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Gore K, Gilbert M, Hawke M, Barbaro J. Investigating autism knowledge, self-efficacy, and confidence following maternal and child health nurse training for the early identification of autism. Front Neurol 2024; 14:1201292. [PMID: 38264089 PMCID: PMC10803615 DOI: 10.3389/fneur.2023.1201292] [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: 04/06/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Early identification of children with a high likelihood of autism can lead to referral for diagnostic services and access to early supports, resulting in improved outcomes for children and families. Maternal and Child Health Nurses (MCHNs) in Victoria, Australia, are well-placed to monitor infants and toddlers for signs of autism, given children and caregivers attend free, regular, well-baby consultations from birth through to school age. This study aimed to identify the impact of personal and workplace factors on MCHNs' competencies of autism knowledge, self-efficacy in identifying autistic infants and toddlers, and confidence in speaking to parents/caregivers about autism. Additionally, the study sought to identify which personal and workplace factors might predict increased competency in these areas. Methods After identifying training needs and current competency levels via a training needs analysis (TNA), 1,428 MCHNs received training on the early signs of autism and in the use of the Social Attention and Communication Surveillance-Revised (SACS-R) tool for early autism identification; the training program was known as Monitoring of Social Attention, Interaction, and Communication (MoSAIC). Results Previous MCHN autism training and knowledge of autism community resources significantly contributed to increased MCHN self-efficacy in identifying autistic infants and toddlers, while knowledge of community resources was the best predictor of confidence in speaking with parents/caregivers about autism. Perceived self-efficacy and confidence in speaking with parents/caregivers about autism significantly increased following the MoSAIC autism training. Discussion Targeted autism training for primary health practitioners is an important first step for early autism identification and initiating conversations with parents/caregivers.
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Affiliation(s)
- Katherine Gore
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | | | | | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
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Gilbert M, Gore K, Hawke M, Barbaro J. Development, delivery, and evaluation of a training program for the early identification of autism: Monitoring of Social Attention, Interaction, and Communication. Front Neurol 2023; 14:1201265. [PMID: 37483439 PMCID: PMC10361691 DOI: 10.3389/fneur.2023.1201265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Early identification of Autistic children is an important precursor to diagnosis, and access to supports and services. Here we describe the training of the maternal and child health (MCH) workforce in the state of Victoria, Australia in the early identification of infants and toddlers with a high likelihood of autism. Methods In 2019, 1,428 MCH nurses completed early autism training held at venues across the state, with an additional 82 nurses completing online-only training. A training needs analysis enabled the research team to determine the workforce's current skill and knowledge levels, and to identify knowledge gaps, training needs and workplace barriers. The professional development program, known as Monitoring of Social Attention, Interaction, and Communication (MoSAIC), comprised: online pre-workshop modules; a face-to-face instructor-led workshop, which included the use of the Social Attention and Communication-Revised (SACS-R) tool; and online post-workshop modules, which included a recording of a face-to-face workshop with all accompanying resources. This was the first time that the MCH workforce received this training package. Attendees were asked to complete a training satisfaction survey immediately following the face-to-face instructor-led workshop and a follow-up survey regarding their autism knowledge and SACS-R implementation 4-6 weeks after the workshop. Results Over 90% (n = 325) of MCH nurses who completed the training satisfaction survey agreed or strongly agreed with statements that the training was clear and of high quality. Most nurses also reported that the training was well-presented and that they would recommend it to a colleague. In the 6 months following the training, a total of 82,581 SACS-R assessments were conducted by the MCH workforce, reflecting that MCH nurses had successfully integrated SACS-R assessments into their work practice after receiving the early autism identification training. Discussion This study demonstrated that training on the early identification of autism can be successfully designed, customized, and delivered to a large primary healthcare workforce for universal developmental surveillance of autism.
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Mohd Radzi SF, Hassan MS, Mohd Radzi MAH. Comparison of classification algorithms for predicting autistic spectrum disorder using WEKA modeler. BMC Med Inform Decis Mak 2022; 22:306. [PMID: 36434656 PMCID: PMC9700876 DOI: 10.1186/s12911-022-02050-x] [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: 01/27/2021] [Accepted: 03/21/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND In healthcare area, big data, if integrated with machine learning, enables health practitioners to predict the result of a disorder or disease more accurately. In Autistic Spectrum Disorder (ASD), it is important to screen the patients to enable them to undergo proper treatments as early as possible. However, difficulties may arise in predicting ASD occurrences accurately, mainly caused by human errors. Data mining, if embedded into health screening practice, can help to overcome the difficulties. This study attempts to evaluate the performance of six best classifiers, taken from existing works, at analysing ASD screening training dataset. RESULT We tested Naive Bayes, Logistic Regression, KNN, J48, Random Forest, SVM, and Deep Neural Network algorithms to ASD screening dataset and compared the classifiers' based on significant parameters; sensitivity, specificity, accuracy, receiver operating characteristic, area under the curve, and runtime, in predicting ASD occurrences. We also found that most of previous studies focused on classifying health-related dataset while ignoring the missing values which may contribute to significant impacts to the classification result which in turn may impact the life of the patients. Thus, we addressed the missing values by implementing imputation method where they are replaced with the mean of the available records found in the dataset. CONCLUSION We found that J48 produced promising results as compared to other classifiers when tested in both circumstances, with and without missing values. Our findings also suggested that SVM does not necessarily perform well for small and simple datasets. The outcome is hoped to assist health practitioners in making accurate diagnosis of ASD occurrences in patients.
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Affiliation(s)
- Siti Fairuz Mohd Radzi
- grid.11875.3a0000 0001 2294 3534Centre for Global Sustainability Studies, Universiti Sains Malaysia, Minden, Malaysia
| | - Mohd Sayuti Hassan
- grid.11875.3a0000 0001 2294 3534Centre for Global Sustainability Studies, Universiti Sains Malaysia, Minden, Malaysia
| | - Muhammad Abdul Hadi Mohd Radzi
- grid.11875.3a0000 0001 2294 3534School of Languages, Literacies, and Translation, Universiti Sains Malaysia, Minden, Malaysia
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Keklik D, Nazik E. Knowledge about childhood autism among nurses in Turkey: A cross-sectional descriptive study. Perspect Psychiatr Care 2021; 57:1637-1644. [PMID: 33484175 DOI: 10.1111/ppc.12729] [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] [Received: 09/24/2020] [Revised: 12/30/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The aim of this study was to determine the level of knowledge that nurses possess about childhood autism. DESIGN AND METHODS This cross-sectional descriptive study was conducted among 278 nurses. A personal information form, which was created by the present researchers, and Knowledge about Childhood Autism among Health Workers questionnaire were used to collect data. FINDINGS The mean knowledge level was 12.29 ± 3.19. There was a significant difference in total scale scores as a function of participation in a training program on childhood autism and acquaintance with a person with autism. PRACTICE IMPLICATIONS Nurses play an important role in the early diagnosis of childhood autism. Therefore, they should be educated about childhood autism.
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Affiliation(s)
- Dilara Keklik
- Faculty of Health Sciences, Çukurova University, Adana, Turkey
| | - Evşen Nazik
- Faculty of Health Sciences, Çukurova University, Adana, Turkey
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Mcintosh CE, Thomas CM. UTILIZATION OF SCHOOL NURSES DURING THE EVALUATION AND IDENTIFICATION OF CHILDREN WITH AUTISM SPECTRUM DISORDERS. PSYCHOLOGY IN THE SCHOOLS 2015. [DOI: 10.1002/pits.21847] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Crais ER, McComish CS, Humphreys BP, Watson LR, Baranek GT, Reznick JS, Christian RB, Earls M. Pediatric Healthcare Professionals’ Views on Autism Spectrum Disorder Screening at 12–18 Months. J Autism Dev Disord 2014; 44:2311-28. [DOI: 10.1007/s10803-014-2101-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Approaches to enhancing the early detection of autism spectrum disorders: a systematic review of the literature. J Am Acad Child Adolesc Psychiatry 2014; 53:141-52. [PMID: 24472250 DOI: 10.1016/j.jaac.2013.11.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 08/21/2013] [Accepted: 11/18/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND A reliable diagnosis of autism can be made as early as 24 months, yet in many children diagnoses are made much later. A delay in diagnosis translates into a missed opportunity to provide early intervention services and to improve outcomes. The aim of the current study was to review the literature on early detection approaches in primary care and other community settings in the United States. METHODS A search was conducted of the peer-reviewed and gray literature to identify studies published from January 1990 through January 2013 testing approaches to enhance the early detection of autism in community settings in the United States. RESULTS The search identified 40 studies describing 35 approaches, which were grouped into the following categories: awareness (n = 4), routine screening (n = 21), and practice improvement to enhance screening (n = 10). Awareness approaches were associated with positive changes in knowledge of autism-related topics. Routine screening yielded high or increased rates of screening and referrals; however, few studies assessed the effect of screening on age at diagnosis or services enrollment. Practice improvement approaches resulted in increased screening and referral rates and highlighted the importance of adopting a multipronged approach to enhance early detection. CONCLUSIONS Although studies that tested screening approaches in community settings found positive results, the effectiveness of such efforts on reducing time to diagnosis and services enrollment remains largely untested. The fact that few studies reported outcomes beyond rates of referral indicates the need for enhanced methodological rigor, particularly with respect to length of follow-up and quality of measures used.
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Giarelli E, Ruttenberg J, Segal A. Continuing Education for Nurses in the Clinical Management of Autism Spectrum Disorders: Results of a Pilot Evaluation. J Contin Educ Nurs 2012; 43:169-76. [DOI: 10.3928/00220124-20111115-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 10/10/2011] [Indexed: 11/20/2022]
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Barbaro J, Ridgway L, Dissanayake C. Developmental surveillance of infants and toddlers by maternal and child health nurses in an Australian community-based setting: promoting the early identification of autism spectrum disorders. J Pediatr Nurs 2011; 26:334-47. [PMID: 21726784 DOI: 10.1016/j.pedn.2010.04.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Revised: 03/04/2010] [Accepted: 04/13/2010] [Indexed: 10/19/2022]
Abstract
Although signs of autism spectrum disorders (ASDs) are evident during the first year of life, few children are diagnosed prior to 3 years. The objective in this article is to highlight the role that primary health care professionals can play in the early identification of ASDs by briefly outlining the successful implementation of The Social Attention and Communication Study. Maternal and child health nurses were trained on the early signs of ASDs, which enabled them to identify these children prior to 2 years. The training procedure used will be outlined, and the early signs that were monitored will be explained in detail. It is recommended that routine monitoring for ASDs in infancy and toddlerhood become standard practice among all primary health care professionals.
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Affiliation(s)
- Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Bundoora, Victoria, Australia
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Abstract
PURPOSE OF REVIEW Early detection and diagnosis of autism spectrum disorders (ASDs) allows opportunities for children and their families to benefit more fully from early supports and interventions. RECENT FINDINGS Recent advances in early detection research have resulted from prospective studies of high-risk infants and large ASD screening studies conducted in community settings. With improvement in early detection of autism, exciting progress has been made in establishing the efficacy of ASD-specific interventions for toddlers as young as 18 months on the basis of controlled clinical trials. SUMMARY There has been increasing emphasis on opportunities to link early behavioral expression to the underlying neurobiology of ASD, potentially bringing us closer to the fundamental mechanisms underlying this disorder.
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Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
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Prospective identification of autism spectrum disorders in infancy and toddlerhood using developmental surveillance: the social attention and communication study. J Dev Behav Pediatr 2010; 31:376-85. [PMID: 20495475 DOI: 10.1097/dbp.0b013e3181df7f3c] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite behavioral markers of autism spectrum disorders (ASDs) being evident within the first year of life, there remains little research on the prospective identification of these children in a community-based setting before 18 months. The aim in the Social Attention and Communication Study was to identify infants and toddlers at risk of an ASD during their first 2 years. METHODS A total of 241 Maternal and Child Health nurses were trained on the early signs of ASDs at 8, 12, 18 and 24 months. Using a developmental surveillance approach with a community-based sample, a cohort of 20,770 children was monitored on early social attention and communication behaviors. Those infants/toddlers identified as "at risk" were referred to the Social Attention and Communication Study team from 12 months for developmental and diagnostic assessments at 6 monthly intervals, until 24 months. RESULTS A total of 216 children were referred, with 110 being further assessed. Of these, 89 children were classified with an ASD at 24 months, and 20 children had developmental and/or language delays, resulting in a Positive Predictive value of 81%. The estimated rate of ASDs in the Social Attention and Communication Study cohort ranged from 1:119 to 1:233 children. Estimated sensitivity ranged from 69% to 83.8%, and estimated specificity ranged from 99.8% to 99.9%. CONCLUSION Developmental surveillance of social and communication behaviors, which differ according to the age at which the child is monitored, enables the accurate identification of children at risk for ASDs between 12 and 24 months. Education on the early signs is recommended for all primary health care professionals to facilitate early identification of ASDs.
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Zwaigenbaum L, Bryson S, Lord C, Rogers S, Carter A, Carver L, Chawarska K, Constantino J, Dawson G, Dobkins K, Fein D, Iverson J, Klin A, Landa R, Messinger D, Ozonoff S, Sigman M, Stone W, Tager-Flusberg H, Yirmiya N. Clinical assessment and management of toddlers with suspected autism spectrum disorder: insights from studies of high-risk infants. Pediatrics 2009; 123:1383-91. [PMID: 19403506 PMCID: PMC2833286 DOI: 10.1542/peds.2008-1606] [Citation(s) in RCA: 277] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
With increased public awareness of the early signs and recent American Academy of Pediatrics recommendations that all 18- and 24-month-olds be screened for autism spectrum disorders, there is an increasing need for diagnostic assessment of very young children. However, unique challenges exist in applying current diagnostic guidelines for autism spectrum disorders to children under the age of 2 years. In this article, we address challenges related to early detection, diagnosis, and treatment of autism spectrum disorders in this age group. We provide a comprehensive review of findings from recent studies on the early development of children with autism spectrum disorders, summarizing current knowledge on early signs of autism spectrum disorders, the screening properties of early detection tools, and current best practice for diagnostic assessment of autism spectrum disorders before 2 years of age. We also outline principles of effective intervention for children under the age of 2 with suspected/confirmed autism spectrum disorders. It is hoped that ongoing studies will provide an even stronger foundation for evidence-based diagnostic and intervention approaches for this critically important age group.
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Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
| | - Susan Bryson
- Department of Pediatrics and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Catherine Lord
- Department of Clinical and Developmental Psychology, University of Michigan, Ann Arbor, Michigan
| | - Sally Rogers
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Alice Carter
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | - Leslie Carver
- Department of Psychology, University of California, San Diego, California
| | - Kasia Chawarska
- Department of Psychology, Yale University, New Haven, Connecticut
| | - John Constantino
- Department of Psychiatry and Pediatrics, Washington University, St Louis, Missouri
| | - Geraldine Dawson
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Karen Dobkins
- Department of Psychology, University of California, San Diego, California
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Jana Iverson
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ami Klin
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Rebecca Landa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Sally Ozonoff
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
| | - Marian Sigman
- Department of Pediatrics and Psychology, University of California, Los Angeles, California
| | - Wendy Stone
- Department of Pediatrics and Psychology, Vanderbilt University, Nashville, Tennessee
| | | | - Nurit Yirmiya
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
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Abstract
BACKGROUND Two strategies have been proposed for early identification of children with autism spectrum disorders (ASD): (1) using a general screening tool followed by an ASD-specific screening tool for those who screen positive on the former or (2) using an ASD-specific tool for all children. The relative yield of these two strategies has not been examined. OBJECTIVES This study compared the number of children identified at risk for ASD at their well child visits between the ages of 18 and 30 months using a general developmental screening tool and an autism-specific screening tool. METHODS The Parents' Evaluation of Developmental Status (PEDS) was used as the general developmental screening tool and the Modified Checklist for Autism in Toddlers (M-CHAT) was used as the autism-specific tool. These tools were administered concurrently to 152 children. RESULTS Cross tabulations and chi tests were used to determine the utility of the PEDS as the first step of a two-part screen for ASD. Of those who screened positive for developmental concerns on the PEDS (n = 38), 16% screened positive for ASD on the M-CHAT; of those who did not screen positive for developmental concerns on the PEDS (n = 114), 14% screened positive for ASD on the M-CHAT (p = .79). CONCLUSION The PEDS missed the majority of children who screened positive for ASD on the M-CHAT, suggesting that these two tools tap into very different domains of developmental concerns. The findings support the use of an ASD-specific tool for all children in conjunction with regular standardized developmental screening.
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