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Karni-Visel Y, Baum N, Schertz M. Understanding autism and its treatment: The child's perspective. Soc Sci Med 2024; 354:117066. [PMID: 38943777 DOI: 10.1016/j.socscimed.2024.117066] [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: 02/16/2024] [Revised: 05/31/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024]
Abstract
INTRODUCTION While parents' and professionals' perceptions regarding children with autism spectrum disorder (ASD) have been studied extensively, limited data regarding the perspectives of children with ASD on their needs and the challenges they face are available. The study aimed to examine how children with ASD understand their condition and the aims of the interventions they undergo. METHODS Nineteen children and adolescents (ages 5.7-14.2 years) formally diagnosed with ASD, with borderline to high intelligence (range 70-140), and able to converse verbally were interviewed in person at a child development clinic. A qualitative approach was used to capture children's perceptions of their strengths and challenges and their understanding of a novel ASD treatment. The interview included direct and projective open-ended questions on each topic. Interpretive content analysis was used to evaluate the children's answers. Medical data were extracted from medical records. The children's parents completed questionnaires on their children's disability levels, awareness of ASD diagnosis, and sociodemographic details. FINDINGS Children spoke of their embodied sensations and feelings and discussed "normality" vs. "disability." They varied in their awareness of their diagnosis/symptoms, and only one boy named his diagnosis and described its consequences in detail. Most children lacked an understanding of the educational and therapeutic aspects of the goals set for them. DISCUSSION AND CONCLUSIONS Children with ASD are aware of their unique emotional and behavioral challenges. Nevertheless, they are frequently excluded from the process of patient information provision and lack an understanding of the goals of interventions. Findings suggest the need to explore developmentally and emotionally adaptive ways to involve children with ASD in discussions of their condition and possible interventions.
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Affiliation(s)
- Yael Karni-Visel
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel.
| | - Nehami Baum
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Mitchell Schertz
- Child Development and Pediatric Neurology Service, Meuhedet Health Services, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
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2
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Wang C, Xiao Z, Xu Y, Zhang Q, Chen J. A novel approach for ASD recognition based on graph attention networks. Front Comput Neurosci 2024; 18:1388083. [PMID: 38659616 PMCID: PMC11039788 DOI: 10.3389/fncom.2024.1388083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Abstract
Early detection and diagnosis of Autism Spectrum Disorder (ASD) can significantly improve the quality of life for affected individuals. Identifying ASD based on brain functional connectivity (FC) poses a challenge due to the high heterogeneity of subjects' fMRI data in different sites. Meanwhile, deep learning algorithms show efficacy in ASD identification but lack interpretability. In this paper, a novel approach for ASD recognition is proposed based on graph attention networks. Specifically, we treat the region of interest (ROI) of the subjects as node, conduct wavelet decomposition of the BOLD signal in each ROI, extract wavelet features, and utilize them along with the mean and variance of the BOLD signal as node features, and the optimized FC matrix as the adjacency matrix, respectively. We then employ the self-attention mechanism to capture long-range dependencies among features. To enhance interpretability, the node-selection pooling layers are designed to determine the importance of ROI for prediction. The proposed framework are applied to fMRI data of children (younger than 12 years old) from the Autism Brain Imaging Data Exchange datasets. Promising results demonstrate superior performance compared to recent similar studies. The obtained ROI detection results exhibit high correspondence with previous studies and offer good interpretability.
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Affiliation(s)
- Canhua Wang
- School of Computer, Jiangxi University of Chinese Medicine, Nanchang, China
| | - Zhiyong Xiao
- School of Electronic & Information Engineering, Jiangxi Institute of Economic Administrators, Nanchang, China
| | - Yilu Xu
- School of Software, Jiangxi Agricultural University, Nanchang, China
| | - Qi Zhang
- Department of Medical Imaging, Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, China
| | - Jingfang Chen
- Department of Medical Imaging, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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3
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Ferrante C, Sorgato P, Fioravanti M, Pacione L, Arduino GM, Ghersi S, Scattoni ML, Servili C, Salomone E. Supporting Caregivers Remotely During a Pandemic: Comparison of WHO Caregiver Skills Training Delivered Online Versus in Person in Public Health Settings in Italy. J Autism Dev Disord 2024; 54:765-784. [PMID: 36454366 PMCID: PMC9713075 DOI: 10.1007/s10803-022-05800-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 12/05/2022]
Abstract
Feasibility, acceptability and effectiveness data of a virtual adaptation of the WHO Caregiver Skills Training (CST; n = 25) were compared with those of a pilot RCT of CST delivered in person (n = 43) against treatment as usual (TAU; n = 43). Virtual CST was delivered with high levels of integrity, but received lower ratings in some caregiver- and facilitator-rated acceptability and feasibility dimensions. Qualitative analysis identified both benefits (flexibility, convenience, clinical usefulness) and challenges, (technological issues, distraction from family members, emotional distance). Virtual and in-person CST improved significantly more on caregiver competence than TAU; there were no other significant effects. Potential for use of virtual CST as a clinical response in contexts where in-person delivery is not possible is discussed.
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Affiliation(s)
- Camilla Ferrante
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Paola Sorgato
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Mariachiara Fioravanti
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy
| | - Laura Pacione
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Giuseppe Maurizio Arduino
- Centro Autismo e Sindrome di Asperger, Ospedale Regina Montis Regalis Mondovì, Mondovì (Cuneo), Italy
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
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Cirnigliaro L, Valle MS, Casabona A, Randazzo M, La Bruna F, Pettinato F, Narzisi A, Rizzo R, Barone R. The Developmental Autism Early Screening (DAES): A Novel Test for Screening Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06184-3. [PMID: 38109035 DOI: 10.1007/s10803-023-06184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2023] [Indexed: 12/19/2023]
Abstract
This study was undertaken to set a novel developmental screening test for autism spectrum disorder (ASD) using the Griffiths Scales of Child Development (Griffith III) (Green et al., 2016; Stroud et al., 2016), in order to intercept the early atypical developmental patterns indicating ASD risk in the first 3 years of age. An observational and interactive ASD screener, the Developmental Autism Early Screening (DAES), was developed by detecting Griffiths III items differentiating toddlers with ASD risk from those with global developmental delay (DD) or neurotypical development. The DAES was validated with ASD-specific diagnostic instruments (ADOS-2) and the cut-off score based on sensitivity, specificity and positive predictive value that best differentiates between ASD and non-ASD children was identified. We enrolled a total sample of 297 subjects, including children at risk for ASD or DD and neurotypical children. At a cut-off score of 12.5, the DAES had a sensitivity of 93%, specificity of 98.4%, positive predictive value of 96.3% and negative predictive value of 96.9% for identifying children at risk for ASD from non-ASD participants (DD/neurotypical children). The DAES total score correlated significantly with the ADOS-2 calibrated severity scores (CSS) (R = 0.53, p < 0.001). Three ASD risk ranges were identified according to DAES total and ADOS-2 CSS: Little-to-no risk (CSS: 1-3, DAES: 1-7); Mild-to-moderate risk (CSS: 4-5, DAES: 8-14); Moderate-to-severe risk (CSS: 6-10, DAES ≥ 15). The DAES provides a direct approach based on developmental profiles to stratify risk for ASD in early childhood ensuring at risk children the most appropriate diagnostic procedures and targeted intervention.
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Affiliation(s)
- Lara Cirnigliaro
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Policlinico Via Santa Sofia, 78, 95123, Catania, Italy
| | - Maria Stella Valle
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Antonino Casabona
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Martina Randazzo
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Policlinico Via Santa Sofia, 78, 95123, Catania, Italy
| | - Francesca La Bruna
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Policlinico Via Santa Sofia, 78, 95123, Catania, Italy
| | - Fabio Pettinato
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Policlinico Via Santa Sofia, 78, 95123, Catania, Italy
| | | | - Renata Rizzo
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Policlinico Via Santa Sofia, 78, 95123, Catania, Italy
| | - Rita Barone
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Policlinico Via Santa Sofia, 78, 95123, Catania, Italy.
- Reseach Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, Troina, Italy.
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Penner M, Lai MC. Enhancing access to autism diagnostic services for children in the community. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2201-2204. [PMID: 37736667 DOI: 10.1177/13623613231201212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
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Dai Y, Deng T, Chen M, Huang B, Ji Y, Feng Y, Liu S, Zhong D, Zhang T, Zhang L. Improving early detection, diagnosis and intervention for children with autism spectrum disorder: A cross-sectional survey in China. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 142:104616. [PMID: 37820392 DOI: 10.1016/j.ridd.2023.104616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 08/01/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Detection and diagnosis of autism spectrum disorder (ASD) are prerequisites for early interventions. However, few studies focused on this topic. AIM This study aims to characterize the timing from symptom detection to intervention in children with ASD and identify predictors of age at ASD diagnosis, presence of intervention, and the time lag between detection and diagnosis. METHODS AND PROCEDURES A cross-sectional survey was conducted with 303 parents (111 fathers and 192 mothers, 21-54 years) of children with ASD in Guangzhou, China. OUTCOMES AND RESULTS The median time from symptom observation to the first doctor visit was 3 months, while the time to ASD diagnosis averaged 6 months. Most children (76.24 %) were diagnosed within one year after detection, and 25.58 % had no intervention after diagnosis. Predictors of earlier ASD diagnosis included ASD-related symptoms identified at an older age, less serious symptoms, and initial symptoms with atypical motor development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with social deficits, sensory anomalies, and without language impairment, primary caregivers other than parents, families with lower income, and less social support utilization increased the odds of a time lag between detection and diagnosis. Children with fathers having lower education were less likely to receive interventions. CONCLUSIONS AND IMPLICATIONS Earlier ASD identification and intervention might be facilitated by health education on typical symptoms of ASD for parents with young children and incorporating ASD screening during routine health examinations for children. For children whose primary caregivers are not their parents and from lower-income families, additional support may be required for timely diagnosis after reporting ASD-related symptoms. Moreover, more intervention supports are expected for children whose fathers have lower education levels. Helping families take full advantage of support is also important for early diagnosis and intervention.
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Affiliation(s)
- Yushen Dai
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Tao Deng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Miaoying Chen
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Baoqin Huang
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Yan Ji
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Yongshen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Shaofei Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Dongmei Zhong
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Tao Zhang
- Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macao, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Mendez MA, Oakley B, Canitano R, San José-Cáceres A, Tinelli M, Knapp M, Cusack J, Parellada M, Violland P, Derk Plas JR, Canal-Bedia R, Bejarano-Martin A, Murphy DG, Quoidbach V, Arango C. Autism care pathway in Europe. Eur Psychiatry 2023; 66:e81. [PMID: 37694810 PMCID: PMC10594203 DOI: 10.1192/j.eurpsy.2023.2435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Autism is a lifelong complex neurodevelopmental condition that affects brain development and behaviour with significant consequences for everyday life. Despite its personal, familial, and societal impact, Europe-wide harmonised guidelines are still lacking for early detection, diagnosis, and intervention, leading to an overall unsatisfactory autistic person and carer journey. METHODS The care pathway for autistic children and adolescents was analysed in Italy, Spain and the UK from the perspective of carers (using a survey aimed at caregivers of autistic children 0-18 years old), the autistic community, and professionals in order to identify major barriers (treatment gaps) preventing carers from receiving information, support, and timely screening/diagnosis and intervention. RESULTS Across all three countries, analysis of the current care pathway showed: long waits from the time carers raised their first concerns about a child's development and/or behaviour until screening and confirmed diagnosis; delayed or no access to intervention once a diagnosis was confirmed; limited information about autism and how to access early detection services; and deficient support for families throughout the journey. CONCLUSIONS These findings call for policy harmonisation in Europe to shorten long wait times for diagnosis and intervention and therefore, improve autistic people and their families' journey experience and quality of life.
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Affiliation(s)
- Maria A. Mendez
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- CIBERSAM (Mental Health Networking Biomedical Research Centre), Madrid, Spain
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- AIMS-2-TRIALS consortium
| | | | - Antonia San José-Cáceres
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- CIBERSAM (Mental Health Networking Biomedical Research Centre), Madrid, Spain
- AIMS-2-TRIALS consortium
| | - Michela Tinelli
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Mara Parellada
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- CIBERSAM (Mental Health Networking Biomedical Research Centre), Madrid, Spain
- AIMS-2-TRIALS consortium
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | | | | | | | | | - Declan G.M. Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- AIMS-2-TRIALS consortium
| | | | - Celso Arango
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- CIBERSAM (Mental Health Networking Biomedical Research Centre), Madrid, Spain
- AIMS-2-TRIALS consortium
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
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Rasga C, Santos JX, Café C, Oliveira A, Duque F, Posada M, Nunes A, Oliveira G, Vicente AM. Prevalence of Autism Spectrum Disorder in the Centro region of Portugal: a population based study of school age children within the ASDEU project. Front Psychiatry 2023; 14:1148184. [PMID: 37711428 PMCID: PMC10499322 DOI: 10.3389/fpsyt.2023.1148184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 08/10/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Accurate prevalence estimates for Autism Spectrum Disorder (ASD) are fundamental to adequately program medical and educational resources for children. However, estimates vary globally and across Europe, and it is therefore wise to conduct epidemiological studies in defined geo-cultural contexts. Methods We used a population screening approach to estimate the prevalence of ASD in the Centro region of Portugal, using a harmonized protocol as part of the Autism Spectrum Disorders in the European Union (ASDEU) project. Results The overall prevalence was estimated at 0.5% (95% CI 0.3-0.7), higher in schools with Autism Units (3.3%, 95%CI 2.7-3.9) than in regular schools (0.3%, 95% CI 0.1-0.5) or schools with Multiple Disability Units (0.3%, 95% CI 0.04-0.6). Discussion The results indicate that the diagnosis of ASD is followed by the most effective educational policies in Centro Region. The variability in prevalence estimates across the different regions from the ASDEU project, and globally, is discussed.
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Affiliation(s)
- Célia Rasga
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- Faculty of Sciences, University of Lisboa, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - João Xavier Santos
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- Faculty of Sciences, University of Lisboa, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Cátia Café
- Unidade de Neurodesenvolvimento e Autismo, Serviço do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Alexandra Oliveira
- Unidade de Neurodesenvolvimento e Autismo, Serviço do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Frederico Duque
- Unidade de Neurodesenvolvimento e Autismo, Serviço do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Manuel Posada
- Institute of Rare Diseases Research, IIER, Instituto de Salud Carlos III, ISCIII, Madrid, Spain
| | - Ana Nunes
- Faculty of Sciences, University of Lisboa, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
- Departamento de Física, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Portugal
| | - Guiomar Oliveira
- Unidade de Neurodesenvolvimento e Autismo, Serviço do Centro de Desenvolvimento da Criança, Centro de Investigação e Formação Clínica, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- Faculty of Medicine, University Clinic of Pediatrics and Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
| | - Astrid Moura Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- Faculty of Sciences, University of Lisboa, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
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Hyassat M, Al-Makahleh A, Rahahleh Z, Al-Zyoud N. The Diagnostic Process for Children with Autism Spectrum Disorder: A Preliminary Study of Jordanian Parents' Perspectives. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1394. [PMID: 37628393 PMCID: PMC10453648 DOI: 10.3390/children10081394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023]
Abstract
Although extensive research has been conducted worldwide to investigate the diagnostic process of Autism Spectrum Disorder (ASD), Jordanian parents' experiences have been overlooked. This study explored parents' journeys toward receiving diagnoses for their children with ASD. In particular, it aimed to provide a clear picture of the process for obtaining these diagnoses for children in Jordan. METHODS Eighteen semi-structured interviews were carried out with 12 mothers and six fathers of children with ASD aged 5 to 11 years old. RESULTS The coding process was based on a thematic analysis method and resulted in the identification of three overlapping themes: dissatisfaction with professionals' abilities to approach parents, an unstructured diagnostic process, and perspectives on diagnosis tools. CONCLUSIONS Our data upheld the idea that parental satisfaction with the diagnostic process is influenced by the duration of the process, the information provided, the support offered, and the communication approach used by professionals. Within the local cultural context, parents were significantly impacted by the societal stigma associated with disability when they sought diagnoses for their children with ASD.
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Affiliation(s)
- Mizyed Hyassat
- Department of Special Education, Princess Rahma University College, Al-Balqa Applied University, Salt 19117, Jordan; (A.A.-M.); (Z.R.)
| | - Ahmad Al-Makahleh
- Department of Special Education, Princess Rahma University College, Al-Balqa Applied University, Salt 19117, Jordan; (A.A.-M.); (Z.R.)
| | - Zahraa Rahahleh
- Department of Special Education, Princess Rahma University College, Al-Balqa Applied University, Salt 19117, Jordan; (A.A.-M.); (Z.R.)
| | - Nawaf Al-Zyoud
- Department of Psychological Sciences, College of Education, Qatar University, Doha 93001, Qatar;
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Mendez MA, Canitano R, Oakley B, San José-Cáceres A, Tinelli M, Knapp M, Cusack J, Parellada M, Violland P, Derk Plas JR, Murphy DGM, Quoidbach V, Arango C. Autism with co-occurring epilepsy care pathway in Europe. Eur Psychiatry 2023; 66:e61. [PMID: 37470323 PMCID: PMC10486251 DOI: 10.1192/j.eurpsy.2023.2426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/24/2023] [Accepted: 05/01/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Autism and epilepsy often occur together. Epilepsy and other associated conditions have a substantial impact on the well-being of autistic people and their families, reduce quality of life, and increase premature mortality. Despite this, there is a lack of studies investigating the care pathway of autistic children with co-occurring epilepsy in Europe. METHODS We analyzed the care pathway for autistic children with associated epilepsy in Italy, Spain, and the United Kingdom from the perspective of caregivers (using a survey aimed at caregivers of autistic children 0-18 years old), the autistic community, and professionals, in order to identify major barriers preventing caregivers and autistic children from receiving timely screening and treatment of possible co-occurring epilepsy. RESULTS Across all three countries, an analysis of the current care pathway showed a lack of systematic screening of epilepsy in all autistic children, lack of treatment of co-occurring epilepsy, and inappropriate use of antiepileptic drugs. A major challenge is the lack of evidence-based harmonized guidelines for autism with co-occurring epilepsy in these countries. CONCLUSIONS Our findings show both heterogeneity and major gaps in the care pathway for autism with associated epilepsy and the great efforts that caregivers must make for timely screening, diagnosis, and adequate management of epilepsy in autistic children. We call for policy harmonization in Europe in order to improve the experiences and quality of life of autistic people and their families.
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Affiliation(s)
- Maria A. Mendez
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Roberto Canitano
- Department of Psychiatry, Azienda ospedaliero-universitaria Senese, Siena, Italy
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- AIMS-2-TRIALS Consortium
| | - Antonia San José-Cáceres
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- AIMS-2-TRIALS Consortium
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto Salud Carlos III, Madrid, Spain
| | - Michela Tinelli
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Martin Knapp
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | | | - Mara Parellada
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- AIMS-2-TRIALS Consortium
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
| | | | | | - Declan G. M. Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- AIMS-2-TRIALS Consortium
| | | | - Celso Arango
- Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- AIMS-2-TRIALS Consortium
- Mental Health Networking Biomedical Research Centre (CIBERSAM), Instituto Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid, Spain
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Fulceri F, Gila L, Caruso A, Micai M, Romano G, Scattoni ML. Building Bricks of Integrated Care Pathway for Autism Spectrum Disorder: A Systematic Review. Int J Mol Sci 2023; 24:ijms24076222. [PMID: 37047213 PMCID: PMC10094376 DOI: 10.3390/ijms24076222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/03/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023] Open
Abstract
An integrated plan within a defined care pathway for the diagnosis, continuative interventions, and periodic redefinition of care of autistic people is essential for better outcomes. Challenges include delivering services across all domains or life stages and effective coordination between health/social care providers and services. Further, in the ‘real world’, service provision varies greatly, and in many settings is significantly weighted towards diagnosis and children’s services rather than treatment and support or adult care. This study aims to identify existing care pathways for Autism Spectrum Disorder (ASD) from referral to care management after diagnosis. The study reviewed the international literature in PubMed and PsycInfo databases and collected information on care for autistic individuals from the Autism Spectrum Disorders in Europe (ASDEU) project partners. The study found that published data mainly focused on specific components of care pathways rather than an integrated and coordinated plan of care and legislative indications. They should be aimed at facilitating access to the services for support and the inclusiveness of autistic individuals. Given the need for care addressing the complex and heterogeneous nature of ASD, effective coordination between different health/social care providers and services is essential. It is also suggested that research priority should be given to the identification of an integrated care pathway ‘model’ centered around case management, individualization, facilitation, support, continuous training and updating, and quality management.
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12
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Loubersac J, Michelon C, Ferrando L, Picot MC, Baghdadli A. Predictors of an earlier diagnosis of Autism Spectrum Disorder in children and adolescents: a systematic review (1987-2017). Eur Child Adolesc Psychiatry 2023; 32:375-393. [PMID: 33909143 DOI: 10.1007/s00787-021-01792-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/19/2021] [Indexed: 01/11/2023]
Abstract
Autism Spectrum Disorder (ASD) is an early onset neurodevelopmental disorder in which the first signs generally emerge at approximately 12 months of age but its diagnosis is feasible only from the age of 18 months. According to the literature, the average age of diagnosis ranges from 2.7 to 7.2 years, which raises the question of factors associated with early diagnosis as a condition for early intervention. In this systematic review, we aim to identify clinical, social, and environmental factors associated with the age at which the diagnosis of ASD is confirmed in children. A literature search was performed in the Pubmed, Web of Sciences, PsycInfo, and Cochrane databases. Among the 530 publications identified, 50 were selected according to the inclusion criteria. This review focuses on studies conducted in 21 countries using data collected over a period from 1987 to 2017. These studies were published before December 31st, 2019. The results suggest that the diagnosis of ASD occurs earlier if there is a delay in social communication or the presence of intellectual disability. There is a low level of evidence concerning associations between the age at diagnosis and sex, race, parental education, or socioeconomic status and accessibility to health care. Further studies using large and well-characterized data sets are needed to simultaneously explore clinical and socio-environmental factors involved in early diagnosis.
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Affiliation(s)
- Julie Loubersac
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
| | - Laetitia Ferrando
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
| | - Marie-Christine Picot
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
- Department of Medical Information, University Hospital, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
- Faculté de Médecine, Université de Montpellier, Montpellier, France.
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13
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Rumrill SP, Rumrill P, Gooden C, Leslie MJ, Ju HJ, Cormier AG. A scoping literature review of transition-related research involving youth with autism spectrum disorder. JOURNAL OF VOCATIONAL REHABILITATION 2023. [DOI: 10.3233/jvr-230010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND: Owing to steadily increasing rates of autism spectrum disorder (ASD) among children, youth, and adults, it is certain that growing numbers of these individuals will need transition and vocational rehabilitation (VR) services for many years to come. ASD research has focused on identifying employment barriers rather than on effective interventions to remove or reduce those barriers. Even so, some evidence has demonstrated support for the effectiveness of specific transition-related interventions. OBJECTIVE: The purpose of this article is to review the existing literature regarding transition and employment for youth with ASD. METHOD: We begin with an overview of the clinical characteristics of ASD and its incidence and prevalence in the U.S. Then, we examine vocational issues facing individuals with ASD. RESULTS: The remainder of the article focuses on transition and VR implications with specific emphases on (a) interdisciplinary transition planning, (b) postsecondary educational supports and services, and (c) employment interventions. CONCLUSION: ASD is a high-incidence disability that presents significant service delivery and advocacy needs for young people with ASD and their families. Evidence-based employment interventions are available to help young people with ASD make smooth transitions to adulthood in the settings of their choice.
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Affiliation(s)
| | | | | | | | - Hyun-Ju Ju
- University of Kentucky, Lexington, KY, USA
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14
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Reading Behaviors through Patterns of Finger-Tracking in Italian Children with Autism Spectrum Disorder. Brain Sci 2022; 12:brainsci12101316. [PMID: 36291249 PMCID: PMC9599730 DOI: 10.3390/brainsci12101316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/13/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
The paper proposes an ecological and portable protocol for the large-scale collection of reading data in high-functioning autism spectrum disorder (ASD) children based on recording the finger movements of a subject reading a text displayed on a tablet touchscreen. By capitalizing on recent evidence that movements of a finger that points to a scene or text during visual exploration or reading may approximate eye fixations, we focus on recognition of written content and function words, pace of reading, and accuracy in reading comprehension. The analysis showed significant differences between typically developing and ASD children, with the latter group exhibiting greater variation in levels of reading ability, slower developmental pace in reading speed, less accurate comprehension, greater dependency on word length and word frequency, less significant prediction-based processing, as well as a monotonous, steady reading pace with reduced attention to weak punctuation. Finger-tracking patterns provides evidence that ASD readers may fail to integrate single word processing into major syntactic structures and lends support to the hypothesis of an impaired use of contextual information to predict upcoming stimuli, suggesting that difficulties in perception may arise as difficulties in prediction.
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15
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Guillon Q, Baduel S, Bejarano-Martín Á, Canal-Bedia R, MagÁn-Maganto M, FernÁndez-Álvarez C, Martín-Cilleros MV, SÁnchez-Gómez MC, García-Primo P, Rose-Sweeney M, Boilson A, LinertovÁ R, Roeyers H, Van der Paelt S, Schendel D, Warberg CK, Cramer S, Narzisi A, Muratori F, Scattoni ML, Moilanen I, Yliherva A, Saemundsen E, Jonsdottir SL, Efrim-Budisteanu M, Arghir A, Papuc SM, Vicente A, Rasga C, Xenia Kafka J, Poustka L, Kothgassner OD, Kawa R, Pisula E, Sellers T, Posada de la Paz M, Rogé B. Determinants of satisfaction with the detection process of autism in Europe: Results from the ASDEU study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:2136-2150. [PMID: 35261293 DOI: 10.1177/13623613221080318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Professional guidance and support in response to first concerns appears to be an important predictor of the level of satisfaction with the detection process of autism in young children. In this study, we analyzed the views of 1342 family members, including 1278 parents, who completed an online survey form collecting information about their experience and satisfaction with the early detection of autism in their child. Specifically, we were interested in how specific experiences with the detection process relate to the satisfaction with it and whether we could identify important predictors of satisfaction. The detection process is an emotionally charged period for parents, often described as painful, chaotic, and lengthy. A better understanding of their experiences is important to take appropriate action to improve the detection process. In our sample, the level of satisfaction with the detection process varied greatly from one respondent to another. Among the different experiences we considered, whether or not respondents received professional guidance and support in response to first concerns explained most of this variation. We also found that difficulty finding information about detection services, lack of professional guidance and support in response to first concerns, having to find a diagnostic service on one's own, and longer delays between confirmation of concerns and first appointment with a specialist were experiences associated with a greater likelihood of being unsatisfied. The findings of this study highlight the importance of the parent-professional relationship in the detection process and have important practical implications for health administrations to improve the detection process.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Renata LinertovÁ
- Canary Island Foundation for Health Research (Fundación Canaria de Investigación Sanitaria/FUNCANIS) and Health Service Research Network for Chronic Diseases (Red de Investigación en Servicios de Salud en Enfermedades Crónicas/REDISSEC), Spain
| | | | | | - Diana Schendel
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.,Aarhus University, Denmark.,Drexel University, USA
| | | | | | | | | | | | - Irma Moilanen
- University of Oulu, Finland.,Oulu University Hospital, Finland
| | | | | | | | | | - Aurora Arghir
- Victor Babes - National Institute of Pathology, Romania
| | | | - Astrid Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
| | - Celia Rasga
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Portugal
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16
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Management of Autism Spectrum Disorder in Italian Units of Child and Adolescent Mental Health: Diagnostic and Referral Pathways. Brain Sci 2022; 12:brainsci12020263. [PMID: 35204027 PMCID: PMC8870086 DOI: 10.3390/brainsci12020263] [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: 12/20/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Overall, the present pilot study provides detailed information on clinical management for Autism Spectrum Disorder (ASD) referral and diagnosis processes that are mandatory for child and adolescent mental health management. The analysis of ASD management, even if carried out on a selected sample of Child and Adolescent Mental Health (CAMH) units, represents a good approximation of how, in Italian outpatient settings, children and adolescents with ASD are recognised and eventually diagnosed. One of the aims of the study was to verify the adherence of Italian CAMH units to international recommendations for ASD referral and diagnosis and whether these processes can be traced using individual chart reports. Overall, the analysis evidenced that Italian CAMH units adopt an acceptable standard for ASD diagnosis, although the reporting of the ASD managing process in the individual chart is not always accurate. Furthermore, data collected suggest some improvements that CAMH units should implement to fill the gap with international recommendations, namely, establishing a multidisciplinary team for diagnosis, improving the assessment of physical and mental conditions by the use of standardised tools, implementing a specific assessment for challenging behaviours that could allow timely and specific planning of intervention.
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17
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Cascio MA, Racine E. Autism service preferences of parents/guardians and autistic adults in five countries. Autism Res 2022; 15:570-585. [PMID: 35040590 DOI: 10.1002/aur.2667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/26/2021] [Accepted: 12/16/2021] [Indexed: 01/14/2023]
Abstract
Scholars and activists debate whether people on the autism spectrum should access autism-specific services or general/inclusive/mainstream services. This article presents quantitative results from a mixed-methods survey of autistic adults and parents/guardians of autistic people in Canada, France, Germany, Italy, and the United States. Respondents reported categories of services used (autism-specific, mixed-disability, or general/inclusive/mainstream), satisfaction, and overall service preference. Most respondents preferred autism-specific services, followed by different categories of services for different service types. Demographic factors had little influence on overall service preferences. No significant differences were found between adults' and parents/guardians' overall service preferences. For parents/guardians, using autism-specific services was associated with a preference for autism-specific services. There were significant associations between the services respondents reported having previously used and their overall service preference. Parents/guardians in Italy and France reported lower satisfaction with many services. These results suggest that a preference for autism-specific services pervades different groups. While most respondents did endorse autism-specific services, the strong secondary preference for different service categories encourages providers and policy makers to attend to diverse needs. While satisfaction was generally middling to high, there remain areas for improvement, especially in general job training services. General services can use a Universal Design approach and collaborate with autism-specific and mixed-disability services to increase accessibility to diverse populations. The influence of previous service use on preferences suggests that providers can leverage strengths of existing services, leverage and create connections, and ask users about previous experiences to better address their expectations. LAY SUMMARY: This study asked autistic adults and parents/guardians of autistic people what they think about autism services. Most parents/guardians and adults liked services that focus on autism, but many parents/guardians and adults liked them for some things and not others. All services can ask people about services they used in the past and learn from the strengths of good services through Universal Design and working with other services.
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Affiliation(s)
- M Ariel Cascio
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Quebec, Canada.,Department of Medicine (Division of Experimental Medicine), Department of Neurology and Neurosurgery, Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
| | - Eric Racine
- Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, Quebec, Canada.,Department of Medicine (Division of Experimental Medicine), Department of Neurology and Neurosurgery, Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada.,Département de médicine, Département de médecine sociale et préventive, Université de Montréal, Montréal, Quebec, Canada
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18
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Early Developmental Signs in Children with Autism Spectrum Disorder: Results from the Japan Environment and Children’s Study. CHILDREN 2022; 9:children9010090. [PMID: 35053715 PMCID: PMC8774672 DOI: 10.3390/children9010090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 12/25/2021] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
Autism spectrum disorder (ASD) is a developmental disability in early childhood. Early identification and intervention in children with ASD are essential for children and their families. This study aimed to identify the earliest signs of ASD. Using a large cohort including data from 104,062 fetal records in the Japan Environment and Children’s Study, we examined the Ages and Stages Questionnaires® (ASQ-3TM) scores of children with and without ASD. The ASQ-3 comprises five domains: communication, gross motor, fine motor, problem solving, and personal-social. The ASQ-3 scores were obtained at ages 6 months, 1 year, and 3 years. There were 64,501 children with available ASQ-3 data. The number of children diagnosed with ASD was 188 (0.29%) at 3 years of age. The highest relative risk (RR) for any domain below the monitoring score at 6 months was in the communication (RR 1.90, 95% CI 1.29–2.78, p = 0.0041), followed by fine motor (RR 1.50, 95% CI 1.28–1.76, p < 0.0001) domain. A low ASQ-3 score in the communication domain at 6 months was related to an ASD diagnosis at 3 years of age. The ASQ-3 score at 6 months can contribute to the early identification of and intervention for ASD.
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19
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Souza LSD, Balestro JI, Cáceres-Assenço AM. Dificuldades comunicativas percebidas por mães de crianças com suspeita de transtorno do espectro do autismo em contexto de distanciamento social. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222431422s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: caracterizar a percepção das mães de crianças com risco para Transtorno do Espectro do Autismo acerca das dificuldades comunicativas dos seus filhos, e investigar possíveis mudanças após intervenção baseada em orientação breve via telemonitoramento. Métodos: participaram oito mães de crianças entre 32 e 45 meses com suspeita de Transtorno do Espectro do Autismo e em processo de investigação diagnóstica. Utilizou-se o Questionário sobre Dificuldades Comunicativas, aplicado antes e após intervenção baseada em orientação por telemonitoramento. A análise inferencial utilizou o teste de postos de Wilcoxon, com nível de significância de 5%. Resultados: a comparação entre os dois momentos não indicou diferença estatística. Porém, houve modificações na análise qualitativa. No domínio 1, observou-se mudança na moda em duas questões. No domínio 2 houve moda discordo inicialmente e, após intervenção, passou a concordo acerca da sensação de outras pessoas evitarem/zombarem seus filhos. No domínio 3, a questão “Pego todos os objetos que meu filho aponta” passou de concordo para discordo (62,5% para 25%) e a “Não consigo ensinar coisas novas para meu filho” não teve mudança na moda, apenas redução da concordância (50% para 25%). No domínio 4, houve redução de concordância, sem mudança da moda. Conclusões: as mães perceberam dificuldades comunicativas e desafios cotidianos para lidar com os filhos. Apesar da ausência de diferença estatística, qualitativamente observaram-se modificações sutis nas percepções das dificuldades após a intervenção.
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20
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Zhang Y, Zhou Z, Xu Q, Li H, Lv Y, Zhu G, Dong P, Li D, Wang Y, Tang X, Xu X. Screening for Autism Spectrum Disorder in Toddlers During the 18- and 24-Month Well-Child Visits. Front Psychiatry 2022; 13:879625. [PMID: 35573353 PMCID: PMC9097214 DOI: 10.3389/fpsyt.2022.879625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 03/31/2022] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Early screening contributes to the early detection of children with autism spectrum disorder (ASD). We conducted a longitudinal ASD screening study in a large community setting. The study was designed to investigate the diagnostic rate of ASD screening and determine the effectiveness of ASD screening model in a community-based sample. METHODS We enrolled children who attended 18- and 24-month well-child care visits in Shanghai Xuhui District. Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) and Binomial Observation Test (BOT) were selected as screening instruments. Screen-positive children were referred to a tertiary diagnostic center for comprehensive ASD diagnostic evaluation. Screen-negative children received well-child checkups and follow-up every 3-6 months until age three and were referred if they were suspected of having ASD. RESULTS A total of 11,190 toddlers were screened, and 36 screen-positive toddlers were diagnosed with ASD. The mean age at diagnosis for these children was 23.1 ± 4.55 months, diagnosed 20 months earlier than ASD children not screened. The diagnostic rate of ASD was 0.32% (95% CI: 0.23-0.45%) in this community-based sample. In addition, 12 screen-negative children were diagnosed with ASD during subsequent well-child visit and follow-up. The average diagnostic rate of ASD rose to 0.43% (95% CI: 0.32-0.57%) when toddlers were followed up to 3 years old. The positive predictive values (PPVs) of M-CHAT-R/F, M-CHAT-R high risk, and BOT for ASD were 0.31, 0.43, and 0.38 respectively. CONCLUSION Our findings provide reliable data for estimating the rate of ASD detection and identifying the validity of community-based screening model. M-CHAT-R/F combined with BOT can be an effective tool for early detection of ASD. This community-based screening model is worth replicating.
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Affiliation(s)
- Ying Zhang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Zhaoe Zhou
- Department of Child Healthcare, Xuhui Maternal and Child Healthcare Hospital, Shanghai, China
| | - Qiong Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Huiping Li
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Yujing Lv
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Guowei Zhu
- Department of Child Healthcare, Xuhui Maternal and Child Healthcare Hospital, Shanghai, China
| | - Ping Dong
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Dongyun Li
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Wang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xinrui Tang
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
| | - Xiu Xu
- Department of Child Healthcare, Children's Hospital of Fudan University, Shanghai, China
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Souza LSD, Balestro JI, Cáceres-Assenço AM. Communication difficulties perceived by mothers of children with suspected autism spectrum disorder during social distancing. REVISTA CEFAC 2022. [DOI: 10.1590/1982-0216/20222431422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to characterize the perception of mothers of children at risk for Autism Spectrum Disorder about their children's communicative difficulties, and to investigate possible changes after intervention based on brief guidance by telemonitoring. Methods: eight mothers of children aged 32 to 45 months with suspected Autism Spectrum Disorder undergoing diagnostic investigation participated. The Communicative Difficulties Questionnaire was used, applied before and after intervention based on a brief telemonitoring guidance. The inferential analysis used the Wilcoxon rank test, at a significance level of 5%. Results: comparison between the two moments did not indicate statistically significant difference. However, there were changes in qualitative analysis. In domain 1, a change in mode was observed in two questions. Initially, in domain 2, a disagreeing mode was seen, which after the intervention evolved to agreeing about the feeling of other people avoiding/bullying their children. In domain 3, the question “I take all objects that my child points to” changed from agreeing to disagreeing (62.5% to 25%), and the question “I can't teach my child new things” had no change in mode, only a reduction of agreement (50% to 25%). In domain 4, there was a reduction in agreement, with no change in mode. Conclusions: the mothers perceived communicative difficulties and daily challenges in dealing with their children. Despite the lack of a statistical difference, qualitatively subtle changes were observed in the perceptions of difficulties, after the intervention.
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22
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Nagai Y, Mizutani Y, Nomura K, Uemura O, Saitoh S, Iwata O. Diagnostic rate of autism spectrum disorder in a high-survival cohort of children born very preterm: A cross-sectional study. Int J Dev Neurosci 2021; 82:188-195. [PMID: 34970792 DOI: 10.1002/jdn.10168] [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: 08/03/2021] [Revised: 12/11/2021] [Accepted: 12/27/2021] [Indexed: 11/11/2022] Open
Abstract
To investigate the diagnostic rate of autism spectrum disorder (ASD) in a high-survival cohort of very preterm children, 77 infants born very preterm (<32 weeks of gestation) were assessed at age 4-6 years old using the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Sixteen children (20.8%) were classified as both DSM-5-positive ASD and ADOS-2-identified "autism," which were defined as confirmed ASD in this study. Our result suggests that the prevalence of ASD in very preterm children might be much higher than reported in previous studies when all children were individually evaluated. Further studies in a large sample are required to clarify the true risk of ASD in preterm birth.
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Affiliation(s)
- Yukiyo Nagai
- Department of Pediatrics, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Yuko Mizutani
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kayo Nomura
- Department of Education, Gifu Shotoku Gakuen University, Gifu, Japan
| | - Osamu Uemura
- Department of Pediatrics, Ichinomiya Medical Treatment & Habilitation Center, Ichinomiya, Japan
| | - Shinji Saitoh
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Osuke Iwata
- Center for Human Development and Family Science, Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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23
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Abstract
We looked at existing recommendations and supporting evidence on the effectiveness of screening young children for autistic spectrum disorder (ASD) for improving short- and long-term outcomes.We conducted a literature search up to the 8th of November 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported.There are discrepancies among the recommendations given by different institutions on universal screening for ASD in children. Some recommend that all children should be screened with an ASD-specific instrument during well-child visits at ages 18 and 24 months in conjunction with ongoing developmental surveillance and broadband developmental screening; some conclude that the current evidence is insufficient to assess the balance of benefits and harms of screening for ASD in young children for whom no concerns of ASD have been raised by their parents or a clinician; and others recommend against universal screening, but for a screening among children with high risks.There is adequate evidence that ASD screening tools applied to children between 12 and 36 months accurately identify those with ASD. There is some evidence showing benefit of early interventions applied to children with ASD, from children identified with developmental concern by their family, teacher or clinicians. We found no evidence on the effectiveness of interventions applied to children with ASD detected through screening.
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Affiliation(s)
- Sophie Jullien
- Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain.
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24
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Franchini M, Schaer M, Eliez S. Recommandations dans le suivi et l’accompagnement précoce des bébés à risque de développer un trouble du spectre de l’autisme (TSA) : dernières avancées scientifiques. ENFANCE 2021. [DOI: 10.3917/enf2.213.0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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25
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Salomone E, Ferrante C, Salandin A, Ferrara F, Torchio E, Foletti G, Ghersi S, Pacione L, Servili C. Acceptability and feasibility of the World Health Organization's Caregiver Skills Training implemented in the Italian National Health System. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:859-874. [PMID: 34362266 DOI: 10.1177/13623613211035228] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Across the globe, children with neurodevelopmental disorders, including autism, have limited access to care through public services. To improve access to care the World Health Organization developed a novel, open-access programme: the Caregiver Skills Training programme. The Caregiver Skills Training consists of nine group sessions and three individual home visits, focused on training the caregiver on how to use everyday play and home routines as opportunities for learning and development. We implemented Caregiver Skills Training in public child neuropsychiatry services in Italy and examined with questionnaires and focus groups how feasible it was to deliver the programme in public health settings and how acceptable and relevant it was for caregiver users. We found that the Caregiver Skills Training was largely considered acceptable and relevant for families and feasible to deliver. We discuss potential solutions to address the specific implementation challenges that were identified, such as strategies to improve training of interventionists and overcome barriers to caregiver participation.
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Affiliation(s)
- Erica Salomone
- University of Milano-Bicocca, Italy.,World Health Organization, Switzerland
| | | | | | | | | | | | | | | | | | - Laura Pacione
- World Health Organization, Switzerland.,University of Toronto, Canada
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26
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Vasilevska Petrovska I, Giannakopoulou AC, Tsecoura V, Winstanley A, Miletto R, Roşca GC, Ivanova B, Kaisa V, Trajkovski V. Parental perspectives on support needs and availability of autism services in South and South-Eastern Europe. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-11-2020-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Amid the expanding demand on the autism service delivery system, little knowledge is accumulated regarding access and availability of support and services in the region of Southern and South-Eastern Europe – critical for improvement of individual outcomes, as well as family quality of life. The purpose of this paper is to explore how service delivery systems are responding to the specific needs of autistic individuals with autism, as perceived by parents.
Design/methodology/approach
A qualitative exploratory descriptive method was used. Thematic analysis was used as a pragmatic method to report on the experiences of parents (92% mothers, n = 55) of children, youth and young autistic adults (76% male) across six South and South-Eastern European counties that participated in a survey involving a combination of qualitative and quantitative data collection.
Findings
Thematic analysis revealed three broad themes: challenging pathways to service utilization, insufficient service options and providers’ competences and lack of continuous and meaningful support across life span.
Originality/value
The findings from this study add to the small body of literature specific to South and South-Eastern Europe, by exposing problems related to meeting the needs of autistic children and youth and potential ways to strengthen services, as perceived by parents. The findings have potential policy ramifications for the region in which the research was conducted.
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27
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Courraud J, Ernst M, Svane Laursen S, Hougaard DM, Cohen AS. Studying Autism Using Untargeted Metabolomics in Newborn Screening Samples. J Mol Neurosci 2021; 71:1378-1393. [PMID: 33515432 PMCID: PMC8233278 DOI: 10.1007/s12031-020-01787-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/30/2020] [Indexed: 12/13/2022]
Abstract
Main risk factors of autism spectrum disorder (ASD) include both genetic and non-genetic factors, especially prenatal and perinatal events. Newborn screening dried blood spot (DBS) samples have great potential for the study of early biochemical markers of disease. To study DBS strengths and limitations in the context of ASD research, we analyzed the metabolomic profiles of newborns later diagnosed with ASD. We performed LC-MS/MS-based untargeted metabolomics on DBS from 37 case-control pairs randomly selected from the iPSYCH sample. After preprocessing using MZmine 2.41, metabolites were putatively annotated using mzCloud, GNPS feature-based molecular networking, and MolNetEnhancer. A total of 4360 mass spectral features were detected, of which 150 (113 unique) could be putatively annotated at a high confidence level. Chemical structure information at a broad level could be retrieved for 1009 metabolites, covering 31 chemical classes. Although no clear distinction between cases and controls was revealed, our method covered many metabolites previously associated with ASD, suggesting that biochemical markers of ASD are present at birth and may be monitored during newborn screening. Additionally, we observed that gestational age, age at sampling, and month of birth influence the metabolomic profiles of newborn DBS, which informs us on the important confounders to address in future studies.
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Affiliation(s)
- Julie Courraud
- Section for Clinical Mass Spectrometry, Danish Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Fuglesangs Allé 26, 8210, Aarhus, Denmark.
| | - Madeleine Ernst
- Section for Clinical Mass Spectrometry, Danish Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Fuglesangs Allé 26, 8210, Aarhus, Denmark
| | - Susan Svane Laursen
- Section for Clinical Mass Spectrometry, Danish Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
| | - David M Hougaard
- Section for Clinical Mass Spectrometry, Danish Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Fuglesangs Allé 26, 8210, Aarhus, Denmark
| | - Arieh S Cohen
- Section for Clinical Mass Spectrometry, Danish Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark
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28
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Bejarano-Martín Á, Canal-Bedia R, Magán-Maganto M, Hernández Fabián A, Calvarro Castañeda AL, Manso de Dios S, Malmierca García P, Díez Villoria E, Jenaro Río C, Posada de la Paz M. Effect of a Focused Social and Communication Intervention on Preterm Children with ASD: A Pilot Study. J Autism Dev Disord 2021; 52:1725-1740. [PMID: 33991290 DOI: 10.1007/s10803-021-05068-8] [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: 04/30/2021] [Indexed: 11/26/2022]
Abstract
While advances in intensive neonatal care have greatly improved survival rates among preterm infants, incidence of neurodevelopmental disorders in this group is still high, with autism spectrum disorder (ASD) being one of the most frequent. To this end, we conducted a social-communication intervention aimed at investigating efficacy in social-communicative skills. Eighteen children (preterm and full-term with ASD and preterm children) aged 18 through 20 months participated in the study. Our findings indicate that most participants in the intervention groups registered significant improvements in terms of socio-communicative skills, cognitive development, and language. Accordingly, these pilot data underscore the need for further research and implementation of early interventions in young preterm children with ASD.
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Affiliation(s)
- Álvaro Bejarano-Martín
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain
| | - Ricardo Canal-Bedia
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain.
- Centro de Atención Integral Al Autismo (INFOAUTISMO), Facultad de Educación, Universidad de Salamanca, Paseo Canalejas, 169, 37008, Salamanca, España.
| | - María Magán-Maganto
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain
| | | | | | - Sara Manso de Dios
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain
| | - Patricia Malmierca García
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain
| | - Emiliano Díez Villoria
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain
| | - Cristina Jenaro Río
- INICO, Instituto Universitario de Integración en La Comunidad, Universidad de Salamanca, 37008, Salamanca, Spain
| | - Manuel Posada de la Paz
- Instituto de Investigación de Enfermedades Raras, Instituto de Salud Carlos III, 28029, Madrid, Spain
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29
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Jonsdottir SL, Saemundsen E, Jonsson BG, Rafnsson V. Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow-up in a Population Sample of 30-Month-Old Children in Iceland: A Prospective Approach. J Autism Dev Disord 2021; 52:1507-1522. [PMID: 33945117 DOI: 10.1007/s10803-021-05053-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 01/24/2023]
Abstract
The Modified Checklist for Autism in Toddlers, Revised with Follow-up was validated on a population sample in Reykjavik, Iceland. The participants (N = 1585) were screened in well-child care at age 30 months and followed up for at least 2 years to identify autism cases. The sensitivity, specificity, positive and negative predictive values were 0.62, 0.99, 0.72, and 0.99, respectively. True-positive children were diagnosed 10 months earlier than false-negative children. Autism symptom severity and the proportions of children with verbal and performance IQs/DQs < 70 were similar between groups. Although the sensitivity was suboptimal, the screening contributed to lowering the age at diagnosis for many children. Adding autism-specific screening to the well-child care program should be considered.
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Affiliation(s)
- Sigridur Loa Jonsdottir
- State Diagnostic and Counseling Center, Digranesvegur 5, 200, Kopavogur, Iceland. .,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
| | - Evald Saemundsen
- State Diagnostic and Counseling Center, Digranesvegur 5, 200, Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Brynjolfur Gauti Jonsson
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Vilhjalmur Rafnsson
- Department of Preventive Medicine, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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30
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Abstract
The architecture of spaces for people on the autistic spectrum is evolving toward inclusive design, which should fit the requirements for independent, autonomous living, and proper support for relatives and caregivers. The use of smart sensor systems represents a valuable support to internal design in order to achieve independent living for impaired people. Accordingly, these devices can monitor or prevent hazardous situations, ensuring security and privacy. Acoustic sensor systems, for instance, could be used in order to realize a passive monitoring system. The correct functioning of such devices needs optimal indoor acoustic criteria. Nevertheless, these criteria should also comply with dedicated acoustic requests that autistic individuals with hearing impairment or hypersensitivity to sound could need. Thus, this research represents the first attempt to balance, integrate, and develop these issues, presenting (i) a wide literature overview related to both topics, (ii) a focused analysis on real facility, and (iii) a final optimization, which takes into account, merges, and elucidates all the presented unsolved issues.
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31
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The ASDEU autism prevalence study in northern Spain. Eur Child Adolesc Psychiatry 2021; 30:579-589. [PMID: 32388625 DOI: 10.1007/s00787-020-01539-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
The prevalence of autism spectrum disorders (ASD) was studied in children in the County of Gipuzkoa (Basque Country, Spain) as part of the European Union's Autism Spectrum Disorder in Europe project (ASDEU- https://asdeu.eu ). To identify cases in a total community sample of 7- to 9-year-old pupils (N = 14,734), a multistage approach was adopted: in the first stage, a teacher nomination (TN) form was completed by school teachers; and in the second stage, all families with a child nominated by their teachers were invited to complete the Social Communication Questionnaire (SCQ). A total of 108 (59%) schools participated fully, yielding a final sample of 9177 of 14.734 (61.9%) pupils. A total of 212 (2.3%) children were nominated via the TN form, and of these, 105 (49.5%) returned the completed SCQ. Twenty-five (23.8%) cases with SCQ scores ≥ 15 were invited to undergo a free clinical assessment, and 10 (40%) new cases of ASD were identified. The prevalence estimate included the 55 cases already being supported by the Gipuzkoa's only ASD association, the Gipuzkoa Autism Society (Asociación Guipuzcoana de Autismo/GAUTENA)), as well as the 10 new subjects identified by the ASDEU field diagnostic process. A sensitivity analysis was performed to estimate new potential ASD cases among the non-participant schools, leading to a final figure of 87 cases of ASD in this age-bracket at the date of the study. This global probabilistic estimate, including non-participating schools, would thus provide a population prevalence of 0.59% (95% CI 0.48-0.73), a result lower than those reported by some other studies. Attrition rates in cross-sectional studies are challenging and support the need for developing longitudinal ASD incidence surveillance study areas (ASD observatories).
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32
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Perinatal Factors in Newborn Are Insidious Risk Factors for Childhood Autism Spectrum Disorders: A Population-based Study. J Autism Dev Disord 2021; 52:52-60. [PMID: 33625618 DOI: 10.1007/s10803-021-04921-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
We analyzed claims data from the Taiwan National Health Insurance database, which contains data of 23.5 million Taiwan residents. We included children born after January 1, 2000 who had received a diagnosis of autism spectrum disorders (ASD). Patients who were not diagnosed with ASD were included in the control group. The ASD prevalence was 517 in 62,051 (0.83%) children. Neonatal jaundice, hypoglycemia, intrauterine growth retardation (IUGR), and craniofacial anomalies (CFA) differed significantly between the ASD and control groups. After logistic regressive analysis, the adjusted odds ratios of IUGR, CFA, neonatal hypoglycemia, and neonatal jaundice were 8.58, 7.37, 3.83, and 1.32, respectively. Those insidiously perinatal risk factors, namely CFA, IUGR, neonatal hypoglycemia, and neonatal jaundice, could increase the risk of ASD.
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33
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Makino A, Hartman L, King G, Wong PY, Penner M. Parent Experiences of Autism Spectrum Disorder Diagnosis: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00237-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractThe purpose of this review was to identify the quantity, breadth, and methodological characteristics of literature examining parent perspectives of autism spectrum disorder diagnosis, synthesize key research findings, and highlight gaps in the current literature. A systematic search was conducted for the period January 1994–February 2020. One hundred and twenty-two articles underwent data extraction. The majority of studies took place in Europe and North America in high-income countries. Over half of the studies used qualitative methodology. Four key components of the diagnostic experience were identified: journey to assessment, assessment process, delivery of the diagnosis and feedback session, and provision of information, resources, and support. Themes of parental emotions and parental satisfaction with the diagnostic process were also found.
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34
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Desideri L, Pérez-Fuster P, Herrera G. Information and Communication Technologies to Support Early Screening of Autism Spectrum Disorder: A Systematic Review. CHILDREN-BASEL 2021; 8:children8020093. [PMID: 33535513 PMCID: PMC7912726 DOI: 10.3390/children8020093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/18/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022]
Abstract
The aim of this systematic review is to identify recent digital technologies used to detect early signs of autism spectrum disorder (ASD) in preschool children (i.e., up to six years of age). A systematic literature search was performed for English language articles and conference papers indexed in Pubmed, PsycInfo, ERIC, CINAHL, WoS, IEEE, and ACM digital libraries up until January 2020. A follow-up search was conducted to cover the literature published until December 2020 for the usefulness and interest in this area of research during the Covid-19 emergency. In total, 2427 articles were initially retrieved from databases search. Additional 481 articles were retrieved from follow-up search. Finally, 28 articles met the inclusion criteria and were included in the review. The studies included involved four main interface modalities: Natural User Interface (e.g., eye trackers), PC or mobile, Wearable, and Robotics. Most of the papers included (n = 20) involved the use of Level 1 screening tools. Notwithstanding the variability of the solutions identified, psychometric information points to considering available technologies as promising supports in clinical practice to detect early sign of ASD in young children. Further research is needed to understand the acceptability and increase use rates of technology-based screenings in clinical settings. .
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Affiliation(s)
| | - Patricia Pérez-Fuster
- Autism and Technologies Laboratory, University Research Institute on Robotics and Information and Communication Technologies (IRTIC), Universitat de València, 46010 València, Spain; (P.P.-F.); (G.H.)
| | - Gerardo Herrera
- Autism and Technologies Laboratory, University Research Institute on Robotics and Information and Communication Technologies (IRTIC), Universitat de València, 46010 València, Spain; (P.P.-F.); (G.H.)
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35
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Scattoni ML, Micai M, Ciaramella A, Salvitti T, Fulceri F, Fatta LM, Poustka L, Diehm R, Iskrov G, Stefanov R, Guillon Q, Rogé B, Staines A, Sweeney MR, Boilson AM, Leósdóttir T, Saemundsen E, Moilanen I, Ebeling H, Yliherva A, Gissler M, Parviainen T, Tani P, Kawa R, Vicente A, Rasga C, Budişteanu M, Dale I, Povey C, Flores N, Jenaro C, Monroy ML, Primo PG, Charman T, Cramer S, Warberg CK, Canal-Bedia R, Posada M, Schendel D. Real-World Experiences in Autistic Adult Diagnostic Services and Post-diagnostic Support and Alignment with Services Guidelines: Results from the ASDEU Study. J Autism Dev Disord 2021; 51:4129-4146. [PMID: 33502713 PMCID: PMC8510906 DOI: 10.1007/s10803-021-04873-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 12/22/2022]
Abstract
Research providing an evidence-base for autistic adult services is sparse. The Autism Spectrum Disorders in the European Union (ASDEU) network implemented an on-line survey to determine gaps in autistic adult diagnostic evaluation and post-diagnostic support services. More than 55% in all groups experienced most of the recommended features for diagnostic evaluation for autistic adults. In contrast, < 2% of adults or carers, and < 21% of professionals experienced each of the recommended features for post-diagnostic support. In contrast to 61% of professionals, only about 30% of autistic adults and carers had knowledge of good local services models for autism diagnosis in adulthood. There are major differences between good practice guidelines for diagnostic and post-diagnostic care for autistic adults, and what is actually experienced by services users and professionals.
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Affiliation(s)
- Maria Luisa Scattoni
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy.
| | - Martina Micai
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Antonio Ciaramella
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Tommaso Salvitti
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Francesca Fulceri
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Laura Maria Fatta
- Istituto Superiore Di Sanità, Research Coordination and Support Service, Regina Elena 299, 00161, Roma, Italy
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Gottingen, Germany
| | - Robert Diehm
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Georgi Iskrov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv Town, Bulgaria
| | - Rumen Stefanov
- Institute for Rare Diseases, Plovdiv, Bulgaria.,Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv Town, Bulgaria
| | - Quentin Guillon
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Bernadette Rogé
- Université Toulouse Jean Jaurès, CERPPS, Toulouse, Occitanie, France
| | - Anthony Staines
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Mary Rose Sweeney
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Andrew Martin Boilson
- School of Nursing, Psychotherapy & Community Health, Dublin City University, Dublin, Republic of Ireland
| | - Thora Leósdóttir
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Evald Saemundsen
- The State Diagnostic and Counselling Centre, 200, Kópavogur, Iceland
| | - Irma Moilanen
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Hanna Ebeling
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,Medical Faculty, Oulu University Hospital, Oulu, Finland
| | - Anneli Yliherva
- Clinic of Child Psychiatry, University and University Hospital of Oulu, Oulu, Finland.,University of Oulu, Logopedic Child Language Research Center, Oulu, Finland
| | - Mika Gissler
- Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland.,University of Turku, Research Centre for Child Psychiatry, Turku, Finland.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Tarja Parviainen
- Finnish Association for Autism and Asperger's Syndrome, Helsinki, Uusimaa, Finland
| | - Pekka Tani
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Astrid Vicente
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Célia Rasga
- Center for Biodiversity, Functional and Integrative Genomics, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisbon, Portugal
| | - Magdalena Budişteanu
- Victor Babeş" National Institute for Research and Development in Pathology and Biomedical Sciences, Timisoara, Romania
| | - Ian Dale
- National Autistic Society, The Centre for Autism, London, UK
| | - Carol Povey
- National Autistic Society, The Centre for Autism, London, UK
| | - Noelia Flores
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Cristina Jenaro
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Maria Luisa Monroy
- Departamento de Psicología Evolutiva y de la Educación, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Patricia García Primo
- Instituto de Salud Carlos III, Institute of Rare Diseases Research Madrid, Madrid, Spain
| | - Tony Charman
- Institute of Psychiatry, Kings College London, London, UK
| | - Susanne Cramer
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Ricardo Canal-Bedia
- Departamento de Personalidad, Evaluación y Tratamiento Psicológicos, INICO-Instituto Universitario de Integración en la Comunidad University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Instituto de Salud Carlos III, Institute of Rare Diseases Research Madrid, Madrid, Spain
| | - Diana Schendel
- Department of Public Health, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Economics and Business, Aarhus University, National Centre for Register-Based Research, Aarhus, Denmark
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36
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Garcia Primo P, Weber C, Posada de la Paz M, Fellinger J, Dirmhirn A, Holzinger D. Explaining Age at Autism Spectrum Diagnosis in Children with Migrant and Non-Migrant Background in Austria. Brain Sci 2020; 10:brainsci10070448. [PMID: 32674382 PMCID: PMC7407505 DOI: 10.3390/brainsci10070448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/31/2022] Open
Abstract
This study explored (i) differences in age at Autism Spectrum Disorder (ASD) diagnosis between children with and without a migrant background in the main diagnostic centre for ASD in Upper Austria (ii) factors related to the age at diagnosis and (iii) whether specific factors differed between the two groups. A retrospective chart analysis included all children who received their first diagnosis before the age of 10 years (n = 211) between 2013 and 2018. Children with a migrant background were diagnosed 13 months earlier than those without (r = 0.278, p < 0.001), and had more severe delays in language, more severe autism, no Asperger’s syndrome, lower parental educational level and more frequent referrals by paediatricians. For the total sample, expressive language delay, severity of restricted and repetitive behaviours, higher nonverbal development, and paediatric referrals explained earlier diagnoses. There was a stronger effect of parental education and weaker effect of language impairment on age at ASD diagnosis in children with a migrant background. In conclusion, no delay in diagnosing ASD in children with a migrant background in a country with universal health care and an established system of paediatric developmental surveillance was found. Awareness of ASD, including Asperger’s syndrome, should be raised among families and healthcare professionals.
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Affiliation(s)
- Patricia Garcia Primo
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
| | - Christoph Weber
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
- Department for Inclusive Education, University of Education Upper Austria, 4020 Linz, Austria
| | - Manuel Posada de la Paz
- Institute of Rare Diseases Research (IIER) & CIBERER, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence:
| | - Johannes Fellinger
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, 4020 Linz, Austria;
- Division of Social Psychiatry, Medical University of Vienna, 1010 Vienna, Austria
| | - Anna Dirmhirn
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, 4020 Linz, Austria;
| | - Daniel Holzinger
- Research Institute of Developmental Medicine, Johannes Kepler University, 4020 Linz, Austria; (P.G.P.); (C.W.); (J.F.); (D.H.)
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, 4020 Linz, Austria;
- Institute of Linguistics, Karl-Franzens University of Graz, 8010 Graz, Austria
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