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Pathak A, Mobin N, Prasad KN, Mondal K, Mitra O, Kumar A, Sinha H. To assess the magnitude of autism spectrum disorder in Jharkhand by M-CHAT-R as a screening tool. J Family Med Prim Care 2022; 11:1497-1501. [PMID: 35516694 PMCID: PMC9067197 DOI: 10.4103/jfmpc.jfmpc_1452_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/04/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder which is a clinically heterogenous condition with a wide range of etiological factors and causing significant public health burden. If diagnosed at an earlier age, early interventions can be started this leads to functional outcome of children with ASD with respect to social, behavior and occupational sphere. Therefore, early detection and intervention are widely recommended in these children. So screening of toddlers who were identified to be "at risk" can be diagnosed using screening questionnaires by interviewing parents. Overall with this study we can conclude that, toddlers identified to be "at risk" and those diagnosed with ASD were not uncommon and M-CHAT-R is a useful screening test for the identification of "at risk" toddlers for Autism Spectrum Disorder in Jharkhand.
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Affiliation(s)
- Apeksha Pathak
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Naghma Mobin
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Kamal N Prasad
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Kalpak Mondal
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Olie Mitra
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Abhinandan Kumar
- Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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DuBay M, Watson LR, Méndez LI, Rojevic C. Psychometric Comparison of the English and Spanish Western-Hemisphere Versions of the Modified Checklist for Autism in Toddlers-Revised. J Dev Behav Pediatr 2021; 42:717-725. [PMID: 34840315 DOI: 10.1097/dbp.0000000000000968] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 03/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Parent-report screening tools for autism spectrum disorder (ASD) are widely used to promote early identification of children with or at risk for ASD. Most screening tools have been developed in English in the United States or United Kingdom; thus, translated versions are needed for use with culturally and linguistically diverse populations. Traditional translation methods include a forward translation, back translation, and review. However, when used in new cultural and linguistic contexts, this "forward-back" approach may have limitations, including differing psychometric properties compared with original instruments. This study presents a psychometric analysis of the forward-back translation methodology of an ASD screening tool. METHODS A retrospective chart review design was used to examine Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R; Robins et al.) records from 2974 toddlers. Data were compared between caregivers who completed the original English M-CHAT-R and caregivers who completed its forward-back "Spanish-Western Hemisphere" translation to compare select psychometric properties of the 2 instruments. RESULTS Significant differences were observed between the 2 versions, including a higher overall risk score, higher initial screen-positive rate, and increased likelihood of leaving items blank among Spanish-speaking respondents. CONCLUSION Traditional translation methods seemed to affect select psychometric properties between translations of the M-CHAT-R. A more rigorous cultural adaptation approach may be necessary to maintain equivalence with the original instrument. Until new rigorous translations are available, it is recommended that language-specific screening tools continue to be used, along with recommended follow-up interviews, to avoid exacerbating existing health disparities.
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Affiliation(s)
- Michaela DuBay
- Speech Communication Disorders Program, Department of Human Services, School of Education and Human Services, University of Virginia, Charlottesville, VA
| | - Linda R Watson
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Lucía I Méndez
- Department of Communication Sciences and Disorders, School of Health and Human Sciences, University of North Carolina, Greensboro, NC
| | - Carolina Rojevic
- Occupational Therapy Department, University of California at San Francisco Benioff Children's Hospital, Oakland, CA
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Krishnan V, Krishnakumar P, Gireeshan VK, George B, Basheer S. Early Social Experience and Digital-Media Exposure in Children with Autism Spectrum Disorder. Indian J Pediatr 2021; 88:793-799. [PMID: 33471317 DOI: 10.1007/s12098-021-03666-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 01/08/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To study the early social experience and digital media exposure in children with autism spectrum disorder (ASD) in comparison with typically developed children. METHODS Details of digital-media exposure and early social experience in 65 children with ASD were compared with those in a control group of equal number of typically developed children, matched for age and gender. Prenatal and perinatal factors were also studied. The diagnosis of ASD was based on the International Clinical Epidemiology Network (INCLEN) diagnostic tool and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) diagnostic criteria. Variables which were biologically relevant and has a P value of < 0.05 in the univariate analysis were analyzed by logistic regression to obtain the adjusted effect measures. RESULTS Children with ASD were exposed to digital media at an earlier age and spent significantly more time with digital media and less time with their mothers, compared to typically developed children. Exposure to digital media before 21 mo was associated with risk of ASD and the risk increased when mothers spent less than 6.5 h per day with the baby. Family history of epilepsy and developmental delay, maternal stress during the antenatal period, and absence of exclusive breastfeeding during the first 6 mo were significantly more in children with ASD. CONCLUSION There are significant differences in the early life social experience and digital-media exposure in children with ASD compared to typically developed counterparts. Given the reported rise in prevalence of ASD, these findings stress the need for further prospective studies to explore these potentially modifiable risk factors.
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Affiliation(s)
- Vaisakh Krishnan
- Department of Pediatrics, Government Medical College, Kozhikode, Kerala, India
| | | | - V K Gireeshan
- Department of Pediatrics, Government Medical College, Manjeri, Kerala, India
| | - Biju George
- Department of Community Medicine, Government Medical College, Kozhikode, Kerala, India
| | - Salah Basheer
- Institute of Mental Health and Neurosciences (IMHANS), Kozhikode, Kerala, India
- Department of Child Psychiatry, IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India
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Abstract
Autism is a grand challenge in global mental health to be dealt with on a priority basis. Phenotypic knowledge, biological understanding, and evidence-based intervention studies are all from western countries. We know very little about autism in the low- and middle-income countries (LMIC). Lack of infrastructure and difficulties in operationalizing research has widened the knowledge gap. We performed a comprehensive scoping review of research in Autism Spectrum Disorder in India to have an overall impression, identify gaps, and formulate evidence-based recommendations for further study. We searched PubMed, SCOPUS, and Cochrane Library to identify relevant Indian studies. A hundred and fifty-nine publications met the inclusion criteria. Most of the research contribution in autism is from few tertiary care medical centres, technological institutes, and not-for-profit organizations. We identified various themes of research like clinical profile, interventions, biomarkers, psychological, social, epidemiological, and risk factors. Evidence-based intervention studies, translation and adaptation of standard diagnostic instruments, and qualitative research on the experience of autism appeared to be state of the art. However, epidemiological studies, biomarkers identification, risk assessment studies were of low quality. There is a need for nationwide studies with representative sampling on epidemiology, biomarkers, and risk factors for a complete evaluation of the actual burden and biology of autism in India. Also, there is a need to design implementation research to evaluate the effectiveness of evidence-based interventions in routine healthcare settings. We recommend that future research should fill these gaps in understanding autism and improving its outcome in India.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
| | - Sujita Kumar Kar
- Department of Psychiatry, King George Medical University, Lucknow, Uttar Pradesh, India
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Jacob P, Ts J, G SK, L M, Gr G, K T, Srinath S. Behavioural, emotional and rhythm-related disturbances in toddlers: Preliminary findings from a community-based study in Kerala, India. Infant Ment Health J 2021; 42:292-298. [PMID: 33394552 DOI: 10.1002/imhj.21905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The need to enhance mental health in primary care settings for infants and toddlers is increasingly becoming apparent. However, the lack of trained healthcare personnel and culturally appropriate measures makes it a challenge in low- and middle-income countries. A needs-based assessment of the extent of the problems in toddlers will help address the lacunae in providing mental health services. METHODS A needs-based assessment was carried out of a community sample of 9,287 mothers with toddlers aged between 13 and 25 months in Kerala, India. This assessment was conducted by junior public health nurses using an indigenously developed checklist titled 'Screening checklist for Behavioural, Emotional and Rhythm-related disturbances in Toddlers' (S-BERT). RESULTS According to the mothers surveyed, 30.4% of toddlers had concerning or distress causing behaviours. Three factors, namely behavioural, rhythm-related and emotional disturbances, were deemed significant when the item response theory was used to examine the factor structure of S-BERT. CONCLUSION This study suggests that behaviours that cause distress to mothers of toddlers are common, if queried specifically. Given the constraints in health resources as the cultural factors in operation, use of indigenous tools and principles of collaborative stepped care may be the way forward.
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Affiliation(s)
- Preeti Jacob
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Jaisoorya Ts
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Manoj L
- National Health Mission, Kerala, India
| | - Gokul Gr
- National Health Mission, Kerala, India
| | - Thennarasu K
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Shoba Srinath
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Jaisoorya TS, Thamby A, Manoj L, Kumar GS, Gokul GR, Narayanaswamy JC, Arumugham SS, Thennarassu K, Reddy YCJ. Prevalence of hoarding disorder among primary care patients. BRAZILIAN JOURNAL OF PSYCHIATRY 2020; 43:168-173. [PMID: 32876135 PMCID: PMC8023159 DOI: 10.1590/1516-4446-2020-0846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/22/2020] [Indexed: 11/22/2022]
Abstract
Objectives: Despite the inclusion of hoarding disorder (HD) in the DSM-5, there is little epidemiological data on hoarding from low and middle-income countries. This study, the first from India, examines the prevalence and correlates of HD among primary care patients in the state of Kerala, India. Methods: To assess correlates, the Hoarding Rating Scale-Interview (HRS-I) and other structured instruments were administered to 7,555 subjects selected by stratified random sampling from 71 primary health centers. Results: The prevalence of HD was 1.02% (95%CI 0.8-1.3). Those with HD were more likely to be older and live alone. In the binary logistic regression analysis, after controlling for significant sociodemographic variables, subjects with HD had a higher odds of reporting chronic illness, depression, anxiety disorder, alcohol abuse, and tobacco dependence. Subjects with HD had significantly higher disability scores than unaffected individuals. Conclusion: Although HD is not uncommon in India, this disorder is rarely reported in specialty settings in India, which suggests that awareness and detection should be improved, considering the co-occurring negative correlates and disability among affected individuals.
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Affiliation(s)
- T S Jaisoorya
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Abel Thamby
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - L Manoj
- National Health Mission (NHM), Thiruvananthapuram, Kerala, India
| | - G Sunil Kumar
- National Health Mission (NHM), Thiruvananthapuram, Kerala, India
| | - G R Gokul
- National Health Mission (NHM), Thiruvananthapuram, Kerala, India
| | | | - Shyam Sundar Arumugham
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - K Thennarassu
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Y C Janardhan Reddy
- National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bengaluru, Karnataka, India
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Alawami AH, Perrin EC, Sakai C. Implementation of M-CHAT Screening for Autism in Primary Care in Saudi Arabia. Glob Pediatr Health 2019; 6:2333794X19852021. [PMID: 31211185 PMCID: PMC6545649 DOI: 10.1177/2333794x19852021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/24/2019] [Accepted: 04/29/2019] [Indexed: 11/16/2022] Open
Abstract
Background. Integration of autism screening into primary care practice in Saudi Arabia is not well established. Objectives. To evaluate the feasibility and effectiveness of implementing the Arabic Modified Checklist for Autism in Toddlers (M-CHAT) in a primary care practice at John Hopkins Aramco Healthcare Center in Saudi Arabia. Method. The Arabic version of M-CHAT was distributed to caregivers of 1207 toddlers (16-32 months) from January to December 2014. Feasibility was assessed by measuring the proportion of visits with M-CHAT completed, and reports of workflow challenges and provider satisfaction. The effectiveness of screening was evaluated based on the number of referrals for autism evaluation and autism identification rates. Results. Total M-CHAT completion rate was 89% (1078 out of 1207 child-specific visits). Those identified as low risk (n = 951; 88%) were reassured and followed routinely. Those screening positive (n = 127; 12%) were referred for diagnostic assessment. Twelve (1% of toddlers screened) were diagnosed with autism at a mean age of 24 months. In addition, positive M-CHAT detected speech delay and social anxiety. Providers acknowledged their satisfaction with the M-CHAT implementation process; the main challenge was communicating to families the importance of screening. Referrals for diagnostic evaluations increased from 23 to 43 cases in the first year, and 35 in the second year. Conclusion. Implementation of the autism screening using the Arabic M-CHAT is feasible and effective in a primary care setting in Saudi Arabia. Sustaining the implementation of developmental screening in practice requires staff engagement and systematic monitoring of the impact of change.
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Sopha SC, Terhune JH, Hoover L, Uradomo L, Boutros CN. Acinar Cell Cystadenoma of the Pancreas: a Multidisciplinary and Contemporary Approach. J Gastrointest Surg 2018; 22:1797-1798. [PMID: 29380117 DOI: 10.1007/s11605-018-3698-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 01/31/2023]
Affiliation(s)
- Sabrina C Sopha
- Department of Pathology, University of Maryland Baltimore Washington Medical Center, 301 Hospital Drive, Glen Burnie, MD, 21601, USA.
| | - J H Terhune
- Department of Surgery, University of Maryland Baltimore Washington Medical Center, 301 Hospital Drive, Glen Burnie, MD, 21601, USA
| | - L Hoover
- Department of Pathology, University of Maryland Baltimore Washington Medical Center, 301 Hospital Drive, Glen Burnie, MD, 21601, USA
| | - L Uradomo
- Department of Gastroenterology, University of Maryland Baltimore Washington Medical Center, 301 Hospital Drive, Glen Burnie, MD, 21601, USA
| | - C N Boutros
- Department of Surgery, University of Maryland Baltimore Washington Medical Center, 301 Hospital Drive, Glen Burnie, MD, 21601, USA
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