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Chawla M, Panda SN, Khullar V. SMILEY-assistive application to support social and emotional skills in SPCD individuals. Med Biol Eng Comput 2024; 62:3507-3529. [PMID: 38890200 DOI: 10.1007/s11517-024-03151-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
According to the available studies, mobile applications have provided significant support in improving the diverse skills of special individuals with social pragmatic communication disorder (SPCD). Over the last decade, SPCD has affected 8 to 11% of individuals, and therapy sessions cost between $50 and $150 per hour. This preliminary study aims to develop an interactive, user-friendly intervention to enhance social and emotional interaction skills in individuals with SPCD. The proposed intervention is an Android application that enhances social and emotional interaction skills. This pilot study involved 29 human subjects aged 7-13 years with pragmatic communication deficits. In a randomized controlled trial, the intervention was developed and implemented with consideration of caregiver and professional requirements. The improvement was analyzed using standard scales, including the Social Communication Questionnaire (SCQ) and the Social Communication Disorder Scale (SCDS). Moreover, the outcomes were examined through statistical parameters (mean, standard deviation) and tests (t-test). The intervention significantly improved the social and emotional skills of individuals with deficits. Before using the intervention, the identified statistical values for SCQ (mean = 6.48 and standard deviation = 3.37) and SCDS (mean = 8.17 and standard deviation = 4.79). However, after using the intervention, values for SCQ (mean = 8.24 and standard deviation = 3.95) and SCDS (mean = 9.48 and standard deviation = 4.72) were improved in comparison to the before-intervention outcome. The evaluation of the t-scores and p-values indicates that there has been significant improvement in the performance of individuals after the successful completion of the intervention. The proposed and applied intervention resulted in a significant impact in terms of improvement in social and emotional skills. The study concluded that it allows individuals to practice social and emotional interaction skills in a structured, controlled, and interactive environment. The proposed intervention has been found acceptable as per the reviews of caregivers and professionals, based on essential criteria including user experience, usability, interactive nature, reliability, and creditability.
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Affiliation(s)
- Muskan Chawla
- Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, Punjab, India.
| | - Surya Narayan Panda
- Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, Punjab, India
| | - Vikas Khullar
- Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, Punjab, India
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2
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Laña B, Crespo-Eguilaz N, Sánchez-Carpintero R. The profile of social communication in Dravet syndrome. Epilepsy Behav 2024; 159:110007. [PMID: 39208587 DOI: 10.1016/j.yebeh.2024.110007] [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: 03/20/2024] [Revised: 07/18/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
Dravet syndrome (DS) presents a multifaceted clinical picture marked by epilepsy, cognitive impairments and behavioral disorders that progresses throughout development. Behavioral disorders include impairments in social relationships and communication, with frequent diagnosis of autism spectrum disorder. This study focused on comprehensively evaluating and comparing social communication profiles among a group of 43 children with Dravet syndrome, 30 children with level 1 autism spectrum disorder, 36 with social (pragmatic) communication disorder, and 18 with intellectual disability. Using validated tools like the Childhood Autism Spectrum Test and Children's Communication Checklist, distinct patterns of social communication deficits were delineated. Our findings indicate that children with Dravet syndrome experience challenges in social relationships, primarily due to difficulties in use of pragmatic language. Areas such as range of interests and social interaction are less affected compared to those with ASD, emphasizing differing profiles between the conditions. While children with DS and ID may have similar intellectual functioning, the different social communication deficits in DS indicate their role in the DS phenotype beyond ID. These results underscore the unique social communication profile of DS and emphasizes the importance of tailored interventions and deep phenotyping efforts for effective DS management.
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Affiliation(s)
- Borja Laña
- Pediatric Neurology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Nerea Crespo-Eguilaz
- Pediatric Neurology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain.
| | - Rocío Sánchez-Carpintero
- Pediatric Neurology Unit, Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
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Pichardo JM, Foley-Nicpon M, Fields D, Hong JE, Court. Exploratory Factor Analysis of the Social Communication Disorder Screener. J Autism Dev Disord 2024; 54:3412-3422. [PMID: 37642878 DOI: 10.1007/s10803-023-06076-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/31/2023]
Abstract
Currently, there are no existing measures to screen for or diagnose Social (Pragmatic) Communication Disorder (SPCD). We conducted an exploratory factor analysis (EFA) of the Social Communication Disorder Screener (SCDS), a 14-item, parent-report measure based on the DSM-5 diagnostic criteria for SPCD. This EFA examined the internal consistency and factor structure of the SCDS for a sample of 500 parents of children, ages 5-18 years, representative of the U.S. census. Results yielded a correlated three-factor solution with good internal consistency reliability. Findings supported the presence of three subscale as well as the derivation of a total composite score reflecting overall verbal and non-verbal communication and limitations across contexts. Clinical and research implications are discussed.
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Affiliation(s)
- Jesus M Pichardo
- Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, 52242, USA.
| | - Megan Foley-Nicpon
- Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, 52242, USA
| | - Danae Fields
- Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, 52242, USA
| | - Jung Eui Hong
- Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, 52242, USA
| | - Court
- Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA, 52242, USA
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Khullar V, Singh HP. Vocal-friend: internet of social-things framework to aid verbal communication. Disabil Rehabil Assist Technol 2023; 18:1527-1535. [PMID: 35404708 DOI: 10.1080/17483107.2022.2060349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/26/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Deficits in social verbal communication in individuals with Social Communication Disorder (SCD) is of concern and SCD in the human community is prevalent in large population throughout the globe. Deficits in verbal social communication are prevalent in a large population. This paper aimed to propose internet connected multi-system architecture which is capable to support verbal communication in a social environment for individuals with social communication deficits. MATERIAL AND METHODS Implementation methodology was included with corpus collection for specific communication, deep learning based machine training for intelligent communication, and implementation of the trained algorithm on internet connected electronic multiple social communication devices. The implemented system is smart enough to initiate and maintain two types of communication; the first type includes communication between multiple individuals on the remote location and the second type includes communication with the individual present in the physical listening range. RESULTS The system was investigated in terms of its algorithmic parameters and found 97% to 100% in terms of training and testing accuracy with negligible mean squared error. Vocal-Friend analysed results based on audio-bot simulative conditions provide more than 91% accuracy, interaction rate and fallback rate. On the basis of the satisfaction analysis, above average results were noticed. CONCLUSION In terms of technical implementations and satisfaction analysis, results found acceptable with above average score.IMPLICATION FOR REHABILITATIONProposed framework is easy to use by caregivers with even having little knowledge.Support individual with deficit to learn social verbal communication skill to survive in society.Aiding parents, caregivers and professionals to understand the communication needs of individuals with communication deficits.Since technology is also grooming in the domain of rehabilitation, so this system could be used in various future applications such as social robots, social virtual assistants etc.
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Affiliation(s)
- Vikas Khullar
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Harjit Pal Singh
- CT Institute of Engineering, Management and Technology, Punjab, India
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Gabbatore I, Marchetti Guerrini A, Bosco F. The fuzzy boundaries of the social (pragmatic) communication disorder (SPCD): Why the picture is still so confusing? Heliyon 2023; 9:e19062. [PMID: 37664706 PMCID: PMC10468801 DOI: 10.1016/j.heliyon.2023.e19062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Since the introduction of Social (Pragmatic) Communication Disorder (SPCD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in 2013, a debate has arisen in the scientific community about its usefulness in differential diagnosis for other clinical categories such as Autism Spectrum Disorder (ASD) and Specific Language Impairment (SLI). Indeed, SPCD criteria share a common deficit in communication and pragmatic skills with these diagnostic entities. Available assessment tools seem scarce and not sensitive enough to clarify diagnostic criteria and clinical boundaries. This study aims to review the existing literature on diagnostic screening for SPCD to highlight confounding variables in the domains examined, overlap with other diagnostic entities, and lack of specificity of available assessment tools in identifying the core deficits of the disorder. Methods The search strategy was defined by combining the following keywords: "social pragmatic communication disorder," "DSM-5," "differential diagnosis," and "child." The search was performed in three databases: Medline (PubMed), Scopus, and Web of Science. All studies published between 2013 and April 2023, written in English, and with a major focus on SPCD were included in the review. Results After the screening for the eligibility, 18 studies were included in the review. Most of these studies aimed to investigate the differential diagnosis between SPCD and other diagnostic categories (e.g., specific language impairment and autism spectrum disorder). Of these researches, only 6 were ad hoc experimental studies, while the others were based on previously collected databases. Conclusions SPCD seems to have its own peculiarities and characteristics, indicating its clinical relevance, as emphasized by the DSM-5. However, the lack of specific instruments and a number of confounding variables make it difficult to identify and differentiate SPCD from other diagnostic entities. Further research is needed to overcome the lack of specific clinical instruments and lack of empirical studies.
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Affiliation(s)
- I. Gabbatore
- Department of Psychology, GIPSI Research Group, University of Turin, Italy
| | - A. Marchetti Guerrini
- Department of Psychology, GIPSI Research Group, University of Turin, Italy
- Associazione La Nostra Famiglia – IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - F.M. Bosco
- Department of Psychology, GIPSI Research Group, University of Turin, Italy
- Centro Interdipartimentale di Studi Avanzati di Neuroscienze – NIT, University of Turin, Turin, Italy
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Brewster PR, Mohammad Ishraq Bari S, Walker GM, Werfel TA. Current and future directions of drug delivery for the treatment of mental illnesses. Adv Drug Deliv Rev 2023; 197:114824. [PMID: 37068660 PMCID: PMC11479664 DOI: 10.1016/j.addr.2023.114824] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/22/2023] [Accepted: 04/11/2023] [Indexed: 04/19/2023]
Abstract
Mental illnesses including anxiety disorders, autism spectrum disorder, post-traumatic stress disorder, schizophrenia, depression, and others exact an immense toll on the healthcare system and society at large. Depression alone impacts 21 million adults and costs over $200 billion annually in the United States. However, pharmaceutical strategies to treat mental illnesses are lagging behind drug development in many other disease areas. Because many of the shortcomings of therapeutics for mental illness relate to delivery problems, drug delivery technologies have the potential to radically improve the effectiveness of therapeutics for these diseases. This review describes the current pharmacotherapeutic approaches to treating mental illnesses as well as drug delivery approaches that have improved existing therapies. Approaches to improve drug bioavailability, provide controlled release of therapeutics, and enable drug targeting to the central nervous system (CNS) will be highlighted. Moreover, next-generation delivery approaches such as environmentally-controlled release and interval/sequential drug release will be addressed. Based on the evolving landscape of the treatment of mental illnesses, the nascent field of drug delivery in mental health has tremendous potential for growth in terms of both economic and patient impact.
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Affiliation(s)
- Parker R Brewster
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA; Department of Chemical Engineering, University of Mississippi, University, MS 38677, USA
| | | | - Glenn M Walker
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA
| | - Thomas A Werfel
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, USA; Department of Chemical Engineering, University of Mississippi, University, MS 38677, USA; Department of BioMolecular Sciences, University of Mississippi, University, MS 38677, USA; Cancer Center and Research Institute, University of Mississippi Medical Center, Jackson, MS 39216, USA.
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Saul J, Griffiths S, Norbury CF. Prevalence and functional impact of social (pragmatic) communication disorders. J Child Psychol Psychiatry 2023; 64:376-387. [PMID: 36114685 PMCID: PMC10087005 DOI: 10.1111/jcpp.13705] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample. METHODS We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2. RESULTS Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes. CONCLUSIONS A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.
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Affiliation(s)
- Jo Saul
- University College London, London, UK
| | | | - Courtenay Frazier Norbury
- University College London, London, UK.,Department of Special Needs Education, University of Oslo, Oslo, Norway
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Diez-Itza E, Viejo A, Fernández-Urquiza M. Pragmatic Profiles of Adults with Fragile X Syndrome and Williams Syndrome. Brain Sci 2022; 12:385. [PMID: 35326341 PMCID: PMC8946534 DOI: 10.3390/brainsci12030385] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023] Open
Abstract
Linguistic phenotypes of individuals with Fragile X (FXS) and Williams (WS) syndromes exhibit various degrees of pragmatic impairment, involving difficulties in social communication and in adapting to conversational principles. The goal of the present study was to explore syndrome-specific pragmatic profiles of adults with FXS and WS based on the assessment of the observance of Gricean maxims of conversation. The participants were 12 Spanish-speaking adults (6 FXS/6 WS), without a diagnosis of ASD, whose extensive naturalistic conversations (71,859 words) were transcribed and coded with the CHILDES/TALKBANK tools and the PREP-CORP pragmatic protocol. Violations of the maxims of conversation were analyzed, and indexes of cooperation and conversational response were obtained. Both groups showed reduced verbal production and repetitive dysfluencies; prominent features in the FXS profile were higher proportion of non-contingent language, perseverations of topic and form, and impulsive conversational responses; in the WS profile, salient characteristics were higher proportion of tangential utterances, reformulations, and conversational responses reflecting overly literal interpretation. Pragmatic profiles of violation of conversational maxims reflect specific communication skills impaired in adults with FXS and WS and raise the need for assessment and intervention methods that specifically address their social communication abilities.
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Affiliation(s)
- Eliseo Diez-Itza
- LOGIN Research Group, University of Oviedo, 33003 Oviedo, Spain; (A.V.); (M.F.-U.)
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Levy Y. ASD-Time for a paradigm shift. Front Psychiatry 2022; 13:956351. [PMID: 35935420 PMCID: PMC9354486 DOI: 10.3389/fpsyt.2022.956351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yonata Levy
- Psychology Department, Hadassah Medical School, Hebrew University, Jerusalem, Israel
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Blázquez Hinojosa A, Lázaro Garcia L, Puig Navarro O, Varela Bondelle E, Calvo Escalona R. Sensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:202-211. [PMID: 34802987 DOI: 10.1016/j.rpsmen.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/16/2019] [Indexed: 10/19/2022]
Abstract
BACKGROUND Controversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD). METHODS This study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. RESULTS DSM-5 sensitivity ranged from .69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the "low-functioning" category. DSM-5 specificity ranged from .64 to .73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD. CONCLUSIONS Further research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.
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Affiliation(s)
- Ana Blázquez Hinojosa
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain.
| | - Luisa Lázaro Garcia
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Departamento de Psiquiatría y Psicobiología Clínica, Universidad de Barcelona, Barcelona, Spain
| | - Olga Puig Navarro
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Eva Varela Bondelle
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain
| | - Rosa Calvo Escalona
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Ellis Weismer S, Tomblin JB, Durkin MS, Bolt D, Palta M. A preliminary epidemiologic study of social (pragmatic) communication disorder in the context of developmental language disorder. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1235-1248. [PMID: 34383380 PMCID: PMC8890438 DOI: 10.1111/1460-6984.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/09/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is extremely limited population-based research on social (pragmatic) communication disorder (SCD). Population-based samples have the potential to better characterize the SCD phenotype by mitigating confounds and biases that are typical of convenience and clinical samples. AIMS The aims of this preliminary epidemiologic study were to advance our understanding of the SCD phenotype relative to developmental language disorder (DLD), obtain an estimate of prevalence, identify risk factors and lay the groundwork for future population level research of SCD. METHODS & PROCEDURES We analysed existing data from the EpiSLI Database to examine social communication skills in 393 8th grade (13-14 years) children with and without a history of DLD. The primary measure used to evaluate SCD was the Children's Communication Checklist (CCC-2). Two case definitions of SCD reflecting DSM-5 criteria were examined. Both definitions involved significant pragmatic impairment, employing a commonly adopted clinical cut-point of 1.5 SD. In one case, pragmatic deficits could occur along with structural language deficits and, in the other case (established using principal component analysis), pragmatic and social skills were disproportionately lower than structural language abilities. OUTCOMES & RESULTS When using the first case definition, SCD was much more common in children with a history of DLD than without DLD and history of language disorder at kindergarten was a significant risk factor for SCD in adolescence. However, it is important to note that SCD could be found in children with no prior deficits in other aspects of language. When the second definition was employed, SCD was equally distributed across children with and without a history of DLD. Male sex was a significant risk factor using this case definition of SCD. The estimated prevalence of SCD ranged from 7% (SE = 1.5%) to 11% (SE = 1.7%), acknowledging that prevalence depends on the cut-point selected to determine communication disorder. CONCLUSIONS & IMPLICATIONS These findings contribute to our understanding of the association between SCD and DLD by recognizing varying profiles of pragmatic and social communication difficulties, which in turn may help refine our diagnostic categories. Preliminary prevalence estimates of SCD can serve as an initial guidepost for identification and planning for intervention services for this condition. WHAT THIS PAPER ADDS What is already known on this subject There is considerable debate about the diagnostic category of SCD and its relation to other neurodevelopmental disorders. What this study adds to existing knowledge Using data from a US-based epidemiologic sample of DLD, this study offers new information about the association between SCD and DLD, provides preliminary estimates of SCD prevalence, and identifies risk factors for SCD. Clinical implications of this study Improved understanding of possible profiles of pragmatic and social communication deficits will help to clarify diagnostic categories and preliminary prevalence estimates may assist with ensuring availability of adequate intervention services.
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Affiliation(s)
- Susan Ellis Weismer
- Department of Communication Sciences and Disorders, Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, USA
| | - J. Bruce Tomblin
- Department of Communication Sciences and Disorder, University of Iowa, Iowa City, IA USA
| | - Maureen S. Durkin
- Department of Population Health Sciences and Pediatrics, Waisman Center, University of Wisconsin- Madison, Madison, WI USA
| | - Daniel Bolt
- Department of Educational Psychology, Waisman Center, University of Wisconsin- Madison, Madison, WI USA
| | - Mari Palta
- Department of Population Health Sciences and Biostatistics and Medical Informatics, University of Wisconsin- Madison, Madison, WI USA
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Amoretti MC, Lalumera E, Serpico D. The DSM-5 introduction of the Social (Pragmatic) Communication Disorder as a new mental disorder: a philosophical review. HISTORY AND PHILOSOPHY OF THE LIFE SCIENCES 2021; 43:108. [PMID: 34559337 PMCID: PMC8463351 DOI: 10.1007/s40656-021-00460-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included the Social (Pragmatic) Communication Disorder (SPCD) as a new mental disorder characterized by deficits in pragmatic abilities. Although the introduction of SPCD in the psychiatry nosography depended on a variety of reasons-including bridging a nosological gap in the macro-category of Communication Disorders-in the last few years researchers have identified major issues in such revision. For instance, the symptomatology of SPCD is notably close to that of (some forms of) Autism Spectrum Disorder (ASD). This opens up the possibility that individuals with very similar symptoms can be diagnosed differently (with either ASD or SPCD) and receive different clinical treatments and social support. The aim of this paper is to review recent debates on SPCD, particularly as regards its independence from ASD. In the first part, we outline the major aspects of the DSM-5 nosological revision involving ASD and SPCD. In the second part, we focus on the validity and reliability of SPCD. First, we analyze literature on three potential validators of SPCD, i.e., etiology, response to treatment, and measurability. Then, we turn to reliability issues connected with the introduction of the grandfather clause and the use of the concepts of spectrum and threshold in the definition of ASD. In the conclusion, we evaluate whether SPCD could play any role in contemporary psychiatry other than that of an independent mental disorder and discuss the role that non-epistemic factors could play in the delineation of the future psychiatry nosography.
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Affiliation(s)
- M Cristina Amoretti
- Department of Classics, Philosophy and History (DAFIST), Philosophy Section, University of Genoa, Via Balbi 4, 16126, Genoa, Italy.
| | - Elisabetta Lalumera
- Department for Life Quality Studies (QUVI), University of Bologna, Corso di Augusto 237, 47921, Rimini, Italy
| | - Davide Serpico
- Department of Classics, Philosophy and History (DAFIST), Philosophy Section, University of Genoa, Via Balbi 4, 16126, Genoa, Italy
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Hui T, Goh TJ, Sung M. Clinical presentations of social communication disorder: A case series. Asian J Psychiatr 2021; 62:102718. [PMID: 34111655 DOI: 10.1016/j.ajp.2021.102718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/23/2021] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
Social Communication Disorder (SCD) is a new DSM-5 diagnostic category poorly understood by clinicians. We describe a case series of four individuals diagnosed with SCD to identify common characteristics and differences in presentations of the disorder. All cases had deficits in the area of social communication, and sub-threshold level of restricted and repetitive behaviours, not sufficient to meet criteria for Autism Spectrum Disorder (ASD). All cases presented with at least one mental health co-morbid condition. There are significant overlaps in clinical presentation between SCD and ASD. It is imperative that accurate diagnostic tools and effective intervention approaches of SCD be developed.
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Affiliation(s)
- Tianyi Hui
- Ministry of Health, 16 College Road, College of Medicine Building, 169854, Singapore
| | - Tze Jui Goh
- Department of Developmental Psychiatry, Institute of Mental Health, Child Guidance Clinic, 03-01, 3 Second Hospital Avenue, Health Promotion Board Building, 168937, Singapore.
| | - Min Sung
- Department of Developmental Psychiatry, Institute of Mental Health, Child Guidance Clinic, 03-01, 3 Second Hospital Avenue, Health Promotion Board Building, 168937, Singapore
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R Bradbury K, Duvall SW, Armstrong K, Hall TA. Survey of training experiences and clinical practice in assessment for autism spectrum disorder by neuropsychologists. Clin Neuropsychol 2021; 36:856-873. [PMID: 34308763 DOI: 10.1080/13854046.2021.1948610] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The primary purpose of this study is to better understand current practices in the assessment of autism spectrum disorder (ASD) by neuropsychologists. METHODS A 21-item survey regarding ASD assessment beliefs and practices was sent via email through neuropsychology listservs. The survey was accessed by 445 licensed psychologists who identified as neuropsychologists. A total of 367 surveys were deemed usable for data analysis. Descriptive statistics were used to characterize the full sample. Exploratory analyses were conducted between groups of interest, including primary population served (pediatric, adult, or lifespan), primary practice setting (medical center vs. private practice) and years in practice (< 5 years, 5 to 14 years, or 15+ years). RESULTS Respondents were well-distributed across age range, years in practice, primary practice setting, and primary practice location. Almost all respondents (most of whom self-identified as pediatric-focused clinicians) believe that neuropsychologists should be able to competently rule in or out ASD and most received training in ASD assessment. Approximately 40% of respondents endorsed wanting more training in ASD assessment to increase their competence and confidence in making this differential diagnosis. Minimal differences in ASD beliefs and assessment practices were seen across years of practice or primary practice setting. Pediatric and lifespan clinicians had similar experience with ASD assessment practices, and both generally differed from adult clinicians. CONCLUSIONS Our findings suggest many respondents desire further specialty ASD training for neuropsychologists. Additionally, the large majority of respondents indicated that future neuropsychologists should receive training in ASD assessment during graduate school, internship and/or post-doctoral fellowship.
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Affiliation(s)
- Kathryn R Bradbury
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA.,Children's Neuropsychological Services, Andover, MA, USA
| | - Susanne W Duvall
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
| | | | - Trevor A Hall
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA.,Pediatric Critical Care and Neurotrauma Recovery Program, Oregon Health & Science University, Portland, OR, USA
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Operationalizing Social Communication in Autism and Related Neurodevelopmental Research: a Scoping Review Over 20 Years. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2021. [DOI: 10.1007/s40474-021-00224-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Hus Y, Segal O. Challenges Surrounding the Diagnosis of Autism in Children. Neuropsychiatr Dis Treat 2021; 17:3509-3529. [PMID: 34898983 PMCID: PMC8654688 DOI: 10.2147/ndt.s282569] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/10/2021] [Indexed: 12/18/2022] Open
Abstract
This comprehensive thematic review aims to highlight and familiarize readers with the challenges and pitfalls encountered in differential diagnosis of autism spectrum disorders (ASD) in children to facilitate the process of accurate identification by stakeholders. Accordingly, articles that best answer our questions and highlight our concerns were chosen from well-established publishers with prime peer reviewed journals. Included are studies showing alternate views of the issues so as to point readers to other possibilities. ASD, a complex dynamic biological-neurodevelopmental disorder, is underscored by its heterogeneous symptomology, severity, and phenotypes - all characterized by social communication deficits and presence of restricted interests and repetitive behaviours (RRBs), the core symptoms in ASD. Language and intellectual capacities do not form ASD core symptoms although vary considerably. Accurate identification is challenging as ASD is often enmeshed with other neurodevelopmental disorders, and medical comorbidities, a situation now recognized as the rule rather than the exception in child psychiatry and developmental medicine. ASD is a disorder with varying performance and severity of symptoms over time, including unexpected loss of early skills, and lost diagnosis in some children following treatment. The review reiterates the urgency in accurate diagnosis in face of the rapid rise in ASD prevalence globally, and risk-increase in delayed or denied treatment with undesirable life-long consequences for most of the affected children. In addition, a call for change is advised to circumvent the ethical dilemma posed by the present "deficit model" in ASD diagnosis. Here, ASD prevalence is presented first, followed by emphasis on importance of accurate early diagnosis, and challenges in its accomplishment due to flaws in diagnostic instruments and other contributing factors. Next follow the required criteria for accurate identification, and its difficulties attributed to comorbid conditions, gender differences, and socio-economic and cultural influences. The conclusion includes future directions and a take away message.
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Affiliation(s)
- Yvette Hus
- Cyprus University of Technology, Department of Rehabilitation Sciences, Theralab Research Collaborator, Limassol, Cyprus
| | - Osnat Segal
- Tel Aviv University, Sackler Faculty of Medicine, Department of Communication Disorders, Tel-Aviv, Israel
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17
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Ellis Weismer S, Rubenstein E, Wiggins L, Durkin MS. A Preliminary Epidemiologic Study of Social (Pragmatic) Communication Disorder Relative to Autism Spectrum Disorder and Developmental Disability Without Social Communication Deficits. J Autism Dev Disord 2020; 51:2686-2696. [PMID: 33037562 DOI: 10.1007/s10803-020-04737-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 12/20/2022]
Abstract
The goal of this preliminary investigation was to compare demographic and clinical characteristics in a sample of children with likely Social (Pragmatic) Communication Disorder (SCD) (N = 117) to those in children with possible (N = 118) and some (N = 126) SCD traits, other developmental delay (DD) (N = 91) and autism spectrum disorder (ASD) (N = 642). We used data from the Study to Explore Early Development (SEED), a multi-site case-control study. Items reflecting SCD DSM-5 criteria were selected from an autism diagnostic measure, with SCD categories identified by creating quartiles. Our results suggest that SCD may fall along a continuum involving elevated deficits (in comparison to DD with no SCD) in social communication and restricted and repetitive behavior that do not reach the clinical threshold for ASD.
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Affiliation(s)
- Susan Ellis Weismer
- Department of Communication Sciences and Disorders and Waisman Center, University of Wisconsin-Madison, 1500, Highland Avenue, Madison, WI, USA.
| | - Eric Rubenstein
- Department of Family Medicine, Department of Population Health Sciences, and Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, USA.,Department of Epidemiology, Boston University, Boston, MA, USA
| | - Lisa Wiggins
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, 1600 Clifton, Road, Atlanta, GA, USA
| | - Maureen S Durkin
- Department of Population Health Sciences and Pediatrics, Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, USA
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18
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Ward A, Boan AD, Carpenter LA, Bradley CC. Evaluating the rate of Social (Pragmatic) Communication Disorder in children at risk for Autism Spectrum Disorder. CHILDRENS HEALTH CARE 2020. [DOI: 10.1080/02739615.2020.1803072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Audrey Ward
- College of Medicine, Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Andrea D. Boan
- College of Medicine, Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Laura A. Carpenter
- College of Medicine, Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Catherine C. Bradley
- College of Medicine, Pediatrics, Medical University of South Carolina, Charleston, SC, USA
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19
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Puglisi ML, Blasi HF, Snowling MJ. Screening for the Identification of Oral Language Difficulties in Brazilian Preschoolers: A Validation Study. Lang Speech Hear Serv Sch 2020; 51:852-865. [PMID: 32496867 DOI: 10.1044/2020_lshss-19-00083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study aimed to develop and validate a screening questionnaire for the early identification of language difficulties in Brazilian Portuguese-speaking preschool children. Method The article is divided into two studies. In the first study, we reported the theoretical principles that guided the development of the Screening for Identification of Oral Language Difficulties by Preschool Teachers (SIOLD) and tested the validity of its structure. The psychometric properties of the SIOLD were tested using a sample of 754 children attending Year 1 of preschool. Thirty-two teachers coming from eight different schools completed individual questionnaires for all their students. Confirmatory factor analysis was used to assess the validity of the SIOLD. In the second study, we investigated the accuracy of the questionnaire for identifying children with oral language difficulties using a different sample of 100 preschool children. Using receiver operating characteristic and precision recall curves, we assessed the sensitivity and specificity of the SIOLD to identify children who showed impaired language performance in a short battery of tests. Results The SIOLD has been shown to be a valid and accurate questionnaire for assessing the form and content of oral language in preschool children. It showed good accuracy, with sensitivity ranging between .750 and .857 and specificity of .946 for the identification of language difficulties. Among the cases positively identified by the SIOLD as having language difficulties, 54.5% were true cases of language disorders, while 45.5% were false alarms. The combination of these findings shows that the SIOLD overpredicts positive cases but identifies most children with true language disorders and passes most children without language disorders, as required of a good screening test. Conclusions The questionnaire provides a useful tool for enabling Brazilian teachers to refer children with language difficulties to the speech-language services. The theoretical and clinical implications are discussed.
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Affiliation(s)
- Marina L Puglisi
- Department of Communication Sciences, Universidade Federal de São Paulo, Brazil.,Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Helena F Blasi
- Department of Speech-Language and Hearing Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Margaret J Snowling
- Department of Experimental Psychology, University of Oxford, United Kingdom.,St. John's College, University of Oxford, United Kingdom
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20
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Blázquez Hinojosa A, Lázaro Garcia L, Puig Navarro O, Varela Bondelle E, Calvo Escalona R. Sensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 14:S1888-9891(19)30099-0. [PMID: 31864965 DOI: 10.1016/j.rpsm.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Controversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD). METHODS This study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. RESULTS DSM-5 sensitivity ranged from 0.69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the "low-functioning" category. DSM-5 specificity ranged from 0.64 to 0.73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD. CONCLUSIONS Further research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.
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Affiliation(s)
- Ana Blázquez Hinojosa
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España.
| | - Luisa Lázaro Garcia
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España; Departamento de Psiquiatría y Psicobiología Clínica, Universidad de Barcelona, Barcelona, España
| | - Olga Puig Navarro
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - Eva Varela Bondelle
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España
| | - Rosa Calvo Escalona
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
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21
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Flax J, Gwin C, Wilson S, Fradkin Y, Buyske S, Brzustowicz L. Social (Pragmatic) Communication Disorder: Another name for the Broad Autism Phenotype? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:1982-1992. [PMID: 30931583 DOI: 10.1177/1362361318822503] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Social (Pragmatic) Communication Disorder is meant to capture the social elements of communication dysfunction in children who do not meet autism spectrum disorder criteria. It is unclear whether Social (Pragmatic) Communication Disorder captures these elements without overlapping with Autism Spectrum Disorder or the Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Language Disorder. Standardized behavioral assessments administered during a family genetics study were used to evaluate the social communication impairment and the restricted interests and repetitive behaviors in persons with autism spectrum disorder, language impairment, or neither. Social communication impairment and restricted interests and repetitive behavior were significantly correlated in all family members regardless of affection status. Rates of social communication impairment and restricted interests and repetitive behavior were highest in individuals with autism spectrum disorder. One-third of family members with language impairment presented with at least mild/moderate levels of social communication impairment (36.6%) and restricted interests and repetitive behavior (43.3%). A subset of unaffected members also presented with mild/moderate levels of social communication impairment (parents = 10.1%, siblings 11.6%) and restricted interests and repetitive behavior (parents = 14.0%, siblings = 22.1%). The majority of child family members with mild/moderate levels of social communication impairment had similar restricted interest and repetitive behavior levels reflecting criteria representing the Broad Autism Phenotype. These data suggest that social pragmatic communication disorder does not capture the profiles of children who have both social communication impairment and restricted interests and repetitive behavior but are in need of clinical services.
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22
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Social Cognitive Reinforcement Program for Children with Social Communication Disorders. ADONGHAKOEJI 2018. [DOI: 10.5723/kjcs.2018.39.5.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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23
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Morales-Hidalgo P, Ferrando PJ, Canals J. Assessing the heterogeneity of autism spectrum symptoms in a school population. Autism Res 2018; 11:979-988. [DOI: 10.1002/aur.1964] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 12/20/2017] [Accepted: 04/09/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Paula Morales-Hidalgo
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology; Universitat Rovira i Virgili; Tarragona Spain
- Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology; Universitat Rovira i Virgili, Ctra. Valls s/n; Tarragona 43007 Spain
| | - Pere J. Ferrando
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology; Universitat Rovira i Virgili; Tarragona Spain
| | - Josefa Canals
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology; Universitat Rovira i Virgili; Tarragona Spain
- Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology; Universitat Rovira i Virgili, Ctra. Valls s/n; Tarragona 43007 Spain
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24
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Angeard N, Huerta E, Jacquette A, Cohen D, Xavier J, Gargiulo M, Servais L, Eymard B, Héron D. Childhood-onset form of myotonic dystrophy type 1 and autism spectrum disorder: Is there comorbidity? Neuromuscul Disord 2018; 28:216-221. [DOI: 10.1016/j.nmd.2017.12.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/08/2017] [Indexed: 11/24/2022]
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25
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Topal Z, Demir Samurcu N, Taskiran S, Tufan AE, Semerci B. Social communication disorder: a narrative review on current insights. Neuropsychiatr Dis Treat 2018; 14:2039-2046. [PMID: 30147317 PMCID: PMC6095123 DOI: 10.2147/ndt.s121124] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Social communication disorder (SCD) is a novel diagnosis listed under the rubric of communication disorders within the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and it is reported to be characterized by impairment in use of verbal and nonverbal communication for social aims. This review attempts to summarize the current understanding of the SCD concept along with its evolution and presents data from previous studies conducted. Suggestions for further research are also delineated. As listed in DSM-5, the criteria for this novel diagnosis are vague, display elevated comorbidity with other neurodevelopmental disorders and other childhood psychopathologies, and show partial overlap with autistic spectrum disorders both in terms of genetics and family histories. Data on cross-cultural presentations and temporal stability are also limited. The social communication model proposed by Catani and Bambini may help integrate the neurobiological findings pertaining to SCD. Valid and reliable assessment methods need to be developed for SCD. This may involve either development of novel instruments capturing the DSM-5 criteria or application of statistical methods such as item response theory to existing instruments. The relationships between broad autism phenotype, pragmatic language impairment, nonverbal learning disorder, learning disorders, autistic spectrum disorders, and SCD should be evaluated with further studies.
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Affiliation(s)
- Zehra Topal
- Department of Child and Adolescent Psychiatry, Hakkari State Hospital, Hakkari, Turkey
| | - Nuran Demir Samurcu
- Department of Child and Adolescent Psychiatry, Izzet Baysal Hospital for Maternity and Pediatric Disorder, Bolu, Turkey
| | - Sarper Taskiran
- Department of Psychiatry, Koc University Medical Faculty, Istanbul, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey,
| | - Bengi Semerci
- Department of Psychology, Bengi Semerci Institute, Hasan Kalyoncu University, Istanbul, Turkey
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Hus Y. Issues in Identification and Assessment of Children with Autism and a Proposed Resource Toolkit for Speech-Language Pathologists. Folia Phoniatr Logop 2017; 69:27-37. [PMID: 29248918 DOI: 10.1159/000477398] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/09/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence of autism spectrum disorder (ASD) has increased significantly in the last decade as have treatment choices. Nonetheless, the vastly diverse autism topic includes issues related to naming, description, iden-tification, assessment, and differentiation from other neu-rodevelopmental conditions. ASD issues directly impact speech-language pathologists (SLPs) who often see these children as the second contact, after pediatric medical practitioners. Because of shared symptomology, differentiation among neurodevelopmental disorders is crucial as it impacts treatment, educational choices, and the performance trajectory of affected children. OBJECTIVES To highlight issues in: identification and differentiation of ASD from other communication and language challenges, the prevalence differences between ASD gender phenotypes, and the insufficient consideration of cultural factors in evaluating ASD in children. A second objective was to propose a tool to assist SLPs in the management of autism in children. SUMMARY A universal resource toolkit development project for SLP communities at large is proposed. The resource is comprised of research-based observation and screening tools for caregivers and educators, as well as parent questionnaires for portraying the children's function in the family, cultural com-munity, and educational setting.
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Mandy W, Wang A, Lee I, Skuse D. Evaluating social (pragmatic) communication disorder. J Child Psychol Psychiatry 2017; 58:1166-1175. [PMID: 28741680 DOI: 10.1111/jcpp.12785] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Social (pragmatic) communication disorder (SPCD) is a new diagnosis introduced by DSM-5, characterised by problems with verbal and nonverbal social communication. It is currently unclear whether SPCD is a valid diagnostic category, because little is known about the characteristics of those who meet its criteria. We sought to identify and describe cases of SPCD, to contribute to debates about its validity. We investigated whether the symptoms of SPCD cluster together to form a coherent syndrome that is distinct from autism spectrum disorder (ASD) in terms of its core and associated features. METHODS Participants were young people (N = 1,081, age range = 4-18 years) who had attended a specialist social communication disorders clinic for children with fluent language and normal-range intelligence. Standardised parent-report data were collected using the Developmental, Dimensional and Diagnostic Interview (3Di), Child Communication Checklist (CCC) and Strengths and Difficulties Questionnaire (SDQ). An algorithm was designed using 3Di and CCC items to implement DSM-5 SPCD criteria. RESULTS Eighty-eight young people met our criteria for SPCD, with 801 meeting DSM-5 ASD criteria and the remaining 192 having neither SPCD nor ASD ('clinical comparison group'). The core symptoms of SPCD co-occurred to a moderate degree (average interitem correlation = .22). SPCD cases had autistic social difficulties that were intermediate between ASD and the clinical comparison group. SPCD was associated with high rates of nonautistic psychopathology, with 63.5% scoring in the abnormal range of the SDQ's Total Problems scale. CONCLUSIONS We did not find evidence that SPCD is qualitatively distinct from ASD. Rather, it appears to lie on the borderlands of the autism spectrum, describing those with autistic traits that fall just below the threshold for an ASD diagnosis. SPCD may have clinical utility for identifying people with autistic traits that are insufficiently severe for ASD diagnosis, but who nevertheless require support.
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Affiliation(s)
- William Mandy
- Research Department of Clinical, Educational and Health Psychology, UCL, London, UK
| | - Adele Wang
- Behavioural and Brain Science Unit, Institute of Child Health, UCL, London, UK
| | - Irene Lee
- Behavioural and Brain Science Unit, Institute of Child Health, UCL, London, UK
| | - David Skuse
- Behavioural and Brain Science Unit, Institute of Child Health, UCL, London, UK.,Department of Child and Adolescent Mental Health, Great Ormond Street Hospital, London, UK
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