognize another's need and the motivation to act on behalf of another appear to play important roles in the production of prosocial behavior. Further, differential responding on the helping, sharing, and comforting tasks lend support to current proposals that the domain of moral behavior is comprised of a variety of distinct subtypes of prosocial behavior.
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Affiliation(s)
| | - Laura J. Best
- Department of Psychology, Queen’s University, Kingston, ON, Canada
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Hirota T, So R, Kim YS, Leventhal B, Epstein RA. A systematic review of screening tools in non-young children and adults for autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 80:1-12. [PMID: 29879612 DOI: 10.1016/j.ridd.2018.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 05/21/2018] [Accepted: 05/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures. AIMS To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings. METHODS AND PROCEDURES Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017. Studies examining the validity of ASD screening tools against the Autism Diagnostic Observation Schedule and/or the Autism Diagnostic Interview - Revised in non-young children (age 4 or above) and adults were included. Three authors independently reviewed each article for data extraction and quality assessment. OUTCOMES AND RESULTS 14 studies met the inclusion criteria, of which 11 studies were with children (4-18 years of age) and 3 studies included adults only (19 years of age and above). Included studies were conducted in a general population/low-risk sample (N = 3) and a clinically referred/high-risk sample (N = 11). In total 11 tools were included. CONCLUSIONS AND IMPLICATIONS Only three screening tools (the Autism-Spectrum Quotient, the Social Communication Questionnaire, and the Social Responsiveness Scale) were examined in more than 2 studies. These tools may assist in differentiating ASD from other neurodevelopmental and psychiatric disorders or typically developed children. In young adult populations, the paucity of the existing research in this group limits definitive conclusion and recommendations.
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Affiliation(s)
- Tomoya Hirota
- Child and Adolescent Psychiatry, Department of Psychiatry, Langley Porter Psychiatric Institute, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Ryuhei So
- Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikatahonmachi, Kita-ward, Okayama, Okayama, 700-0915, Japan; Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Young Shin Kim
- Child and Adolescent Psychiatry, Department of Psychiatry, Langley Porter Psychiatric Institute, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Bennett Leventhal
- Child and Adolescent Psychiatry, Department of Psychiatry, Langley Porter Psychiatric Institute, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Richard A Epstein
- Chapin Hall Center for Children at the University of Chicago, 1313 E 60th St., Chicago, IL, 60637, USA
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Pisula E, Porębowicz-Dörsmann A. Family functioning, parenting stress and quality of life in mothers and fathers of Polish children with high functioning autism or Asperger syndrome. PLoS One 2017; 12:e0186536. [PMID: 29036188 PMCID: PMC5643111 DOI: 10.1371/journal.pone.0186536] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 10/03/2017] [Indexed: 11/23/2022] Open
Abstract
The aim of the study was to investigate the perception of the family functioning in parents of children with autism spectrum disorders (ASD) with normal-range intelligence and the relationships between family functioning, parenting stress and quality of life. Dyads of parents of children with ASD without intellectual disability and parents of typically developing children (controls) completed a set of self-report questionnaires. Parents of children with ASD reported lower functioning of the family as a whole and their own functioning as family members; they exhibited higher levels of parenting stress and lower quality of life. Mothers of children with ASD experienced more stress in personal domain than fathers. Relationships between family functioning, parenting stress and quality of life have been established. There were also moderate to strong correlations in mother-father dyads between their assessments of family functioning, parenting stress and QoL in social relationships and environmental domains.
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Affiliation(s)
- Ewa Pisula
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Dalwai S, Ahmed S, Udani V, Mundkur N, Kamath SS, Nair MKC. Consensus statement of the Indian academy of pediatrics on evaluation and management of autism spectrum disorder. Indian Pediatr 2017; 54:385-393. [DOI: 10.1007/s13312-017-1112-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Autism Spectrum Disorders. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Harrop C, Gulsrud A, Shih W, Hovsepyan L, Kasari C. Characterizing caregiver responses to restricted and repetitive behaviors in toddlers with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 20:330-42. [PMID: 25948600 DOI: 10.1177/1362361315580443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Restricted and repetitive behaviors are a core feature of autism spectrum disorder. This descriptive study documented the presence of restricted and repetitive behaviors in 85 toddlers with autism spectrum disorder as they interacted with their caregiver in a play interaction. For each child restricted and repetitive behavior, a caregiver response/non-response was coded. Caregiver responses were rated as successful or unsuccessful. In all, 83 toddlers demonstrated at least one restricted and repetitive behavior in 10 min. The most common child restricted and repetitive behavior was repetitive object use with 72 children displaying at least one instance of this category of restricted and repetitive behavior. Overall, caregivers responded to fewer than half of their child's restricted and repetitive behaviors, and caregiver response varied by child restricted and repetitive behavior type. The most common response was redirection. Success varied by child restricted and repetitive behavior type and caregiver response--redirections were most successful for child verbal and motor restricted and repetitive behaviors, whereas physical or verbal responses were rated more successful for repetitive object use and visual restricted and repetitive behaviors. This study represents the first attempt to characterize how caregivers respond to restricted and repetitive behaviors. Toddlers with autism spectrum disorder are already demonstrating a variety of restricted and repetitive behaviors within the context of a free play sessions, and caregivers differentially and naturally respond to them.
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Affiliation(s)
- Clare Harrop
- The University of North Carolina at Chapel Hill, USA
| | | | - Wendy Shih
- University of California Los Angeles, USA
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Hoffmann W, Heinzel-Gutenbrunner M, Becker K, Kamp-Becker I. [Screening interview for early detection of high-functioning autism spectrum disorders]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2015; 43:207-18; quiz 218-9. [PMID: 26098008 DOI: 10.1024/1422-4917/a000354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Various different questionnaires are available for the screening of autism spectrum disorders (ASD). These screening instruments show high sensitivity and are able to identify a large number of individuals with ASD, but they lack the specificity to differentiate individuals with ASD from those children and adolescents with other complex neurobehavioural disorders (such as attention-deficit/hyperactivity disorder, emotional disorders, and others), especially for those without intellectual disabilities. METHOD The present study evaluates the data of 309 individuals (153 with high-functioning ASD, 156 with other psychiatric disorders, IQ > 70) to find out whether selected items of the ADI-R can be used for an economic and sensitive screening of high-functioning ASD. RESULTS The results show that 8 items of the ADI-R can be used to discriminate high-functioning ASD and other psychiatric disorders. A cutoff of 5 led to a sensitivity of 0.93 and a cutoff of 6 to a specificity of 0.74. CONCLUSION The combination of early onset, serious abnormalities in social contact with stereotyped or compulsive-ritualized behaviour or interests can be detected with few interview questions for screening of ASD. Nevertheless, a more detailed and specific assessment in an expert setting should follow the screening process.
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Affiliation(s)
- Wiebke Hoffmann
- 1 Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie der Phillips-Universität Marburg
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Tarazi FI, Sahli ZT, Pleskow J, Mousa SA. Asperger’s syndrome: diagnosis, comorbidity and therapy. Expert Rev Neurother 2015; 15:281-93. [DOI: 10.1586/14737175.2015.1009898] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Harrop C, McConachie H, Emsley R, Leadbitter K, Green J. Restricted and repetitive behaviors in autism spectrum disorders and typical development: cross-sectional and longitudinal comparisons. J Autism Dev Disord 2014; 44:1207-19. [PMID: 24234675 DOI: 10.1007/s10803-013-1986-5] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Restricted and repetitive behaviors (RRBs) are characteristic of autism spectrum disorders (ASD). However, compared to social and communicative impairments, less is known about their development, trajectory and etiology. This study explored RRBs in young children with ASD matched to typically developing (TD) children on non-verbal development. RRBs were coded from direct observation at three time points within 13 months of development. Children with ASD displayed higher frequency and greater diversity of RRBs at all time points, however RRBs were not unique to ASD and evident in the TD control group albeit at a reduced frequency. RRBs did not correlate with social and communicative impairments in the ASD group, suggesting dissociation between these domains.
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Hathorn C, Alateeqi N, Graham C, O'Hare A. Impact of adherence to best practice guidelines on the diagnostic and assessment services for autism spectrum disorder. J Autism Dev Disord 2014; 44:1859-66. [PMID: 24573334 DOI: 10.1007/s10803-014-2057-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Despite their range and complexity, adherence to Scottish Intercollegiate Guidelines Network guideline for the diagnosis and assessment of autism spectrum disorders (ASD) was shown to be high within child development and specialist diagnostic clinics serving a geographical cohort of children diagnosed under the age of 7 years. A retrospective analysis of comprehensive clinical notes demonstrated that the recommended discretionary use of structured history instruments was increased after medical training (p = 0.003). 56% (51/90) of children received the diagnosis of ASD at their initial specialist appointment. 51% underwent the recommended discretionary structured observational instrument. This further assessment was more likely to be required for older children in the reaudited group (p = 0.001). The implications for service capacity planning when delivering best practice recommendations are discussed.
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Muncie HL, Russo E, Mohr D. Autism Spectrum Disorders. Fam Med 2014. [DOI: 10.1007/978-1-4939-0779-3_37-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
It takes considerable time before Autism Spectrum Disorders are diagnosed. Validated diagnostic instruments are available, but not applicable to primary healthcare. By means of a case–control study we investigated whether there were differences in presented complaints and referral patterns between children with ASD (n = 49) and a control group of children without ASD (n = 81). Children with ASD were often presented as crybabies and often showed feeding problems. They visited the GP’s surgery more often with anxiety disorders, enuresis, and sleeping disorders. They were referred more often to physiotherapists and speech-therapists and had tympanostomy tubes and tonsillectomies more often. Depression in the parents of children with ASD was remarkably prevalent.
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Abstract
Asperger syndrome hinders adaptation to developmental challenges during childhood and adolescence, particularly with regard to interpersonal relationships. Individuals with Asperger syndrome display lack of empathy and limited ability to understand social and emotional exchanges with other people. Individuals with Asperger syndrome are significantly exposed to the risk of suicidal behavior, especially during adolescence. The authors describe cases of suicidal behavior in two adolescent boys with Asperger syndrome.
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Affiliation(s)
- Jana Kocourkova
- Department of Child Psychiatry, Charles University Second Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
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17
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Burns TG, King TZ, Spencer KS. Mullen Scales of Early Learning: The Utility in Assessing Children Diagnosed With Autism Spectrum Disorders, Cerebral Palsy, and Epilepsy. APPLIED NEUROPSYCHOLOGY-CHILD 2013; 2:33-42. [DOI: 10.1080/21622965.2012.682852] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mitchell CM, Croy C, Spicer P, Frankel K, Emde RN. Trajectories of cognitive development among American Indian young children. Dev Psychol 2011; 47:991-9. [PMID: 21744958 DOI: 10.1037/a0024011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Children who begin kindergarten with stronger skills learn faster than do those who enter with lower skills. Minority children tend to enter kindergarten already at a disadvantage, and the gap widens across time. However, little is known about cognitive development among American Indian young children. In this study, 110 American Indian infants from one Northern Plains reservation community were assessed four times between ages 6 months and 36 months, with the Mullen Scales of Early Learning. At 6 months of age, scores were near the national norms; a drop occurred between 6 months and 15 months. Scores then tended to level off below the norms through 36 months. In each domain, we observed a crucial decline over the 1st year of life and relatively little change in the 2nd and 3rd years of life, highlighting the importance of developing culturally syntonic interventions to facilitate cognitive development during the 1st year of life.
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Affiliation(s)
- Christina M Mitchell
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA.
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Ozonoff S, Young GS, Carter A, Messinger D, Yirmiya N, Zwaigenbaum L, Bryson S, Carver LJ, Constantino JN, Dobkins K, Hutman T, Iverson JM, Landa R, Rogers SJ, Sigman M, Stone WL. Recurrence risk for autism spectrum disorders: a Baby Siblings Research Consortium study. Pediatrics 2011; 128:e488-95. [PMID: 21844053 PMCID: PMC3164092 DOI: 10.1542/peds.2010-2825] [Citation(s) in RCA: 834] [Impact Index Per Article: 64.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE The recurrence risk of autism spectrum disorders (ASD) is estimated to be between 3% and 10%, but previous research was limited by small sample sizes and biases related to ascertainment, reporting, and stoppage factors. This study used prospective methods to obtain an updated estimate of sibling recurrence risk for ASD. METHODS A prospective longitudinal study of infants at risk for ASD was conducted by a multisite international network, the Baby Siblings Research Consortium. Infants (n = 664) with an older biological sibling with ASD were followed from early in life to 36 months, when they were classified as having or not having ASD. An ASD classification required surpassing the cutoff of the Autism Diagnostic Observation Schedule and receiving a clinical diagnosis from an expert clinician. RESULTS A total of 18.7% of the infants developed ASD. Infant gender and the presence of >1 older affected sibling were significant predictors of ASD outcome, and there was an almost threefold increase in risk for male subjects and an additional twofold increase in risk if there was >1 older affected sibling. The age of the infant at study enrollment, the gender and functioning level of the infant's older sibling, and other demographic factors did not predict ASD outcome. CONCLUSIONS The sibling recurrence rate of ASD is higher than suggested by previous estimates. The size of the current sample and prospective nature of data collection minimized many limitations of previous studies of sibling recurrence. Clinical implications, including genetic counseling, are discussed.
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Affiliation(s)
- Sally Ozonoff
- Department of Psychiatry, University of California-Davis, Sacramento, California 95817, USA.
| | - Gregory S. Young
- Department of Psychiatry, University of California–Davis, Sacramento, California
| | - Alice Carter
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts
| | | | - Nurit Yirmiya
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Susan Bryson
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Leslie J. Carver
- Department of Psychology, University of California–San Diego, San Diego, California
| | | | - Karen Dobkins
- Department of Psychology, University of California–San Diego, San Diego, California
| | | | - Jana M. Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca Landa
- Center for Autism and Related Disorders (CARD), Kennedy Krieger Institute, Baltimore, Maryland; and
| | - Sally J. Rogers
- Department of Psychiatry, University of California–Davis, Sacramento, California
| | - Marian Sigman
- Division of Child and Adolescent Psychiatry Neuropsychiatric Institute and Hospital, University of California–Los Angeles, Los Angeles, California
| | - Wendy L. Stone
- Department of Psychology, University of Washington, Seattle, Washington
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Sharma S, Woolfson LM, Hunter SC. Confusion and inconsistency in diagnosis of Asperger syndrome: a review of studies from 1981 to 2010. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2011; 16:465-86. [PMID: 21810909 DOI: 10.1177/1362361311411935] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This paper presents a review of past and current research on the diagnosis of Asperger syndrome (AS) in children. It is suggested that the widely used criteria for diagnosing AS in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV are insufficient and invalid for a reliable diagnosis of AS. In addition, when these diagnostic criteria are applied, there is the potential bias of receiving a diagnosis towards the high-functioning end of the autism spectrum. Through a critical review of 69 research studies carried out between 1981 and 2010, this paper shows that six possible criteria for diagnosing AS (specifically, the age at which signs and symptoms related to autism become apparent, language and social communication abilities, intellectual abilities, motor or movement skills, repetitive patterns of behaviour and the nature of social interaction) overlap with the criteria for diagnosing autism. However, there is a possibility that some finer differences exist in the nature of social interaction, motor skills and speech patterns between groups with a diagnosis of AS and autism. These findings are proposed to be of relevance for designing intervention studies aimed at the treatment of specific symptoms in people with an autism spectrum disorder.
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Affiliation(s)
- Shilpi Sharma
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.
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21
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Kamp-Becker I, Wulf C, Bachmann CJ, Ghahreman M, Heinzel-Gutenbrunner M, Gerber G, Remschmidt H, Becker K. Frühsymptome des Asperger-Syndroms im Kindesalter. KINDHEIT UND ENTWICKLUNG 2010. [DOI: 10.1026/0942-5403/a000021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Obwohl sich Eltern autistischer Kinder bereits in den ersten Lebensjahren Sorgen über die Entwicklung ihres Kindes machen, wird die Diagnose, insbesondere die des Asperger-Syndroms (AS), auch heute noch relativ spät gestellt. Vorhandene Studienergebnisse zu Frühsymptomen beziehen sich zumeist auf den frühkindlichen Autismus und zu ersten Symptomen bei AS liegen bisher nur wenige Studien vor. In der vorliegenden Untersuchung wird der Frage nachgegangen, welche spezifischen Frühsymptome beim AS auftreten, die eine frühe Diagnosestellung und differentialdiagnostische Unterscheidung zwischen AS und AHDS ermöglichen. Die Eltern von 117 Kindern im Alter von fünf bis 18 Jahren (74 mit Diagnose AS, 43 mit ADHS) wurden retrospektiv hinsichtlich früher Auffälligkeiten in der Entwicklung ihrer Kinder befragt. Es wurden zehn früh auftretende Symptome bei AS ermittelt, die eine gute Differenzierung zwischen den Diagnosen ermöglichen: Früh beginnende Kontakt- und Kommunikationsprobleme in Kombination mit im Entwicklungsverlauf zunehmenden stereotypen Verhaltensweisen stellen Symptome dar, die einer weiteren, differenzierten Diagnostik bedürfen.
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Affiliation(s)
- Inge Kamp-Becker
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
| | - Claudia Wulf
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
| | - Christian J. Bachmann
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
- Klinik für Psychiatrie, Psychosomatik & Psychotherapie des Kindes- und Jugendalters der Charité Berlin
| | - Mardjan Ghahreman
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie Fulda
| | | | - Gerti Gerber
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
| | - Helmut Remschmidt
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
| | - Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie der Phillips-Universität Marburg
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Assessment of Social Skills and Social Competence in Learners with Autism Spectrum Disorders. ABCT CLINICAL ASSESSMENT SERIES 2010. [DOI: 10.1007/978-1-4419-0609-0_13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Patterns of growth in adaptive social abilities among children with autism spectrum disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2009; 37:1019-34. [PMID: 19521762 DOI: 10.1007/s10802-009-9326-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adaptive social skills were assessed longitudinally at approximately ages 2, 3, 5, 9, and 13 years in a sample of 192 children with a clinical diagnosis of autism (n = 93), PDD-NOS (n = 51), or nonspectrum developmental disabilities (n = 46) at age 2. Growth curve analyses with SAS proc mixed were used to analyze social trajectories over time. Both individual characteristics and environmental resources emerged as key predictors of adaptive social behavior outcome. The gap between children with autism and the other two diagnostic groups widened with time as the social skills of the latter groups improved at a higher rate. However, within diagnostic groups, improvement ranged from minimal to very dramatic. Children with autism most at risk for problems with social adaptive abilities later in life can be identified with considerable accuracy at a very young age so they can be targeted for appropriate early intervention services.
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Autism spectrum disorders in infancy and toddlerhood: a review of the evidence on early signs, early identification tools, and early diagnosis. J Dev Behav Pediatr 2009; 30:447-59. [PMID: 19823139 DOI: 10.1097/dbp.0b013e3181ba0f9f] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To date, the biological basis of autism spectrum disorders (ASDs) remains unknown. Thus, identification and diagnosis are reliant on behavioral presentation and developmental history. There have been significant advances in our knowledge of the early signs of ASD through the use of retrospective videotape analysis, parental report, screening studies, and more recently, studies on high-risk infant siblings. Despite behavioral markers being identified within the first year of life, the current average age of diagnosis for ASD remains at approximately 3 years or older. Consequently, these children are not receiving intervention in their early years, which is increasingly recognized as an important time to begin intervention. There remains little research on the prospective identification of these children in a community-based sample before 18 months. It is recommended that future prospective studies monitor behavior repeatedly over time, thereby increasing the opportunity to identify early manifestations of ASD and facilitating the charting of subtle behavioral changes that occur in the development of infants and toddlers with ASD.
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Reilly C, Campbell A, Keran P. Screening for Asperger syndrome in school‐age children: issues and instruments. EDUCATIONAL PSYCHOLOGY IN PRACTICE 2009. [DOI: 10.1080/02667360802697589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Colin Reilly
- a St Michael’s House Services , Ballymun Road, Dublin 9, Ireland
- b School of Education , University College Dublin , Belfield, Dublin 4, Ireland
| | - Audrey Campbell
- c St Catherine’s Association , Newcastle, Co Wicklow, Ireland
| | - Patricia Keran
- d Applied Behaviour Analysis Centre for Autism Schooling (ABACUS) , Kilnamanagh, Tallaght, Dublin 22, Ireland
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Epstein T, Saltzman-Benaiah J, O'Hare A, Goll JC, Tuck S. Associated features of Asperger Syndrome and their relationship to parenting stress. Child Care Health Dev 2008; 34:503-11. [PMID: 19154552 DOI: 10.1111/j.1365-2214.2008.00834.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies have shown an increased level of stress in parents of autistic children relative to parents of non-autistic children. Few studies have examined parenting stress specifically within the Asperger Syndrome (AS) population. Children with AS often have associated difficulties such as sensory sensitivities and problems with executive functioning (i.e. planning, inhibiting, shifting set). This study was designed to study parenting stress as well as to consider the relationship between parenting stress and some of the associated difficulties of AS. More specifically, the aims of this study were to demonstrate the following: that, as a group, parents of children with AS would report elevated levels of parenting stress, a finding which may be more significant for mothers than fathers; that children with AS show impairment in executive functioning as well as heightened sensory sensitivity according to parent report; that parent report of their child's demanding characteristics would be positively associated with their self-reported levels of parenting stress. METHODS Participants in this study were the parents of 39 children between the ages of 5 and 12 years, reflecting a 71% response rate, in the Lothian region of Scotland who completed The Parenting Stress Index, the Behavioural Rating Inventory of Executive Function and the Short Sensory Profile. RESULTS The study revealed that both mothers and fathers of AS children reported elevated levels of parenting stress. There was a significant positive correlation between mother's parenting stress and the child's level of impairment, both with respect to executive dysfunction as well as sensory difficulties. CONCLUSION The challenges of parenting a child with AS should not be underestimated. Further study is needed to explore the causative role that child impairments play in parenting stress and what types of interventions may prove most helpful to these families.
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Affiliation(s)
- T Epstein
- Tourette Syndrome Neurodevelopmental Clinic, Toronto Western Hospital, Toronto, ON, Canada
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Reaven JA, Hepburn SL, Ross RG. Use of the ADOS and ADI-R in children with psychosis: importance of clinical judgment. Clin Child Psychol Psychiatry 2008; 13:81-94. [PMID: 18411867 PMCID: PMC4426195 DOI: 10.1177/1359104507086343] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview - Revised (ADI-R) are considered to be the 'gold standard' in diagnostic evaluations for autism. Developed as research tools and now gaining wide clinical use, the ADOS/ADI-R assessment package has been demonstrated to differentiate children with autism from those with other developmental disabilities; however, little work concerning the reliability and validity of the tools in children with a known history of psychosis has been undertaken. We report on the administration of the ADOS, ADI-R and clinical judgment in three cases of Childhood-Onset Schizophrenia. All 3 children met both ADOS and ADI-R criteria for an autism spectrum diagnosis, even though none of them received a clinical diagnosis of autism from either a research child psychiatrist or an experienced clinically trained, research psychologist with expertise in autism. Issues concerning overlap of symptom presentation and implications for research and clinical use of these assessment tools are discussed.
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Affiliation(s)
- Judith A Reaven
- Department of Psychiatry, University of Colorado at Denver and Health Sciences Center, Aurora 80045, USA.
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28
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Wilczynski SM, Menousek K, Hunter M, Mudgal D. Individualized education programs for youth with Autism Spectrum Disorders. PSYCHOLOGY IN THE SCHOOLS 2007. [DOI: 10.1002/pits.20255] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Le Couteur A, Haden G, Hammal D, McConachie H. Diagnosing autism spectrum disorders in pre-school children using two standardised assessment instruments: the ADI-R and the ADOS. J Autism Dev Disord 2007; 38:362-72. [PMID: 17605097 DOI: 10.1007/s10803-007-0403-3] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 05/24/2007] [Indexed: 02/04/2023]
Abstract
The reliable diagnosis of Autism/Autism Spectrum Disorder in pre-school children is important for access to early intervention and for accurate ascertainment for research. This paper explores the combined use of two standardised assessment instruments--the Autism Diagnostic Interview Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS)--in a large sample of pre-school children. The children were recruited to research studies, and a 'best estimate' clinical diagnosis reached. The findings show good agreement between the instruments especially for children with core Autism. The instruments appear to have a complementary effect in aiding diagnosis and confirm the importance of a multidisciplinary assessment process with access to information from different sources and settings. The presence of repetitive behaviours during the ADOS appeared of diagnostic significance.
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Affiliation(s)
- Ann Le Couteur
- School of Clinical Medical Sciences, Child Health, University of Newcastle, Sir James Spence Institute, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NE1 4LP, UK.
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Overton T, Fielding C, Garcia de Alba R. Differential diagnosis of Hispanic children referred for autism spectrum disorders: complex issues. J Autism Dev Disord 2007; 37:1996-2007. [PMID: 17273933 DOI: 10.1007/s10803-006-0349-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Accepted: 12/11/2006] [Indexed: 10/23/2022]
Abstract
This study examines the decision-making process used for differential diagnosis of a sample of Hispanic children referred for autism spectrum disorders (ASDs). Of the sample of 28 children, 18 were diagnosed with ASDs. Of the 10 children who were not diagnosed with ASDs, 80% were found to have multiple diagnostic labels or comorbidities. Mann-Whitney U analyses determined the differences between the children with the most severe social impairment, children with less severe social impairment and the non-autistic children on several domains commonly used to assess ASDs. These analyses indicated significant differences in some characteristics of the children in the sample. Based on these results, a decision-tree for the diagnosis of children with and without ASDs with comorbid disorders was developed.
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Affiliation(s)
- Terry Overton
- Educational Psychology Department, University of Texas-Pan American, Edinburg, TX 78541, USA.
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Toth K, Dawson G, Meltzoff AN, Greenson J, Fein D. Early social, imitation, play, and language abilities of young non-autistic siblings of children with autism. J Autism Dev Disord 2007; 37:145-57. [PMID: 17216560 PMCID: PMC2259442 DOI: 10.1007/s10803-006-0336-2] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2006] [Accepted: 11/14/2006] [Indexed: 10/23/2022]
Abstract
Studies are needed to better understand the broad autism phenotype in young siblings of children with autism. Cognitive, adaptive, social, imitation, play, and language abilities were examined in 42 non-autistic siblings and 20 toddlers with no family history of autism, ages 18-27 months. Siblings, as a group, were below average in expressive language and composite IQ, had lower mean receptive language, adaptive behavior, and social communication skills, and used fewer words, distal gestures, and responsive social smiles than comparison children. Additionally, parents reported social impairments in siblings by 13 months of age. These results suggest that the development of young non-autistic siblings is affected at an early age and, thus, should be closely monitored, with appropriate interventions implemented as needed.
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Affiliation(s)
- Karen Toth
- UW Autism Center and Center on Human Development and Disability, University of Washington, Seattle, USA
- Department of Psychology, University of Washington, Post Box 357920, Seattle, WA 98195, USA, e-mail:
| | - Geraldine Dawson
- UW Autism Center and Center on Human Development and Disability, University of Washington, Seattle, USA
- Department of Psychology, University of Washington, Post Box 357920, Seattle, WA 98195, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA
| | - Andrew N. Meltzoff
- UW Autism Center and Center on Human Development and Disability, University of Washington, Seattle, USA
- Department of Psychology, University of Washington, Post Box 357920, Seattle, WA 98195, USA
| | - Jessica Greenson
- UW Autism Center and Center on Human Development and Disability, University of Washington, Seattle, USA
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs-Mansfield, CT, USA
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Abstract
This paper describes approaches to care and associated service use by families with a child with autism. A combined telephone and self-administered survey was completed by 301 families with a child, 8 years old or younger, in North Carolina, during the winter of 2003-2004. Findings indicate that 66% of families used one or more approach to care and there was a significant (p < 0.05) association between approach and the pattern of service use. There appears to be a distinctive set of services associated with each approach to care, but with overlap between them. Speech/language therapy at school was the most frequently used service and also identified as the best service. The majority (81%) of families reported they were satisfied with services.
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Affiliation(s)
- Kathleen C Thomas
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB #7590, Chapel Hill, NC 27599-7590, USA.
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