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Fan SJS, Chen SP. Does culture play a role? A pilot study on Western services for a Chinese-Canadian family with children with Autism spectrum disorder. Disabil Rehabil 2024; 46:2584-2592. [PMID: 37382677 DOI: 10.1080/09638288.2023.2227566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE Autism spectrum disorder (ASD) affects one in 66 children in Canada, and its symptoms may be particularly challenging for parents from a Chinese background. Further, when working with Chinese families, Western-educated service providers may experience difficulty in applying culturally relevant and family-centered care. This study examined the experiences of one Chinese-Canadian family as they receive intervention services for their two children with ASD. MATERIALS AND METHODS This pilot, single-case design, qualitative case study included semi-structured interviews with the parents, grandparents, as well as three service providers' views. RESULTS Three major themes emerged from the data in the form of tensions: (1) within the family members; (2) within the therapeutic relationships, and (3) in addressing culture in therapy. CONCLUSIONS Results suggested that although the family identified key cultural differences, service providers did not sufficiently address these within the therapeutic relationship, and the need for culturally-relevant and family-centered care was not fulfilled.
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Affiliation(s)
- Shu Jun Selina Fan
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Shu-Ping Chen
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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2
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Themistocleous CK, Andreou M, Peristeri E. Autism Detection in Children: Integrating Machine Learning and Natural Language Processing in Narrative Analysis. Behav Sci (Basel) 2024; 14:459. [PMID: 38920791 PMCID: PMC11200366 DOI: 10.3390/bs14060459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 06/27/2024] Open
Abstract
Despite the consensus that early identification leads to better outcomes for individuals with autism spectrum disorder (ASD), recent research reveals that the average age of diagnosis in the Greek population is approximately six years. However, this age of diagnosis is delayed by an additional two years for families from lower-income or minority backgrounds. These disparities result in adverse impacts on intervention outcomes, which are further burdened by the often time-consuming and labor-intensive language assessments for children with ASD. There is a crucial need for tools that increase access to early assessment and diagnosis that will be rigorous and objective. The current study leverages the capabilities of artificial intelligence to develop a reliable and practical model for distinguishing children with ASD from typically-developing peers based on their narrative and vocabulary skills. We applied natural language processing-based extraction techniques to automatically acquire language features (narrative and vocabulary skills) from storytelling in 68 children with ASD and 52 typically-developing children, and then trained machine learning models on the children's combined narrative and expressive vocabulary data to generate behavioral targets that effectively differentiate ASD from typically-developing children. According to the findings, the model could distinguish ASD from typically-developing children, achieving an accuracy of 96%. Specifically, out of the models used, hist gradient boosting and XGBoost showed slightly superior performance compared to the decision trees and gradient boosting models, particularly regarding accuracy and F1 score. These results bode well for the deployment of machine learning technology for children with ASD, especially those with limited access to early identification services.
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Affiliation(s)
| | - Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, 24100 Kalamata, Greece
| | - Eleni Peristeri
- School of English, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
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3
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Okabe M, Sato T, Takahashi M, Honjo A, Okawa M, Ishida M, Kukimoto-Niino M, Shirouzu M, Miyamoto Y, Yamauchi J. Autism Spectrum Disorder- and/or Intellectual Disability-Associated Semaphorin-5A Exploits the Mechanism by Which Dock5 Signalosome Molecules Control Cell Shape. Curr Issues Mol Biol 2024; 46:3092-3107. [PMID: 38666924 PMCID: PMC11049140 DOI: 10.3390/cimb46040194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that includes autism, Asperger's syndrome, and pervasive developmental disorder. Individuals with ASD may exhibit difficulties in social interactions, communication challenges, repetitive behaviors, and restricted interests. While genetic mutations in individuals with ASD can either activate or inactivate the activities of the gene product, impacting neuronal morphogenesis and causing symptoms, the underlying mechanism remains to be fully established. Herein, for the first time, we report that genetically conserved Rac1 guanine-nucleotide exchange factor (GEF) Dock5 signalosome molecules control process elongation in the N1E-115 cell line, a model line capable of achieving neuronal morphological changes. The increased elongation phenotypes observed in ASD and intellectual disability (ID)-associated Semaphorin-5A (Sema5A) Arg676-to-Cys [p.R676C] were also mediated by Dock5 signalosome molecules. Indeed, knockdown of Dock5 using clustered regularly interspaced short palindromic repeat (CRISPR)/CasRx-based guide(g)RNA specifically recovered the mutated Sema5A-induced increase in process elongation in cells. Knockdown of Elmo2, an adaptor molecule of Dock5, also exhibited similar recovery. Comparable results were obtained when transfecting the interaction region of Dock5 with Elmo2. The activation of c-Jun N-terminal kinase (JNK), one of the primary signal transduction molecules underlying process elongation, was ameliorated by either their knockdown or transfection. These results suggest that the Dock5 signalosome comprises abnormal signaling involved in the process elongation induced by ASD- and ID-associated Sema5A. These molecules could be added to the list of potential therapeutic target molecules for abnormal neuronal morphogenesis in ASD at the molecular and cellular levels.
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Affiliation(s)
- Miyu Okabe
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
| | - Takanari Sato
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
| | - Mikito Takahashi
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
| | - Asahi Honjo
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
| | - Maho Okawa
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
| | - Miki Ishida
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
| | - Mutsuko Kukimoto-Niino
- Laboratory for Protein Functional and Structural Biology, Center for Biosystems Dynamics Research, RIKEN, Yokohama 230-0045, Japan; (M.K.-N.); (M.S.)
| | - Mikako Shirouzu
- Laboratory for Protein Functional and Structural Biology, Center for Biosystems Dynamics Research, RIKEN, Yokohama 230-0045, Japan; (M.K.-N.); (M.S.)
| | - Yuki Miyamoto
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
- Laboratory of Molecular Pharmacology, National Research Institute for Child Health and Development, Tokyo 157-8535, Japan
| | - Junji Yamauchi
- Laboratory of Molecular Neurology, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan; (M.O.); (Y.M.)
- Laboratory for Protein Functional and Structural Biology, Center for Biosystems Dynamics Research, RIKEN, Yokohama 230-0045, Japan; (M.K.-N.); (M.S.)
- Diabetic Neuropathy Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
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4
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Vela JC, Ramos N, Fielding C, Elizondo D. Exploring Latine Parent Leaders' and a Program Coordinator's Lived Experiences with a Culturally Adapted Parent-Directed Training Program. J Autism Dev Disord 2024:10.1007/s10803-024-06270-0. [PMID: 38443658 DOI: 10.1007/s10803-024-06270-0] [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: 01/28/2024] [Indexed: 03/07/2024]
Abstract
The purpose of the current study was to explore the lived experiences among parent leaders and a program coordinator who participated in a parent-directed training program to support other Latine parents of children with autism spectrum disorder. We used qualitative methods to explore 4 Latine parent leaders' and 1 program coordinator's experiences with a parent-directed training program to support other Latine parents who have children with autism spectrum disorder. We interviewed parent leaders and a program coordinator to learn about their lived experiences as leaders in a parent-directed training program. The following themes emerged from Interpretative Phenomenological Analysis data analysis: (a) personal growth, (b) leadership development, (c) sense of connection and community, (d) contributing to a larger and meaningful purpose, and (e) applying knowledge and skills to help other parents. A culturally adapted parent-directed training program has the potential to positively influence Latine parent leaders who are prepared to support parents of children with ASD. There were positive program impacts on parent leaders regarding personal growth, leadership development, connection and community, contribution to a larger purpose, and use of knowledge and skills to help other parents. We also discovered the importance of building a safe community for Latine parent leaders and other parents who have children with ASD in a parent-directed training program.
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Affiliation(s)
- Javier Cavazos Vela
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA.
| | - Noe Ramos
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
| | - Cheryl Fielding
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
| | - Denisse Elizondo
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
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Liu CH, Chen YL, Chen PJ, Ni HC, Lai MC. Exploring camouflaging by the Chinese version Camouflaging Autistic Traits Questionnaire in Taiwanese autistic and non-autistic adolescents: An initial development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:690-704. [PMID: 37427427 DOI: 10.1177/13623613231181732] [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: 07/11/2023]
Abstract
LAY ABSTRACT Camouflaging is a coping strategy used by some autistic and other neurodivergent people to fit in neurotypical social contexts. The self-reported Camouflaging Autistic Traits Questionnaire has been validated for use in research with adults in some Western societies, but not in non-Western cultural-ethnic groups. We translated Camouflaging Autistic Traits Questionnaire into traditional Chinese and examined the use of this measure in Taiwanese adolescents via both self-report and caregiver-report in 100 autistic and 105 non-autistic adolescents. Both self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire were composed of two factors (i.e. a "compensation-masking" subscale and an "assimilation" subscale). Both adolescent self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire total score and subscales were reliable in measurement, and they highly correlated with each other. Taiwanese autistic adolescents were more likely to camouflage than non-autistic adolescents, especially on assimilation. Female autistic adolescents showed higher assimilation than male autistic adolescents. Higher camouflaging, especially assimilation, was associated with higher stress in autistic and non-autistic adolescents alike. Both self-reported and caregiver-reported Chinese version Camouflaging Autistic Traits Questionnaire were reliable and offered meaningful information to help us understand the social coping experiences of autistic and non-autistic adolescents.
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Affiliation(s)
| | | | - Pei-Jung Chen
- Chang Gung Memorial Hospital at Taoyuan, Taiwan
- King's College London, UK
| | | | - Meng-Chuan Lai
- Centre for Addiction and Mental Health, Canada
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
- University of Cambridge, UK
- National Taiwan University Hospital and College of Medicine, Taiwan
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6
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O’Neill P, Magnacca C, Gunnarsson KF, Khokhar N, Koudys J, Malkin A. Cultural Responsiveness in Behavior Analysis: Provider and Recipient Perceptions in Ontario. Behav Anal Pract 2024; 17:212-227. [PMID: 38405292 PMCID: PMC10890994 DOI: 10.1007/s40617-023-00825-w] [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: 06/13/2023] [Indexed: 02/27/2024] Open
Abstract
Cultural responsiveness is critical to providing high-quality behavior analytic services, particularly when providers and recipients have different cultural backgrounds. The purpose of this study was to systematically replicate and extend (Beaulieu et al. (2019) Behavior Analysis in Practice, 12(3), 557-575) by investigating the diversity among applied behavior analysis (ABA) service providers and service recipients in Ontario, service providers' training and experiences in working with diverse families, and service providers' and recipients' perceptions of behavior analysts' cultural responsiveness in practice. Results from 428 participants suggest that service providers and recipients in Ontario differ in demographic characteristics; service providers report having little training in how to serve diverse families; and although service recipients rate providers' skills relatively positively, there is room for improvement. Results suggest a path forward for behavior analysis that includes education and training in cultural responsiveness as well as encouraging and fostering a bidirectional relationship between behavior analysts and the families they serve. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-023-00825-w.
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Affiliation(s)
- Paige O’Neill
- Department of Applied Disability Studies, Brock University, St. Catharines, ON Canada
- Present Address: University of Nebraska Medical Center’s Munroe-Meyer Institute, Omaha, NE USA
| | - Carly Magnacca
- Department of Applied Disability Studies, Brock University, St. Catharines, ON Canada
- Present Address: Department of Psychology, York University, Toronto, ON Canada
| | - Karl F. Gunnarsson
- Landspitali University Hospital of Iceland, Reykjavik, Iceland
- Department of Physical Therapy, University of Iceland, Reykjavik, Iceland
| | - Nazurah Khokhar
- Department of Applied Disability Studies, Brock University, St. Catharines, ON Canada
| | - Julie Koudys
- Department of Applied Disability Studies, Brock University, St. Catharines, ON Canada
| | - Albert Malkin
- Faculty of Education, Western University, London, ON Canada
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Bui DT, Ton ANV, Nguyen CTD, Nguyen SH, Tran HK, Nguyen XT, Nguyen HT, Pham GLT, Tran DS, Harrington J, Pham HN, Pham TNV, Cao TA. Pathogenic/likely pathogenic mutations identified in Vietnamese children diagnosed with autism spectrum disorder using high-resolution SNP genotyping platform. Sci Rep 2024; 14:2360. [PMID: 38287090 PMCID: PMC10825208 DOI: 10.1038/s41598-024-52777-y] [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: 05/24/2023] [Accepted: 01/23/2024] [Indexed: 01/31/2024] Open
Abstract
Among the most prevalent neurodevelopmental disorders, Autism Spectrum Disorder (ASD) is highly diverse showing a broad phenotypic spectrum. ASD also couples with a broad range of mutations, both de novo and inherited. In this study, we used a proprietary SNP genotyping chip to analyze the genomic DNA of 250 Vietnamese children diagnosed with ASD. Our Single Nucleotide Polymorphism (SNP) genotyping chip directly targets more than 800 thousand SNPs in the genome. Our primary focus was to identify pathogenic/likely pathogenic mutations that are potentially linked to more severe symptoms of autism. We identified and validated 23 pathogenic/likely pathogenic mutations in this initial study. The data shows that these mutations were detected in several cases spanning multiple biological pathways. Among the confirmed SNPs, mutations were identified in genes previously known to be strongly associated with ASD such as SLCO1B1, ACADSB, TCF4, HCP5, MOCOS, SRD5A2, MCCC2, DCC, and PRKN while several other mutations are known to associate with autistic traits or other neurodevelopmental disorders. Some mutations were found in multiple patients and some patients carried multiple pathogenic/likely pathogenic mutations. These findings contribute to the identification of potential targets for therapeutic solutions in what is considered a genetically heterogeneous neurodevelopmental disorder.
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Affiliation(s)
- Duyen T Bui
- Genetica Research Foundation, National Innovation Center, Hanoi, Vietnam.
- Gene Friend Way Inc, San Francisco, USA.
| | - Anh N V Ton
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
- Hue University of Medicine and Pharmacy, Thua Thien Hue, Vietnam
| | - Chi T D Nguyen
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
| | - Son H Nguyen
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
| | - Hao K Tran
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
| | - Xuan T Nguyen
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
| | - Hang T Nguyen
- Genetica Research Foundation, National Innovation Center, Hanoi, Vietnam
- Gene Friend Way Inc, San Francisco, USA
| | - Giang L T Pham
- Genetica Research Foundation, National Innovation Center, Hanoi, Vietnam
- Gene Friend Way Inc, San Francisco, USA
| | - Dong S Tran
- Genetica Research Foundation, National Innovation Center, Hanoi, Vietnam
- Gene Friend Way Inc, San Francisco, USA
| | - Jillian Harrington
- Genetica Research Foundation, National Innovation Center, Hanoi, Vietnam
- Gene Friend Way Inc, San Francisco, USA
| | - Hiep N Pham
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
| | - Tuyen N V Pham
- Pediatric Center Hue Central Hospital, Hue City, Thua Thien Hue, Vietnam
| | - Tuan A Cao
- Genetica Research Foundation, National Innovation Center, Hanoi, Vietnam
- Gene Friend Way Inc, San Francisco, USA
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Cepanec M, Šimleša S. Item-Based Analysis of Some ADOS-2 Items with Typically Developing Participants Might help Improve Cross-Cultural Validity of ADOS-2. J Autism Dev Disord 2024; 54:109-120. [PMID: 36323993 DOI: 10.1007/s10803-022-05791-w] [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] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Most internationally recognized instruments for the screening and diagnosis of autism spectrum disorder have been developed in the USA, which calls into question the degree of their cultural adaptation to diverse populations. The aim of this study is to examine the characteristics of social communication in typically developing Croatian-speaking participants (N = 220) using ADOS-2-defined item-level normative values. Croatian subjects showed the expected ("typical") results in the domain of verbal communication, slightly atpical results in nonverbal communication (primarily gesture use), and more significant deviations in pragmatics (offering and asking for information), relative to the expectations of the ADOS-2. As ADOS-2 has become an important component of thorough ASD diagnostic evaluations worldwide, identifying methods for increasing the cross-cultural validity is essential.
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Affiliation(s)
- Maja Cepanec
- Child Communication Research Laboratory, Department of Speech and Language Pathology, Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia.
| | - Sanja Šimleša
- Child Communication Research Laboratory, Department of Speech and Language Pathology, Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia
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9
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Hernandez CD, Williams Awodeha NF, Cameron MJ. Culture and Language Inclusion in the Practice of Applied Behavior Analysis: Next Steps for Improving Outcomes for Autistic Clients. Behav Anal Pract 2023; 16:1280-1289. [PMID: 38076741 PMCID: PMC10700268 DOI: 10.1007/s40617-023-00791-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 05/03/2024] Open
Abstract
As applied behavior analysis (ABA) is widely prescribed as an intervention for autistic children, ABA practitioners must have a thorough understanding of the impact of language and culture on the individuals and families they serve. The twin purposes of this article are to discuss cultural humility in ASD service delivery, and to provide an overview of practice parameters for the expansion of equity and inclusion. These efforts are guided by the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. Readers will be provided with recommendations for incorporating culturally and linguistically appropriate services into training, practice, and supervision in ABA settings.
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Cherewick M, Daniel C, Shrestha CC, Giri P, Dukpa C, Cruz CM, Rai RP, Matergia M. Psychosocial interventions for autistic children and adolescents delivered by non-specialists in low- and middle-income countries: a scoping review. Front Psychol 2023; 14:1181976. [PMID: 37609501 PMCID: PMC10440606 DOI: 10.3389/fpsyg.2023.1181976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Most autistic individuals reside in low- and middle-income countries (LMIC) and have limited access to medical providers and specialists. Support for delivery of psychosocial interventions by non-specialists is growing to address this mental health care gap. This scoping review involved a systematic analysis of studies of non-specialist delivered psychosocial interventions for children and adolescents diagnosed with autism and living in low- and middle-income countries. Methods The primary objective of this review was to identify psychosocial interventions for autistic children and adolescents in LMIC delivered by non-specialists (parent, teacher, peer, community, multi-level) and to summarize resulting effects on targeted outcomes. The search strategy was completed in four databases with predetermined inclusion and exclusion criteria. The systematic search generated 3,601 articles. A total of 18 studies met inclusion/exclusion criteria. Data extraction was completed, and results summarized by; (1) participant sample; (2) intervention procedures; (3) implementation by non-specialists; (4) effect on evaluated outcomes; and (5) assessment of risk of bias. Studies examined a range of child and adolescent outcomes including assessment of communication skills, social skills, motor skills, functional and adaptive behaviors, emotional regulation, attention and engagement, sensory challenges, depression, anxiety, and quality of life. Several studies also evaluated intervention effects on family relationships, parent/caregiver stress and parent/caregiver mental health. Results Collectively, the 18 studies included a total of 952 ASC participants ranging in age from 2 to 16 years. Of the included studies, 8 studies were parent/caregiver-mediated, 1 study was peer-mediated, 2 studies were teacher-mediated, and 7 studies included multi-level non-specialist mediated components. Effects on evaluated outcomes are reported. Conclusion Non-specialist delivered interventions for autistic children and adolescents are effective for an array of outcomes and are particularly well suited for low- and middle-income countries. Implications for future research are discussed.
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Affiliation(s)
- Megan Cherewick
- Department of Community & Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Christina Daniel
- Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO, United States
| | | | - Priscilla Giri
- Darjeeling Ladenla Road Prerna, Darjeeling, West Bengal, India
| | - Choden Dukpa
- Darjeeling Ladenla Road Prerna, Darjeeling, West Bengal, India
| | - Christina M. Cruz
- Department of Psychiatry, School Psychology Program, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Roshan P. Rai
- Darjeeling Ladenla Road Prerna, Darjeeling, West Bengal, India
| | - Michael Matergia
- Broadleaf Health & Education Alliance, Stroudsburg, PA, United States
- Center for Global Health, Colorado School of Public Health, Aurora, CO, United States
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11
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Fong VC, Shim J, Yoon A, Lee BS, Iarocci G. A preliminary exploration of different coping strategies used by Korean immigrant parents of autistic children in high versus low family quality of life ratings. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1307-1319. [PMID: 36317392 PMCID: PMC10291356 DOI: 10.1177/13623613221133961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
The experiences of coping in parents of autistic children have been extensively studied in the literature. While this research has identified both effective and ineffective coping strategies used by caregivers, no studies to date have examined how coping strategies used by parents might be linked to family quality of life outcomes. Furthermore, few studies exist examining both coping strategies and family quality of life in culturally and linguistically diverse populations. Thus, this study aimed to address both limitations. A total of 12 Korean immigrant parents of autistic children, 6 representing the high family quality of life group and 6 representing the low family quality of life group, shared their experiences related to coping and managing stress. Responses fell under three broad categories (problem-focused, emotion-focused, and adjustment-focused) with differences observed when comparing the high versus low family quality of life groups. A better understanding of the link between coping strategies and family quality of life outcomes may help identify effective and culturally sensitive supports for caregivers and families to improve their quality of life and well-being.
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12
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Wilson RB, Thompson AR, Rowse G, Smith R, Dugdale AS, Freeth M. Autistic women's experiences of self-compassion after receiving their diagnosis in adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:1336-1347. [PMID: 36373832 PMCID: PMC10291390 DOI: 10.1177/13623613221136752] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
Knowledge of autistic individuals' experiences of self-compassion is very limited. This study investigated autistic women's experiences of self-compassion after receiving their diagnosis in adulthood. Eleven autistic women were interviewed about their experiences of receiving their diagnosis in adulthood and their experiences of self-compassion. Systematic analysis of the interview transcripts revealed common themes in the participants' experiences. Participants reported that their autism diagnosis helped them to better understand themselves, particularly when reflecting on problematic past experiences. After receiving an autism diagnosis, participants described being able to relate to themselves with greater self-kindness compared to previous self-criticism; this included allowing themselves to assert their needs and engage in self-care activities. Participants spoke about having difficult social experiences, including feeling pressure to conform to expectations in society and often feeling misunderstood. The findings highlight the barriers autistic women face obtaining their diagnoses and demonstrate the need for autism training for professionals to support early identification. Findings from this study suggest that interventions aimed at developing self-compassion could support and enhance autistic women's well-being.
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Affiliation(s)
| | | | | | - Richard Smith
- Derbyshire Community Health Services, NHS Foundation Trust, UK
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13
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Ağırkan M, Koç M, Avcı ÖH. How effective are group-based psychoeducation programs for parents of children with ASD in Turkey? A systematic review and meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104554. [PMID: 37301054 DOI: 10.1016/j.ridd.2023.104554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 05/23/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
Recent research shows that group-based psychoeducation programs designed for parents of children with ASD have grown in popularity over time. The international evidence for the effectiveness of psychoeducation programs designed for parents of children with ASD in developed societies emphasizes the importance of providing a synthesis of the effectiveness of programs in developing societies. This study's primary aim is to assess the efficacy of group-based psychoeducation programs in Turkey for parents of children with ASD. The second aim is to investigate how the programs are influenced by the potential moderators (type of involvement, research design, number of sessions, duration of sessions, and number of participants). For these purposes, a database search was conducted that included group-based psychoeducation programs for parents of children with ASD implemented in Turkey. Twelve group-based psychoeducation programs that met the inclusion criteria were included in the study. The results showed that group-based psychoeducation programs for parents of children with ASD had "medium" effects on psychological symptoms [ES(SE) = 0.65 (.08), 95%CI (0.48-0.81)], "low" effects on social skills [ES(SE) = 0.32 (.16), 95%CI (0.02-0.62)], and "high" effects on well-being [ES(SE) = 1.05 (.19), 95%CI (0.66-1.43)]. According to moderator analyses, the type of involvement and the number of sessions were statistically significant moderators of psychological symptoms, but not the research design, duration of sessions, or number of participants.
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Affiliation(s)
- Murat Ağırkan
- Department of Psychological Counseling and Guidance, Faculty of Education, Erzincan Binali Yıldırım University, 23200 Erzincan, Turkey.
| | - Muharrem Koç
- Department of Psychological Counseling and Guidance, Hacettepe University, 06530 Beytepe, Ankara, Turkey.
| | - Özlem Haskan Avcı
- Department of Psychological Counseling and Guidance, Hacettepe University, 06530 Beytepe, Ankara, Turkey.
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14
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Kato Y, Shirai R, Ohbuchi K, Oizumi H, Yamamoto M, Miyata W, Iguchi T, Mimaki Y, Miyamoto Y, Yamauchi J. Hesperetin Ameliorates Inhibition of Neuronal and Oligodendroglial Cell Differentiation Phenotypes Induced by Knockdown of Rab2b, an Autism Spectrum Disorder-Associated Gene Product. Neurol Int 2023; 15:371-391. [PMID: 36976668 PMCID: PMC10057161 DOI: 10.3390/neurolint15010025] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
Autism spectrum disorder (ASD) is a central nervous system (CNS) neurodevelopmental disorder that includes autism, pervasive developmental disorder, and Asperger’s syndrome. ASD is characterized by repetitive behaviors and social communication deficits. ASD is thought to be a multifactorial disorder with a range of genetic and environmental factors/candidates. Among such factors is the rab2b gene, although it remains unclear how Rab2b itself is related to the CNS neuronal and glial developmental disorganization observed in ASD patients. Rab2 subfamily members regulate intracellular vesicle transport between the endoplasmic reticulum and the Golgi body. To the best of our knowledge, we are the first to report that Rab2b positively regulates neuronal and glial cell morphological differentiation. Knockdown of Rab2b inhibited morphological changes in N1E-115 cells, which are often used as the neuronal cell differentiation model. These changes were accomplished with decreased expression levels of marker proteins in neuronal cells. Similar results were obtained for FBD-102b cells, which are used as the model of oligodendroglial cell morphological differentiation. In contrast, knockdown of Rab2a, which is another Rab2 family member not known to be associated with ASD, affected only oligodendroglial and not neuronal morphological changes. In contrast, treatment with hesperetin, a citrus flavonoid with various cellular protective effects, in cells recovered the defective morphological changes induced by Rab2b knockdown. These results suggest that knockdown of Rab2b inhibits differentiation in neuronal and glial cells and may be associated with pathological cellular phenotypes in ASD and that hesperetin can recover their phenotypes at the in vitro level at least.
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Affiliation(s)
- Yukino Kato
- Department of Molecular Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (Y.K.); (W.M.); (Y.M.)
| | - Remina Shirai
- Department of Molecular Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (Y.K.); (W.M.); (Y.M.)
| | - Katsuya Ohbuchi
- Tsumura Research Laboratories, Tsumura & Co., Inashiki 200-1192, Ibaraki, Japan; (K.O.); (H.O.); (M.Y.)
| | - Hiroaki Oizumi
- Tsumura Research Laboratories, Tsumura & Co., Inashiki 200-1192, Ibaraki, Japan; (K.O.); (H.O.); (M.Y.)
| | - Masahiro Yamamoto
- Tsumura Research Laboratories, Tsumura & Co., Inashiki 200-1192, Ibaraki, Japan; (K.O.); (H.O.); (M.Y.)
| | - Wakana Miyata
- Department of Molecular Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (Y.K.); (W.M.); (Y.M.)
| | - Tomoki Iguchi
- Department of Medicinal Pharmacognosy, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (T.I.); (Y.M.)
| | - Yoshihiro Mimaki
- Department of Medicinal Pharmacognosy, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (T.I.); (Y.M.)
| | - Yuki Miyamoto
- Department of Molecular Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (Y.K.); (W.M.); (Y.M.)
- Department of Pharmacology, National Research Institute for Child Health and Development, Setagaya 157-8535, Tokyo, Japan
| | - Junji Yamauchi
- Department of Molecular Life Sciences, Tokyo University of Pharmacy and Life Sciences, Hachioji 192-0392, Tokyo, Japan; (Y.K.); (W.M.); (Y.M.)
- Department of Pharmacology, National Research Institute for Child Health and Development, Setagaya 157-8535, Tokyo, Japan
- Diabetic Neuropathy Project, Tokyo Metropolitan Institute of Medical Science, Setagaya 156-8506, Tokyo, Japan
- Correspondence: ; Tel.: +81-42-676-7164; Fax: +81-42-676-8841
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15
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DuBay M, Sideris J, Rouch E. Is traditional back translation enough? Comparison of translation methodology for an ASD screening tool. Autism Res 2022; 15:1868-1882. [PMID: 35913014 PMCID: PMC9796320 DOI: 10.1002/aur.2783] [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] [Received: 03/24/2022] [Accepted: 07/15/2022] [Indexed: 01/01/2023]
Abstract
Early identification of autism spectrum disorders (ASD) in non-English speaking children often relies on translation of English ASD screening measures. Most measures employ a forward-back translation approach, despite data suggesting that this method may result in poor psychometric properties. Some studies in non-ASD fields have suggested that a rigorous method of translation with cultural adaptation may yield better psychometric properties, but no studies in the ASD field have compared the two approaches directly. This investigation compares these two translation methodologies to determine if they produce psychometrically similar or dissimilar measures. Three hundred and eighty US-based Spanish-speaking caregivers of children 8-16 months old were randomly assigned to complete either a forward-back Spanish translation or a rigorous translation with cultural adaptation of a parent-report ASD screening tool. Measurement invariance analyses determined that the two translations were psychometrically dissimilar. Additional qualitative explanatory methods using cognitive interviews examined textual differences and participant preferences between non-invariant items. LAY SUMMARY: Autism screening questionnaires created in English need to be translated into other languages so non-English speaking parents can fill them out accurately. Traditionally, researchers have not considered cultural differences when they translate these questionnaires. When we compared a direct translation to a translation with cultural adaptations, the two questionnaires were statistically different. Parents interpreted and responded to the same questions differently, depending on which version they filled out.
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Affiliation(s)
- Michaela DuBay
- School of Education and Human DevelopmentUniversity of VirginiaCharlottesvilleVirginiaUSA
| | - John Sideris
- Chan Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Erica Rouch
- School of Education and Human DevelopmentUniversity of VirginiaCharlottesvilleVirginiaUSA
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16
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The Optimal Cut-Off Point for Thai Diagnostic Autism Scale and Probability Prediction of Autism Spectrum Disorder Diagnosis in Suspected Children. Healthcare (Basel) 2022; 10:healthcare10101868. [DOI: 10.3390/healthcare10101868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
The Thai Diagnostic Autism Scale (TDAS) was developed to diagnose autism spectrum disorder (ASD) under the context and characteristics of the Thai population. Although the tool has an excellent agreement, the interpretation of diagnostic results needs to rely on the optimal cut-off point to maximize efficiency and clarity. This study aims to find an optimal cut-off point for TDAS in the diagnosis of ASD and to compare its agreement with the DSM-5 ASD criteria. This study was conducted on 156 children aged 12–48 months old who were suspected of having ASD and had enrolled from hospitals in the four regions of Thailand in 2017–2018. The optimal cut-off point for TDAS was considered by using receiver operating characteristic (ROC) curves according to the DSM-5 ASD criteria. The areas under the curve (AUCs) for TDAS and ADOS-2 were also compared. Multivariable logistic regression was performed to create a predictive model for the probability of ASD. The AUC of TDAS was significantly higher than that of ADOS-2 (0.8748 vs. 0.7993; p = 0.033). The optimal cut-off point for TDAS was ≥20 points (accuracy = 82.05%, sensitivity = 82.86%, and specificity = 80.93%). Our findings show that TDAS with a cut-off point can yield higher diagnostic accuracy than ADOS-2 and TDAS domain. Diagnosis by using this cut-off point could be useful in practical assessments.
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17
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Andreou M, Skrimpa V. Re-Examining Labels in Neurocognitive Research: Evidence from Bilingualism and Autism as Spectrum-Trait Cases. Brain Sci 2022; 12:1113. [PMID: 36009175 PMCID: PMC9405985 DOI: 10.3390/brainsci12081113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/10/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the fact that the urge to investigate bilingualism and neurodevelopmental disorders as continuous indices rather than categorical ones has been well-voiced among researchers with respect to research methodological approaches, in the recent literature, when it comes to examining language, cognitive skills and neurodivergent characteristics, it is still the case that the most prevalent view is the categorisation of adults or children into groups. In other words, there is a categorisation of individuals, e.g., monolingual vs. bilingual children or children with typical and atypical/non-typical/non-neurotypical development. We believe that this labelling is responsible for the conflicting results that we often come across in studies. The aim of this review is to bring to the surface the importance of individual differences through the study of relevant articles conducted in bilingual children and children with autism, who are ideal for this study. We concur with researchers who already do so, and we further suggest moving away from labels and instead shift towards the view that not everything is either white or black. We provide suggestions as to how this shift could be implemented in research, while mostly aiming at starting a discourse rather than offering a definite path.
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Affiliation(s)
- Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, 24100 Kalamata, Greece
| | - Vasileia Skrimpa
- Department of English, School of Arts and Humanities, University of Cologne, 50931 Cologne, Germany
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18
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Identifying neuroanatomical and behavioral features for autism spectrum disorder diagnosis in children using machine learning. PLoS One 2022; 17:e0269773. [PMID: 35797364 PMCID: PMC9262216 DOI: 10.1371/journal.pone.0269773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/27/2022] [Indexed: 11/19/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause significant social, communication, and behavioral challenges. Diagnosis of ASD is complicated and there is an urgent need to identify ASD-associated biomarkers and features to help automate diagnostics and develop predictive ASD models. The present study adopts a novel evolutionary algorithm, the conjunctive clause evolutionary algorithm (CCEA), to select features most significant for distinguishing individuals with and without ASD, and is able to accommodate datasets having a small number of samples with a large number of feature measurements. The dataset is unique and comprises both behavioral and neuroimaging measurements from a total of 28 children from 7 to 14 years old. Potential biomarker candidates identified include brain volume, area, cortical thickness, and mean curvature in specific regions around the cingulate cortex, frontal cortex, and temporal-parietal junction, as well as behavioral features associated with theory of mind. A separate machine learning classifier (i.e., k-nearest neighbors algorithm) was used to validate the CCEA feature selection and for ASD prediction. Study findings demonstrate how machine learning tools might help move the needle on improving diagnostic and predictive models of ASD.
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19
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Jolliffe R, Adams D, Simpson K. Trait Anxiety in Individuals on the Autism Spectrum: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00308-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AbstractAlthough anxiety is commonly researched in autism, the focus has predominantly been on anxiety disorders and not upon general levels of anxiousness or trait anxiety. This review summarises research investigating trait anxiety in autism. Systematic searches yielded 1099 records, with 23 studies meeting inclusion criteria. Study participants were mainly males from Western countries, with no representation of older adults or individuals with intellectual disability. All articles used self-report questionnaire trait anxiety measures. Anxiety measure psychometric details were absent in most studies, with 21 using subjective measures that are not validated for use in autism. Results showed higher trait anxiety scores in autism versus control groups, and correlations between trait anxiety scores and other study outcomes.
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20
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Montenegro MC, Abdul-Chani M, Valdez D, Rosoli A, Garrido G, Cukier S, Paula CS, Garcia R, Rattazzi A, Montiel-Nava C. Perceived Stigma and Barriers to Accessing Services: Experience of Caregivers of Autistic Children Residing in Latin America. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 120:104123. [PMID: 34798480 DOI: 10.1016/j.ridd.2021.104123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Relationship of perceived stigma and barrier to service access among Latino populations with autism in cross-cultural settings has not been fully explored. AIM The present study explored the relationship between difficulty accessing services and perceived stigma among caregivers of autistic children in Latin America. Additionally, explore contextual factors that better explain the perception of stigma when accessing services. METHODS AND PROCEDURE Approximately 2500 caregivers from six Latin American countries completed an online survey. Descriptive inferential analysis and a pointbiserial correlation were conducted to understand direct relationship between difficulty accessing services and perceived stigma and to test their relationship. Added contextual factors contributing to this relationship were examined through a binary logistic regression. OUTCOMES AND RESULTS Barriers to accessing services predicted stigma. Contextual factors such as country of residence, frustration experienced by caregivers, gender of autistic child and challenging behaviours had higher odds of experiencing some form of perceived stigma. CONCLUSIONS AND IMPLICATIONS These results suggest experiences with stigma to be heavily influenced by environmental factors such cultural differences which in combination with contextual factors could further increase the likelihood of perceiving stigma. When observing stigma within a social-cognitive approach, it is possible that a strong-held adherence to cultural norms, in addition to negative experiences (e.g., frustration) when accessing services, could be influencing caregivers perceived stigma.
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Affiliation(s)
- María Cecilia Montenegro
- Department of Psychological Science-University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, 78539, TX, United States
| | - Monica Abdul-Chani
- Department of Psychology-University of Alabama at Birmingham, 1720 University Blvd, Birmingham, 35294, AL, United States
| | - Daniel Valdez
- Facultad Latinoamericana de Ciencias Sociales Sede Argentina (FLACSO), Tucumán 1966, C1050 AAN, Buenos Aires, Argentina
| | - Analia Rosoli
- Organización Estados Iberoamericanos para la Educación, la Ciencia y la Cultura (OEI), Av. Sarasota #20, Torre AIRD, 2do. Piso, 10109, Santo Domingo, Dominican Republic
| | - Gabriela Garrido
- Universidad de la República, Av. 18 de Julio 1824, 11100, Montevideo, Uruguay
| | - Sebastian Cukier
- PANAACEA, Domingo Repetto 1145, CP B1640EMQ, Buenos Aires, Argentina
| | - Cristiane Silvestre Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento Universidade Presbiteriana Mackenzie (UPM), Rua da Consolacão, 930 Consolacão, 01302-907, São Paulo, Brazil
| | - Ricardo Garcia
- Universidad de Chile, Avenida Libertador Bernardo o'Higgins 1058, 8330111. Santiago, Chile
| | - Alexia Rattazzi
- PANAACEA, Domingo Repetto 1145, CP B1640EMQ, Buenos Aires, Argentina
| | - Cecilia Montiel-Nava
- Department of Psychological Science-University of Texas Rio Grande Valley, 1201 W University Dr, Edinburg, 78539, TX, United States.
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21
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Li YA, Chen ZJ, Li XD, Gu MH, Xia N, Gong C, Zhou ZW, Yasin G, Xie HY, Wei XP, Liu YL, Han XH, Lu M, Xu J, Huang XL. Epidemiology of autism spectrum disorders: Global burden of disease 2019 and bibliometric analysis of risk factors. Front Pediatr 2022; 10:972809. [PMID: 36545666 PMCID: PMC9760802 DOI: 10.3389/fped.2022.972809] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 11/17/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND To explore the geographical pattern and temporal trend of autism spectrum disorders (ASD) epidemiology from 1990 to 2019, and perform a bibliometric analysis of risk factors for ASD. METHODS In this study, ASD epidemiology was estimated with prevalence, incidence, and disability-adjusted life-years (DALYs) of 204 countries and territories by sex, location, and sociodemographic index (SDI). Age-standardized rate (ASR) and estimated annual percentage change (EAPC) were used to quantify ASD temporal trends. Besides, the study performed a bibliometric analysis of ASD risk factors since 1990. Publications published were downloaded from the Web of Science Core Collection database, and were analyzed using CiteSpace. RESULTS Globally, there were estimated 28.3 million ASD prevalent cases (ASR, 369.4 per 100,000 populations), 603,790 incident cases (ASR, 9.3 per 100,000 populations) and 4.3 million DALYs (ASR, 56.3 per 100,000 populations) in 2019. Increases of autism spectrum disorders were noted in prevalent cases (39.3%), incidence (0.1%), and DALYs (38.7%) from 1990 to 2019. Age-standardized rates and EAPC showed stable trend worldwide over time. A total of 3,991 articles were retrieved from Web of Science, of which 3,590 were obtained for analysis after removing duplicate literatures. "Rehabilitation", "Genetics & Heredity", "Nanoscience & Nanotechnology", "Biochemistry & Molecular biology", "Psychology", "Neurosciences", and "Environmental Sciences" were the hotspots and frontier disciplines of ASD risk factors. CONCLUSIONS Disease burden and risk factors of autism spectrum disorders remain global public health challenge since 1990 according to the GBD epidemiological estimates and bibliometric analysis. The findings help policy makers formulate public health policies concerning prevention targeted for risk factors, early diagnosis and life-long healthcare service of ASD. Increasing knowledge concerning the public awareness of risk factors is also warranted to address global ASD problem.
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Affiliation(s)
- Yang-An Li
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Ze-Jian Chen
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Xiao-Dan Li
- Nursing Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China
| | - Ming-Hui Gu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Nan Xia
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Chen Gong
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA United States
| | - Zhao-Wen Zhou
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA United States
| | - Gvzalnur Yasin
- Faculty of Rehabilitation Medicine, College of Xinjiang Uyghur Medicine, Xinjiang China
| | - Hao-Yu Xie
- Division of Physical Therapy Education, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, United States
| | - Xiu-Pan Wei
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Ya-Li Liu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Xiao-Hua Han
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Min Lu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Jiang Xu
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
| | - Xiao-Lin Huang
- Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China.,World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan China
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22
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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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23
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Reitzel M, Letts L, Di Rezze B, Phoenix M. Critically Examining the Person–Environment Relationship and Implications of Intersectionality for Participation in Children's Rehabilitation Services. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:709977. [PMID: 36188778 PMCID: PMC9397911 DOI: 10.3389/fresc.2021.709977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/16/2021] [Indexed: 01/03/2023]
Abstract
Participation of children in rehabilitation services is associated with positive functional and developmental outcomes for children with disabilities. Participation in therapy is at risk when the personal and environmental contexts of a child create barriers to accessing services. The International Classification of Functioning, Disability and Health (ICF) provides a framework for conceptualizing the personal and environmental factors linked to a child. However, it does not facilitate critical examination of the person–environment relationship and its impact on participation in children's rehabilitation. This perspective study proposes the use of intersectionality theory as a critical framework in complement with the ICF to examine the impact of systemic inequities on the participation in therapy for children with disabilities. Clinicians are called to be critical allies working alongside children and families to advocate for inclusive participation in children's rehabilitation by identifying and transforming systemic inequities in service delivery.
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Affiliation(s)
- Meaghan Reitzel
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- *Correspondence: Meaghan Reitzel
| | - Lori Letts
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Bloorview Research Institute, Toronto, ON, Canada
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24
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Bordes Edgar V, Meneses V, Shaw D, Romero RA, Salinas CM, Kissel A. Clinical utility of the ECLECTIC framework in providing culturally-informed autism spectrum disorder evaluations: a pediatric case-based approach. Clin Neuropsychol 2021; 36:1148-1171. [PMID: 34126862 DOI: 10.1080/13854046.2021.1936187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Social cognition does not exist within a vacuum. One's culture and surrounding social environment influence 1) development of social skills and behaviors, and 2) society's expectations regarding "normal" behavior versus behaviors consistent with the diagnosis of Autism Spectrum Disorder (ASD). Use of a comprehensive cultural framework such as Fujii's ECLECTIC model undergirds valid ASD testing by enhancing clinician awareness of potential biases during clinical decision-making and by supporting culturally relevant recommendations. Method: Four diverse pediatric patients presenting for concerns of ASD are described. Neuropsychological test data and salient cultural considerations are presented within the ECLECTIC framework. Results: The cases illustrate relevant cultural factors critical to the ASD assessment for youth with wide diversity (Southeast Asian, Deaf, Black, Hispanic/Latinx, and Chinese cultures) and varied contextual factors (adoption, underlying Down syndrome). The ECLETIC model better allows integration of salient factors such as cognition, family dynamics, behaviors, educational services, and language dominance. Conclusions: Unrecognized ethnocentric biases may shadow the complexities and nuances involved in ASD assessment across cultures. Such errors are minimized using a comprehensive cultural framework to guide equitable neuropsychological services. The ECLECTIC model's emphasis on cultural and contextual factors results in more accurate findings and more individualized planning for the patient. Recommendations for clinical application are provided.
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Affiliation(s)
- Veronica Bordes Edgar
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Children's Medical Center, Dallas, TX, USA
| | - Veronica Meneses
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Pediatric Developmental Disabilities, Scottish Rite Hospital for Children, Dallas, TX, USA
| | - Daphna Shaw
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Children's Medical Center, Dallas, TX, USA
| | - Regilda Anne Romero
- Department of Psychiatry, University of Florida, Gainesville, FL, USA.,Center for Autism and Neurodevelopment, University of Florida Health, Jacksonville, FL, USA
| | - Christine M Salinas
- Neuropsychology Concierge®, Indialantic, FL, USA.,Niños Health, Indialantic, FL, USA
| | - Abigail Kissel
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Children's Medical Center, Dallas, TX, USA
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Cardon A, Marshall T. To raise a child with autism spectrum disorder: A qualitative, comparative study of parental experiences in the United States and Senegal. Transcult Psychiatry 2021; 58:335-350. [PMID: 32981465 DOI: 10.1177/1363461520953342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Raising a child with Autism Spectrum Disorder (ASD) can often be a difficult and stressful process for families and caregivers. Though research on ASDs in Africa is burgeoning, very little is known about autism in francophone West Africa. Furthermore, no known ASD studies have explored parental experiences in particular from a cross-cultural perspective. This research used Interpretative Phenomenological Analysis to analyze in-depth, semi-structured interviews with seven Senegalese and seven American families to investigate parental experiences within the Senegalese community with further illustration by cross-cultural comparison. Comparative analysis of data across the two countries was undertaken to identify cultural variables previously unreported, especially those that may affect Senegalese family experience. Analysis of interviews revealed thematic differences in social and community support. Although access to effective treatment services was low among Senegalese families compared to the American families, traditional Senegalese household structures and community relations were hypothesized to serve as protective factors against the high social isolation and resulting logistical struggles reported in the U.S. sample. Further targeted research within the Senegalese environment is recommended, particularly to explore social stigma and its possible effects on families with autism, causal beliefs and treatment practices, and parental mental health and wellbeing.
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Affiliation(s)
- Adair Cardon
- Division of Psychology, Brunel University London, Uxbridge, UK.,University of California, Santa Barbara, USA
| | - Tara Marshall
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada.,Centre for Culture and Evolution, Brunel University London, Uxbridge, UK
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Ebrahim MT, Alothman AA. Resilience and social support as predictors of post-traumatic growth in mothers of children with autism spectrum disorder in Saudi Arabia. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 113:103943. [PMID: 33799234 DOI: 10.1016/j.ridd.2021.103943] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/06/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There are few studies about the role of resilience and social support in post-traumatic growth (PTG) in parents of children with autism spectrum disorder (ASD). AIM This study examined the relationship between social support, resilience, and PTG and the predictive role of resilience and social support related to PTG in Saudi Arabian mothers. METHODS AND PROCEDURES A survey-based quantitative study was conducted in 88 mothers aged 18-46 years (M = 33.5; SD = 8.02) who had a child with ASD. They were sampled from nine day care centers in Riyadh and the Central-Eastern-Southern region. OUTCOMES AND RESULTS The findings showed a significant positive correlation between perceived social support, resilience, and PTG, and revealed that Resilience-competence was the only significant predictor of PTG-personal strength, appreciation of life, spiritual change new possibilities, and total PTG, while positive acceptance of change was a significant predictor of PTG-relating to others. Moreover, social support from friends and significant others were significant predictors of PTG-total. CONCLUSIONS AND IMPLICATIONS We found that, for mothers of a child with ASD in Saudi Arabia, the biggest factors predicting post-traumatic growth were a notion of personal competence and social support from friends. Intervention is suggested to lower the risk of trauma.
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Affiliation(s)
- Mona Tawakkul Ebrahim
- Department of Educational Sciences, College of Education, Majmaah University, Majmaah, 11952, Saudi Arabia.
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Washington P, Tariq Q, Leblanc E, Chrisman B, Dunlap K, Kline A, Kalantarian H, Penev Y, Paskov K, Voss C, Stockham N, Varma M, Husic A, Kent J, Haber N, Winograd T, Wall DP. Crowdsourced privacy-preserved feature tagging of short home videos for machine learning ASD detection. Sci Rep 2021; 11:7620. [PMID: 33828118 PMCID: PMC8027393 DOI: 10.1038/s41598-021-87059-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/22/2021] [Indexed: 02/01/2023] Open
Abstract
Standard medical diagnosis of mental health conditions requires licensed experts who are increasingly outnumbered by those at risk, limiting reach. We test the hypothesis that a trustworthy crowd of non-experts can efficiently annotate behavioral features needed for accurate machine learning detection of the common childhood developmental disorder Autism Spectrum Disorder (ASD) for children under 8 years old. We implement a novel process for identifying and certifying a trustworthy distributed workforce for video feature extraction, selecting a workforce of 102 workers from a pool of 1,107. Two previously validated ASD logistic regression classifiers, evaluated against parent-reported diagnoses, were used to assess the accuracy of the trusted crowd's ratings of unstructured home videos. A representative balanced sample (N = 50 videos) of videos were evaluated with and without face box and pitch shift privacy alterations, with AUROC and AUPRC scores > 0.98. With both privacy-preserving modifications, sensitivity is preserved (96.0%) while maintaining specificity (80.0%) and accuracy (88.0%) at levels comparable to prior classification methods without alterations. We find that machine learning classification from features extracted by a certified nonexpert crowd achieves high performance for ASD detection from natural home videos of the child at risk and maintains high sensitivity when privacy-preserving mechanisms are applied. These results suggest that privacy-safeguarded crowdsourced analysis of short home videos can help enable rapid and mobile machine-learning detection of developmental delays in children.
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Affiliation(s)
- Peter Washington
- grid.168010.e0000000419368956Department of Bioengineering, Stanford University, Stanford, CA USA
| | | | - Emilie Leblanc
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Brianna Chrisman
- grid.168010.e0000000419368956Department of Bioengineering, Stanford University, Stanford, CA USA
| | - Kaitlyn Dunlap
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Aaron Kline
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Haik Kalantarian
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Yordan Penev
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Kelley Paskov
- grid.168010.e0000000419368956Department of Biomedical Data Science, Stanford University, Stanford, CA USA
| | - Catalin Voss
- grid.168010.e0000000419368956Department of Computer Science, Stanford University, Stanford, CA USA
| | - Nathaniel Stockham
- grid.168010.e0000000419368956Department of Neuroscience, Stanford University, Stanford, CA USA
| | - Maya Varma
- grid.168010.e0000000419368956Department of Computer Science, Stanford University, Stanford, CA USA
| | - Arman Husic
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Jack Kent
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA
| | - Nick Haber
- grid.168010.e0000000419368956Graduate School of Education, Stanford University, Stanford, CA USA
| | - Terry Winograd
- grid.168010.e0000000419368956Department of Computer Science, Stanford University, Stanford, CA USA
| | - Dennis P. Wall
- grid.168010.e0000000419368956Department of Pediatrics (Systems Medicine), Stanford University, Stanford, CA USA ,grid.168010.e0000000419368956Department of Biomedical Data Science, Stanford University, Stanford, CA USA ,grid.168010.e0000000419368956Department of Psychiatry and Behavioral Sciences (By Courtesy), Stanford University, Stanford, CA USA
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Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) in autism research: literature review. Ir J Psychol Med 2021; 39:272-286. [PMID: 33818321 DOI: 10.1017/ipm.2021.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Autism spectrum disorder (ASD) remains a behaviourally defined condition. Its molecular basis is unknown; however, its prevalence has been increasing significantly. There have been several abnormalities in neurotransmitter systems reported in ASD. In our review, we described studies involving positron emission tomography (PET) and single-photon emission computed tomography (SPECT) that can provide useful and corroborative data. METHOD We conducted a literature review by comprehensive database searching on EMBASE, Scopus, PubMed, and PsychINFO looking for articles published since January 2009. Thirty-one studies were carefully selected - 22 PET studies and 9 SPECT studies - and reviewed by 2 independent researchers. References of the articles were also cross-checked. RESULTS Results of the studies, which mainly involve small groups of participants, are frequently inconclusive and often controversial due to the nature of ASD and its wide spectrum. Studies are conducted under different conditions and with poor control for confounding factors which creates difficulties in comparing the data. CONCLUSIONS There is ongoing need to improve methodology of the studies involving molecular imaging in ASD. Lack of consistent findings causes difficulties in evaluation, diagnosis, and treatment of the condition.
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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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Testing a Tailored Social-Ecological Model for Autism Spectrum Disorders. Matern Child Health J 2021; 25:956-966. [PMID: 33394274 DOI: 10.1007/s10995-020-03064-5] [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] [Accepted: 11/07/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To propose a tailored social ecological model for Autism Spectrum Disorders and explore relationships between variables in a large nationally-representative dataset. METHODS A tailored social-ecological model was developed and examined across variables in the 2016/2017 National Survey of Children's Health. A series of iterative multivariable logistic regressions were performed including individual, family, and community/neighborhood variables. A multivariable logistic regression using state-level fixed effects was performed to understand dynamics related to macro-level policies. RESULTS In the full model, gender, disability severity, certain types of insurance coverage and household income were significantly related to ASD diagnosis. Females had lower odds of a diagnosis compared to males (aOR: 0.27; CI:0.18-0.41). Children with at least one other moderate/severe disability had odds 7.61 higher (CI:5.36-10.82) of a diagnosis than children without moderate/severe disabilities. Children with public insurance only (aOR:1.66; CI:1.14-2.41) or both private and public insurance coverage (aOR: 2.62; CI:1.6-4.16) had higher odds of a diagnosis compared to children with private insurance only. For those who reported it was "somewhat" or "very often" hard to cover basics with their income, odds of a diagnosis were higher compared to those who reported it was "never" or "hardly ever" hard to cover basics (aOR: 1.676; CI:0.21-2.56). CONCLUSIONS FOR PRACTICE Patterns of ASD diagnosis are related to individual and family characteristics. There is some evidence that a child's environment has some relationship to reported ASD diagnosis. Professionals should be aware of an individual's environmental factors or context when assessing for ASD.
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Como DH, Stein Duker LI, Polido JC, Cermak SA. Oral Health and Autism Spectrum Disorders: A Unique Collaboration between Dentistry and Occupational Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:E135. [PMID: 33375475 PMCID: PMC7795681 DOI: 10.3390/ijerph18010135] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 12/16/2022]
Abstract
Children with autism spectrum disorders (ASD) are at risk for oral health disparities. With the dramatic rise in ASD prevalence to 1 in 54 children, it is likely that an increasing number of dental practitioners will encounter or be asked to treat children with ASD. This paper reviews explanations related to the increasing prevalence of ASD, provides reasons why children with ASD are at increased risk for poor oral health, and discusses unique interprofessional collaborations between dental practitioners and occupational therapists. Occupational therapists and dentists can work together to plan modifications to the dental environment or adapt dental protocols to reduce some of the barriers encountered by those with ASD, provide desensitization strategies before the clinic visit, or help a child with emotional regulation during clinical treatments.
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Affiliation(s)
- Dominique H. Como
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (L.I.S.D.); (S.A.C.)
| | - Leah I. Stein Duker
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (L.I.S.D.); (S.A.C.)
| | - José C. Polido
- Children’s Hospital Los Angeles and Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA;
| | - Sharon A. Cermak
- Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA; (L.I.S.D.); (S.A.C.)
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32
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Rescorla LA, Adams A, Ivanova MY. The CBCL/1½-5's DSM-ASD Scale: Confirmatory Factor Analyses Across 24 Societies. J Autism Dev Disord 2020; 50:3326-3340. [PMID: 31559509 DOI: 10.1007/s10803-019-04189-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Previous research supports the CBCL/1½-5's DSM-ASD scale (and its precursor, the DSM-PDP scale) as a Level 1 ASD screener. Confirmatory factor analyses (CFAs) with data from population samples in 24 societies (N = 19,850) indicated good measurement invariance across societies, especially for configural and metric invariance. Items 4. 25, 67, 80, and 98 may be especially good discriminators of ASD because they have tend to have low base rates, strong loadings on the ASD latent construct, and the best measurement invariance across societies. Further research is needed to test the discriminative power of these items in predicting ASD, but our strong measurement findings support the international psychometric robustness of the CBCL/1½-5's DSM-ASD scale.
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Affiliation(s)
- Leslie A Rescorla
- Department of Psychology, Bryn Mawr College, 101 N. Merion Avenue, Bryn Mawr, PA, 19010, USA.
| | - Allison Adams
- Department of Psychology, Bryn Mawr College, 101 N. Merion Avenue, Bryn Mawr, PA, 19010, USA
| | - Masha Y Ivanova
- University of Vermont, 1 S. Prospect Street, Burlington, VT, 05401, USA
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Young RL, Nah Y. Examining Autism Detection in Early Childhood (ADEC) in the Early Identification of Young Children with Autism Spectrum Disorders (ASD). AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Quebles I, Solomon O, Smith KA, Rao SR, Lu F, Azen C, Anaya G, Yin L. Racial and Ethnic Differences in Behavioral Problems and Medication Use Among Children With Autism Spectrum Disorders. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:369-388. [PMID: 32936891 PMCID: PMC8423191 DOI: 10.1352/1944-7558-125.5.369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/14/2020] [Indexed: 06/03/2023]
Abstract
We examined racial and ethnic differences in the prevalence of behavioral problems measured by the Child Behavioral Checklist (CBCL), sleep disturbances measured by the Child Sleep Habits Questionnaire (CSHQ), and medication use among children with Autism Spectrum Disorders (ASD). We analyzed data from the Autism Treatment Network (ATN) dataset for 2,576 children ages 6 to 18 years of age diagnosed with ASD. Multivariable logistic regression accounting for age, gender, Diagnostic and Statistical Manual of Mental Disorders (4th Edition - Text Revision), diagnosis (Autistic Disorder, PDD-NOS, Asperger's Disorder), and parents' education did not show any racial or ethnic differences in behavioral challenges, conduct problems, or sleep disturbances for any of the groups, but Black children had lower odds of Total Problem Behaviors and Asian children had lower odds of Hyperactivity compared to White children. As a group, children from racial and ethnic minorities had lower odds of Total Problem Behaviors and Conduct Problems compared to White children. Hispanic children had lower odds of medication use for Behavioral Challenges, Total Problem Behaviors, Hyperactivity, and Conduct Problems. Asian children had lower odds of medication use for Behavioral Challenges, Total Problem Behaviors, and Hyperactivity; and had close to lower odds in medication use for Conduct Problems. Black children had lower odds for medication use for Total Problem Behaviors only. As a group, children from racial and ethnic minorities had lower odds for medication use for Behavioral Challenges, Total Problem Behaviors, Hyperactivity, and Conduct problems, but not for Sleep Disturbances. While these results are consistent with previous studies showing that White children are significantly more likely to receive psychotropic medication compared to children from racial and ethnic minority groups, we found no such differences for sleep challenges, suggesting that they are more consistently identified and equitably treated than other behavioral problems associated with ASD. We draw upon Andersen's (1995) Behavioral Model of Healthcare Use to suggest predisposing, enabling, and needs factors that may contribute to this pattern of racial and ethnic differences in the use of medications among children ASD.
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Affiliation(s)
- Irina Quebles
- Irina Quebles, Olga Solomon, and Kathryn A. Smith, Children's Hospital Los Angeles, University of Southern California
| | - Olga Solomon
- Irina Quebles, Olga Solomon, and Kathryn A. Smith, Children's Hospital Los Angeles, University of Southern California
| | - Kathryn A Smith
- Irina Quebles, Olga Solomon, and Kathryn A. Smith, Children's Hospital Los Angeles, University of Southern California
| | - Sowmya R Rao
- Sowmya R. Rao and Frances Lu, Massachusetts General Hospital, Boston
| | - Frances Lu
- Sowmya R. Rao and Frances Lu, Massachusetts General Hospital, Boston
| | - Colleen Azen
- Colleen Azen, Grace Anaya, and Larry Yin, Children's Hospital Los Angeles, University of Southern California
| | - Grace Anaya
- Colleen Azen, Grace Anaya, and Larry Yin, Children's Hospital Los Angeles, University of Southern California
| | - Larry Yin
- Colleen Azen, Grace Anaya, and Larry Yin, Children's Hospital Los Angeles, University of Southern California
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35
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Preliminary data of a preschool teacher-screening checklist for autism spectrum disorder in Singapore. ADVANCES IN AUTISM 2020. [DOI: 10.1108/aia-01-2020-0005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
There are limited tools developed for preschool teachers to aid them in identifying these children with possible autism spectrum disorder (ASD). This study aims to describe the development and present preliminary data of a checklist for ASD screening for preschool teachers (CAPT-S) in Singapore that is easy for preschool teachers to use to identify ASD in mainstream preschoolers from 3 to 6 years old.
Design/methodology/approach
This study adopted a cross-sectional questionnaire design. The CAPT-S is a 12-item checklist based on the current Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition criteria and derived from a survey in a previous study that examined preschool teachers’ perceptions of challenging behaviors in preschoolers with ASD in Singapore. Participants consisted of 63 preschool teachers (mean age = 29.4 years; SD = 9.8) teaching in mainstream preschool centers located in Singapore, and they were asked to use the CAPT-S to rate their students on a four-point Likert scale on frequency of observed behavior.
Findings
Preliminary results indicated construct validity was demonstrated and high reliability in terms of internal consistency and moderate test–retest reliability of the CAPT-S. Diagnostic validity of the CAPT-S was also established, even after controlling for variables such as working experience and time spent working with that student. The optimal cutoff score of 24 produced high sensitivity and specificity.
Originality/value
The present study adds an important contribution to the literature on using preschool teachers as an additional informant in the screening process of ASD. The CAPT-S may be suitable for preschool teachers to use to identify children with possible ASD, although future studies would need to be conducted to examine its effectiveness.
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Shochet IM, Orr JA, Kelly RL, Wurfl AM, Saggers BR, Carrington SB. Psychosocial resources developed and trialled for Indigenous people with autism spectrum disorder and their caregivers: a systematic review and catalogue. Int J Equity Health 2020; 19:134. [PMID: 32762685 PMCID: PMC7412645 DOI: 10.1186/s12939-020-01247-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/29/2020] [Indexed: 11/17/2022] Open
Abstract
Background People with autism spectrum disorder (ASD) face many psychosocial challenges throughout life, highlighting the need for programs and resources promoting psychosocial wellbeing. Indigenous peoples with ASD and/or other neurodevelopmental disorders must overcome cultural and social barriers to access such supports. This study aimed to identify psychosocial programs and resources developed world-wide for this population by systematically reviewing research evaluating programs aiming to promote the psychosocial wellbeing of this population and/or their caregivers; and collating and reviewing resources developed to promote their psychosocial wellbeing. Methods Searches were last conducted in December 2019. The systematic review searched 28 electronic databases, and 25 electronic databases were searched for resources promoting psychosocial wellbeing. Additional published and unpublished studies were identified from relevant reviews, authors of eligible articles, and experts working in Indigenous Health. Articles and resources were screened for inclusion using pre-defined criteria. Articles included in the systematic review were assessed for quality using the Mixed Methods Assessment Tool. The diversity and paucity of outcomes reported precluded pooling of study findings for meta-analysis. Results Seven articles situated in the USA (2), Canada (3) and Australia (2); and eleven resources developed in Australia (9), Canada (1) and New Zealand (1) met inclusion criteria. All articles showed some promising findings for improving psychosocial wellbeing for Indigenous children with ASD and/or another neurodevelopmental disorder, and 5 of 7 evaluated the cultural adaptation of an existing evidence-based program for an Indigenous population. However, methodological quality was moderate or low (57% and 43% of articles respectively) and no studies had adult participants. The psychosocial wellbeing supports provided by the 11 resources included psychoeducation, community support, and services/workshops. Conclusions Despite the paucity of research and resources found, important exemplars demonstrate that existing programs can be adapted to support Indigenous people with ASD and other neurodevelopmental disorders. While future policy should endeavour to facilitate Indigenous people’s access to support services, and encourage researchers to develop and evaluate programs promoting psychosocial wellbeing for this population, given complexities of designing and evaluating new programs, careful and appropriate cultural adaptations of existing evidence-based programs would increase feasibility of ongoing research without compromising outcomes.
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Affiliation(s)
- Ian M Shochet
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Jayne A Orr
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia. .,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.
| | - Rachel L Kelly
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Astrid M Wurfl
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia.,The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia
| | - Beth R Saggers
- The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,School of Cultural and Professional Learning, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Suzanne B Carrington
- The Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Queensland, Australia.,School of Cultural and Professional Learning, Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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Bertelli MO, Del Furia C, Bonadiman M, Rondini E, Banks R, Lassi S. The Relationship Between Spiritual Life and Quality of Life in People with Intellectual Disability and/or Low-Functioning Autism Spectrum Disorders. JOURNAL OF RELIGION AND HEALTH 2020; 59:1996-2018. [PMID: 31602541 DOI: 10.1007/s10943-019-00891-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Spirituality seems to represent a relevant domain in the person-centred care planning and outcome assessment for persons with intellectual disability and low-functioning autism spectrum disorder. Despite this, the impact of spirituality on subjective well-being and quality of life (QoL) has been scarcely investigated. The aim of the present study was to map the international scientific literature in order to identify the reasons of such misconsideration and the key points for future research and practice implementation. The relationship between spirituality and QoL depends on a complexity of factors, ranging from QoL theoretical models to services' organisation. Personal attitude, family members, health and social-care personnel, training, faith and life communities, and even different religions seem to deserve an in-depth analysis.
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Affiliation(s)
- Marco O Bertelli
- CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Via del Sansovino, 176, 50142, Florence, Italy.
| | - Chiara Del Furia
- CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Via del Sansovino, 176, 50142, Florence, Italy
- Istituto Don Orione, Florence, Italy
| | | | - Elisa Rondini
- CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Via del Sansovino, 176, 50142, Florence, Italy
- Istituto Don Orione, Florence, Italy
- Dipartimento di Filosofia, Scienze Sociali, Umane e della Formazione, Università di Perugia, Perugia, Italy
| | - Roger Banks
- National Senior Psychiatry Lead, NHS England, Leeds, UK
| | - Stefano Lassi
- Associazione Trisomia 21 Onlus, Florence, Italy
- Facoltà Teologica dell'Italia Centrale, Florence, Italy
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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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Kuhn JL, Vanegas SB, Salgado R, Borjas SK, Magaña S, Smith DaWalt L. The Cultural Adaptation of a Transition Program for Latino Families of Youth with Autism Spectrum Disorder. FAMILY PROCESS 2020; 59:477-491. [PMID: 30844083 PMCID: PMC7191653 DOI: 10.1111/famp.12439] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
During the transition to adulthood, effective and culturally relevant supports are critical for families of youth with autism spectrum disorder (ASD). There is a dearth of documented program development and research on supports for Spanish-speaking Latino families during this life stage. The present work describes the cultural adaptation process of an evidence-based transition program for Latino families of youth with ASD. A model of the actions necessary to meaningfully conduct a cultural adaptation in this context is described. After implementing the culturally adapted program titled Juntos en la Transición with five Spanish-speaking families, parents reported high social validity of the program through surveys and interviews. The cultural adaptation process followed in this work is important for the further development of programs that address the transition needs of Latino youth with ASD and their families. Our impressions may also be useful to those who aim to develop culturally sensitive and ecologically valid multifamily group intervention programs for families from cultural and linguistic minority groups.
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Wiggins LD, Durkin M, Esler A, Lee LC, Zahorodny W, Rice C, Yeargin-Allsopp M, Dowling NF, Hall-Lande J, Morrier MJ, Christensen D, Shenouda J, Baio J. Disparities in Documented Diagnoses of Autism Spectrum Disorder Based on Demographic, Individual, and Service Factors. Autism Res 2020; 13:464-473. [PMID: 31868321 PMCID: PMC7521364 DOI: 10.1002/aur.2255] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/27/2019] [Accepted: 12/03/2019] [Indexed: 01/23/2023]
Abstract
The objectives of our study were to (a) report how many children met an autism spectrum disorder (ASD) surveillance definition but had no clinical diagnosis of ASD in health or education records and (b) evaluate differences in demographic, individual, and service factors between children with and without a documented ASD diagnosis. ASD surveillance was conducted in selected areas of Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin. Children were defined as having ASD if sufficient social and behavioral deficits and/or an ASD diagnosis were noted in health and/or education records. Among 4,498 children, 1,135 (25%) had ASD indicators without having an ASD diagnosis. Of those 1,135 children without a documented ASD diagnosis, 628 (55%) were not known to receive ASD services in public school. Factors associated with not having a clinical diagnosis of ASD were non-White race, no intellectual disability, older age at first developmental concern, older age at first developmental evaluation, special education eligibility other than ASD, and need for fewer supports. These results highlight the importance of reducing disparities in the diagnosis of children with ASD characteristics so that appropriate interventions can be promoted across communities. Autism Res 2020, 13: 464-473. © 2019 International Society for AutismResearch,Wiley Periodicals, Inc. LAY SUMMARY: Children who did not have a clinical diagnosis of autism spectrum disorder (ASD) documented in health or education records were more likely to be non-White and have fewer developmental problems than children with a clinical diagnosis of ASD. They were brought to the attention of healthcare providers at older ages and needed fewer supports than children with a clinical diagnosis of ASD. All children with ASD symptoms who meet diagnostic criteria should be given a clinical diagnosis so they can receive treatment specific to their needs.
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Affiliation(s)
- Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maureen Durkin
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Amy Esler
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Li-Ching Lee
- Department of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland
| | - Walter Zahorodny
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Catherine Rice
- Department of Psychiatry, Early Emory Center for Child Development and Enrichment, Emory University, Atlanta, Georgia
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Nicole F Dowling
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jennifer Hall-Lande
- Institute on Community Integration, University of Minnesota, Minneapolis, Minnesota
| | - Michael J Morrier
- Department of Psychiatry, Early Emory Center for Child Development and Enrichment, Emory University, Atlanta, Georgia
| | - Deborah Christensen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Josephine Shenouda
- Department of Pediatrics, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Jon Baio
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Kandeh MS, Kandeh MK, Martin N, Krupa J. Autism in black, Asian and minority ethnic communities: a report on the first Autism Voice UK Symposium. ADVANCES IN AUTISM 2020. [DOI: 10.1108/aia-12-2018-0051] [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
Little is known about the way autism is interpreted and accepted among the black, Asian and minority ethnic (BAME) populations in the UK. This report summarises a Symposium on autism in the UK-BAME community in 2018, organised by Autism Voice UK, Participatory Autism Research Collective and the Critical Autism and Disabilities Studies Research Group at London South Bank University.
Design/methodology/approach
The stance a family or community takes about a condition such as autism is influenced by their cultural background. The aims of the Symposium were to highlight different perspectives about autism in BAME communities and to preserve the cultural dignity of the community in supporting autistic members. Beliefs about autism, its diagnosis and acceptance of and support for autistic people from a specific cultural perspective of BAME communities must be cautiously interpreted by autism professionals because beliefs vary among different cultural groups.
Findings
Thematic analysis of feedback from participants yielded the following foci. Firstly, cultural, ethnic and religious sensitivities were important to participants who felt that these were often ignored by non-BAME professionals. Secondly, the need for collaboration to improve autism awareness within the community and understanding by professionals of the intersectionality between autism and identity in BAME families was prioritised. Thirdly, issues around feelings of stigma were common, but delegates felt that these were not well understood beyond people identifying as BAME.
Originality/value
An action plan was created which highlighted raising public awareness through community engagement, improvement of access to information for parents and culturally aware autism education for professionals and BAME communities.
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Garcia S, Hall-Lande J, Nye-Lengerman K. Factors Influencing Low Prevalence of Neurodevelopmental Disabilities Among US Hispanic/Latino Children. J Racial Ethn Health Disparities 2019; 6:1107-1121. [PMID: 31292923 DOI: 10.1007/s40615-019-00613-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Hispanic/Latino (H/L) children have lower prevalence of neurodevelopmental disabilities (NDD) than other groups. The explanations for this are complex, but may be related to nativity, language barriers, and lack of access to and utilization of healthcare. Previous research focused on how these factors affect children with NDD, but little research has jointly examined whether these factors predict NDD. This study examines whether social and environmental factors explain low prevalence of NDD in this population. METHODS This study uses nationally representative Integrated Public Use Microdata Series National Health Interview Survey data (N = 200,622) and multivariate logistic regression analysis to compare NDD prevalence in white and H/L children (average age of 10.2), and examines whether nativity, healthcare access, healthcare utilization, and language barriers explain this disability disparity. RESULTS Findings reveal that the H/L NDD disparity is not explained by differences in access to or utilization of healthcare, or as a result of language differences that may create barriers to NDD diagnosis. While H/L children whose sampled adult was born in the USA have lower rates of NDD than whites, H/Ls whose sampled adult were not born in the USA have even lower probability of NDD than H/Ls who were born in the USA. CONCLUSIONS These findings may be a result of cultural differences in knowledge or understanding of what constitutes a disability or the result of differential treatment within the healthcare system among H/Ls. The findings underscore the importance of accessible and culturally appropriate health and clinical care interventions among H/L communities.
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Affiliation(s)
- Sarah Garcia
- Department of Sociology, University of Minnesota, 909 Social Sciences, 267 19th Ave S, Minneapolis, MN, 55455, USA.
| | - Jennifer Hall-Lande
- Institute on Community Integration, University of Minnesota, 105 Pattee Hall, 150 Pillsbury Dr. SE, Minneapolis, MN, 55455, USA
| | - Kelly Nye-Lengerman
- Institute on Community Integration, University of Minnesota, 105 Pattee Hall, 150 Pillsbury Dr. SE, Minneapolis, MN, 55455, USA
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Kiely B, Vettam S, Adesman A. Correlates of genetic attributions among parents of children in the USA with developmental disabilities. APPLICATION OF CLINICAL GENETICS 2019; 12:55-61. [PMID: 31043799 PMCID: PMC6469480 DOI: 10.2147/tacg.s164757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Introduction As technologies for identifying causal genetic variants in children with autism spectrum disorders (ASD) and other developmental conditions continue to advance, there is a need to understand the factors that influence parental beliefs about the causes of their child’s disabilities. This study assessed the correlates of etiologic attributions among US parents of children with ASD, intellectual disability (ID), and/or developmental delay (DD). Methods Data were obtained from the Centers for Disease Control and Prevention’s nationally representative Survey of Pathways to Diagnosis and Services. Respondents were classified according to whether their child had ASD without ID or DD (ASD-only), ASD with ID and/or DD (ASD+ID/DD), or ID and/or DD without ASD (ID/DD-only). Respondents rated the extent to which they believed that genetics/heredity and environmental exposures (prenatal and/or postnatal) had contributed to their child’s condition. Logistic regression analyses and chi-square tests were used to assess the relationship between parental beliefs and child characteristics. Results The parents of children with comorbid ASD and ID/DD were found to be significantly less likely than those in the other condition groups to attribute their child’s condition to genetics. Within the ASD+ID/DD group, parental endorsement of genetics was lower among those who reported a history of language regression (p=0.006). Conclusion Further research is needed to evaluate the impact of parental genetic attributions on medical decision-making.
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Affiliation(s)
- Bridget Kiely
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA,
| | - Sujit Vettam
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA,
| | - Andrew Adesman
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, NY, USA,
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Wang B, Cao F, Boyland JT. Addressing Autism Spectrum Disorders in China. New Dir Child Adolesc Dev 2019; 2019:137-162. [DOI: 10.1002/cad.20266] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Sun F, Dai M, Lin L, Sun X, Murray AL, Auyeung B, Jing J. Psychometric properties of the chinese version of autism spectrum quotient-children's version: A sex-specific analysis. Autism Res 2018; 12:303-315. [PMID: 30592171 DOI: 10.1002/aur.2053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/06/2018] [Indexed: 11/10/2022]
Abstract
A Simplified Chinese translation of the Autism Spectrum Quotient-Children's Version (AQ-C) is needed for research in mainland China. Autism Spectrum Disorder (ASD) is a condition that differs in presentation and prevalence by sex. Thus, evaluating the psychometric validity of the AQ-C in males and females is an important step in its validation. The present study aims to develop a Chinese translation of the parent-report AQ-C, and test its psychometric properties among Mandarin Chinese speaking boys and girls. A total of 1,020 non-clinical children and 134 children with ASD were assessed. Factor analyses were performed for the whole sample, as well as for girls and boys separately. A 30-item, 5-factor model (the Chinese AQ-C) showed adequate goodness of fit (root mean square error of approximation [RMSEA] = 0.037; comparative fit index [CFI] = 0.907; Tucker-Lewis index [TLI] = 0.901) for the whole sample. According to parents' reports, non-clinical boys had significantly higher scores than non-clinical girls on the Chinese AQ-C. Sex-specific factor structures were identified resulting in a 4-factor model with 32 items for girls (the Chinese AQ-Girls), and a 4-factor model with 34 items for boys (the Chinese AQ-Boys). The cut-off scores of the Chinese AQ-C, AQ-Girls, and AQ-Boys were 44.5, 42.5, and 46.5, respectively. These three Chinese versions of the AQ-C all showed satisfactory internal consistency (α = 0.786-0.840) and concurrent validity with the Social Responsiveness Scale (r = 0.789-0.814) for the total scale. Differences have been found in the sex-specific factor structures of the AQ-C which would be more reliable to use for future research when measuring autistic traits in the general population. Autism Res 2019, 12: 303-315 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study developed Chinese versions of the Autism Spectrum Quotient-Children's Version (AQ-C) in Chinese boys and girls together and separately. The AQ-C showed good psychometric properties in boys and girls together and separately. There were differences in sex-specific factor structures of the AQ-C. These results suggest that the sex-specific Chinese versions of the AQ-C provide reliable and valid measurement of autistic traits.
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Affiliation(s)
- Fan Sun
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Meixia Dai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiang Sun
- MIND Institute, University of California, Davis, California.,Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong, China.,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Aja Louise Murray
- Institute of Criminology, University of Cambridge, Cambridge, UK.,Psychology Department, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Bonnie Auyeung
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.,Psychology Department, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
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Chen H, Wang J, Uddin LQ, Wang X, Guo X, Lu F, Duan X, Wu L, Chen H. Aberrant functional connectivity of neural circuits associated with social and sensorimotor deficits in young children with autism spectrum disorder. Autism Res 2018; 11:1643-1652. [PMID: 30475453 DOI: 10.1002/aur.2029] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/07/2018] [Accepted: 09/18/2018] [Indexed: 12/15/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by atypical functional integration of brain regions. The vast majority of neuroimaging studies of ASD have focused on older children, adolescents, and adults with the disorder. Very little work has explored whole-brain functional connectivity of young children with ASD. Here, we collected resting-state functional magnetic resonance imaging data from 58 young children (mean age 4.98 years; 29 with ASD; 29 matched healthy controls [HC]). All children were under sedation during scanning. A functional "connectedness" method was first used to seek for brain regions showing atypical functional connectivity (FC) in children with ASD. Then, a recurrent-seek strategy was applied to reveal atypical FC circuits in ASD children. FC matrices between regions-of-interest (ROIs) were compared between ASD and HC. Finally, a support vector regression (SVR) method was used to assess the relationship between the FC circuits and ASD symptom severity. Two atypical FC circuits comprising 23 ROIs in ASD were revealed: one predominantly comprised brain regions involved with social cognition showing under-connectivity in ASD; the other predominantly comprised sensory-motor and visual brain regions showing over-connectivity in ASD. The SVR analysis showed that the two FC circuits were separately related to social deficits and restricted behavior scores. These findings indicate disrupted FC of neural circuits involved in the social and sensorimotor processes in young children with ASD. The finding of the atypical FC patterns in young children with ASD underscores the utility of studying younger children with the disorder, and highlights nuanced patterns of brain connectivity underlying behavior closer to disorder onset. Autism Research 2018, 11: 1643-1652. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Autism spectrum disorder (ASD) is an early-onset neurodevelopmental disorder. Understanding brain functional alterations at early ages is important for understanding biological mechanisms of ASD. Here, we found two atypical brain functional circuits in young children with ASD that were related to social and sensorimotor function. These results show how atypical patterns of brain functional connectivity in young children with of ASD may underlie core symptoms of the disorder.
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Affiliation(s)
- Heng Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, From University of Electronic Science and Technology of China, Chengdu, China.,School of life Science and technology, center for information in medicine, University of Electronic Science and Technology of China, Chengdu, China.,School of Medicine, Guizhou University, Guiyang, China
| | - Jia Wang
- Department of Children's and Adolescent Health, Public Health College of Harbin Medical University, Harbin, China
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Xiaomin Wang
- Department of Children's and Adolescent Health, Public Health College of Harbin Medical University, Harbin, China
| | - Xiaonan Guo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, From University of Electronic Science and Technology of China, Chengdu, China.,School of life Science and technology, center for information in medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, From University of Electronic Science and Technology of China, Chengdu, China.,Chengdu Mental Health Center, Chengdu, China
| | - Xujun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, From University of Electronic Science and Technology of China, Chengdu, China.,School of life Science and technology, center for information in medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lijie Wu
- Department of Children's and Adolescent Health, Public Health College of Harbin Medical University, Harbin, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, From University of Electronic Science and Technology of China, Chengdu, China.,School of life Science and technology, center for information in medicine, University of Electronic Science and Technology of China, Chengdu, China
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Tariq Q, Daniels J, Schwartz JN, Washington P, Kalantarian H, Wall DP. Mobile detection of autism through machine learning on home video: A development and prospective validation study. PLoS Med 2018; 15:e1002705. [PMID: 30481180 PMCID: PMC6258501 DOI: 10.1371/journal.pmed.1002705] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/25/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The standard approaches to diagnosing autism spectrum disorder (ASD) evaluate between 20 and 100 behaviors and take several hours to complete. This has in part contributed to long wait times for a diagnosis and subsequent delays in access to therapy. We hypothesize that the use of machine learning analysis on home video can speed the diagnosis without compromising accuracy. We have analyzed item-level records from 2 standard diagnostic instruments to construct machine learning classifiers optimized for sparsity, interpretability, and accuracy. In the present study, we prospectively test whether the features from these optimized models can be extracted by blinded nonexpert raters from 3-minute home videos of children with and without ASD to arrive at a rapid and accurate machine learning autism classification. METHODS AND FINDINGS We created a mobile web portal for video raters to assess 30 behavioral features (e.g., eye contact, social smile) that are used by 8 independent machine learning models for identifying ASD, each with >94% accuracy in cross-validation testing and subsequent independent validation from previous work. We then collected 116 short home videos of children with autism (mean age = 4 years 10 months, SD = 2 years 3 months) and 46 videos of typically developing children (mean age = 2 years 11 months, SD = 1 year 2 months). Three raters blind to the diagnosis independently measured each of the 30 features from the 8 models, with a median time to completion of 4 minutes. Although several models (consisting of alternating decision trees, support vector machine [SVM], logistic regression (LR), radial kernel, and linear SVM) performed well, a sparse 5-feature LR classifier (LR5) yielded the highest accuracy (area under the curve [AUC]: 92% [95% CI 88%-97%]) across all ages tested. We used a prospectively collected independent validation set of 66 videos (33 ASD and 33 non-ASD) and 3 independent rater measurements to validate the outcome, achieving lower but comparable accuracy (AUC: 89% [95% CI 81%-95%]). Finally, we applied LR to the 162-video-feature matrix to construct an 8-feature model, which achieved 0.93 AUC (95% CI 0.90-0.97) on the held-out test set and 0.86 on the validation set of 66 videos. Validation on children with an existing diagnosis limited the ability to generalize the performance to undiagnosed populations. CONCLUSIONS These results support the hypothesis that feature tagging of home videos for machine learning classification of autism can yield accurate outcomes in short time frames, using mobile devices. Further work will be needed to confirm that this approach can accelerate autism diagnosis at scale.
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Affiliation(s)
- Qandeel Tariq
- Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America
- Department of Biomedical Data Science, Stanford University, California, United States of America
| | - Jena Daniels
- Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America
- Department of Biomedical Data Science, Stanford University, California, United States of America
| | - Jessey Nicole Schwartz
- Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America
- Department of Biomedical Data Science, Stanford University, California, United States of America
| | - Peter Washington
- Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America
- Department of Biomedical Data Science, Stanford University, California, United States of America
| | - Haik Kalantarian
- Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America
- Department of Biomedical Data Science, Stanford University, California, United States of America
| | - Dennis Paul Wall
- Department of Pediatrics, Division of Systems Medicine, Stanford University, California, United States of America
- Department of Biomedical Data Science, Stanford University, California, United States of America
- * E-mail:
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Kalantarian H, Washington P, Schwartz J, Daniels J, Haber N, Wall DP. Guess What?: Towards Understanding Autism from Structured Video Using Facial Affect. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2018; 3:43-66. [PMID: 33313475 PMCID: PMC7730314 DOI: 10.1007/s41666-018-0034-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Autism Spectrum Disorder (ASD) is a condition affecting an estimated 1 in 59 children in the United States. Due to delays in diagnosis and imbalances in coverage, it is necessary to develop new methods of care delivery that can appropriately empower children and caregivers by capitalizing on mobile tools and wearable devices for use outside of clinical settings. In this paper, we present a mobile charades-style game, Guess What?, used for the acquisition of structured video from children with ASD for behavioral disease research. We then apply face tracking and emotion recognition algorithms to videos acquired through Guess What? game play. By analyzing facial affect in response to various prompts, we demonstrate that engagement and facial affect can be quantified and measured using real-time image processing algorithms: an important first-step for future therapies, at-home screenings, and outcome measures based on home video. Our study of eight subjects demonstrates the efficacy of this system for deriving highly emotive structured video from children with ASD through an engaging gamified mobile platform, while revealing the most efficacious prompts and categories for producing diverse emotion in participants.
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Affiliation(s)
| | | | - Jessey Schwartz
- Department of Pediatrics, Stanford University, Stanford, CA USA
| | - Jena Daniels
- Department of Pediatrics, Stanford University, Stanford, CA USA
| | - Nick Haber
- Department of Pediatrics, Stanford University, Stanford, CA USA
| | - Dennis P. Wall
- Department of Pediatrics, Stanford University, Stanford, CA USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA USA
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49
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Kang-Yi CD, Grinker RR, Beidas R, Agha A, Russell R, Shah SB, Shea K, Mandell DS. Influence of Community-Level Cultural Beliefs about Autism on Families' and Professionals' Care for Children. Transcult Psychiatry 2018; 55:623-647. [PMID: 29972327 PMCID: PMC7008392 DOI: 10.1177/1363461518779831] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This qualitative study aimed to understand how community-level cultural beliefs affect families' and professionals' care for children with autism and developmental delays in immigrant communities, as a first step towards promoting early identification and access to early intervention services. The study was part of the larger New York City (NYC) Korean Community Autism Project, which was designed to identify strategies to increase awareness of autism and reduce delays in treatment seeking within the NYC Korean-American community. Our study elicited early childcare workers' and church leaders' beliefs about autism and developmental disorders and, in particular, early intervention. We also elicited responses to newly developed outreach materials targeting this community. An inductive approach was used to identify concepts and categories associated with autism. Our study confirmed that discomfort, stigma and discrimination are the prevailing community attitudes toward autism and developmental disorders in the Korean-American community. Families' and professionals' understanding of autism and their care for children are affected by these community beliefs. Approaching immigrant communities with general information about child development and education rather than directly talking about autism and developmental disorders is likely to engage more families and professionals in need for diagnostic evaluation and early intervention for autism.
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Affiliation(s)
| | | | | | | | | | - Sandeep B Shah
- New Hampshire Department of Education Vocational Rehabilitation
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Daniels J, Schwartz JN, Voss C, Haber N, Fazel A, Kline A, Washington P, Feinstein C, Winograd T, Wall DP. Exploratory study examining the at-home feasibility of a wearable tool for social-affective learning in children with autism. NPJ Digit Med 2018; 1:32. [PMID: 31304314 PMCID: PMC6550272 DOI: 10.1038/s41746-018-0035-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 05/18/2018] [Accepted: 05/25/2018] [Indexed: 12/30/2022] Open
Abstract
Although standard behavioral interventions for autism spectrum disorder (ASD) are effective therapies for social deficits, they face criticism for being time-intensive and overdependent on specialists. Earlier starting age of therapy is a strong predictor of later success, but waitlists for therapies can be 18 months long. To address these complications, we developed Superpower Glass, a machine-learning-assisted software system that runs on Google Glass and an Android smartphone, designed for use during social interactions. This pilot exploratory study examines our prototype tool’s potential for social-affective learning for children with autism. We sent our tool home with 14 families and assessed changes from intake to conclusion through the Social Responsiveness Scale (SRS-2), a facial affect recognition task (EGG), and qualitative parent reports. A repeated-measures one-way ANOVA demonstrated a decrease in SRS-2 total scores by an average 7.14 points (F(1,13) = 33.20, p = <.001, higher scores indicate higher ASD severity). EGG scores also increased by an average 9.55 correct responses (F(1,10) = 11.89, p = <.01). Parents reported increased eye contact and greater social acuity. This feasibility study supports using mobile technologies for potential therapeutic purposes.
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Affiliation(s)
- Jena Daniels
- 1Division of Systems Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA USA
| | - Jessey N Schwartz
- 1Division of Systems Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA USA
| | - Catalin Voss
- 2Department of Computer Science, Stanford University, Palo Alto, CA USA
| | - Nick Haber
- 1Division of Systems Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA USA
| | - Azar Fazel
- 1Division of Systems Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA USA
| | - Aaron Kline
- 1Division of Systems Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA USA
| | - Peter Washington
- 2Department of Computer Science, Stanford University, Palo Alto, CA USA
| | - Carl Feinstein
- 3Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA USA
| | - Terry Winograd
- 2Department of Computer Science, Stanford University, Palo Alto, CA USA
| | - Dennis P Wall
- 1Division of Systems Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA USA.,3Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA USA.,4Department of Biomedical Data Science, Stanford University, Palo Alto, CA USA
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