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Qi SY, Zhang SJ, Lin LL, Li YR, Chen JG, Ni YC, Du X, Zhang J, Ge P, Liu GH, Wu JY, Lin S, Gong M, Lin JW, Chen LF, He LL, Lin D. Quantifying attention in children with intellectual and developmental disabilities through multicenter electrooculogram signal analysis. Sci Rep 2024; 14:22186. [PMID: 39333619 PMCID: PMC11437286 DOI: 10.1038/s41598-024-70304-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 08/14/2024] [Indexed: 09/29/2024] Open
Abstract
In a multicenter case-control investigation, we assessed the efficacy of the Electrooculogram Signal Analysis (EOG-SA) method, which integrates attention-related visual evocation, electrooculography, and nonlinear analysis, for distinguishing between intellectual and developmental disabilities (IDD) and typical development (TD) in children. Analyzing 127 participants (63 IDD, 64 TD), we applied nonlinear dynamics for feature extraction. Results indicated EOG-SA's capability to distinguish IDD, with higher template thresholds and Correlation Dimension values correlating with clinical severity. The template threshold proved a robust indicator, with higher values denoting severe IDD. Discriminative metrics showed areas under the curve of 0.91 (template threshold) and 0.85/0.91 (D2), with sensitivities and specificities of 77.6%/95.9% and 93.5%/71.0%, respectively. EOG-SA emerges as a promising tool, offering interpretable neural biomarkers for early and nuanced diagnosis of IDD.
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Affiliation(s)
- Shi-Yi Qi
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Si-Jia Zhang
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
- Tongxiang Hospital of Traditional Chinese Medicine, Tongxiang, Zhejiang Province, China
| | - Li-Li Lin
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
- Institute of Acupuncture and Meridian, Fujian Academy of Chinese Medical Sciences, Fuzhou, Fujian Province, China
| | - Yu-Rong Li
- Department of Electrical Engineering and Automation, Fuzhou University, Fuzhou, Fujian Province, China
| | - Jian-Guo Chen
- Department of Electrical Engineering and Automation, Fuzhou University, Fuzhou, Fujian Province, China
| | - You-Cong Ni
- School of Computer and Cyberspace Security, Fujian Normal University, Fuzhou, Fujian Province, China
| | - Xin Du
- School of Computer and Cyberspace Security, Fujian Normal University, Fuzhou, Fujian Province, China
| | - Jie Zhang
- Department of Rehabilitation, The Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Pin Ge
- Fujian Maternity and Child Health Hospital, Fuzhou, Fujian Province, China
| | - Gui-Hua Liu
- Fujian Maternity and Child Health Hospital, Fuzhou, Fujian Province, China
| | - Jiang-Yun Wu
- Department of Rehabilitation, The Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Shen Lin
- Fujian Maternity and Child Health Hospital, Fuzhou, Fujian Province, China
| | - Meng Gong
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Jin-Wen Lin
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Lan-Fang Chen
- Department of Rehabilitation, The Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Ling-Ling He
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China
| | - Dong Lin
- Department of Acupuncture and Tuina, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China.
- Department of Rehabilitation, The Third People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China.
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Kim H, Karakaya MF, Skinner M, Baker D. A Systematic Literature Review of Racial Disproportionality in Autism in the U.S. J Autism Dev Disord 2024:10.1007/s10803-024-06247-z. [PMID: 38416385 DOI: 10.1007/s10803-024-06247-z] [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: 01/13/2024] [Indexed: 02/29/2024]
Abstract
In recent years, the Autism and Developmental Disabilities Monitoring Network has observed a shift in racial disparities in autism. To delineate the historical shift of racial disproportionality in US autism prevalence, our literature review examines three key topics: publication trends concerning racial disproportionality in autism, discernible national and state-level patterns, and underlying factors contributing to the disproportionality. Using the PRISMA framework, we synthesized 24 empirical studies on racial disproportionality in autism and its change over time. These studies explored national patterns and spatiotemporal variations to provide a comprehensive understanding of racial disparities in autism. Studies indicated similar national patterns for Black and Asian racial groups; both groups had had mixed results around the turn of the millennium. By 2007, the Asian group was overrepresented again. Hispanic and Native American groups have consistently been underrepresented. However, significant spatiotemporal variations were found, suggesting that these disparities might reflect inherent inequalities within the current identification and classification system. The patterns of racial disproportionality in autism seem to be influenced by numerous factors. These include varying state definitions of autism, disparities in resource distribution, differences in symptom recognition across cultures, service preferences, cultural mismatches between professionals and families, and prevailing biases and stigmas, as revealed by the reviewed studies. These findings prompt a closer look into the causes and implications of these disparities, offering the underlying issues within the current diagnostic system and highlighting the need for further research to ensure equal educational opportunities regardless of disabilities and race/ethnicity.
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Affiliation(s)
- Hyejung Kim
- Binghamton University, Binghamton, NY, 13902, USA.
| | | | | | - Diana Baker
- Hobart and William Smith Colleges, Geneva, NY, USA
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Shenouda J, Barrett E, Davidow AL, Sidwell K, Lescott C, Halperin W, Silenzio VMB, Zahorodny W. Prevalence and Disparities in the Detection of Autism Without Intellectual Disability. Pediatrics 2023; 151:e2022056594. [PMID: 36700335 DOI: 10.1542/peds.2022-056594] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Intellectual ability predicts functional outcomes for children with autism spectrum disorder (ASD). It is essential to classify ASD children with and without intellectual disability (ID) to aid etiological research, provide services, and inform evidence-based educational and health planning. METHODS Using a cross-sectional study design, data from 2000 to 2016 active ASD surveillance among 8-year-olds residing in the New York-New Jersey Metropolitan Area were analyzed to determine ASD prevalence with and without ID. Multivariable Poisson regression models were used to identify trends for ASD with ID (ASD-I) and without ID (ASD-N). RESULTS Overall, 4661 8-year-olds were identified with ASD. Those that were ASI-I were 1505 (32.3%) and 2764 (59.3%) were ASD-N. Males were 3794 (81.4%), 946 (20.3%) were non-Hispanic Black (Black), 1230 (26.4%) were Hispanic, and 2114 (45.4%) were non-Hispanic white (white). We observed 2-fold and 5-fold increases in the prevalence of ASD-I and ASD-N, respectively, from 2000-2016. Black children were 30% less likely to be identified with ASD-N compared with white children. Children residing in affluent areas were 80% more likely to be identified with ASD-N compared with children in underserved areas. A greater proportion of children with ASD-I resided in vulnerable areas compared with children with ASD-N. Males had higher prevalence compared with females regardless of ID status; however, male-to-female ratios were slightly lower among ASD-I compared with ASD-N cases. CONCLUSIONS One-in-3 children with ASD had ID. Disparities in the identification of ASD without ID were observed among Black and Hispanic children as well as among children residing in underserved areas.
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Affiliation(s)
- Josephine Shenouda
- Rutgers School of Public Health, Piscataway, New Jersey
- Rutgers New Jersey Medical School, Newark, New Jersey
| | - Emily Barrett
- Rutgers School of Public Health, Piscataway, New Jersey
| | - Amy L Davidow
- New York University School of Global Public Health, New York, New York
| | - Kate Sidwell
- Rutgers New Jersey Medical School, Newark, New Jersey
| | - Cara Lescott
- Rutgers New Jersey Medical School, Newark, New Jersey
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Cohen SR, Joseph K, Levinson S, Blacher J, Eisenhower A. "My Autism Is My Own": Autistic Identity and Intersectionality in the School Context. AUTISM IN ADULTHOOD 2022; 4:315-327. [PMID: 36777377 PMCID: PMC9908286 DOI: 10.1089/aut.2021.0087] [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: 11/13/2022]
Abstract
Background School is an important context for identity development across childhood and adolescence. These formative experiences impact adulthood. Minimal research has examined first-person autistic perspectives of how school experiences shape autistic identity as well as other intersecting identities. In this study, we examined the school messages that autistic individuals received and how individuals engaged with these external messages to formulate their identities. Methods Ten U.S.-based autistic adolescents and adults ages 15-35 participated in qualitative interviews about their elementary through secondary school experiences, interactions with teachers and peers, and how these shaped their identities. Two interviewees also engaged in three follow-up interviews each for member checking and further data gathering. Using a critical constructivist approach informed by grounded theory, we coded interviews inductively. We ensured the trustworthiness of data through peer debriefing, reflexive journaling, memoing, and member checking. Results In the school context, autistic students received stigmatizing messages from teachers and peers regarding their autism. These messages varied in relation to students' other identities, including race and gender. Participants felt that, following autism disclosure, teachers viewed them narrowly through an autism lens. Participants actively resisted these negative messages from teachers and peers by reclaiming their autistic identity. They reframed and redefined their autistic identity, embraced their autism-related strengths, and actively made choices about how, when, and to whom to disclose their autism. Decisions around autism disclosure intersected with decisions to emphasize other identities such as race or mental health, especially when these identities were more visible or more acceptable to others. Conclusions The school context conveyed powerful, stigmatizing messages around autism. In response, autistic students actively reclaimed and shaped their identities to prioritize a positive, empowered sense of self. Findings show a need for educators to model positive perceptions of autism, build an inclusive school community, and advocate for autistic representation in schools to facilitate autism-affirming messages.
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Affiliation(s)
- Shana R. Cohen
- Department of Education Studies, University of California San Diego, La Jolla, California, USA
| | - Kohrissa Joseph
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Sarah Levinson
- Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California, USA
| | - Jan Blacher
- School of Education, University of California, Riverside, Riverside, California, USA
| | - Abbey Eisenhower
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
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Diemer MC, Gerstein ED, Regester A. Autism presentation in female and Black populations: Examining the roles of identity, theory, and systemic inequalities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1931-1946. [PMID: 35899909 DOI: 10.1177/13623613221113501] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Although the prevalence of autism has been rising in recent years, disparities in diagnosis still remain. Female and Black populations in the United States are diagnosed later, are more likely to have an intellectual disability, and are excluded from research as well as services designed for autistic individuals. Autistic Black girls are effectively invisible in the current scientific literature. Intersectional theory, which looks at a person as a whole, examines models that are inclusive toward diverse gender, ability, and racial/ethnic backgrounds. This theory may be a useful approach to clinical and research work with autism so that practitioners may be most effective for the whole population of autistic people. The authors recommend research focusing on inclusion of autistic populations with intellectual disability and research studies that include evaluations as part of the procedure. Clinically, the authors recommend a focus on screening all young children for autism and improving provider knowledge in working with diverse autistic populations.
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Kim ET, Franz L, Fannin DK, Howard J, Maslow G. Educational classifications of autism spectrum disorder and intellectual disability among school‐aged children in North Carolina: Associations with race, rurality, and resource availability. Autism Res 2021; 14:1046-1060. [PMID: 33644951 DOI: 10.1002/aur.2492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 02/10/2021] [Indexed: 12/11/2022]
Abstract
Disparities exist in the recognition of autism spectrum disorder (ASD) and intellectual disability (ID) in racial/ethnic minorities in the United States. This study examined whether rurality, race/ethnicity, and low resource availability are associated with disparities in primary educational classifications of ASD and ID in North Carolina (NC). Descriptive maps were created. Multilevel logistic regression models examined two separate outcomes (mild ID vs. ASD; moderate/severe ID vs. ASD). For the interaction term included in the model (race/ethnicity and residence), predicted probabilities were estimated and plotted. The effects of other covariates were also estimated. Rural counties had fewer students with ASD and a greater number of students with ID compared to urban counties. The majority of students with ASD were non-Hispanic Whites, while the majority of students with ID were non-Hispanic Blacks. Compared to non-Hispanic White students, non-Hispanic Black students were overrepresented in the ID classification and underrepresented in the ASD classification across urban and rural areas. Indicators of low resource availability were also associated with higher probabilities of ID vs. ASD classification. Differences in primary educational classification based on urban-rural divide, race/ethnicity, and resource availability are important to understand as they may point to disparities that could have significant policy and service implications. Because disparities manifest through complex interactions between environmental, socioeconomic and system-level factors, reduction in these disparities will require broader approaches that address structural determinants. Future research should utilize disparity frameworks to understand differences in primary educational classifications of ASD and ID in the context of race/ethnicity and rurality. LAY SUMMARY: Rural counties in North Carolina had fewer students with ASD and a greater number of students with ID compared to urban counties. Compared to non-Hispanic White students, non-Hispanic Black students were over-represented in the ID educational classification and underrepresented in the ASD classification. Differences in classification of ASD and ID based on urban-rural divide, race/ethnicity, and resource availability may point to disparities that could have significant policy and service implications. Autism Res 2021, 14: 1046-1060. © 2021 International Society for Autism Research, Wiley Periodicals LLC.
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Affiliation(s)
| | - Lauren Franz
- Duke Global Health Institute Duke University Durham North Carolina USA
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development Duke University School of Medicine Durham North Carolina USA
- Division of Child and Adolescent Psychiatry, Center for Autism Research in Africa University of Cape Town Cape Town South Africa
| | - Danai Kasambira Fannin
- Department of Communication Sciences and Disorders, College of Health and Sciences North Carolina Central University Durham North Carolina USA
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
| | - Gary Maslow
- Department of Psychiatry and Behavioral Sciences Duke University School of Medicine Durham North Carolina USA
- Department of Pediatrics Duke University School of Medicine Durham North Carolina USA
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