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Furnier SM, Ellis Weismer S, Rubenstein E, Gangnon R, Rosenberg S, Nadler C, Wiggins LD, Durkin MS. Using adaptive behavior scores to convey level of functioning in children with autism spectrum disorder: Evidence from the Study to Explore Early Development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1135-1149. [PMID: 37609907 PMCID: PMC10884350 DOI: 10.1177/13623613231193194] [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: 08/24/2023]
Abstract
LAY ABSTRACT Autistic people are often described as "low-" or "high-functioning" based on their scores on cognitive tests. These terms are common in publications and in everyday communication. However, recent research and feedback from the autistic community suggests that relying on cognitive ability alone to describe functioning may miss meaningful differences in the abilities of autistic children and adults and in the kinds of support they may need. Additional methods are needed to describe "functioning" in autistic children. We examined whether scores from a test measuring adaptive behaviors would provide information on the functional abilities of children with autism that is different from cognitive ability and autism symptom severity. Adaptive behaviors include age-appropriate skills that allow people to function in their everyday lives and social interactions. We found that a large amount of the variation in adaptive behavior scores was not explained by cognitive development, autism symptom severity, and behavioral and emotional problems. In addition, there was a wide range of adaptive ability levels in children with autism in our study, including in those with low, average, or high cognitive scores. Our results suggest that adaptive behavior scores could provide useful information about the strengths and support needs of autistic children above and beyond measures of cognitive ability and autism symptom severity. Adaptive behavior scores provide important information on the needs of autistic people.
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Miniarikova E, Audras-Torrent L, Berard M, Peries M, Picot MC, Munir K, Baghdadli A. Adaptive behaviors and related factors in children and adolescents with autism spectrum disorder: Report from ELENA cohort. J Psychiatr Res 2023; 163:43-54. [PMID: 37201237 DOI: 10.1016/j.jpsychires.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/02/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
There are strong individual differences in adaptive behaviors (AB) in autism spectrum disorder (ASD) with conflicting results in literature about specific patterns and related factors. The present study aims to describe AB and identify related factors in terms of clinical and socio-familial characteristics in 875 children and adolescents with ASD in the multiregional ELENA cohort in France. Results showed that AB in children and adolescents with ASD were lower than in typically developing subjects, regardless of age group. AB were associated with clinical (gender, age at diagnosis, IQ, ASD severity, psychiatric comorbidities, motor and language skills, challenging behaviors), interventional (school attendance, special interventions) and familial characteristics (age, educational and socio-economic status of parents, household status, number of siblings). There is a need of interventions focusing on improvement of AB, tailored to children's characteristics.
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Affiliation(s)
- Ela Miniarikova
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France.
| | - Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France.
| | - Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | - Marie-Christine Picot
- Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, France.
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Faculté de Médecine, Université de Montpellier, France.
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3
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Munsell EGS, Orsmond GI, Fulford D, Coster WJ. Self-management of daily life tasks in diploma-track youth with disabilities. Disabil Rehabil 2022; 44:8011-8021. [PMID: 34877919 DOI: 10.1080/09638288.2021.2008524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Youth with disabilities who graduate with a regular high school diploma often continue to have difficulties in their daily functioning that ultimately impact adulthood outcomes. To better understand these functional difficulties and determine how best to address them, it is important to distinguish deficits in discrete skills from difficulty organizing skills to self-manage complex tasks associated with adult roles. The purpose of this study was to explore the extent to which challenges in social, executive function and behavior management factors relate to these two aspects of daily functioning. METHODS This is a secondary analysis of the National Longitudinal Transition Study 2 funded by the United States Department of Education. The direct and indirect associations between youth underlying factors and self-management of daily life tasks (SMDLT) versus discrete functional skills were modelled using structural equation modelling. RESULTS A model incorporating social skills, communication, and behavior regulation explained 55% of the variance in SMDLT. In contrast, the model predicting discrete functional skills had fewer significant associations and described less variance (37%) in the outcome. CONCLUSIONS Findings suggest that using measures of SMDLT and designing targeted interventions for SMDLT might help improve participation in independent living and productivity for diploma-track youth with disabilities.Implications for rehabilitationSuccessful transition from high school to adult roles requires the ability to self-manage the daily life tasks required for those roles, such as employment, post-secondary education, and independent living.The ability to self-manage daily tasks is distinct from mastery of discrete functional skills and should be assessed with measures that uniquely examine this domain.Social and communication skills, executive functioning, and behavioral regulation, are important contributors to the ability to self-manage life tasks for diploma-track youth with disabilities and should be incorporated into multifaceted interventions.Interventions to improve self-management of tasks should include teaching strategies and practice coordinating underlying skills in flexible ways that meet the varying demands of tasks and diverse environments.
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Affiliation(s)
- Elizabeth G S Munsell
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Gael I Orsmond
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Daniel Fulford
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA.,Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Wendy J Coster
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
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Stevens MA, Selders KJ, Jeckel O, Brownfield V, Nowell KP. An Evaluation of Parent and Teacher Discrepancies on an Adaptive Behavior Measure for Youth with Autism Spectrum Disorder, Intellectual Disability, and Global Developmental Delay. J Autism Dev Disord 2022:10.1007/s10803-022-05550-x. [PMID: 35445930 DOI: 10.1007/s10803-022-05550-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
Comprehensive evaluations include data from multiple informants, but discrepancies occur on adaptive skill measures of youth with autism spectrum disorder (ASD) and intellectual disabilities (ID). This study investigated discrepancies between parent-teacher ratings on a measure of adaptive behavior [Adaptive Behavior Assessment System, Third Edition (ABAS-3)] in a clinical sample of 115 youth. Agreement between informants was determined and then discrepancies were identified using paired-sample t-tests for the whole sample and subsamples. Factors associated with parent-teacher discrepancies were investigated including age, diagnoses, IQ, autism symptomology, and parent education. Parent-teacher scores were moderately correlated for the ABAS-3 composite and domains. Teachers rated youth with ASD and ID as having higher adaptive skills. Autism symptomology significantly predicted discrepancies between informants on the ABAS-3.
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Affiliation(s)
- Mallory A Stevens
- Department of Educational, School, and Counseling Psychology, University of Missouri, 16 Hill Hall, Columbia, MO, 65211, USA.
| | - Kimberly J Selders
- Department of Special Education, University of Missouri, Columbia, MO, USA
| | - Olivia Jeckel
- Department of Psychological Services, University of Missouri, Columbia, MO, USA
| | | | - Kerri P Nowell
- Department of Health Psychology, Thompson Center for Autism and Neurodevelopmental Disorder, University of Missouri, Columbia, MO, USA
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5
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Pre- and Postnatal Fine Particulate Matter Exposure and Childhood Cognitive and Adaptive Function. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073748. [PMID: 35409432 PMCID: PMC8997879 DOI: 10.3390/ijerph19073748] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023]
Abstract
Increasing evidence exists for an association between early life fine particulate matter (PM2.5) exposure and several neurodevelopmental outcomes, including autism spectrum disorder (ASD); however, the association between PM2.5 and adaptive and cognitive function remains poorly understood. Participants included 658 children with ASD, 771 with a non-ASD developmental disorder, and 849 population controls from the Study to Explore Early Development. Adaptive functioning was assessed in ASD cases using the Vineland Adaptive Behavior Scales (VABS); cognitive functioning was assessed in all groups using the Mullen Scales of Early Learning (MSEL). A satellite-based model was used to assign PM2.5 exposure averages during pregnancy, each trimester, and the first year of life. Linear regression was used to estimate beta coefficients and 95% confidence intervals, adjusting for maternal age, education, prenatal tobacco use, race-ethnicity, study site, and season of birth. PM2.5 exposure was associated with poorer VABS scores for several domains, including daily living skills and socialization. Associations were present between prenatal PM2.5 and lower MSEL scores for all groups combined; results were most prominent for population controls in stratified analyses. These data suggest that early life PM2.5 exposure is associated with specific aspects of cognitive and adaptive functioning in children with and without ASD.
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6
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Abdel Malek S, Mesterman R, Switzer L, DiRezze B, deVeber G, Fehlings D, Lunsky Y, Phoenix M, Gorter JW. Exploring demographic, medical, and developmental determinants of adaptive behaviour in children with hemiplegic cerebral palsy. Eur J Paediatr Neurol 2022; 36:19-25. [PMID: 34823070 DOI: 10.1016/j.ejpn.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022]
Abstract
Hemiplegic cerebral palsy (CP), the most common subtype, is characterized by high levels of mobility. Despite this, children with hemiplegic CP can face challenges functioning in and adapting to situations of everyday life. The purpose of this cross-sectional study (Hemi-NET database) was to identify factors associated with adaptive behaviour in 59 children with hemiplegic CP (ages 4-18; GMFCS I-IV). Using multivariate regression analyses, the relationship between demographic, medical, and developmental factors and adaptive behaviour (measured by the Adaptive Skills Composite score of the BASC-2) was explored. Results indicate that 34% of children had impaired adaptive skills. An autism diagnosis and lower communication functioning were significantly associated with poorer adaptive skills (R2 = 0.42, F(4, 43) = 7.87, p < 0.001), while factors such as IQ scores and GMFCS level were not. The results contribute to the growing literature that suggests that clinicians and researchers need to look beyond motor functioning when working with individuals with CP.
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Affiliation(s)
- Sandra Abdel Malek
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada.
| | - Ronit Mesterman
- Department of Paediatrics, McMaster University, 1280 Main Street West, Health Sciences Centre, 3A, Hamilton, Ontario, L8S 4K1, Canada
| | - Lauren Switzer
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
| | - Briano DiRezze
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Gabrielle deVeber
- Division of Neurology, Hospital for Sick Children, 555 University Avenue, Neurology Clinic, 6C Atrium, Toronto, Ontario, M5G 1X8, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada; Department of Pediatrics, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, Ontario, M5G 1X8, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Yona Lunsky
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario, M5T 1R8, Canada; Azrieli Centre for Adult Neurodevelopmental Disabilities, CAMH, McCain Complex Care & Recovery Building, 1025 Queen Street West, Toronto, Ontario, M6K 1H4, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
| | - Jan Willem Gorter
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada; Department of Paediatrics, McMaster University, 1280 Main Street West, Health Sciences Centre, 3A, Hamilton, Ontario, L8S 4K1, Canada
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A Preliminary Examination of the Impact of Working Memory Training on Syntax and Processing Speed in Children with ASD. J Autism Dev Disord 2021; 52:4233-4251. [PMID: 34724165 PMCID: PMC8559141 DOI: 10.1007/s10803-021-05295-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/27/2022]
Abstract
In addition to deficits in pragmatics, children with autism spectrum disorders (ASD) have weaknesses in complex syntax and working memory (WM). These two deficits may be closely related. Previous work investigated the effects of WM training in developmental language disorders and showed significant improvement in both WM and syntax. The current study tests the impact of 12 h of WM training across 8 weeks in 30 children with ASD, aged 5 to 11. Results showed direct improvements on untrained WM tasks, as well as transfer effects to syntax and processing speed. Stronger WM led to better syntactic abilities. While they must be replicated, these exciting results provide impetus for further studies of WM interventions.
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Munsell EGS, Orsmond GI, Fulford D, Coster WJ. Metacognition Mediates the Effect of Social Communication and Internalizing Behaviors on Self-management of Daily Life Tasks for Diploma-Track Autistic Youth. J Autism Dev Disord 2021; 52:4274-4285. [PMID: 34611837 DOI: 10.1007/s10803-021-05306-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 11/28/2022]
Abstract
Social communication and executive functioning challenges as well as co-occurring anxiety/depression may make acquiring the skills needed to manage daily life tasks difficult for diploma-track autistic youth, thus limiting their participation in adult roles. This study describes the associations between executive function, social communication skills, and internalizing behaviors on task management in academically capable autistic adolescents (n = 46) using multiple regression with mediator analysis. The three predictors and youth age explained a moderate amount of variance in task management. Metacognition mediated the effect of social communication skills and internalizing behaviors on task management. Relations between underlying factors that influence self-management of daily life tasks are complex, supporting the need for multifaceted assessment and intervention approaches for academically capable autistic youth.
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Affiliation(s)
- Elizabeth G S Munsell
- Occupational Therapy Department, College of Health & Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA.
| | - Gael I Orsmond
- Occupational Therapy Department, College of Health & Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Daniel Fulford
- Occupational Therapy Department, College of Health & Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA.,Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Wendy J Coster
- Occupational Therapy Department, College of Health & Rehabilitation Sciences: Sargent College, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA
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Chen M, Nah YH, Waschl N, Poon K, Chen P. Developing and Piloting a Computerized Adaptive Test for a Culturally Appropriate Measure of Adaptive Behavior. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2021. [DOI: 10.1177/07342829211047005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Culturally bounded in nature, adaptive behavior is the degree to which a person meets the requirements of personal independence and social responsibilities. This study aimed to develop a computerized adaptive test (CAT) of a culturally appropriate adaptive behavior measure (i.e., the Activities and Participation Rating Scale [APRS]) in the Singapore context for children aged 7 to 12 years, that is, the CAT-APRS-Primary. In Study 1, an item bank consisting of 310 adaptive skills was developed and piloted among 56 caregivers. In Study 2, the refined 310 items were calibrated using Rasch analysis among 352 caregivers. After the removal of five poor items based on the Rasch analysis, the finalized 305 items were used for the CAT development, with these items showing good Rasch person and item fit statistics. Preliminary utility of the CAT-APRS-Primary was established, with participants completing 24 items on average. Limitations and implications for future research were discussed.
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Affiliation(s)
- Mo Chen
- National Institute of Education, Nanyang Technological University, Singapore
| | - Yong-Hwee Nah
- National Institute of Education, Nanyang Technological University, Singapore
| | - Nicolette Waschl
- National Institute of Education, Nanyang Technological University, Singapore
| | - Kenneth Poon
- National Institute of Education, Nanyang Technological University, Singapore
| | - Ping Chen
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing, China
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10
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Åsberg Johnels J, Yngvesson P, Billstedt E, Gillberg C, Halldner L, Råstam M, Gustafsson P, Selinus EN, Lichtenstein P, Hellner C, Anckarsäter H, Lundström S. The relationship between intelligence and global adaptive functioning in young people with or without neurodevelopmental disorders. Psychiatry Res 2021; 303:114076. [PMID: 34247062 DOI: 10.1016/j.psychres.2021.114076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 11/18/2022]
Abstract
Previous studies have shown an association between IQ and adaptive global functioning, i.e. how well a person is functioning in different domains of life. However, it is unclear to what extent such an association applies in children with neurodevelopmental disorders (NDDs). The study group consisted of 550 population-screened children assessed with the K-SADS, WISC-IV, and the C-GAS. Approximately half of the sample had been diagnosed with one or several NDDs (ADHD, autism, language disorder and tic disorder). A factorial ANOVA with IQ level and the presence of NDD was conducted, with C-GAS score as the dependent variable. Results revealed a significant interaction effect between IQ-group and NDD-status. In the non-NDD group (49% girls), higher IQ scores were clearly linked with better global adaptive functioning. Among children with NDDs (35% girls), however, higher IQ scores were not clearly associated with better functioning. Thus, the association between IQ and adaptive functioning were found to differ depending on the presence of NDD. These results have implications for the interpretation of IQ test results in neurodevelopmental assessments and point towards the importance of providing support based on an assessment of needs and functioning rather than scores from IQ tests.
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Affiliation(s)
| | - Paul Yngvesson
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | | | - Linda Halldner
- Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Råstam
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Eva Norén Selinus
- Centre for Clinical Research, County of Västmanland, Uppsala University, Västerås, Sweden; Centre for Psychiatry Research, Stockholm, Sweden; The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Clara Hellner
- Centre for Ethics Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Anckarsäter
- Centre for Ethics Law and Mental Health, University of Gothenburg, Gothenburg, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden; Centre for Ethics Law and Mental Health, University of Gothenburg, Gothenburg, Sweden.
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Ghanouni P, Seaker L. Healthcare Services During the Transitions to Adulthood Among Individuals with ASD Aged 15-25 Years Old: Stakeholders' Perspectives. J Autism Dev Disord 2021; 52:2575-2588. [PMID: 34216328 DOI: 10.1007/s10803-021-05159-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 10/20/2022]
Abstract
Although previous research has shown that the transition to adulthood may be challenging, there exists a lack of research regarding perspectives of stakeholders on the transition of individuals with Autism Spectrum Disorder (ASD). This study aimed to investigate stakeholders' experiences regarding healthcare services for youth with ASD during their transition. We involved 20 stakeholders, including 17 parents of youth with ASD as well as 3 services providers. The study yielded three major themes including: (a) accessibility and quality of care; (b) tensions and conflicts; and (c) navigation and integrated care. The findings can be used to direct change within the healthcare services towards better practices for youth with ASD and increasing the likelihood of positive health outcomes.
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Affiliation(s)
- Parisa Ghanouni
- Department of Occupational Therapy, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Liam Seaker
- Department of Occupational Therapy, Dalhousie University, PO Box 15000, Halifax, NS, B3H 4R2, Canada
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Dempsey J, Ahmed K, Simon AR, Hayutin LG, Monteiro S, Dempsey AG. Adaptive Behavior Profiles of Intellectually Gifted Children with Autism Spectrum Disorder. J Dev Behav Pediatr 2021; 42:374-379. [PMID: 34110306 DOI: 10.1097/dbp.0000000000000907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 11/17/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study is to identify whether the well-described pattern of declining adaptive functioning across age among children with autism spectrum disorder (ASD) also exists among intellectually gifted children with ASD because their cognitive abilities might serve as a protective factor. METHODS Data from the Simons Simplex Collection were used to identify 51 participants with full-scale intelligence (IQ) scores of 130 or above with this group labeled as the intellectually gifted range (IGR). Two comparison samples of children with IQs in the intellectual disability range (IDR; < 70 Standard Score [SS]) and average range (AR; 85-115 SS) were created based on matching of age (±2 years), maternal education level, and sex. RESULTS Multivariate analysis of variance indicated a main overall effect for the IQ group on a measure of adaptive skills (Λ = 0.61, F(6, 296), p < 0.001). Post hoc comparisons revealed that the IDR group scored lower on all subscales than the AR and IGR groups, but the scores between the latter groups did not differ from one another in socialization and daily living skills (DLS) domains. Age was negatively correlated with adaptive communication scores in all groups but only associated with socialization and DLS domain scores in the IGR group (r = -0.51 and -0.48, respectively). CONCLUSION The findings suggest that intellectual giftedness does not serve as a protective factor against age-related declines in adaptive functioning among individuals with ASD.
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Affiliation(s)
- Jack Dempsey
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | | | - Andrea R Simon
- Department of Health Care Administration, Trinity University, San Antonio, TX
| | - Lisa G Hayutin
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Sonia Monteiro
- Department of Pediatrics, Section of Developmental Pediatrics, Baylor College of Medicine Houston, TX
| | - Allison G Dempsey
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO
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13
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Correlates of Feeding Difficulties Among Children with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2021; 52:255-274. [PMID: 33666799 DOI: 10.1007/s10803-021-04947-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 12/27/2022]
Abstract
Feeding difficulties related to selective intake, or eating a limited variety of foods, are very common in children with autism spectrum disorder (ASD). A systematic search of PubMed, Embase, PsycInfo, and CINAHL identified 29 studies that evaluated eight correlates: age, ASD symptoms and severity, cognitive and adaptive skills, sensory processing and perception, challenging behavior, weight status, gastrointestinal symptoms, and parenting stress. Feeding difficulties related to selective intake are consistently correlated with impaired sensory processing and perception and tend to be positively associated with rigidity and challenging behavior. These feeding difficulties tend to persist with advancing age. Other correlates demonstrated inconsistent findings. A significant limitation of research reviewed is variability in terminology, definitions, and measurement of feeding difficulties.
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Campbell K, Carbone PS, Liu D, Stipelman CH. Improving Autism Screening and Referrals With Electronic Support and Evaluations in Primary Care. Pediatrics 2021; 147:e20201609. [PMID: 33568493 PMCID: PMC7919108 DOI: 10.1542/peds.2020-1609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Universal screening for autism promotes early evidence-based treatment. However, many children are not screened, and screened children are often not referred for autism evaluation. METHODS We implemented process changes in 3 phases: phase 1, changing the screening instrument and adding decision support; phase 2, adding automatic reminders; and phase 3, adding a referral option for autism evaluations in primary care. We analyzed the proportion of visits with autism screening at 2 intervention clinics before and after implementation of process changes versus 27 community clinics (which received only automatic reminders in phase 2) with χ2 test and interrupted time series. We evaluated changes in referral for autism evaluation by calculating the rate ratio for referral. RESULTS In 12 233 visits over 2 years (baseline and phased improvements), autism screening increased by 52% in intervention clinics (58.6%-88.8%; P < .001) and 21% in community clinics (43.4%-52.4%; P < .001). In phase 1, interrupted time series trend for screening in intervention clinics increased by 2% per week (95% confidence interval [CI]: 1.1% to 2.9%) and did not increase in community clinics. In phase 2, screening in the community clinics increased by 0.46% per week (95% CI: 0.03% to 0.89%). In phase 3, the intervention clinic providers referred patients for diagnostic evaluation 3.4 times more frequently (95% CI: 2.0 to 5.8) than at baseline. CONCLUSIONS We improved autism screening and referrals by changing the screening instrument, adding decision support, using automatic reminders, and offering autism evaluation in primary care in intervention clinics. Automatic reminders alone improved screening in community clinics.
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Affiliation(s)
- Kathleen Campbell
- Department of Pediatrics, The University of Utah, Salt Lake City, Utah
| | - Paul S Carbone
- Department of Pediatrics, The University of Utah, Salt Lake City, Utah
| | - Diane Liu
- Department of Pediatrics, The University of Utah, Salt Lake City, Utah
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15
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Sahin E, Bury S, Flower R, Lawson L, Richdale A, Hedley D. Psychometric Evaluation of an Australian Version of the Vocational Index for Adults with Autism. AUTISM IN ADULTHOOD 2020; 2:185-192. [PMID: 36601441 PMCID: PMC8992869 DOI: 10.1089/aut.2019.0060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Autistic individuals are underrepresented in employment and postsecondary education. Research is hampered by a lack of psychometrically valid instruments that can be used to assess the vocational activities of autistic people. This study examined the psychometric properties of an Australian modified version of the Vocational Index for Adults with Autism (M-VIAA), an assessment of vocational independence. Methods Participants were 105 autistic and 106 nonautistic young adults aged 17-26 years recruited from the longitudinal Study of Australian School Leavers with Autism. We examined psychometric properties of the M-VIAA by (1) comparing scores between autistic and nonautistic participants, (2) examining convergent validity with daily living skills, and (3) divergent validity with autistic traits. We explored change over time by comparing baseline and 24-month follow-up scores in autistic participants. Results We found vocational independence to be significantly higher in nonautistic participants compared with autistic participants. We did not find a significant relationship between daily living skills and the M-VIAA. There was a small but significant relationship between the M-VIAA and autistic traits. Scores on the M-VIAA remained stable over time for a subsample of autistic participants. Conclusions The present study provides preliminary support for the M-VIAA with some limitations. Support for construct validity was mixed with support for concurrent and discriminant, but not convergent validity. We suggest that the M-VIAA may not capture the full complexity of vocational challenges faced by autistic people. Future research should build on the structure of the VIAA while ensuring applicability across cultures and contexts, as well as ensuring the richness of vocational activities of autistic people is captured. Lay summary Why was this study done?: Despite the urgent need to improve employment and other vocational outcomes of autistic people, there are few instruments that measure the range of vocational independence demonstrated by these individuals. The Vocational Index for Adults with Autism (VIAA) is an instrument that identifies the common vocational activities that autistic people engage in following high school. There is a need, however, for researchers to examine the usefulness of the instrument and its applicability in countries outside the United States.What was the purpose of this study?: The goal of this study was to evaluate a modified version of the VIAA (M-VIAA) in a group of autistic people from Australia.What did the researchers do?: We examined responses to the M-VIAA in 211 autistic and nonautistic young adults. We compared the M-VIAA with participant's daily living skills and level of autistic traits, as well as any change in scores over time.What were the results of the study?: Vocational independence was higher in nonautistic participants than in autistic participants. Vocational independence was not related to daily living skills; however, it was related to autistic traits. Over 2 years, scores on the M-VIAA did not change a lot for the autistic participants.What do these findings add to what was already known?: Our study provides some initial support for the M-VIAA in a non-US-based population. However, we also identified that the instrument may not represent the full range of challenges nor the richness of vocational activities experienced by autistic individuals in postsecondary vocational settings.What are potential weaknesses in the study?: The M-VIAA provides limited information about the richness of postsecondary vocational and education activities that autistic individuals may be engaged in. Because few individuals reported having an intellectual disability, we are unable to say how our results might apply to these individuals. Because we modified the instrument for use in Australia, our results may not apply to different countries or to the original version of the instrument.How will these findings help autistic adults now or in the future?: Our study provides preliminary support for the Australian version of the VIAA but suggests that it could be improved to better reflect the richness and range of vocational challenges experienced by autistic people. Our findings therefore identify areas for improvement for assessing the vocational activities and independence of autistic people.
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Affiliation(s)
- Ensu Sahin
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Simon Bury
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Rebecca Flower
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Indooroopilly, Australia.,Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
| | - Lauren Lawson
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Indooroopilly, Australia
| | - Amanda Richdale
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Indooroopilly, Australia
| | - Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Address correspondence to: Darren Hedley, PhD, Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne 3086, Victoria, Australia
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17
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Cognitive Mediators of School-Related Socio-Adaptive Behaviors in ASD and Intellectual Disability Pre- and Adolescents: A Pilot-Study in French Special Education Classrooms. Brain Sci 2019; 9:brainsci9120334. [PMID: 31766578 PMCID: PMC6956364 DOI: 10.3390/brainsci9120334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/12/2019] [Accepted: 11/19/2019] [Indexed: 12/01/2022] Open
Abstract
The school inclusion of students with autism is still a challenge. To address the cognitive underpinnings of school-related adaptive behaviors, 27 students with autism and 18 students with intellectual and/or severe learning disability, aged from 11 to 17, were recruited. They underwent socio-emotional processing and executive functioning assessments, as well as school-related adaptive behavior and quality of life measurements. Both groups performed equally on socio-emotional and executive assessments, and they reported the same low quality of life. However, students with autism exhibited more limitations than the students with intellectual disabilities on complex school adaptive behaviors (socialization and autonomy) and problem behaviors, but both groups performed equally on more basic adaptive behaviors (school routines, communication). Multiple regression analyses highlighted between-group differences in terms of adaptive functioning profiles, which were linked with different cognitive predictors according to students’ medical conditions. The greater school-related limitations of students with autism were mostly explained by socio-emotional performance, while IQ (intellectual quotient) mostly explained the comparable between-group limitations. The low quality of life of both groups was slightly explained by executive performance. The role of both socio-emotional and executive functioning in students’ adaptive behaviors and quality of life suggests remediation targets for promoting the school inclusion of students with autism.
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18
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Salomone E, Leadbitter K, Aldred C, Barrett B, Byford S, Charman T, Howlin P, Green J, Le Couteur A, McConachie H, Parr JR, Pickles A, Slonims V. The Association Between Child and Family Characteristics and the Mental Health and Wellbeing of Caregivers of Children with Autism in Mid-Childhood. J Autism Dev Disord 2019; 48:1189-1198. [PMID: 29177606 PMCID: PMC5861164 DOI: 10.1007/s10803-017-3392-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We examined predictors of mental health difficulties and wellbeing in caregivers of children with autism in the Pre-school Autism Communication Trial cohort in middle childhood (N = 104). Child’s intellectual disability, daily living skills impairment, elevated emotional and behavioural difficulties, high educational level of caregiver and household income below the median significantly predicted caregivers’ mental health difficulties, but autism severity, child communication skills and family circumstances did not. Lower caregiver mental wellbeing was predicted by elevated child emotional and behavioural difficulties. The need to support the mental health and wellbeing of caregivers of children with autism is discussed in light of the results.
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Affiliation(s)
- Erica Salomone
- University of Turin, Via Po, 14, 10123, Turin, Italy. .,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | | | | | - Barbara Barrett
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sarah Byford
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jonathan Green
- University of Manchester, Manchester, UK.,UK Royal Manchester Children's Hospital, Manchester Academic Health Sciences Centre, Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Ann Le Couteur
- Newcastle University, Newcastle, UK.,Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | | | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vicky Slonims
- Evelina London Children's Hospital, Guys and St Thomas University NHS Trust, London, UK
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Bertoncelli CM, Altamura P, Vieira ER, Bertoncelli D, Thummler S, Solla F. Identifying Factors Associated With Severe Intellectual Disabilities in Teenagers With Cerebral Palsy Using a Predictive Learning Model. J Child Neurol 2019; 34:221-229. [PMID: 30665307 DOI: 10.1177/0883073818822358] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Intellectual disability and impaired adaptive functioning are common in children with cerebral palsy, but there is a lack of studies assessing these issues in teenagers with cerebral palsy. Therefore, the aim of this study was to develop and test a predictive machine learning model to identify factors associated with intellectual disability in teenagers with cerebral palsy. METHODS This was a multicenter controlled cohort study of 91 teenagers with cerebral palsy (53 males, 38 females; mean age ± SD = 17 ± 1 y; range: 12-18 y). Data on etiology, diagnosis, spasticity, epilepsy, clinical history, communication abilities, behaviors, motor skills, eating, and drinking abilities were collected between 2005 and 2015. Intellectual disability was classified as "mild," "moderate," "severe," or "profound" based on adaptive functioning, and according to the DSM-5 after 2013 and DSM-IV before 2013, the Wechsler Intelligence Scale for Children for patients up to ages 16 years, 11 months, and the Wechsler Adult Intelligence Scale for patients ages 17-18. Statistical analysis included Fisher's exact test and multiple logistic regressions to identify factors associated with intellectual disability. A predictive machine learning model was developed to identify factors associated with having profound intellectual disability. The guidelines of the "Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis Statement" were followed. RESULTS Poor manual abilities (P ≤ .001), gross motor function (P ≤ .001), and type of epilepsy (intractable: P = .04; well controlled: P = .01) were significantly associated with profound intellectual disability. The average model accuracy, specificity, and sensitivity was 78%. CONCLUSION Poor motor skills and epilepsy were associated with profound intellectual disability. The machine learning prediction model was able to adequately identify high likelihood of severe intellectual disability in teenagers with cerebral palsy.
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Affiliation(s)
- Carlo M Bertoncelli
- Department of Pediatric Orthopaedic Surgery, Lenval University Pediatric Hospital of Nice, Nice, France
- EEAP H. Germain Fondation Lenval-Children's Hospital, Nice, France
| | - Paola Altamura
- Department of Medicinal Chemistry and Pharmaceutical Technology, University of Chieti, Chieti, Italy
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, FL, USA
| | - Domenico Bertoncelli
- Department of Information Engineering, Computer Science and Mathematics, University of L'Aquila, Italy
| | - Susanne Thummler
- Children's Hospitals of Nice CHU-Lenval, Child and Adolescent Psychiatry, Nice, France
| | - Federico Solla
- Department of Pediatric Orthopaedic Surgery, Lenval University Pediatric Hospital of Nice, Nice, France
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20
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Kilincaslan A, Kocas S, Bozkurt S, Kaya I, Derin S, Aydin R. Daily living skills in children with autism spectrum disorder and intellectual disability: A comparative study from Turkey. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:187-196. [PMID: 30576945 DOI: 10.1016/j.ridd.2018.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Better daily living skills (DLS) are associated with increased independence and positive functional outcomes in Autism Spectrum Disorder (ASD). METHOD The present study aimed to investigate daily living skills (DLS) and the associated factors in 51 children with ASD and intellectual disability (ASD group) and 51 age- and gender-matched controls with intellectual disability (ID group). The severity of the autistic symptoms was measured with the clinician-rated Childhood Autism Rating Scale and the parent-reported Autism Behavior Checklist (ABC) in all children. The mothers also completed the Pediatric Quality of Life Inventory and the Basic DLS Questionnaire. RESULTS The ASD group scored lower than the comparison group in the total DLS score, personal hygiene, dressing, safety and interpersonal skills, despite being comparable in the parent-reported quality of life. Regression analysis of the whole sample demonstrated that the child's age, intellectual level, speech level, autism symptom severity and the monthly household income were independent correlates of the total DLS. Exploratory analyses for each group revealed differential effects of these variables: in the ASD group; a higher speech level and monthly income, while in the ID group; an older age, a higher intellectual level and monthly income and a lower ABC score emerged as significant predictors of higher DLS. CONCLUSIONS Deficient DLS in Turkish children with ASD, given their IQ, suggest that lower level of adaptive skills is inherent in ASD, rather than culture-specific to US and Western Europe.
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Affiliation(s)
- Ayse Kilincaslan
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sule Kocas
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sumeyye Bozkurt
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilyas Kaya
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Songül Derin
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Resa Aydin
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Farmer C, Swineford L, Swedo SE, Thurm A. Classifying and characterizing the development of adaptive behavior in a naturalistic longitudinal study of young children with autism. J Neurodev Disord 2018; 10:1. [PMID: 29329511 PMCID: PMC5795287 DOI: 10.1186/s11689-017-9222-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/19/2017] [Indexed: 12/21/2022] Open
Abstract
Background Adaptive behavior, or the ability to function independently in ones’ environment, is a key phenotypic construct in autism spectrum disorder (ASD). Few studies of the development of adaptive behavior during preschool to school-age are available, though existing data demonstrate that the degree of ability and impairment associated with ASD, and how it manifests over time, is heterogeneous. Growth mixture models are a statistical technique that can help parse this heterogeneity in trajectories. Methods Data from an accelerated longitudinal natural history study (n = 105 children with ASD) were subjected to growth mixture model analysis. Children were assessed up to four times between the ages of 3 to 7.99 years. Results The best fitting model comprised two classes of trajectory on the Adaptive Behavior Composite score of the Vineland Adaptive Behavior Scale, Second Edition—a low and decreasing trajectory (73% of the sample) and a moderate and stable class (27%). Conclusions These results partially replicate the classes observed in a previous study of a similarly characterized sample, suggesting that developmental trajectory may indeed serve as a phenotype. Further, the ability to predict which trajectory a child is likely to follow will be useful in planning for clinical trials. Electronic supplementary material The online version of this article (10.1186/s11689-017-9222-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cristan Farmer
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Lauren Swineford
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA.,Department of Speech and Hearing Sciences, Washington State University, Spokane, WA, 99202, USA
| | - Susan E Swedo
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Audrey Thurm
- Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, 20892, USA.
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