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Kokaua J, Kolose-Pulefolau B, Ruhe T, Aldridge F, Foliaki S, Kokaua L, Mapusua T, Dacombe J, Richards R, Blakelock R, Bowden N. Is parent education a factor in identifying autism/takiwātanga in an ethnic cohort of Pacific children in Aotearoa, New Zealand? A national cross-sectional study using linked administrative data. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1667-1676. [PMID: 38153045 PMCID: PMC11191371 DOI: 10.1177/13623613231217800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
LAY ABSTRACT Previous studies of autism in Aotearoa, New Zealand, suggest that fewer Pacific children receive an autism diagnosis compared to European children. This study aimed to explore if formal education qualification of parents is related to receiving an autism diagnosis for their Pacific child. Our findings show that autism was identified in 1.1% of Pacific children compared with 1.6% among non-Māori, non-Pacific children. Parents with higher levels of education were more likely to receive an autism diagnosis for their Pacific child. While the study findings indicate education plays a positive role in receiving a diagnosis for autistic children, they suggest a systemic failure of supporting Pacific parents and communities to navigate the health and education systems that exist in Aotearoa, New Zealand.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Nicholas Bowden
- University of Otago, New Zealand
- Te Whatu Ora Canterbury Rohe, New Zealand
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Terner M, Israel-Yaacov S, Golan O. Sex differences in autism screening: An examination of the Childhood Autism Spectrum Test-Hebrew version. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241235053. [PMID: 38465585 DOI: 10.1177/13623613241235053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
LAY ABSTRACT Autism is a neurodevelopmental condition, characterized by social communication alterations and restricted, repetitive behaviors. Typically diagnosed in early childhood, screening and diagnosis at a later age can be challenging, particularly in girls who exhibit a wider range of behaviors and characteristics. Our study set out to examine the effectiveness of the Hebrew translation of the Childhood Autism Spectrum Test, a parent report questionnaire, in identifying these diverse characteristics of autism within an Israeli sample of boys and girls. We examined parent reports on 403 (211 autistic, 192 non-autistic) children, aged 4-12 years. Results revealed the Childhood Autism Spectrum Test-Hebrew version was a valuable tool in differentiating between autistic and typically developing children, correctly identifying 93% of children with autism and 82% of typically developing children. In addition, specific items of the Childhood Autism Spectrum Test-Hebrew version were particularly useful in differentiating between autistic and non-autistic boys and autistic and non-autistic girls. Using these items, in addition to the overall score of the questionnaire, increased the correct identification of children as autistic or typically developing, especially in girls. The Childhood Autism Spectrum Test-Hebrew version test results corresponded well with the Autism Diagnostic Interview-Revised, which relies on parental input, but not with the clinician-administered Autism Diagnostic Observation Schedule-2. Our findings highlight the potential benefits of gender-specific tools to better support correct identification of autism in boys and in girls. More research is recommended to further explore these gender differences and to validate our findings with a larger, diverse group.
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Affiliation(s)
| | | | - Ofer Golan
- Bar-Ilan University, Israel
- OTI - The Israeli Autism Association, Israel
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Zakirova-Engstrand R, Yakubova G. A scoping review of autism research conducted in Central Asia: Knowledge gaps and research priorities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:342-354. [PMID: 37161788 PMCID: PMC10851649 DOI: 10.1177/13623613231170553] [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] [Indexed: 05/11/2023]
Abstract
LAY ABSTRACT Very little is known about the status of autism research in Central Asia. Through the library databases, we identified and reviewed 11 scientific studies conducted with autistic people and their families in five Central Asian countries-Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Of the 11 studies, 10 were conducted in Kazakhstan and 1 in Uzbekistan. Within these limited number of research studies, different topics such as diagnosis, risk factors of autism, biology, and various service and intervention areas were addressed. We identified several knowledge gaps and research priorities to address the needs of autistic people, their families, and professionals in Central Asia.
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Kim H, Kim SA, Lee H, Dodds R. Korean Immigrant Mothers and the Journey to Autism Diagnosis and Services for Their Child in the United States. J Autism Dev Disord 2023:10.1007/s10803-023-06145-w. [PMID: 37874474 DOI: 10.1007/s10803-023-06145-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/25/2023]
Abstract
Since autism diagnosis is directly linked to the availability of supportive services, identifying best practices for early diagnosis of autism has long been a concern of professionals and families. Meanwhile, studies show persistent racial disparities in autism diagnosis. Although numerous clinical diagnostic guidelines have been published, there is not enough discussion of diagnostic procedures through the lens of culturally diverse families. PURPOSE This study focuses on the autism diagnostic experiences that Korean immigrant mothers had with their children. METHODS Eleven first-generation Korean-American mothers of children with autism were included in the study. The data was collected using semi-structured interviews in Korean. RESULTS The main five factors (i.e., cultural beliefs and values, language barriers, complex emotions, immigration and navigating systems, and facilitators and assets) that mainly influence the diagnosis process were identified through thematic analysis. CONCLUSION Dynamics are interactive within and between the factors, influencing the entire diagnostic process by either delaying or facilitating the identification of a child's autism and the provision of treatment.
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Affiliation(s)
- Hyeyoung Kim
- Human Development & Psychology, University of California Los Angeles, Los Angeles, CA, 90095, USA.
| | - Sohyun An Kim
- Center for Dyslexia, Diverse Learners, and Social Justice, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Han Lee
- Human Development & Psychology, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Robin Dodds
- Division of Special Education & Counseling, California State University, Los Angeles, CA, 90032, USA
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Junttila M, Jussila K, Joskitt L, Ebeling H, Kielinen M, Loukusa S, Miettunen J, Mäntymaa M, Mattila ML. Factor analysis of the autism spectrum screening questionnaire in a population-based child sample. Nord J Psychiatry 2023; 77:696-705. [PMID: 37355342 DOI: 10.1080/08039488.2023.2225060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/27/2023] [Accepted: 06/02/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE The aim of this study was to investigate several possible factor structures of the Autism Spectrum Screening Questionnaire (ASSQ). MATERIALS AND METHODS We used the 27-item screening tool for school-aged children in a general population of 8-year-old children (n = 3,538) and compared the occurring solutions to previously published factor models. RESULTS A one-factor solution and a four-factor solution were identified in Exploratory Factor Analysis (EFA) and confirmed with Confirmatory Factor Analysis (CFA), while two-, three-, five- and six-factor solutions were rejected. In CFA, our four-factor solution showed the best goodness-of-fit indexes when compared with factor models previously presented by Posserud et al. and Ehlers et al. CONCLUSIONS The results indicate a strong underlying connection between all ASSQ items which is elicited by the one-factor solution. Although as a screening tool, ASSQ is functioning with the unifactorial solution, the four factors can help to identify certain clusters of autism spectrum traits.
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Affiliation(s)
- Maria Junttila
- Child Psychiatry, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | - Katja Jussila
- Child Psychiatry, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
- Division of Psychology, VISE, Faculty of Education and Psychology, University of Oulu, Finland
| | - Leena Joskitt
- Child Psychiatry, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | - Hanna Ebeling
- Child Psychiatry, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | | | - Soile Loukusa
- Research Unit of Logopedics, University of Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, University of Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Mirjami Mäntymaa
- Child Psychiatry, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
| | - Marja-Leena Mattila
- Child Psychiatry, Oulu University Hospital, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Oulu, Finland
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Tincani M, Ji H, Upthegrove M, Garrison E, West M, Hantula D, Vucetic S, Dragut E. Vocational Interventions for Individuals with ASD: Umbrella Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2023. [DOI: 10.1007/s40489-023-00368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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Caldera A, Wickremasinghe AR, Muttiah N, Godamunne PKS, Jayasena B, Chathurika LKE, Perera KMN, Mendis M, Tilakarathne D, Peiris MKR, Wijesinghe T, Senarathna N, Saubhagya WDL, Chandraratne M, Sumanasena S. REACh for the preschoolers; a developmental assessment tool for 2-5 year old children in Sri Lanka. BMC Pediatr 2023; 23:80. [PMID: 36797694 PMCID: PMC9933303 DOI: 10.1186/s12887-023-03895-5] [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: 12/07/2021] [Accepted: 10/17/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Preschool children in low resource settings are at higher risk of missing developmental potential due to the lack of standardized and validated methods for the timely detection of children with developmental delays or neurodevelopmental disorders. The preschool teacher is a non-specialist resourceful link within the community to detect and offer interventions early. This paper discusses the preliminary iteration of designing and testing the psychometric properties of a developmental assessment for children aged 24 to 60 months in Sri Lanka. This assessment is designed to be conducted by preschool teachers in their preschool setting. METHODS Three processes followed: 1. Designing and development of the Ragama Early Assessment for Children (REACh) complete preschool developmental assessment and a tool kit 2. Testing and training teachers on conducting the REACh assessment 3. Preliminary assessment of the psychometric properties including content validity, internal consistency, interrater reliability and concurrent validity. RESULTS A literature search identified 11 assessments and 542 items representing cognitive, social-emotional and adaptive, language and motor domains. Content validity was assessed to select and adapt items. A complete assessment tool was designed to be administered in four settings within the preschool. This was further improved during pre and pilot testing and teacher training. Cronbach's alpha measuring internal consistency was > 0.70 for cognitive, language, social-emotional and adaptive domains across all three age groups in 1809 children. Interrater reliability was > 65% for age groups 36-47 and 47- 60 months. Concurrent validity using a clinical gold standard demonstrated sensitivity of more than 0.75 for all age groups with variable specificities (24-35 months: 0.71, 36- 47 months: 0.43 and 48-60 months: 0.67) assessed in 75 children. CONCLUSIONS This culturally and linguistically adapted tool was tested nationally in Sri Lanka. The inte-rrater reliability between teachers and research assistants was higher than 65% for all domains in children more than 36 months. The preliminary iteration confirms it as an acceptable screening assessment for all age groups but with significantly lower specificity in the 36-47 month age group. Further improvement in certain domains together with intense teacher training is likely to enhance the validity and reliability of the assessment. TRIAL REGISTRATION Ethics clearance for the procedure was granted prospectively from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya (ERC no. P 131/06/2018).
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Affiliation(s)
- A.V Caldera
- grid.45202.310000 0000 8631 5388Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - A. R Wickremasinghe
- grid.45202.310000 0000 8631 5388Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - N Muttiah
- grid.45202.310000 0000 8631 5388Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - P. K. S Godamunne
- grid.45202.310000 0000 8631 5388Department of Medical Education, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - B.N Jayasena
- grid.45202.310000 0000 8631 5388Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - L. K. E Chathurika
- grid.45202.310000 0000 8631 5388Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - K. M. N Perera
- grid.45202.310000 0000 8631 5388Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - M Mendis
- grid.45202.310000 0000 8631 5388Department of Public Health, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | | | | | - T Wijesinghe
- grid.45202.310000 0000 8631 5388Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - N.E Senarathna
- Ministry of Women and Child Affairs, Children’s Secretariat, Colombo, Sri Lanka
| | - W. D. L Saubhagya
- Ministry of Women and Child Affairs, Children’s Secretariat, Colombo, Sri Lanka
| | - M Chandraratne
- grid.45202.310000 0000 8631 5388Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - S.P Sumanasena
- grid.45202.310000 0000 8631 5388Department of Disability Studies, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Hampton M, McNamara S. The impact of educational rewards on the diagnosis of autism spectrum disorder. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101188. [PMID: 36272247 DOI: 10.1016/j.ehb.2022.101188] [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: 04/23/2021] [Revised: 07/19/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects social interactions and communication. The prevalence of ASD has risen dramatically in recent years, but the underlying factors leading to this rise are not clear. In this paper, we test whether changes in state-level educational policy that impact school-level resources are associated with the rise in ASD diagnostic prevalence. Early identification of ASD can improve an array of outcomes for children, and school systems play an important role with identification of the condition. It is plausible that children attending schools with better resources from state governments are more likely to receive an ASD diagnosis and presumably appropriate services. We focus on one educational policy in particular, state-level rewards, which consist of a monetary transfer from state governments to school districts. To test the impact of educational rewards on ASD diagnosis, we rely on policy variation across states and time and estimate both two-way fixed effects (TWFE) models alongside recently advanced methods in the difference-in-differences (DiD) literature. Under a baseline TWFE specification we estimate that rewards policies are associated with a 18.46% increase in ASD diagnosis. Further, using DiD methods that account for bias in settings of differential policy timing, we find that the magnitude of the effect increases to 24.8%. We believe these findings to be suggestive evidence that educational rewards policies improved the likelihood of detection and diagnosis of ASD.
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Affiliation(s)
- Matt Hampton
- Department of Accounting, Finance, and Economics, Austin Peay State University, College of Business, Clarksville, TN 37040, USA.
| | - Scott McNamara
- Department of Kinesiology, University of New Hampshire, College of Health and Human Services, Durham, NH 03824.
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Buranova N, Dampf M, Stevenson B, Sohl K. ECHO Autism: Early Intervention Connecting Community Professionals to Increase Access to Best Practice Autism Intervention. Clin Pediatr (Phila) 2022; 61:518-522. [PMID: 35470694 DOI: 10.1177/00099228221090710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Autism spectrum disorder (ASD) is estimated to affect 1 in 44 children in the United States. Disparities exist related to socioeconomic, racial/ethnic and geographic demographics. Due to the shortages of autism specialists in diagnosis, treatment and education for people with ASD, novel approaches to improve access to best practices are needed to ensure quality services. ECHO Autism: Early Intervention clinic consists of biweekly sessions focused on early identification and management of evidence-based practices for young children with ASD. It is an adaptation of the ECHO Autism clinic that has been proven effective for primary care providers. The clinic provides a safe, virtual learning environment where diverse professionals who work with children at risk or diagnosed with ASD can collaborate and learn together. ECHO Autism: Early Intervention bridges the care gap between autism specialists, community intervention providers, and children with autism to increase capacity for autism intervention best practices in underserved communities. Through participation in this convenient, web-based small group, the providers get specific case guidance on children at risk or diagnosed with autism and share best practices for autism specific interventions. Finally, the clinic connects participants with community resources, and family/caregiver support. In our article, we address the current challenge of access to quality early intervention specific to ASD in rural and underserved communities and how this issue can be addressed through a virtual ECHO Autism clinic. The aim of this concept article is to describe the innovative ECHO Autism: Early Intervention clinic and discuss its benefits and impact in the field.
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Matson JL, Callahan MM, Montrenes JJ. Development and initial testing of the BABY-BISCUIT in an at-risk population. Dev Neurorehabil 2022; 25:361-369. [PMID: 34962445 DOI: 10.1080/17518423.2021.2018736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Early identification of autism spectrum disorder (ASD) via screeners for diagnostic measures are a high priority. At present, there is no consensus on one screener due to the need for better sensitivity and specificity. In this study, we report on the development and utility of the BABY-BISCUIT, a six-item screener based on a modified subset of items from the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT). METHODS A sample of 504 children between 17-3 9months of age, who consisted of toddlers identified as at-risk for neurodevelopmental and other health disorders, were tested during an annual screening through the Louisiana EarlySteps program. RESULTS An exploratory factor analysis yielded a one-factor solution (X2 = 48.62, df = 9, p = <.001). High sensitivity (i.e., 100.0%) at the cost of reduced specificity (i.e., 33.3%, AUC = 0.957) was found for an optimal screening cutoff score of 1. CONCLUSIONS Findings from this study suggest that the BABY-BISCUIT has the potential to be a short and easily administered screener for ASD to inform whether further ASD assessment is necessary. Further investigation of convergent validity with established ASD measures is recommended.
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Lord C, Charman T, Havdahl A, Carbone P, Anagnostou E, Boyd B, Carr T, de Vries PJ, Dissanayake C, Divan G, Freitag CM, Gotelli MM, Kasari C, Knapp M, Mundy P, Plank A, Scahill L, Servili C, Shattuck P, Simonoff E, Singer AT, Slonims V, Wang PP, Ysrraelit MC, Jellett R, Pickles A, Cusack J, Howlin P, Szatmari P, Holbrook A, Toolan C, McCauley JB. The Lancet Commission on the future of care and clinical research in autism. Lancet 2022; 399:271-334. [PMID: 34883054 DOI: 10.1016/s0140-6736(21)01541-5] [Citation(s) in RCA: 254] [Impact Index Per Article: 127.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
| | - Paul Carbone
- Department of Pediatrics at University of Utah, Salt Lake City, UT, USA
| | - Evdokia Anagnostou
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | | | - Themba Carr
- Rady Children's Hospital San Diego, Encinitas, CA, USA
| | - Petrus J de Vries
- Division of Child & Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | | | | | | | | | | | - Peter Mundy
- University of California, Davis, Davis, CA, USA
| | | | | | - Chiara Servili
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | | | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Vicky Slonims
- Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul P Wang
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, NY, USA; Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | | | - Rachel Jellett
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Patricia Howlin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Szatmari
- Holland Bloorview Kids Rehabilitation Hospital, Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Shrestha R, Dissanayake C, Barbaro J. Implementing and evaluating Social Attention and Communication Surveillance (SACS) to prospectively identify autism in very young children in Nepal. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 115:104013. [PMID: 34144316 DOI: 10.1016/j.ridd.2021.104013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although Autism Spectrum Disorder (ASD) can be identified as early as 12 months and diagnosed by 24 months, the mean age of diagnosis of ASD in Nepal is ∼58 months, with children missing the opportunity for early intervention. AIMS This study implemented and evaluated a Nepali version of the Social Attention and Communication Surveillance (SACS-N) tool, to identify children between 11-30 months who are at "high likelihood" of ASD in a local community in Nepal. METHODS Sixty Female Community Health Volunteers (FCHVs) were trained to monitor and identify the early signs of ASD using SACS-N. RESULTS Overall, 1926 children were monitored with the SACS-N, with 11 children (0.57 %) referred for further assessments at 11-15 months (n = 4), 16-21 months (n = 4), and 22-30 months (n = 3). Of these children, 10 children had a developmental disorder, including ASD and Global Developmental Delay; no information was available on one child who migrated. Hence, the positive predictive value (PPV) of SACS-N for all developmental disorders was 100 %. Of seven children attending a gold standard diagnostic/ developmental assessment, three had ASD (43 % PPV for ASD). The estimated prevalence of ASD ranged between 0.16 % to 0.26 %. CONCLUSION Community-based developmental monitoring of ASD and other developmental delays by FCHVs is a feasible, cost-effective and sustainable approach to promoting early identification of ASD in Nepal. Further training and awareness of autism is needed for more accurate and increased referral rates using the SACS-N, including regular supervision of FCHVs.
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Affiliation(s)
- Rena Shrestha
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia.
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Haque MM, Rabbani M, Dipal DD, Zarif MII, Iqbal A, Schwichtenberg A, Bansal N, Soron TR, Ahmed SI, Ahamed SI. Informing Developmental Milestone Achievement for Children With Autism: Machine Learning Approach. JMIR Med Inform 2021; 9:e29242. [PMID: 33984830 PMCID: PMC8262602 DOI: 10.2196/29242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 01/09/2023] Open
Abstract
Background Care for children with autism spectrum disorder (ASD) can be challenging for families and medical care systems. This is especially true in low- and- middle-income countries such as Bangladesh. To improve family–practitioner communication and developmental monitoring of children with ASD, mCARE (Mobile-Based Care for Children with Autism Spectrum Disorder Using Remote Experience Sampling Method) was developed. Within this study, mCARE was used to track child milestone achievement and family sociodemographic assets to inform mCARE feasibility/scalability and family asset–informed practitioner recommendations. Objective The objectives of this paper are threefold. First, it documents how mCARE can be used to monitor child milestone achievement. Second, it demonstrates how advanced machine learning models can inform our understanding of milestone achievement in children with ASD. Third, it describes family/child sociodemographic factors that are associated with earlier milestone achievement in children with ASD (across 5 machine learning models). Methods Using mCARE-collected data, this study assessed milestone achievement in 300 children with ASD from Bangladesh. In this study, we used 4 supervised machine learning algorithms (decision tree, logistic regression, K-nearest neighbor [KNN], and artificial neural network [ANN]) and 1 unsupervised machine learning algorithm (K-means clustering) to build models of milestone achievement based on family/child sociodemographic details. For analyses, the sample was randomly divided in half to train the machine learning models and then their accuracy was estimated based on the other half of the sample. Each model was specified for the following milestones: Brushes teeth, Asks to use the toilet, Urinates in the toilet or potty, and Buttons large buttons. Results This study aimed to find a suitable machine learning algorithm for milestone prediction/achievement for children with ASD using family/child sociodemographic characteristics. For Brushes teeth, the 3 supervised machine learning models met or exceeded an accuracy of 95% with logistic regression, KNN, and ANN as the most robust sociodemographic predictors. For Asks to use toilet, 84.00% accuracy was achieved with the KNN and ANN models. For these models, the family sociodemographic predictors of “family expenditure” and “parents’ age” accounted for most of the model variability. The last 2 parameters, Urinates in toilet or potty and Buttons large buttons, had an accuracy of 91.00% and 76.00%, respectively, in ANN. Overall, the ANN had a higher accuracy (above ~80% on average) among the other algorithms for all the parameters. Across the models and milestones, “family expenditure,” “family size/type,” “living places,” and “parent’s age and occupation” were the most influential family/child sociodemographic factors. Conclusions mCARE was successfully deployed in a low- and middle-income country (ie, Bangladesh), providing parents and care practitioners a mechanism to share detailed information on child milestones achievement. Using advanced modeling techniques this study demonstrates how family/child sociodemographic elements can inform child milestone achievement. Specifically, families with fewer sociodemographic resources reported later milestone attainment. Developmental science theories highlight how family/systems can directly influence child development and this study provides a clear link between family resources and child developmental progress. Clinical implications for this work could include supporting the larger family system to improve child milestone achievement.
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Affiliation(s)
- Munirul M Haque
- R.B. Annis School of Engineering, University of Indianapolis, Indianapolis, IN, United States
| | - Masud Rabbani
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Dipranjan Das Dipal
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Md Ishrak Islam Zarif
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Anik Iqbal
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
| | - Amy Schwichtenberg
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Naveen Bansal
- Department of Mathematical and Statistical Sciences, Marquette University, Milwaukee, WI, United States
| | | | | | - Sheikh Iqbal Ahamed
- Ubicomp Lab, Department of Computer Science, Marquette University, Milwaukee, WI, United States
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Alvari G, Furlanello C, Venuti P. Is Smiling the Key? Machine Learning Analytics Detect Subtle Patterns in Micro-Expressions of Infants with ASD. J Clin Med 2021; 10:1776. [PMID: 33921756 PMCID: PMC8073678 DOI: 10.3390/jcm10081776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 01/01/2023] Open
Abstract
Time is a key factor to consider in Autism Spectrum Disorder. Detecting the condition as early as possible is crucial in terms of treatment success. Despite advances in the literature, it is still difficult to identify early markers able to effectively forecast the manifestation of symptoms. Artificial intelligence (AI) provides effective alternatives for behavior screening. To this end, we investigated facial expressions in 18 autistic and 15 typical infants during their first ecological interactions, between 6 and 12 months of age. We employed Openface, an AI-based software designed to systematically analyze facial micro-movements in images in order to extract the subtle dynamics of Social Smiles in unconstrained Home Videos. Reduced frequency and activation intensity of Social Smiles was computed for children with autism. Machine Learning models enabled us to map facial behavior consistently, exposing early differences hardly detectable by non-expert naked eye. This outcome contributes to enhancing the potential of AI as a supportive tool for the clinical framework.
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Affiliation(s)
- Gianpaolo Alvari
- Department of Psychology and Cognitive Sciences, University of Trento, 38068 Rovereto, Italy;
- Data Science for Health (DSH) Research Unit, Bruno Kessler Foundation (FBK), 38123 Trento, Italy
| | | | - Paola Venuti
- Department of Psychology and Cognitive Sciences, University of Trento, 38068 Rovereto, Italy;
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Low HM, Wong TP, Lee LW, Makesavanh S, Vongsouangtham B, Phannalath V, Che Ahmad A, Lee ASS. Can pictorial narration offer a solution to teacher training on the effective inclusion of students with autism spectrum disorder in low-resource settings? Investigation on knowledge and stigma change. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1216-1233. [PMID: 33467885 DOI: 10.1177/1362361320984899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT In this study, we explored whether pictorial narration could offer a solution to teacher training on effective inclusion of students with autism spectrum disorder in the Lao People's Democratic Republic. For this purpose, pre- and post-training knowledge data were collected from 87 Laotian teachers who participated in teacher training using a pictorial narrative e-module called The Story of KhamdyTM. The teachers' knowledge test results and feedback were analyzed. The findings indicated that teachers' acceptance toward the training method had positive effects on their knowledge changes and supported the use of a pictorial narration approach in imparting knowledge about inclusive education and autism spectrum disorder to teachers in a least developed country.
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Anderson A, Barbaro J, Maybery M. Introduction to Special Issue “Autism Spectrum Disorder: Research and Practice”. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University,
| | - Murray Maybery
- School of Psychology, University of Western Australia, Australia,
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Magán-Maganto M, Canal-Bedia R, Hernández-Fabián A, Bejarano-Martín Á, Fernández-Álvarez CJ, Martínez-Velarte M, Martín-Cilleros MV, Flores-Robaina N, Roeyers H, Posada de la Paz M. Spanish Cultural Validation of the Modified Checklist for Autism in Toddlers, Revised. J Autism Dev Disord 2020; 50:2412-2423. [PMID: 30328577 DOI: 10.1007/s10803-018-3777-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The Modified Checklist for Autism in Toddlers-revised/follow-up (M-CHAT-R/F) was developed to reduce the number of cases requiring telephone verification. The aim of this study was to validate a Spanish version of the M-CHAT-R/F in the Spanish public health system. The M-CHAT-R/F was translated, culturally adapted, and then administered to 6625 children. Of the 39 positive screening cases, 15 children were diagnosed with autism spectrum disorder (ASD) and 24 with non-ASD disorders or delays. The sensitivity was 0.79 and specificity of 0.99. Positive and negative predictive values were 0.39 and 0.99, respectively. These results are similar to the English equivalent, though observed prevalence was lower. This study supports Spanish National Health System policy makers to consider a universal ASD screening program.
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Affiliation(s)
- María Magán-Maganto
- Centro de Atención Integral al Autismo (INFOAUTISMO), Faculty of Education, University Institute of Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Ricardo Canal-Bedia
- Centro de Atención Integral al Autismo (INFOAUTISMO), Faculty of Education, University Institute of Community Integration (INICO), University of Salamanca, Salamanca, Spain.
| | | | - Álvaro Bejarano-Martín
- Centro de Atención Integral al Autismo (INFOAUTISMO), Faculty of Education, University Institute of Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Clara J Fernández-Álvarez
- Centro de Atención Integral al Autismo (INFOAUTISMO), Faculty of Education, University Institute of Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | | | - Maria V Martín-Cilleros
- Centro de Atención Integral al Autismo (INFOAUTISMO), Faculty of Education, University Institute of Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Noelia Flores-Robaina
- Faculty of Psychology, University Institute of Community Integration (INICO), University of Salamanca, Salamanca, Spain
| | - Herbert Roeyers
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Forti S, Colombo B, Clark J, Bonfanti A, Molteni S, Crippa A, Antonietti A, Molteni M. Soundbeam imitation intervention: Training children with autism to imitate meaningless body gestures through music. ADVANCES IN AUTISM 2020. [DOI: 10.1108/aia-07-2019-0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This paper aims to present the application and critical reflection on the effects of a intervention for children with autism spectrum disorder (ASD): the Soundbeam Imitation Intervention (SII). The intervention is based on the imitation of meaningless body gestures supported by a musical feedback. The rationale underlying SII is that mirror neurons deficit may represent the cause for the incomplete development of social and motor functioning in children with ASD. Following this assumption, it is possible to hypothesise that a systematic activation of this a system through the simultaneous observation-execution of meaningless body gestures may affect functional changes of mirror-related functions.
Design/methodology/approach
A sample of 14 children, who were between 5 and 9 years of age, with a diagnosis of ASD were involved in a six weeks’ SII programme. The programme is designed as a three-step progression, where each step includes exercises that focus on an activity: synchronous/one arm imitation, synchronous/two arms imitation and delayed imitation. Exercises are based on repeated movements-melodies associations of increasing difficulty. Motor imitation and social attention were assessed using a synchronous video-modelling task pre and post intervention.
Findings
Data highlight significant improvements in imitation accuracy and duration of social sustained attention were achieved.
Originality/value
Data reported in this paper provide preliminary and promising evidence that imitation and social attention skills acquired through SII can be generalised to a video-modelling imitation setting. The SII ordinal execution has included meaningless gestures, usually excluded from previous interventions, and this adds further validity to the training.
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de Leeuw A, Happé F, Hoekstra RA. A Conceptual Framework for Understanding the Cultural and Contextual Factors on Autism Across the Globe. Autism Res 2020; 13:1029-1050. [PMID: 32083402 PMCID: PMC7614360 DOI: 10.1002/aur.2276] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/02/2020] [Accepted: 01/24/2020] [Indexed: 12/14/2022]
Abstract
Autism research is heavily skewed toward western high-income countries. Culturally appropriate screening and diagnostic instruments for autism are lacking in most low- and middle-income settings where the majority of the global autism population lives. To date, a clear overview of the possible cultural and contextual factors that may affect the process of identifying and diagnosing individuals with autism spectrum disorders (ASD) is missing. This study aims to outline these factors by proposing a conceptual framework. A multidisciplinary review approach was applied to inform the development of the conceptual framework, combining a systematic review of the relevant autism research literature with a wider literature search spanning key texts in global mental health, cultural psychiatry, cross-cultural psychology, and intellectual disability research. The resulting conceptual framework considers the identification, help-seeking, and diagnostic process at four interrelated levels: (a) the expression; (b) recognition; (c) interpretation; and (d) reporting of autism symptoms, and describes the cultural and contextual factors associated with each of these levels, including cultural norms of typical and atypical behavior, culture-specific approaches to parenting, mental health literacy, cultural beliefs, attitudes and stigma, as well as the affordability, availability, accessibility, and acceptability of services. This framework, mapping out the cultural and contextual factors that can affect the identification, help-seeking, and diagnosis of ASD may function as a springboard for the development of culturally appropriate autism screening and diagnostic instruments, and inform future cross-cultural autism research directions. The framework also has relevance for clinicians and policy makers aiming to improve support for underserved autism populations worldwide. Autism Res 2020, 13: 1029-1050. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The vast majority of autism research is conducted in western high-income settings. We therefore know relatively little of how culture and context can affect the identification, help-seeking, and diagnosis of autism across the globe. This study synthesizes what is known from the autism research literature and a broader literature and maps out how culture and context may affect (a) the expression, (b) recognition, (c) interpretation, and (d) reporting of autism symptoms.
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Affiliation(s)
- Anne de Leeuw
- Amsterdam University Medical Centre, location VUmc, Amsterdam, The Netherlands
| | - Francesca Happé
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Rosa A Hoekstra
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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20
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A High Prevalence of Autism Spectrum Disorder in Preschool Children in an Immigrant, Multiethnic Population in Sweden: Challenges for Health Care. J Autism Dev Disord 2020; 51:538-549. [PMID: 32533384 PMCID: PMC7835151 DOI: 10.1007/s10803-020-04563-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study examines the prevalence of autism spectrum disorder (ASD) in preschool children in an immigrant population. Possible risk factors for ASD and individual needs for the children and their families are described, as well as implications for health care. The estimated minimum prevalence for ASD in the area was 3.66% for children aged 2–5 years. Multiple risk factors and extensive individual needs for the children and their families were observed. The high prevalence of ASD and the plethora of needs in immigrant communities pose challenges for health care. A coordinated health care system is necessary to meet the many and individual needs.
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21
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Barbaro J, Yaari M. Study protocol for an evaluation of ASDetect - a Mobile application for the early detection of autism. BMC Pediatr 2020; 20:21. [PMID: 31952489 PMCID: PMC6969425 DOI: 10.1186/s12887-019-1888-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 12/15/2019] [Indexed: 11/18/2022] Open
Abstract
Background Autism Spectrum Conditions (ASC) can be reliably diagnosed by 24 months of age. However, despite the well-known benefits of early intervention, there is still a research-practice gap in the timely identification of ASC, particularly in low-resourced settings. The Social Attention and Communication Surveillance (SACS) tool, which assesses behavioural markers of autism between 12 to 24 months of age, has been implemented in Maternal and Child Health (MCH) settings, with excellent psychometric properties. ASDetect is a free mobile application based on the SACS, which is designed to meet the need for an effective, evidence-based tool for parents, to learn about children’s early social-communication development and assess their child’s ‘likelihood’ for ASC. Study aims The primary aim of this study is to evaluate the psychometric properties of ASDetect in the early detection of children with ASC. A secondary aim is to assess ASDetect’s acceptability and parental user experience with the application. Methods Families are recruited to download the application and participate in the study via social media, health professionals (e.g., MCH nurses, paediatricians) and word of mouth. All participating caregivers complete a demographic questionnaire, survey regarding their user experience, and the Social Responsiveness Scale-2 (SRS-2), an autism screening questionnaire; they are also invited to participate in focus groups. Children identified at ‘high likelihood’ for ASC based on the ASDetect results, the SRS-2 or parental and/or professional concerns undergo a formal, gold-standard, diagnostic assessment. Receiver Operating Characteristic analyses will be used to assess psychometric properties of ASDetect. Thematic analyses will be used to explore themes arising in the focus groups to provide insights regarding user experiences with the app. Multiple regression analyses will be carried out to determine the extent to which demographic factors, parental stress and beliefs on health surveillance and child results on ASDetect are associated with the parental user-experience of the application. Discussion With a strong evidence-base and global access, ASDetect has the potential to empower parents by providing them with knowledge of their child’s social-communication development, validating and reassuring any parental concerns, and supporting them in communicating with other health professionals, ultimately enhancing child and family outcomes and well-being.
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Affiliation(s)
- Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health. College of Science, Heath & Engineering. La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Maya Yaari
- Olga Tennison Autism Research Centre, School of Psychology and Public Health. College of Science, Heath & Engineering. La Trobe University, Melbourne, Victoria, 3086, Australia.,Goshen - Community Child Health and Well-Being. Haruv Campus for Children. Mount Scopus, 9765418, Jerusalem, Israel
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22
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Tokunaga A, Akiyama T, Miyamura T, Honda S, Nakane H, Iwanaga R, Tanaka G. Neonatal behavior and social behavior and sensory issues in 18-month toddlers. Pediatr Int 2019; 61:1202-1209. [PMID: 31655009 DOI: 10.1111/ped.14033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 10/11/2018] [Accepted: 07/11/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND There has long existed a need for early detection and early intervention for children with autism spectrum disorder. Accordingly, the aim of this study was to demonstrate, in a prospective manner, the relationship between behavioral features during the neonatal period and social behavior and sensory issues at 18 months. METHODS Participants were 105 full-term infants considered "healthy" by an obstetrician. The behavioral features of the infants were evaluated using the Neonatal Behavioral Assessment Scale (NBAS) between 2 and 7 days after birth. Follow-up assessments were conducted 18 months later using a Japanese version of the Modified Checklist for Autism in Toddlers (M-CHAT-JV) and the Infant / Toddler Sensory Profile (ITSP). RESULTS Sixteen (15.2%) of the 105 infants were M-CHAT-JV-positive. There were significant differences between the M-CHAT-JV-positive and M-CHAT-JV-negative groups in two of the NBAS clusters: orientation and motor. We observed a significant negative correlation between the NBAS orientation cluster and the ITSP "low registration" and "auditory processing" sections, as well as between the NBAS motor cluster and the ITSP "sensation avoiding" and "tactile processing" sections. Logistic regression analysis showed that the NBAS orientation cluster and ITSP low registration were significantly associated with the M-CHAT-JV at 18 months. CONCLUSIONS The results suggest a relationship between the NBAS orientation cluster in full-term neonates and their social behavior and sensory features at 18 months.
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Affiliation(s)
- Akiko Tokunaga
- Department of Psychiatric Rehabilitation Science, Unit Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | | | - Sumihisa Honda
- Department of Public Health and Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hideyuki Nakane
- Department of Psychiatric Rehabilitation Science, Unit Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoichiro Iwanaga
- Department of Psychiatric Rehabilitation Science, Unit Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Goro Tanaka
- Department of Psychiatric Rehabilitation Science, Unit Rehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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24
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Adaptation of the Autism Spectrum Screening Questionnaire (ASSQ) to preschool children. PLoS One 2018; 13:e0199590. [PMID: 29990348 PMCID: PMC6038992 DOI: 10.1371/journal.pone.0199590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/11/2018] [Indexed: 12/27/2022] Open
Abstract
The Autism Spectrum Screening Questionnaire (ASSQ) is equipped with good properties for screening the broader phenotype of autistic traits, but it is standardized for a limited age range-from 7 to 16 years. To contribute to the early detection of Autism Spectrum Disorder (ASD), particularly in high functioning children with ASD, likely to cause maladjustments during school age, the present study examined psychometric properties to apply the ASSQ to a younger age. We tested parents' ASSQ ratings for preschool children in clinical (N = 154, average age 60.77 months, range 55-72 months) and community settings (N = 1390, average age 60.53 months, range 57-68 months) in Japan. The results showed, just as in school-aged children, the ASSQ had reliability and validity as a screening instrument for preschool children in community settings. A cut-off of 7 with sensitivity of 0.93 and specificity of 0.84 is recommended for community screening. Still, based on the current study with a clinical group, an optimal cut-off score with high sensitivity and high specificity for parents' ASSQ ratings could not be established. The clinicians should be reminded that the ASSQ is a screening instrument, not a diagnosing instrument. Also, this result suggest multi-faceted evaluation is necessary in clinical settings, for example, the addition of teachers' ratings.
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Characterizing Health Disparities in the Age of Autism Diagnosis in a Study of 8-Year-Old Children. J Autism Dev Disord 2018; 48:2396-2407. [DOI: 10.1007/s10803-018-3500-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lo BH, Klopper F, Barnes EH, Williams K. Agreement between concern about autism spectrum disorder at the time of referral and diagnosis, and factors associated with agreement. J Paediatr Child Health 2017; 53:742-748. [PMID: 28374573 DOI: 10.1111/jpc.13511] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/21/2017] [Indexed: 11/28/2022]
Abstract
AIM This study examined the level of agreement between referral reason and diagnostic outcome for pre-school aged children showing developmental delays and differences. In particular, the level of agreement when there was concern about autism spectrum disorder (ASD) was investigated. METHODS Clinical records for children (n = 677) assessed for developmental concerns at a multidisciplinary assessment clinic in Sydney, Australia, were examined. Referral reason and diagnostic outcome were compared. Referral sources and factors including age, developmental level and language functioning, were explored for potential association with the consistency between referral reason and diagnosis. RESULTS Approximately 30% of children referred for developmental assessment with ASD concern were not diagnosed with ASD. Agreement between referral reason and diagnosis was similar regardless of referral source and child age. Of children where diagnostic outcome was discordant with referral reason, 24% had delayed language. Variability in cognitive or developmental profiles was common (64%), regardless of diagnostic outcome. CONCLUSIONS Referral for ASD diagnostic assessments in the cases where ASD is not the primary cause for a child's difficulties increases pressure on assessment services, can delay access to ASD-specific intervention services for children who do have ASD, and can contribute to parent anxiety unnecessarily. The current evidence that a substantial minority of children were referred for ASD diagnostic assessments when ASD was not the primary cause for the difficulties emphasises the value of adopting a developmental differences framework, focusing on dimensions of behaviour and functioning, rather than an autism-specific service structure.
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Affiliation(s)
- Bee H Lo
- Parramatta Early Childhood Assessment Team, Children's Hospital Westmead, Sydney, New South Wales, Australia
| | - Felicity Klopper
- Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Elizabeth H Barnes
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Katrina Williams
- Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Morales-Hidalgo P, Roigé-Castellví J, Vigil-Colet A, Canals Sans J. The Childhood Autism Spectrum Test (CAST): Spanish adaptation and validation. Autism Res 2017; 10:1491-1498. [PMID: 28383173 DOI: 10.1002/aur.1793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/06/2017] [Accepted: 03/10/2017] [Indexed: 11/09/2022]
Abstract
The Childhood Autism Spectrum Test (CAST; Scott, Baron-Cohen, Bolton & Brayne, 2002) has proved to be a good test for screening autism spectrum disorders (ASD) and social communication problems. This study provides evidence on its psychometric properties, describe its validity for screening and provides data on its discriminative capabilities in a Spanish sample of 4-12 year-old children from community and clinical settings (N = 1460 and 36, respectively). Factorial and convergent validity is also assessed. The full Spanish version with a cut-off score of 15 presented a high sensitivity (83.9%) and specificity (92.5%), a positive predictive value (PPV) of .63 and an internal consistency (α) of .826. Some items showed low discriminating power and these results led us to propose a reduced version with 28 items and a cut-off score of 13, which presented a high sensitivity (85.7%) and specificity (91.16%), a PPV of .61 and an α of .839. Correlations were high between the Spanish full and reduced versions of the CAST, and ADI-R (Autism Diagnostic Interview Revised) and ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition). Like previous adaptation studies, a two-factor structure was found. The data show that the CAST can be a valid and reliable questionnaire for ASD screening in Spanish clinical and community populations. Autism Res 2017, 10: 1491-1498. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Paula Morales-Hidalgo
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Joana Roigé-Castellví
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Andreu Vigil-Colet
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Josefa Canals Sans
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
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