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Bosetti C, Ferrini L, Ferrari AR, Bartolini E, Calderoni S. Children with Autism Spectrum Disorder and Abnormalities of Clinical EEG: A Qualitative Review. J Clin Med 2024; 13:279. [PMID: 38202286 PMCID: PMC10779511 DOI: 10.3390/jcm13010279] [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: 11/20/2023] [Revised: 12/22/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
Over the last decade, the comorbidity between Autism Spectrum Disorder (ASD) and epilepsy has been widely demonstrated, and many hypotheses regarding the common neurobiological bases of these disorders have been put forward. A variable, but significant, prevalence of abnormalities on electroencephalogram (EEG) has been documented in non-epileptic children with ASD; therefore, several scientific studies have recently tried to demonstrate the role of these abnormalities as a possible biomarker of altered neural connectivity in ASD individuals. This narrative review intends to summarize the main findings of the recent scientific literature regarding abnormalities detected with standard EEG in children/adolescents with idiopathic ASD. Research using three different databases (PubMed, Scopus and Google Scholar) was conducted, resulting in the selection of 10 original articles. Despite an important lack of studies on preschoolers and a deep heterogeneity in results, some authors speculated on a possible association between EEG abnormalities and ASD characteristics, in particular, the severity of symptoms. Although this correlation needs to be more strongly elucidated, these findings may encourage future studies aimed at demonstrating the role of electrical brain abnormalities as an early biomarker of neural circuit alterations in ASD, highlighting the potential diagnostic, prognostic and therapeutic value of EEG in this field.
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Affiliation(s)
- Chiara Bosetti
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy; (C.B.); (L.F.); (A.R.F.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Luca Ferrini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy; (C.B.); (L.F.); (A.R.F.); (S.C.)
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy
| | - Anna Rita Ferrari
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy; (C.B.); (L.F.); (A.R.F.); (S.C.)
| | - Emanuele Bartolini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy; (C.B.); (L.F.); (A.R.F.); (S.C.)
- Tuscany PhD Programme in Neurosciences, 50139 Florence, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy; (C.B.); (L.F.); (A.R.F.); (S.C.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
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Buffle P, Armijos C, Naranjo A, Gentaz E. Feasibility of an observational procedure to enhance early identification of autism spectrum disorder in paediatric settings: A mixed-methods study on an Ecuadorian sample. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:84-94. [PMID: 37313623 PMCID: PMC10771021 DOI: 10.1177/13623613231175587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
LAY ABSTRACT In Ecuador, the low official estimate of the number of persons with autism spectrum disorder suggest that many children are not identified and are not receiving support. Screening tools are short parent-addressed questionnaires used to identify children that may be developing with autism. Their use is recommended, but their application can be perceived as challenging in paediatric routines. Some professionals prefer looking for autism-related behaviours in a child rather than using screening questionnaires. Although a short observation does not replace the use of validated screening questionnaires, tasks to guide the observation of autistic early signs can help professionals decide to screen or refer the family for assessment and early intervention. In this study, we tested observational tasks that could be adapted to the Ecuadorian paediatric contexts.
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Affiliation(s)
- Paulina Buffle
- University of Geneva, Switzerland
- Pontificia Universidad Católica del Ecuador, Ecuador
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Mazón-Cabrera R, Liesenborgs J, Brône B, Vandormael P, Somers V. Novel maternal autoantibodies in autism spectrum disorder: Implications for screening and diagnosis. Front Neurosci 2023; 17:1067833. [PMID: 36816132 PMCID: PMC9932693 DOI: 10.3389/fnins.2023.1067833] [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: 10/12/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder for which early recognition is a major challenge. Autoantibodies against fetal brain antigens have been found in the blood of mothers of children with ASD (m-ASD) and can be transferred to the fetus where they can impact neurodevelopment by binding to fetal brain proteins. This study aims to identify novel maternal autoantibodies reactive against human fetal brain antigens, and explore their use as biomarkers for ASD screening and diagnosis. Methods A custom-made human fetal brain cDNA phage display library was constructed, and screened for antibody reactivity in m-ASD samples from the Simons Simplex Collection (SSC) of the Simons Foundation Autism Research Initiative (SFARI). Antibody reactivity against 6 identified antigens was determined in plasma samples of 238 m-ASD and 90 mothers with typically developing children (m-TD). Results We identified antibodies to 6 novel University Hasselt (UH)-ASD antigens, including three novel m-ASD autoantigens, i.e., ribosomal protein L23 (RPL23), glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and calmodulin-regulated spectrin-associated protein 3 (CAMSAP3). Antibody reactivity against a panel of four of these targets was found in 16% of m-ASD samples, compared to 4% in m-TD samples (p = 0.0049). Discussion Maternal antibodies against 4 UH-ASD antigens could therefore provide a novel tool to support the diagnosis of ASD in a subset of individuals.
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Affiliation(s)
- Rut Mazón-Cabrera
- Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Transnational University Limburg, Diepenbeek, Belgium
| | - Jori Liesenborgs
- Expertise Centre for Digital Media, UHasselt, Transnational University Limburg, Diepenbeek, Belgium
| | - Bert Brône
- Department of Neurosciences, Biomedical Research Institute, UHasselt, Transnational University Limburg, Diepenbeek, Belgium
| | - Patrick Vandormael
- Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Transnational University Limburg, Diepenbeek, Belgium
| | - Veerle Somers
- Department of Immunology and Infection, Biomedical Research Institute, UHasselt, Transnational University Limburg, Diepenbeek, Belgium,*Correspondence: Veerle Somers,
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Li TS, Gau SSF, Chou TL. Exploring social emotion processing in autism: evaluating the reading the mind in the eyes test using network analysis. BMC Psychiatry 2022; 22:161. [PMID: 35241030 PMCID: PMC8892759 DOI: 10.1186/s12888-022-03773-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/09/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Features of autism spectrum disorder (ASD) include difficulties in processing and interpreting socioemotional information. The "Reading the Mind in the Eyes" test (RMET) is a validated measurement for processing socioemotional ability. However, previous RMET studies did not explore patterns of incorrect answers and the emotional valence of the test items. This study used the Taiwanese version of the RMET and the network analysis methods to examine the differences in underlying mechanisms of socioemotional processes between 30 males with autism spectrum disorder (ASD) (mean age = 18 years) and 30 healthy control males (mean age = 17 years). For each test item, a picture of a person's eyes and partial face was shown with four words describing the emotional status on picture corners. Participants were instructed to choose one of the four words that best matched the person's thinking or feeling. We further classified the words into three valences of emotional categories to examine socioemotional processes. RESULTS Our results showed that ASD males performed poorer on the RMET than the controls. ASD males had higher network density and in-degree scores, especially in negative words, than control males. CONCLUSIONS The findings suggest that males with ASD might have deficits in mapping the best emotional concept words to the target item, especially for processing negative emotion.
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Affiliation(s)
- Tai-Shan Li
- grid.19188.390000 0004 0546 0241Department of Psychology, National Taiwan University, No.1, Sec. 4, Roosevelt Road, Taipei, 106 Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
| | - Tai-Li Chou
- Department of Psychology, National Taiwan University, No.1, Sec. 4, Roosevelt Road, Taipei, 106, Taiwan.
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A Nine-Item Red Flag Sign Card for Identification of Autism Spectrum Disorder among Toddlers Aged 12 to 18 Months. Indian J Pediatr 2022; 89:288-290. [PMID: 35029807 DOI: 10.1007/s12098-021-04021-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/21/2021] [Indexed: 11/05/2022]
Abstract
There is a dearth of validated red flags measures for early identification of autism spectrum disorder (ASD) among toddlers. Hence, a new screening measure was developed. Item generation was done through literature search. Content validity (CVI) assessment was done. Criterion validity was done using Diagnostic and Statistical Manual 5 (DSM-5) as reference standard, data were collected from the case records of children with ASD diagnosis at 2 y, and evaluated for developmental milestones between 12 and 18 mo in a tertiary care setting. Item reduction of the measure from 18 to 9 was done. The area under the curve in the receiver operating characteristic (ROC) curve for new measure was 0.81 (95% CI = 0.73, 0.87); z = 7.874; p < 0.001 against DSM-5 score of ≥ 2 in the new measure; achieved sensitivity of 93.42% (95% CI = 85.3, 97.8) and specificity of 60% (95% CI = 45.9, 73.0). Thus, new validated red flag sign card (Concern-9) can be used effectively for early screening and identification of ASD among children aged 12-18 mo.
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Schjølberg S, Shic F, Volkmar FR, Nordahl-Hansen A, Stenberg N, Torske T, Larsen K, Riley K, Sukhodolsky DG, Leckman JF, Chawarska K, Øien RA. What are we optimizing for in autism screening? Examination of algorithmic changes in the M-CHAT. Autism Res 2022; 15:296-304. [PMID: 34837355 PMCID: PMC8821132 DOI: 10.1002/aur.2643] [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: 05/08/2021] [Revised: 11/02/2021] [Accepted: 11/16/2021] [Indexed: 02/03/2023]
Abstract
The present study objectives were to examine the performance of the new M-CHAT-R algorithm to the original M-CHAT algorithm. The main purpose was to examine if the algorithmic changes increase identification of children later diagnosed with ASD, and to examine if there is a trade-off when changing algorithms. We included 54,463 screened cases from the Norwegian Mother and Child Cohort Study. Children were screened using the 23 items of the M-CHAT at 18 months. Further, the performance of the M-CHAT-R algorithm was compared to the M-CHAT algorithm on the 23-items. In total, 337 individuals were later diagnosed with ASD. Using M-CHAT-R algorithm decreased the number of correctly identified ASD children by 12 compared to M-CHAT, with no children with ASD screening negative on the M-CHAT criteria subsequently screening positive utilizing the M-CHAT-R algorithm. A nonparametric McNemar's test determined a statistically significant difference in identifying ASD utilizing the M-CHAT-R algorithm. The present study examined the application of 20-item MCHAT-R scoring criterion to the 23-item MCHAT. We found that this resulted in decreased sensitivity and increased specificity for identifying children with ASD, which is a trade-off that needs further investigation in terms of cost-effectiveness. However, further research is needed to optimize screening for ASD in the early developmental period to increase identification of false negatives.
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Affiliation(s)
- Synnve Schjølberg
- a: Norwegian Institute of Public Health, University of Washington School of Medicine
| | - Frederick Shic
- b: Seattle Children’s Research Institute, University of Washington School of Medicine
| | - Fred R. Volkmar
- c: Yale Child Study Center, The Arctic University of Norway,d: Southern Connecticut University, The Arctic University of Norway
| | | | - Nina Stenberg
- f: Oslo University Hospital, The Arctic University of Norway
| | - Tonje Torske
- g: Vestre Viken Hospital:, The Arctic University of Norway
| | | | - Katherine Riley
- b: Seattle Children’s Research Institute, University of Washington School of Medicine
| | | | | | | | - Roald A. Øien
- c: Yale Child Study Center, The Arctic University of Norway,h: UiT – The Arctic University of Norway,Corresponding author tel: +4793099994, PB 6070, 9037 Tromsoe, Norway
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Pillay S, Duncan M, de Vries PJ. Who’s waiting for a school? Rates, socio-demographics, disability and referral profile of children with autism spectrum disorder awaiting school placement in the Western Cape Province of South Africa. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1849-1863. [DOI: 10.1177/13623613211067324] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this study, we examined the demographic, disability, referral and service needs profile of children with autism spectrum disorder waiting for school placement in the Western Cape Province of South Africa and combined our findings with those of a previous study on children with autism spectrum disorder attending schools in the province over the same period of time. In June 2016, there were 744 children with autism spectrum disorder or suspected autism spectrum disorder waiting for an appropriate school placement, 478 children were pre-school age and 266 children were school-going age. Fifty-three percent (53%) of pre-school age children and 38% of school-going age children were reported to be at home and receiving no educational or other intervention while they waited for a school. More than half the children on the waiting list had been waiting for services for more than a year. The combined data on children with autism spectrum disorder in school and waiting for schools showed a total of 1684 known children with autism spectrum disorder in the Western Cape in June 2016, representing less than 0.1% of the childhood population in the province. The results highlight the need for education systems strengthening to accommodate all children with autism spectrum disorder in appropriate educational settings from as early as possible. We propose multi-stakeholder engagement to develop contextually appropriate policies, best practice guidelines and actions for the education of children with autism spectrum disorder in South Africa. Lay abstract In South Africa, there are limited educational opportunities for children with autism spectrum disorder and many children with autism spectrum disorder have to wait for school placement. This study examined the education waiting list for children with autism spectrum disorder in the Western Cape Province of South Africa and reported on the demographic, disability, referral and service provision characteristics of these children. In June 2016, there were 744 children with definite autism spectrum disorder or possible autism spectrum disorder between the ages of 1 and 17 years waiting for school placement. There were children of compulsory school-going age who were reported to be at home and not receiving any intervention while they waited. More than half the children on the waiting list had been waiting for more than a year. We then combined the findings of this study with the findings of a previous study on children with autism spectrum disorder already attending schools in the province over the same period of time. We found a total of 1684 children known to have autism spectrum disorder – this was less than 0.1% of all young people in the province at the time. Between 2012 and 2016, there was a 276% increase in the number of children with autism spectrum disorder waiting for schools in the Western Cape. The results show that education systems in the Western Cape need to be strengthened to accommodate all children with autism spectrum disorder in appropriate education settings from as early as possible. We recommend engaging with different stakeholders to develop policies, best practice guidelines and actions for autism spectrum disorder education in South Africa.
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Affiliation(s)
- Sarosha Pillay
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
- Centre for Autism Research in Africa, Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
| | - Madeleine Duncan
- Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa
| | - Petrus J de Vries
- Centre for Autism Research in Africa, Division of Child & Adolescent Psychiatry, University of Cape Town, South Africa
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Willig TN, Henry V, Netter JC, Contis P, Castro-Gutierrez C, Oget-Gendre C, Bonnier C, Cabarrou E, Raffier L, Kabantchenko A. The Organization of Diagnosis, Care and Funding for Specific Learning and Developmental Disorders (SLDD): A French Regional Experimental Protocol. Front Pediatr 2022; 9:652686. [PMID: 35071121 PMCID: PMC8767009 DOI: 10.3389/fped.2021.652686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Access in France to early diagnosis and care for the most severe, but infrequent, Neurodevelopmental Disorders (NDD), autism spectrum disorder and global developmental delay, in children aged 0-7 was improved through measures implemented in 2019. However, there are no such measures for specific learning disorders (SLD), attention, motricity and language disorders (SLDD), despite their annual incidence of between 5 and 8%. Method: We describe the design of a new type of organization and financing of care for SLDD including evaluation procedure, as well as other factors, mainly at the prevention level that will contribute to local and national policy for this frequent health problem. This in response to a national call for projects, commonly called Article 51, targeted innovation in healthcare delivery and funding in the context of medium-term national reform. This provides project stakeholders with the opportunity to set up and implement "bottom-up" projects, mainly using local professionals. A joint initiative by the regional Health Authorities of the Occitanie region, the French Social Security system and a non-profit Association (Occitadys) proposed an experimental new structure of NDD care and funding. Discussion: We here discuss the design of this experiment that aims, over two to three years, to alleviate families' financial burden of care and establish a regional three-tier care system with respect to evaluation, re-education and rehabilitation care. Our approach may benefit SLDD health-care planning, and addresses the questions of prevention, early detection and care-design for families, taking local and socioeconomic disparities into account.
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Affiliation(s)
- Thiébaut-Noël Willig
- Occitadys, Toulouse, France
- Consultation de Pédiatrie, Clinique Ambroise Paré, ELSAN and EvEnTAil 31, Toulouse, France
- Association Française de Pédiatrie Ambulatoire (AFPA), Orléans, France
| | - Vincent Henry
- Occitadys, Toulouse, France
- SMPEA Peyre Plantade, Centre Hospitalier Universitaire (CHU) de Montpellier, Université de Montpellier, Montpellier, France
| | - Jean-Claude Netter
- Occitadys, Toulouse, France
- Centre de référence des troubles des apprentissages de Bigorre, Centre Hospitalier de Bigorre, Tarbes, France
| | - Patrick Contis
- Occitadys, Toulouse, France
- Handicapped Children Institutes and Union Régionale des Professionnels de Santé Médecins Libéraux (URPS ML) Occitanie organisation, Toulouse, France
| | | | - Claire Oget-Gendre
- Équipe d'appui à la rapporteure générale ≪ Expérimentations innovantes en santé ≫, secrétariat général des ministères sociaux, ministère des solidarités et de la santé, Paris, France
| | - Christophe Bonnier
- Direction des Projets, Agence Régionale de Santé Occitanie, Montpellier, France
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Carollo A, Bonassi A, Lim M, Gabrieli G, Setoh P, Dimitriou D, Aryadoust V, Esposito G. Developmental disabilities across the world: A scientometric review from 1936 to 2020. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104031. [PMID: 34333315 DOI: 10.1016/j.ridd.2021.104031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Developmental disabilities have been largely studied in the past years. Their etiological mechanisms have been underpinned to the interactions between genetic and environmental factors. These factors show variability across the world. Thus, it is important to understand where the set of knowledge obtained on developmental disabilities originates from and whether it is generalizable to low- and middle-income countries. AIMS This study aims to understand the origins of the available literature on developmental disabilities, keeping a focus on parenting, and identify the main trend of research. METHODS AND PROCEDURE A sample of 11,315 publications from 1936 to 2020 were collected from Scopus and a graphical country analysis was conducted. Furthermore, a qualitative approach enabled the clustering of references by keywords into four main areas: "Expression of the disorder", "Physiological Factors", "How it is studied" and "Environmental factors". For each area, a document co-citation analysis (DCA) on CiteSpace software was performed. OUTCOMES AND RESULTS Results highlight the leading role of North America in the study of developmental disabilities. Trends in the literature and the documents' scientific relevance are discussed in details. CONCLUSIONS AND IMPLICATIONS Results demand for investigation in different socio-economical settings to generalize our knowledge. What this paper adds? The current paper tries to provide insight into the origins of the literature on developmental disabilities with a focus on parenting, together with an analysis of the trends of research in the field. The paper consisted of a multi-disciplinary and multi-method review. In fact, the review tried to integrate the analysis of the relation between developmental disabilities with a closer look at the scientific contributions to the field across the world. Specifically, the paper integrates a total of 11,315 papers published on almost a century of research (from 1936 to 2020). An initial qualitative analysis on keywords was combined to a subsequent quantitative approach in order to maximize the comprehension of the impact of almost a century of scientific contributions. Specifically, documents were studied with temporal and structural metrics on a scientometric approach. This allowed the exploration of patterns within the literature available on Scopus in a quantitative way. This method not only assessed the importance of single documents within the network. As a matter of fact, the document co-citation analysis used on CiteSpace software provided insight into the relations existing between multiple documents in the field of research. As a result, the leading role of North America in the literature of developmental disabilities and parenting emerged. This was accompanied by the review of the main trends of research within the existing literature.
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Affiliation(s)
- Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Andrea Bonassi
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Mobile and Social Computing Lab, Bruno Kessler Foundation, Trento, Italy
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Giulio Gabrieli
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Peipei Setoh
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Dagmara Dimitriou
- Sleep Research and Education Laboratory, UCL Institute of Education, London, United Kingdom
| | - Vahid Aryadoust
- National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy; Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
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Lin Y, Gu Y, Xu Y, Hou S, Ding R, Ni S. Autistic spectrum traits detection and early screening: A machine learning based eye movement study. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2021; 35:83-92. [PMID: 34432921 DOI: 10.1111/jcap.12346] [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] [Received: 04/29/2021] [Revised: 06/29/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022]
Abstract
PROBLEM Autism spectrum disorders (ASD) are pervasive neurodevelopmental disorders and generally accompanied by social disorders, verbal or nonverbal communication defects, inability to concentrate and other negative symptoms that affect the autistic person's normal life. However, traditional screening methods are time-consuming and public health resources are limited. METHODS This study proposed a novel technique that combined eye-movement data and machine learning algorithms for predicting autistic traits. We converted raw eye movement data into features, trained and tested a model for early screening. FINDINGS In the preliminary experiment, 107 participants (average age = 24.84 ± 5.24 years) wore HTC Vive to watch a VR scene for 15-20 s. We explored eight classification models, among which the ensemble model performed best, with 0.73 accuracy, 0.68 precision, 0.81 recall, 0.74 F1-score, and an area under the curve of 0.90. And in the test experiment, 22 participants (average age = 12.68 ± 7.61 years) diagnosed as ASD took the experiment and the ensemble model showed a recall of 0.77. Eye movement data is an effectively distinguishable tool and we find that the proportion of time to observe figure and animal region continuously can distinguish participants with obvious and unobvious autistic traits effectively in the model. CONCLUSION This study focuses on the detection of autistic traits, and proposes a more objective and faster method for undertaking early screening, which provides possibilities to save precious time to intervene and alleviate its symptoms before making a definite diagnosis.
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Affiliation(s)
- Yiqi Lin
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, Guangdong, China
| | - Yating Gu
- Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, China
| | - Yekai Xu
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, Guangdong, China
| | - Shumeng Hou
- Harbin Institute of Technology at Shenzhen, Shenzhen, Guangdong, China
| | - Ruyi Ding
- Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, China
| | - Shiguang Ni
- Shenzhen International Graduate School, Tsinghua University, Shenzhen, Guangdong, China
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The effectiveness of early parental coaching in the autism spectrum disorder. J Pediatr (Rio J) 2021; 97:453-458. [PMID: 33069667 PMCID: PMC9432305 DOI: 10.1016/j.jped.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/28/2020] [Accepted: 09/01/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Analysis of the effectiveness of early Parental Coaching in the Autism Spectrum Disorder. METHOD Randomized, controlled and blinded clinical trial to analyze parent-child interaction videos. RESULTS The sample consisted of 18 children being followed up at the Autism Outpatient Clinic of a Neuropediatric Center in southern Brazil diagnosed with Autism Spectrum Disorder, between 29 and 42 months of age, randomly allocated to two groups: the Study Group (SG; n=9), which received Parental Coaching performed by a professional certified by the Early Start Denver Model; and the Control Group (CG; n=9), which was in a routine follow-up, without treatment and training of parents by a trained professional. The parents of the SG were willing to attend weekly meetings and to apply the instructional techniques at home with their children. It took 12 weeks and an average of 2h per meeting. CONCLUSIONS The learning rate for comprehensive development skills in the Early Start Denver Model checklist, such as receptive communication, expressive communication, social capacity, imitation, cognition, games, fine motor skills, gross motor skills, behavior, and personal independence was significantly higher in the SG, as well as the strategies and the quality of interaction between parents and children. Thus, Parental Coaching presents as a possibility of early intervention in children with Autism Spectrum Disorder.
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Dale BA, Finch WH, Shellabarger KAR, Davis A. Wechsler Intelligence Scale for Children, Fifth Edition Profiles of Children With Autism Spectrum Disorder Using a Classification and Regression Trees Analysis. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2021. [DOI: 10.1177/07342829211025924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Wechsler Intelligence Scales for Children (WISC) are the most widely used instrument in assessing cognitive ability, especially with children with autism spectrum disorder (ASD). Previous literature on the WISC has demonstrated a divergent pattern of performance on the WISC for children ASD compared to their typically developing peers; however, there is a lack of research concerning the most recent iteration, the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). Due to the distinctive changes made to the WISC-V, we sought to identify the pattern of performance of children with ASD on the WISC-V using a classification and regression (CART) analysis. The current study used the standardization sample data of the WISC-V obtained from NCS Pearson, Inc. Sixty-two children diagnosed with ASD, along with their demographically matched controls, comprised the sample. Results revealed the Comprehension and Letter-Number Sequencing subtests were the most important factors in predicting group membership for children with ASD with an accompanying language impairment. Children with ASD without an accompanying language impairment, however, were difficult to distinguish from matched controls through the CART analysis. Results suggest school psychologists and other clinicians should administer all primary and supplemental subtests of the WISC-V as part of a comprehensive assessment of ASD.
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Affiliation(s)
- Brittany A. Dale
- Department of Special Education, Ball State University, Muncie, IN, USA
| | - W. Holmes Finch
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
| | | | - Andrew Davis
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
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13
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Stenberg N, Schjølberg S, Shic F, Volkmar F, Øyen AS, Bresnahan M, Svendsen BK, von Tetzchner S, Thronæs NT, Macari S, Cicchetti DV, Chawarska K, Suren P, Øien RA. Functional Outcomes of Children Identified Early in the Developmental Period as at Risk for ASD Utilizing the The Norwegian Mother, Father and Child Cohort Study (MoBa). J Autism Dev Disord 2021; 51:922-932. [PMID: 32424708 PMCID: PMC7954713 DOI: 10.1007/s10803-020-04539-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Early identification of autism spectrum disorder (ASD) is regarded as crucial for swift access to early intervention and, subsequently, better outcomes later in life. However, current instruments miss large proportions of children who later go on to be diagnosed with ASD, raising a question of what these instruments measure. The present study utilized data from the Norwegian Mother, Father, and Child Cohort Study and the Autism Birth Cohort study to explore the subsequent developmental and diagnostic characteristics of children raising developmental concern on the six-critical discriminative item criterion of the M-CHAT (DFA6) at 18 months of age (N = 834). The DFA6 identified 28.8% of children diagnosed with ASD (N = 163), but 4.4% with language disorder (N = 188) and 81.3% with intellectual disability (N = 32) without ASD. Scoring in the «at-risk» range was associated with lower IQ, impaired functional language, and greater severity of autism symptoms whether children had ASD or not.
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Affiliation(s)
| | | | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Fred Volkmar
- School of Medicine, Child Study Center, Yale University, New Haven, USA
| | - Anne-Siri Øyen
- Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Hospital, Oslo, Norway
| | | | | | | | - Nina Torheim Thronæs
- Department of Education, UiT - The Arctic University of Norway, PB 6050, 9037, Tromsø, Norway
| | - Suzanne Macari
- School of Medicine, Child Study Center, Yale University, New Haven, USA
| | | | | | - Pål Suren
- Norwegian Institute of Public Health, Oslo, Norway
| | - Roald A Øien
- Department of Education, UiT - The Arctic University of Norway, PB 6050, 9037, Tromsø, Norway.
- School of Medicine, Child Study Center, Yale University, New Haven, USA.
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14
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Allison C, Matthews FE, Ruta L, Pasco G, Soufer R, Brayne C, Charman T, Baron-Cohen S. Quantitative Checklist for Autism in Toddlers (Q-CHAT). A population screening study with follow-up: the case for multiple time-point screening for autism. BMJ Paediatr Open 2021; 5:e000700. [PMID: 34131593 PMCID: PMC8166626 DOI: 10.1136/bmjpo-2020-000700] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/22/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This is a prospective population screening study for autism in toddlers aged 18-30 months old using the Quantitative Checklist for Autism in Toddlers (Q-CHAT), with follow-up at age 4. DESIGN Observational study. SETTING Luton, Bedfordshire and Cambridgeshire in the UK. PARTICIPANTS 13 070 toddlers registered on the Child Health Surveillance Database between March 2008 and April 2009, with follow-up at age 4; 3770 (29%) were screened for autism at 18-30 months using the Q-CHAT and the Childhood Autism Spectrum Test (CAST) at follow-up at age 4. INTERVENTIONS A stratified sample across the Q-CHAT score distribution was invited for diagnostic assessment (phase 1). The 4-year follow-up included the CAST and the Checklist for Referral (CFR). All with CAST ≥15, phase 1 diagnostic assessment or with developmental concerns on the CFR were invited for diagnostic assessment (phase 2). Standardised diagnostic assessment at both time-points was conducted to establish the test accuracy of the Q-CHAT. MAIN OUTCOME MEASURES Consensus diagnostic outcome at phase 1 and phase 2. RESULTS At phase 1, 3770 Q-CHATs were returned (29% response) and 121 undertook diagnostic assessment, of whom 11 met the criteria for autism. All 11 screened positive on the Q-CHAT. The positive predictive value (PPV) at a cut-point of 39 was 17% (95% CI 8% to 31%). At phase 2, 2005 of 3472 CASTs and CFRs were returned (58% response). 159 underwent diagnostic assessment, including 82 assessed in phase 1. All children meeting the criteria for autism identified via the Q-CHAT at phase 1 also met the criteria at phase 2. The PPV was 28% (95% CI 15% to 46%) after phase 1 and phase 2. CONCLUSIONS The Q-CHAT can be used at 18-30 months to identify autism and enable accelerated referral for diagnostic assessment. The low PPV suggests that for every true positive there would, however, be ~4-5 false positives. At follow-up, new cases were identified, illustrating the need for continued surveillance and rescreening at multiple time-points using developmentally sensitive instruments. Not all children who later receive a diagnosis of autism are detectable during the toddler period.
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Affiliation(s)
- Carrie Allison
- Psychiatry Department, Autism Research Centre, University of Cambridge, Cambridge, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Liliana Ruta
- Institute for Biomedical Research and Innovation (IRIB) - National Research Council of Italy (CNR), Messina, Italy
| | - Greg Pasco
- Dept of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Renee Soufer
- Psychiatry Department, Autism Research Centre, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Tony Charman
- Dept of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Simon Baron-Cohen
- Psychiatry Department, Autism Research Centre, University of Cambridge, Cambridge, UK
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15
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Brewer N, Young RL, Lucas CA. Autism Screening in Early Childhood: Discriminating Autism From Other Developmental Concerns. Front Neurol 2020; 11:594381. [PMID: 33362696 PMCID: PMC7758341 DOI: 10.3389/fneur.2020.594381] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/23/2020] [Indexed: 12/27/2022] Open
Abstract
Early identification of autism, followed by appropriate intervention, has the potential to improve outcomes for autistic individuals. Numerous screening instruments have been developed for children under 3 years of age. Level 1 screeners are used in large-scale screening to detect at-risk children in the general population; Level 2 screeners are concerned with distinguishing children with signs of autism from those with other developmental problems. The focus here is evaluation of Level 2 screeners. However, given the contributions of Level 1 screeners and the necessity to understand how they might interface with Level 2 screeners, we briefly review Level 1 screeners and consider instrument characteristics and system variables that may constrain their effectiveness. The examination of Level 2 screeners focuses on five instruments associated with published evaluations in peer-reviewed journals. Key criteria encompass the traditional indices of test integrity such as test reliability (inter-rater, test-retest) and construct validity, including concurrent and predictive validity, sensitivity (SE), and specificity (SP). These evaluations reveal limitations, including inadequate sample sizes, reliability issues, and limited involvement of independent researchers. Also lacking are comparative test evaluations under standardized conditions, hindering interpretation of differences in discriminative performance across instruments. Practical considerations constraining the use of such instruments—such as the requirements for training in test administration and test administration time—are canvassed. Published Level 2 screener short forms are reviewed and, as a consequence of that evaluation, future directions for assessing the discriminative capacity of items and measures are suggested. Suggested priorities for future research include targeting large and diverse samples to permit robust appraisals of Level 2 items and scales across the 12–36 month age range, a greater focus on precise operationalization of items and response coding to enhance reliability, ongoing exploration of potentially discriminating items at the younger end of the targeted age range, and trying to unravel the complexities of developmental trajectories in autistic infants. Finally, we emphasize the importance of understanding how screening efficacy is dependent on clinicians' and researchers' ability not only to develop screening tests but also to negotiate the complex organizational systems within which screening procedures must be implemented.
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Affiliation(s)
- Neil Brewer
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
| | - Robyn L Young
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
| | - Carmen A Lucas
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
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16
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Lai M, Lee J, Chiu S, Charm J, So WY, Yuen FP, Kwok C, Tsoi J, Lin Y, Zee B. A machine learning approach for retinal images analysis as an objective screening method for children with autism spectrum disorder. EClinicalMedicine 2020; 28:100588. [PMID: 33294809 PMCID: PMC7700906 DOI: 10.1016/j.eclinm.2020.100588] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 09/17/2020] [Accepted: 09/24/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is characterised by many of features including problem in social interactions, different ways of learning, some children showing a keen interest in specific subjects, inclination to routines, challenges in typical communication, and particular ways of processing sensory information. Early intervention and suitable supports for these children may make a significant contribution to their development. However, considerable difficulties have been encountered in the screening and diagnosis of ASD. The literature has indicated that certain retinal features are significantly associated with ASD. In this study, we investigated the use of machine learning approaches on retinal images to further enhance the classification accuracy. METHODS Forty-six ASD participants were recruited from three special needs schools and 24 normal control were recruited from the community. Among them, 23 age-gender matched ASD and normal control participant-pairs were constructed for the primary analysis. All retinal images were captured using a nonmydriatic fundus camera. Automatic retinal image analysis (ARIA) methodology applying machine-learning technology was used to optimise the information of the retina to develop a classification model for ASD. The model's validity was then assessed using a 10-fold cross-validation approach to assess its validity. FINDINGS The sensitivity and specificity were 95.7% (95% CI 76.0%, 99.8%) and 91.3% (95% CI 70.5%, 98.5%) respectively. The area under the ROC curve was 0.974 (95% CI 0.934, 1.000); however, it was noted that the specificity for female participants might not be as high as that for male participants. INTERPRETATION Because ARIA is a fully automatic cloud-based algorithm and relies only on retinal images, it can be used as a risk assessment tool for ASD screening. Further diagnosis and confirmation can then be made by professionals, and potential treatment may be provided at a relatively early stage.
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Affiliation(s)
- Maria Lai
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Jack Lee
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | | | | | - Wing Yee So
- The Jockey Club Hong Chi School, Wan Chai, Hong Kong SAR
| | - Fung Ping Yuen
- The Hong Chi Morninghill School, Tuen Mun, Hong Kong SAR
| | - Chloe Kwok
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Jasmine Tsoi
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yuqi Lin
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Benny Zee
- Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
- Clinical Trials and Biostatistics Lab, CUHK Shenzhen Research Institute, Shenzhen, China
- Corresponding author at: Centre for Clinical Research and Biostatistics, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR
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17
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Tang C, Zheng W, Zong Y, Qiu N, Lu C, Zhang X, Ke X, Guan C. Automatic Identification of High-Risk Autism Spectrum Disorder: A Feasibility Study Using Video and Audio Data Under the Still-Face Paradigm. IEEE Trans Neural Syst Rehabil Eng 2020; 28:2401-2410. [PMID: 32991285 DOI: 10.1109/tnsre.2020.3027756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
It is reported that the symptoms of autism spectrum disorder (ASD) could be improved by effective early interventions, which arouses an urgent need for large-scale early identification of ASD. Until now, the screening of ASD has relied on the child psychiatrist to collect medical history and conduct behavioral observations with the help of psychological assessment tools. Such screening measures inevitably have some disadvantages, including strong subjectivity, relying on experts and low-efficiency. With the development of computer science, it is possible to realize a computer-aided screening for ASD and alleviate the disadvantages of manual evaluation. In this study, we propose a behavior-based automated screening method to identify high-risk ASD (HR-ASD) for babies aged 8-24 months. The still-face paradigm (SFP) was used to elicit baby's spontaneous social behavior through a face-to-face interaction, in which a mother was required to maintain a normal interaction to amuse her baby for 2 minutes (a baseline episode) and then suddenly change to the no-reaction and no-expression status with 1 minute (a still-face episode). Here, multiple cues derived from baby's social stress response behavior during the latter episode, including head-movements, facial expressions and vocal characteristics, were statistically analyzed between HR-ASD and typical developmental (TD) groups. An automated identification model of HR-ASD was constructed based on these multi-cue features and the support vector machine (SVM) classifier; moreover, its screening performance was satisfied, for all the accuracy, specificity and sensitivity exceeded 90% on the cases included in this study. The experimental results suggest its feasibility in the early screening of HR-ASD.
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18
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Geng X, Kang X, Wong PCM. Autism spectrum disorder risk prediction: A systematic review of behavioral and neural investigations. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2020; 173:91-137. [PMID: 32711819 DOI: 10.1016/bs.pmbts.2020.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
A reliable diagnosis of autism spectrum disorder (ASD) is difficult to make until after toddlerhood. Detection in an earlier age enables early intervention, which is typically more effective. Recent studies of the development of brain and behavior in infants and toddlers have provided important insights in the diagnosis of autism. This extensive review focuses on published studies of predicting the diagnosis of autism during infancy and toddlerhood younger than 3 years using behavioral and neuroimaging approaches. After screening a total of 782 papers, 17 neuroimaging and 43 behavioral studies were reviewed. The features for prediction consist of behavioral measures using screening tools, observational and experimental methods, brain volumetric measures, and neural functional activation and connectivity patterns. The classification approaches include logistic regression, linear discriminant function, decision trees, support vector machine, and deep learning based methods. Prediction performance has large variance across different studies. For behavioral studies, the sensitivity varies from 20% to 100%, and specificity ranges from 48% to 100%. The accuracy rates range from 61% to 94% in neuroimaging studies. Possible factors contributing to this inconsistency may be partially due to the heterogeneity of ASD, different targeted populations (i.e., high-risk group for ASD and general population), age when the features were collected, and validation procedures. The translation to clinical practice requires extensive further research including external validation with large sample size and optimized feature selection. The use of multi-modal features, e.g., combination of neuroimaging and behavior, is worth further investigation to improve the prediction accuracy.
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Affiliation(s)
- Xiujuan Geng
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Xin Kang
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong; Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Patrick C M Wong
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong; Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Shatin, Hong Kong; Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
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19
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Levy SE, Wolfe A, Coury D, Duby J, Farmer J, Schor E, Van Cleave J, Warren Z. Screening Tools for Autism Spectrum Disorder in Primary Care: A Systematic Evidence Review. Pediatrics 2020; 145:S47-S59. [PMID: 32238531 DOI: 10.1542/peds.2019-1895h] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Recommendations conflict regarding universal application of formal screening instruments in primary care (PC) and PC-like settings for autism spectrum disorder (ASD). OBJECTIVES We systematically reviewed evidence for universal screening of children for ASD in PC. DATA SOURCES We searched Medline, PsychInfo, Educational Resources Informational Clearinghouse, and Cumulative Index of Nursing and Allied Health Literature. STUDY SELECTION We included studies in which researchers report psychometric properties of screening tools in unselected populations across PC and PC-like settings. DATA EXTRACTION At least 2 authors reviewed each study, extracted data, checked accuracy, and assigned quality ratings using predefined criteria. RESULTS We found evidence for moderate to high positive predictive values for ASD screening tools to identify children aged 16 to 40 months and 1 study for ≥48 months in PC and PC-like settings. Limited evidence evaluating sensitivity, specificity, and negative predictive value of instruments was available. No studies directly evaluated the impact of screening on treatment or harm. LIMITATIONS Potential limitations include publication bias, selective reporting within studies, and a constrained search. CONCLUSIONS ASD screening tools can be used to accurately identify percentages of unselected populations of young children for ASD in PC and PC-like settings. The scope of challenges associated with establishing direct linkage suggests that clinical and policy groups will likely continue to guide screening practices. ASD is a common neurodevelopmental disorder associated with significant life span costs.1,2 Growing evidence supports functional gains and improved outcomes for young children receiving intensive intervention, so early identification on a population level is a pressing public health challenge.3,4.
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Affiliation(s)
- Susan E Levy
- Center for Autism Research, Department of Pediatrics, The Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Audrey Wolfe
- Spaulding Rehabilitation Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Daniel Coury
- Autism Intervention Research Network on Physical Health and Autism Treatment Network, MassGeneral Hospital for Children, Boston, Massachusetts.,Department of Pediatrics, Nationwide Children's Hospital and School of Medicine, The Ohio State University, Columbus, Ohio
| | - John Duby
- Department of Pediatrics, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Justin Farmer
- Autism Intervention Research Network on Physical Health and Autism Treatment Network, MassGeneral Hospital for Children, Boston, Massachusetts
| | - Edward Schor
- Lucille Packard Foundation for Children's Health, Palo Alto, California
| | - Jeanne Van Cleave
- General Pediatrics, Children's Hospital Colorado and University of Colorado Anshutz Medical Campus, Aurora, Colorado; and
| | - Zachary Warren
- Vanderbilt Kennedy Center Treatment and Research Institute for Autism Spectrum Disorders, Departments of Pediatrics, Psychiatry, and Special Education, Vanderbilt University, Nashville, Tennessee
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20
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Bjørk M, Riedel B, Spigset O, Veiby G, Kolstad E, Daltveit AK, Gilhus NE. Association of Folic Acid Supplementation During Pregnancy With the Risk of Autistic Traits in Children Exposed to Antiepileptic Drugs In Utero. JAMA Neurol 2019; 75:160-168. [PMID: 29279889 DOI: 10.1001/jamaneurol.2017.3897] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Importance Strategies to prevent autism in children exposed to antiepileptic drugs (AEDs) during pregnancy are important. Objective To explore whether folic acid supplementation and folate status in pregnancy are associated with reduced risk of autistic traits owing to in utero AED exposure. Design, Setting, and Participants The population-based, prospective Norwegian Mother and Child Cohort Study approached Norwegian-speaking women attending routine ultrasonographic examinations from June 1999 through December 31, 2008 (163 844 of 277 702 women refused). No exclusion criteria were applied beyond language. Questionnaires during and after pregnancy, analysis of blood samples, and linkage to the Medical Birth Registry of Norway were performed. Children aged 18 to 36 months of women with available information on use of AEDs and of folic acid supplementation (n = 104 946) were included in the analysis from March 1, 2016, through June 13, 2017. Exposures Maternal folic acid supplementation 4 weeks before to 12 weeks after conception. Plasma folate concentration was analyzed at gestational weeks 17 to 19. Main Outcomes and Measures Autistic traits were evaluated using the Modified Checklist for Autism in Toddlers and Social Communication Questionnaire. Odds ratios (ORs) for autistic traits in children by maternal use vs nonuse of folic acid supplements were adjusted for maternal health and socioeconomic factors. Folate concentrations and folic acid doses were associated with the degree of autistic traits. Results The overall mean (SD) age of the 104 946 mothers of participating children was 29.8 (4.6) years, with complete information available for analysis in 103 868. Mean (SD) age of women with epilepsy who received AED treatment was 29.4 (4.9); women with epilepsy who did not receive AED treatment, 29.1 (4.9); and without epilepsy, 29.8 (4.6) years. In the 335 children exposed to AEDs, the risk for autistic traits was significantly higher at 18 months of age (adjusted OR [AOR], 5.9; 95% CI, 2.2-15.8) and 36 months of age (AOR, 7.9; 95% CI, 2.5-24.9) when their mothers had not used folic acid supplements compared with children of mothers who had used supplements. Among women without epilepsy, the corresponding risks were lower at 18 months of age (AOR, 1.3; 95% CI, 1.2-1.4) and 36 months of age (AOR, 1.7; 95% CI, 1.5-1.9); among the 389 children of women with untreated epilepsy, the corresponding risks were not significant at 18 months of age (AOR, 1.0; 95% CI, 0.4-3.0) and 36 months of age (AOR, 2.5; 95% CI, 0.4-16.6). Degree of autistic traits was inversely associated with maternal plasma folate concentrations (β = -0.3; P = .03) and folic acid doses (β = -0.5; P < .001). Concentrations of AEDs were not associated with the degree of autistic traits. Conclusions and Relevance Risk of autistic traits in children exposed to AEDs in utero may be mitigated by periconceptional folic acid supplementation and folate status. Fertile women using AEDs should take folic acid supplements continuously.
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Affiliation(s)
- Marte Bjørk
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Bettina Riedel
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Laboratory of Clinical Biochemistry, Section of Clinical Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Olav Spigset
- Department of Clinical Pharmacology, St Olav University Hospital, Trondheim, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gyri Veiby
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Eivind Kolstad
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Anne Kjersti Daltveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Nils Erik Gilhus
- Department of Clinical Medicine, University of Bergen, Bergen, Norway.,Department of Neurology, Haukeland University Hospital, Bergen, Norway
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21
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Sánchez-García AB, Galindo-Villardón P, Nieto-Librero AB, Martín-Rodero H, Robins DL. Toddler Screening for Autism Spectrum Disorder: A Meta-Analysis of Diagnostic Accuracy. J Autism Dev Disord 2019; 49:1837-1852. [PMID: 30617550 PMCID: PMC6483963 DOI: 10.1007/s10803-018-03865-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Great efforts focus on early detection of autism spectrum disorder, although some scientists and policy-makers have questioned early universal screening. The aim of this meta-analysis was to evaluate the diagnostic accuracy of the different screening tools. Several electronic databases were used to identify published studies. A Bayesian model was used to estimate the screening accuracy. The pooled sensitivity was 0.72 (95% CI 0.61–0.81), and the specificity was 0.98 (95% CI 0.97–0.99). Subgroup analyses to remove heterogeneity indicated sensitivity was 0.77 (95% CI 0.69–0.84), and specificity was 0.99 (95% CI 0.97–0.99; SD ≤ 0.01). Level 1 screening tools for ASD showed consistent statistically significant results and therefore are adequate to detect autism at 14–36 months.
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Affiliation(s)
| | | | - Ana B Nieto-Librero
- IBSAL-University of Salamanca, C/ Alfonso X El Sabio s/n, 37007, Salamanca, Spain
| | - Helena Martín-Rodero
- Medical School Library, University of Salamanca, C/ Alfonso X El Sabio s/n, 37007, Salamanca, Spain
| | - Diana L Robins
- AJ Drexel Autism Institute, 3020 Market Street, Suite 560, Philadelphia, PA, 19104-3734, USA
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22
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The Feasibility and Validity of Autism Spectrum Disorder Screening Instrument: Behavior Development Screening for Toddlers (BeDevel)—A Pilot Study. Autism Res 2019; 12:1112-1128. [DOI: 10.1002/aur.2117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 03/20/2019] [Accepted: 04/21/2019] [Indexed: 11/07/2022]
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23
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Can autism be catered with artificial intelligence-assisted intervention technology? A comprehensive survey. Artif Intell Rev 2019. [DOI: 10.1007/s10462-019-09686-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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24
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Marlow M, Servili C, Tomlinson M. A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries. Autism Res 2019; 12:176-199. [DOI: 10.1002/aur.2033] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 06/08/2018] [Accepted: 06/27/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Marguerite Marlow
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
| | - Chiara Servili
- Department of Mental Health and Substance Abuse; World Health Organization; Geneva Switzerland
| | - Mark Tomlinson
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
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Ruta L, Chiarotti F, Arduino GM, Apicella F, Leonardi E, Maggio R, Carrozza C, Chericoni N, Costanzo V, Turco N, Tartarisco G, Gagliano A, Allison C, Baron Cohen S, Pioggia G, Muratori F. Validation of the Quantitative Checklist for Autism in Toddlers in an Italian Clinical Sample of Young Children With Autism and Other Developmental Disorders. Front Psychiatry 2019; 10:488. [PMID: 31427993 PMCID: PMC6690232 DOI: 10.3389/fpsyt.2019.00488] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 06/21/2019] [Indexed: 12/19/2022] Open
Abstract
Background: The Quantitative Checklist for Autism in Toddlers (Q-CHAT) is parent-report screening questionnaire for detecting threshold and sub-threshold autistic features in toddlers. The Q-CHAT is a dimensional measure normally distributed in the general population sample and is able to differentiate between a group of children with a diagnosis of autism and unselected toddlers. Objectives: We aim to investigate the psychometric properties, score distribution, and external validity of the Q-CHAT in an Italian clinical sample of young children with autism versus children with developmental delay and typically developing children. Method: N = 126 typically developing children (TD), n = 139 children with autism, and n = 50 children presenting developmental delay (DD) were administered the Q-CHAT. Standardized measures of cognitive functions, language, and behaviors were also obtained. Results: The Q-CHAT scores were normally distributed and demonstrated adequate internal consistency and good item to total score correlations. The mean Q-CHAT score in the autism group was significantly higher than those found in the DD sample and TD children. No difference on the mean Q-CHAT score between DD and TD children was found. The accuracy of the Q-CHAT to discriminate between autism and TD was very good. Two different cut-points (27 and 31, respectively) maximized sensitivity and specificity for autism versus TD and DD, respectively. Finally, higher Q-CHAT scores were correlated with lower language and social communication skills. Conclusions: In clinical settings, the Q-CHAT demonstrated good psychometric properties and external validity to discriminate autism children not just from children with typical development but also from children with developmental delay.
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Affiliation(s)
- Liliana Ruta
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Messina, Italy.,Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - Flavia Chiarotti
- Center for Behavioral Sciences and Mental Health, National Institute of Health, Rome, Italy
| | | | - Fabio Apicella
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - Elisa Leonardi
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Messina, Italy
| | | | - Cristina Carrozza
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Messina, Italy
| | - Natasha Chericoni
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - Valeria Costanzo
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy
| | - Nazarena Turco
- Centro Autismo e Sindrome di Asperger ASLCN1, Mondovì, Italy
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Messina, Italy
| | | | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Simon Baron Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Messina, Italy
| | - Filippo Muratori
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Pisa, Italy.,University of Pisa, Pisa, Italy
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Pacione SM, Pathak A, Patel S, Tremblay L, Welsh TN. Body schema activation for self-other matching in youth. COGNITIVE DEVELOPMENT 2018. [DOI: 10.1016/j.cogdev.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Li C, Zhu G, Feng J, Xu Q, Zhou Z, Zhou B, Hu C, Liu C, Li H, Wang Y, Yan W, Ge X, Xu X. Improving the early screening procedure for autism spectrum disorder in young children: Experience from a community‐based model in shanghai. Autism Res 2018; 11:1206-1217. [PMID: 30230702 DOI: 10.1002/aur.1984] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/19/2018] [Accepted: 06/08/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Chunyang Li
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Guowei Zhu
- Department of Child Healthcare Xuhui District Maternal and Child Healthcare Hospital Xuhui District Shanghai China
| | - Jingjing Feng
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Qiong Xu
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Zhaoe Zhou
- Department of Child Healthcare Xuhui District Maternal and Child Healthcare Hospital Xuhui District Shanghai China
| | - Bingrui Zhou
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Chunchun Hu
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Chunxue Liu
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Huiping Li
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
| | - Yi Wang
- Department of Neurology Children's Hospital of Fudan University Shanghai China
| | - Weili Yan
- Department of Clinical Epidemiology Children's Hospital of Fudan University Shanghai China
| | - Xiaoling Ge
- Department of Information Children's Hospital of Fudan University Shanghai China
| | - Xiu Xu
- Department of Child Healthcare Children's Hospital of Fudan University Shanghai
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28
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Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2018; 40:367-375. [PMID: 30270970 DOI: 10.1007/s10862-018-9642-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II). Detailed developmental and medical history was obtained from all participants. Diagnosis was based on clinical consensus of at least two expert clinicians, using test results, clinical observations, and parent report. 23% of participants with a reported community diagnosis of ASD were classified as non-spectrum based on our consensus diagnosis. ASD and non-spectrum participants did not differ on age at evaluation and age of first community diagnosis. Non-verbal IQ scores and Adaptive Behavior Composite scores were significantly higher in the non-spectrum group compared to the ASD group (104.5 ± 21.7 vs. 80.1 ± 21.6, p < .01; 71.1 ± 15 versus 79.5 ± 17.6, p < .05, respectively). Participants enrolled with community diagnosis of PDD-NOS were significantly more likely to be classified as non-spectrum on the study consensus diagnosis than Participants with Autism or Asperger (36% versus 9.5%, Odds Ratio = 5.4, p < .05). This study shows suboptimal agreement between community diagnoses of ASD and consensus diagnosis using standardized instruments. These findings are based on limited data, and should be further studied, taking into consideration the influence of DSM 5 diagnostic criteria on ASD prevalence.
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Hirota T, So R, Kim YS, Leventhal B, Epstein RA. A systematic review of screening tools in non-young children and adults for autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 80:1-12. [PMID: 29879612 DOI: 10.1016/j.ridd.2018.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 05/21/2018] [Accepted: 05/26/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Existing reviews of screening tools for Autism Spectrum Disorder (ASD) focus on young children, and not all screening tools have been examined against validated diagnostic procedures. AIMS To examine the validity of screening tools for ASD in non-young children and adults to provide clinical recommendations about the use of these tools in a variety of clinical settings. METHODS AND PROCEDURES Electronic databases, including MEDLINE, EMBASE, PsychINFO, Cochrane Library and CINAHL, were searched through March 2017. Studies examining the validity of ASD screening tools against the Autism Diagnostic Observation Schedule and/or the Autism Diagnostic Interview - Revised in non-young children (age 4 or above) and adults were included. Three authors independently reviewed each article for data extraction and quality assessment. OUTCOMES AND RESULTS 14 studies met the inclusion criteria, of which 11 studies were with children (4-18 years of age) and 3 studies included adults only (19 years of age and above). Included studies were conducted in a general population/low-risk sample (N = 3) and a clinically referred/high-risk sample (N = 11). In total 11 tools were included. CONCLUSIONS AND IMPLICATIONS Only three screening tools (the Autism-Spectrum Quotient, the Social Communication Questionnaire, and the Social Responsiveness Scale) were examined in more than 2 studies. These tools may assist in differentiating ASD from other neurodevelopmental and psychiatric disorders or typically developed children. In young adult populations, the paucity of the existing research in this group limits definitive conclusion and recommendations.
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Affiliation(s)
- Tomoya Hirota
- Child and Adolescent Psychiatry, Department of Psychiatry, Langley Porter Psychiatric Institute, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Ryuhei So
- Department of Psychiatry, Okayama Psychiatric Medical Center, 3-16 Shikatahonmachi, Kita-ward, Okayama, Okayama, 700-0915, Japan; Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Young Shin Kim
- Child and Adolescent Psychiatry, Department of Psychiatry, Langley Porter Psychiatric Institute, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Bennett Leventhal
- Child and Adolescent Psychiatry, Department of Psychiatry, Langley Porter Psychiatric Institute, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Richard A Epstein
- Chapin Hall Center for Children at the University of Chicago, 1313 E 60th St., Chicago, IL, 60637, USA
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30
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Sturner R, Howard B, Bergmann P, Morrel T, Landa R, Walton K, Marks D. Accurate Autism Screening at the 18-Month Well-Child Visit Requires Different Strategies than at 24 Months. J Autism Dev Disord 2018; 47:3296-3310. [PMID: 28762159 DOI: 10.1007/s10803-017-3231-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Accuracy of autism screening using M-CHAT plus the follow-up interview (M-CHAT/F) for children screened positive at 18-months was compared to screening at 24-months. Formal ASD testing was criterion for a community sample of M-CHAT positive children (n = 98), positive predictive value (PPV) was 0.40 for the M-CHAT and 0.58 for the M-CHAT/F. MCHAT/F PPV was 0.69 among children 20+ months compared to 0.36 for <20 months. Multivariate analyses incorporating data from the Ages and Stages Questionnaire, MacArthur-Bates Communicative Development Inventory, M-CHAT and M-CHAT/F results, and M-CHAT items suggest language variables carry greatest relative importance in contributing to an age-based algorithm with potential to improve PPV for toddlers <20 months to the same level as observed in older toddlers.
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Affiliation(s)
- Raymond Sturner
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA. .,Center for Promotion of Child Development through Primary Care, Baltimore, MD, 21210, USA. .,, 6017 Altamont Place, Baltimore, MD, 21210, USA.
| | - Barbara Howard
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.,Total Child Health, Baltimore, MD, 21210, USA
| | - Paul Bergmann
- Foresight Logic, Inc., Saint Paul, MN, USA.,PrairieCare Institute, Minneapolis, MN, USA
| | | | - Rebecca Landa
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.,Kennedy Krieger Institute, Baltimore, MD, 21287, USA
| | - Kejuana Walton
- Total Child Health, Baltimore, MD, 21210, USA.,Baltimore Healthy Start, Baltimore, MD, 21218, USA
| | - Danielle Marks
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.,Sinai Hospital, Baltimore, MD, 21215, USA.,Maternal and Child Health Unit, Public Health Division, Wyoming Department of Health, Evanston, WY, USA
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31
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Murphy D, Glaser K, Hayward H, Eklund H, Cadman T, Findon J, Woodhouse E, Ashwood K, Beecham J, Bolton P, McEwen F, Wilson E, Ecker C, Wong I, Simonoff E, Russell A, McCarthy J, Chaplin E, Young S, Asherson P. Crossing the divide: a longitudinal study of effective treatments for people with autism and attention deficit hyperactivity disorder across the lifespan. PROGRAMME GRANTS FOR APPLIED RESEARCH 2018. [DOI: 10.3310/pgfar06020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BackgroundAutism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) frequently persist into adolescence and young adulthood. However, there are few clinical services that support those with these disorders through adulthood.ObjectiveOur aim was to determine if clinical services meet the needs of people with ASD and ADHD, who are ‘at transition’ from childhood to adulthood.DesignA longitudinal study of individuals with ASD and ADHD, the impact of services and treatments.MethodsOur research methods included (1) interviewing > 180 affected individuals (and their families) with a confirmed diagnosis of ASD and/or ADHD, (2) screening for ASD and ADHD in approximately 1600 patients and (3) surveying general practitioner prescribing to 5651 ASD individuals across the UK. In addition, we tested the effectiveness of (1) new ASD diagnostic interview measures in 169 twins, 145 familes and 150 non-twins, (2) a magnetic resonance imaging-based diagnostic aid in 40 ASD individuals, (3) psychological treatments in 46 ASD individuals and (4) the feasability of e-learning in 28 clinicians.SettingNHS clinical services and prisons.ParticipantsFocus – young people with ASD and ADHD as they ‘transition’ from childhood and adolescence into early adulthood.InterventionsTesting the utility of diagnostic measures and services, web-based learning interventions, pharmacological prescribing and cognitive–behavioural treatments.Main outcome measuresSymptom severity, service provision and met/unmet need.ResultsPeople with ASD and ADHD have very significant unmet needs as they transition through adolescence and young adulthood. A major contributor to this is the presence of associated mental health symptoms. However, these are mostly undiagnosed (and untreated) by clinical services. Furthermore, the largest determinant of service provision was age and not severity of symptoms. We provide new tools to help diagnose both the core disorders and their associated symptoms. We also provide proof of concept for the effectiveness of simple psychological interventions to treat obsessional symptoms, the potential to run treatment trials in prisons and training interventions.LimitationsOur findings only apply to clinical service settings.ConclusionsAs individuals ‘transition’ their contact with treatment and support services reduces significantly. Needs-led services are required, which can both identify individuals with the ‘core symptoms’ of ASD and ADHD and treat their residual symptoms and associated conditions.Future workTo test our new diagnostic measures and treatment approaches in larger controlled trials.Trial registrationCurrent Controlled Trials ISRCTN87114880.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Declan Murphy
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Karen Glaser
- Institute of Gerontology, King’s College London, London, UK
| | - Hannah Hayward
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Hanna Eklund
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Tim Cadman
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - James Findon
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Emma Woodhouse
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | - Karen Ashwood
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
| | | | - Patrick Bolton
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Fiona McEwen
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Ellie Wilson
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Christine Ecker
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Ian Wong
- Department of Pharmacology and Pharmacy, University of Hong Kong, PokFuLam, Hong Kong
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King’s College London, London, UK
| | - Ailsa Russell
- Department of Psychology, University of Bath, Bath, UK
| | | | - Eddie Chaplin
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Susan Young
- Sackler Institute for Translational Neurodevelopment and Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
| | - Philip Asherson
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK
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Ammons CJ, Doss CF, Bala D, Kana RK. Brain Responses Underlying Anthropomorphism, Agency, and Social Attribution in Autism Spectrum Disorder. Open Neuroimag J 2018; 12:16-29. [PMID: 29682095 PMCID: PMC5885471 DOI: 10.2174/1874440001812010016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/27/2018] [Accepted: 03/03/2018] [Indexed: 02/03/2023] Open
Abstract
Background: Theory of Mind (ToM), the ability to attribute mental states to oneself and others, is frequently impaired in Autism Spectrum Disorder (ASD) and may result from altered activation of social brain regions. Conversely, Typically Developing (TD) individuals overextend ToM and show a strong tendency to anthropomorphize and interpret biological motion in the environment. Less is known about how the degree of anthropomorphism influences intentional attribution and engagement of the social brain in ASD. Objective: This fMRI study examines the extent of anthropomorphism, its role in social attribution, and the underlying neural responses in ASD and TD using a series of human stick figures and geometrical shapes. Methods: 14 ASD and 14 TD adults watched videos of stick figures and triangles interacting in random or socially meaningful ways while in an fMRI scanner. In addition, they completed out-of-scanner measures of ToM skill and real-world social deficits. Whole brain statistical analysis was performed for regression and within and between group comparisons of all conditions using SPM12’s implementation of the general linear model. Results: ToM network regions were activated in response to social movement and human-like characters in ASD and TD. In addition, greater ToM ability was associated with increased TPJ and MPFC activity while watching stick figures; whereas more severe social symptoms were associated with reduced right TPJ activation in response to social movement. Conclusion: These results suggest that degree of anthropomorphism does not differentially affect social attribution in ASD and highlights the importance of TPJ in ToM and social attribution.
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Affiliation(s)
- Carla J Ammons
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Constance F Doss
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Bala
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajesh K Kana
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
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33
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Vietze P, Lax LE. Early Intervention ABA for Toddlers with ASD: Effect of Age and Amount. CURRENT PSYCHOLOGY 2018. [DOI: 10.1007/s12144-018-9812-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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34
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Evidence of Validity of the Autism Mental Status Examination (AMSE) in a Brazilian Sample. J Autism Dev Disord 2018. [DOI: 10.1007/s10803-018-3530-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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35
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Topçu S, Ulukol B, Öner Ö, Şimşek Orhon F, Başkan S. Comparison of tidos with m-chat for screening autism spectrum disorder. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2017.1422682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Seda Topçu
- Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Betül Ulukol
- Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Özgür Öner
- Department of Child and Adolescent Psychiatry, Bahçeşehir University, İstanbul, Turkey
| | - Filiz Şimşek Orhon
- Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Sevgi Başkan
- Division of Social Pediatrics, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
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36
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Abstract
Asperger syndrome is an uncommon condition, but probably more common than classic autism (the only published population study estimated prevalence at 36 per 10 000 children for Asperger syndrome and 5 per 10 000 for autism (Ehlers & Gillberg, 1993)). Misdiagnosis or delayed diagnosis of this disorder is a serious problem, and the average age at diagnosis is several years later than for autism (Gillberg, 1989). Obviously, this can be traumatic for individuals and families; furthermore, the most effective intervention programmes begin early, and establishing management strategies at an early age can minimise later behavioural problems (Howlin, 1998).
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37
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Olliac B, Crespin G, Laznik MC, Cherif Idrissi El Ganouni O, Sarradet JL, Bauby C, Dandres AM, Ruiz E, Bursztejn C, Xavier J, Falissard B, Bodeau N, Cohen D, Saint-Georges C. Infant and dyadic assessment in early community-based screening for autism spectrum disorder with the PREAUT grid. PLoS One 2017; 12:e0188831. [PMID: 29216234 PMCID: PMC5720624 DOI: 10.1371/journal.pone.0188831] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/14/2017] [Indexed: 12/04/2022] Open
Abstract
Background The need for early treatment of autism spectrum disorders (ASD) necessitates early screening. Very few tools have been prospectively tested with infants of less than 12 months of age. The PREAUT grid is based on dyadic assessment through interaction and shared emotion and showed good metrics for predicting ASD in very-high-risk infants with West syndrome. Methods We assessed the ability of the PREAUT grid to predict ASD in low-risk individuals by prospectively following and screening 12,179 infants with the PREAUT grid at four (PREAUT-4) and nine (PREAUT-9) months of age. A sample of 4,835 toddlers completed the Checklist for Autism in Toddlers (CHAT) at 24 months (CHAT-24) of age. Children who were positive at one screening (N = 100) were proposed a clinical assessment (including the Children Autism Rating Scale, a Developmental Quotient, and an ICD-10-based clinical diagnosis if appropriate) in the third year of life. A randomly selected sample of 1,100 individuals who were negative at all screenings was followed by the PMI team from three to five years of age to identify prospective false negative cases. The clinical outcome was available for 45% (N = 45) of positive children and 52.6% (N = 579) of negative children. Results Of the 100 children who screened positive, 45 received a diagnosis at follow-up. Among those receiving a diagnosis, 22 were healthy, 10 were diagnosed with ASD, seven with intellectual disability (ID), and six had another developmental disorder. Thus, 50% of infants positive at one screening subsequently received a neurodevelopmental diagnosis. The PREAUT grid scores were significantly associated with medium and high ASD risk status on the CHAT at 24 months (odds ratio of 12.1 (95%CI: 3.0–36.8), p < 0.001, at four months and 38.1 (95%CI: 3.65–220.3), p < 0.001, at nine months). Sensitivity (Se), specificity, negative predictive values, and positive predictive values (PPVs) for PREAUT at four or nine months, and CHAT at 24 months, were similar [PREAUT-4: Se = 16.0 to 20.6%, PPV = 25.4 to 26.3%; PREAUT-9: Se = 30.5 to 41.2%, PPV = 20.2 to 36.4%; and CHAT-24: Se = 33.9 to 41.5%, PPV = 27.3 to 25.9%]. The repeated use of the screening instruments increased the Se but not PPV estimates [PREAUT and CHAT combined: Se = 67.9 to 77.7%, PPV = 19.0 to 28.0%]. Conclusions The PREAUT grid can contribute to very early detection of ASD and its combination with the CHAT may improve the early diagnosis of ASD and other neurodevelopmental disorders.
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Affiliation(s)
- Bertrand Olliac
- Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Esquirol, Limoges, France
- Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1094, Tropical Neuroepidemiology, Limoges, France
| | - Graciela Crespin
- PREAUT Association Programme de Recherche et d’Etudes sur l’Autisme, Paris, France
| | - Marie-Christine Laznik
- Department of Child and Adolescent Psychiatry, Association Santé Mentale du 13ème, Paris, France
| | | | - Jean-Louis Sarradet
- PREAUT Association Programme de Recherche et d’Etudes sur l’Autisme, Paris, France
| | - Colette Bauby
- PREAUT Association Programme de Recherche et d’Etudes sur l’Autisme, Paris, France
- PMI Center (Center for Protection of Mother and Infant), Paris, France
| | - Anne-Marie Dandres
- PREAUT Association Programme de Recherche et d’Etudes sur l’Autisme, Paris, France
- PMI Center (Center for Protection of Mother and Infant), Paris, France
| | - Emeline Ruiz
- PREAUT Association Programme de Recherche et d’Etudes sur l’Autisme, Paris, France
| | - Claude Bursztejn
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospital, Strasbourg, France
| | - Jean Xavier
- Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- ISIR, CNRS, UMR 7222, UMPC, Paris, France
| | - Bruno Falissard
- INSERM U669, Université Paris-Sud and Université Paris-Descartes, Paris, France
| | - Nicolas Bodeau
- Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - David Cohen
- Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- ISIR, CNRS, UMR 7222, UMPC, Paris, France
| | - Catherine Saint-Georges
- Department of Child and Adolescent Psychiatry, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
- ISIR, CNRS, UMR 7222, UMPC, Paris, France
- Association CEREP-PHYMENTIN, Paris, France
- * E-mail:
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Magán-Maganto M, Bejarano-Martín Á, Fernández-Alvarez C, Narzisi A, García-Primo P, Kawa R, Posada M, Canal-Bedia R. Early Detection and Intervention of ASD: A European Overview. Brain Sci 2017; 7:brainsci7120159. [PMID: 29194420 PMCID: PMC5742762 DOI: 10.3390/brainsci7120159] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/20/2017] [Accepted: 11/28/2017] [Indexed: 01/13/2023] Open
Abstract
Over the last several years there has been an increasing focus on early detection of Autism Spectrum Disorder (ASD), not only from the scientific field but also from professional associations and public health systems all across Europe. Not surprisingly, in order to offer better services and quality of life for both children with ASD and their families, different screening procedures and tools have been developed for early assessment and intervention. However, current evidence is needed for healthcare providers and policy makers to be able to implement specific measures and increase autism awareness in European communities. The general aim of this review is to address the latest and most relevant issues related to early detection and treatments. The specific objectives are (1) analyse the impact, describing advantages and drawbacks, of screening procedures based on standardized tests, surveillance programmes, or other observational measures; and (2) provide a European framework of early intervention programmes and practices and what has been learnt from implementing them in public or private settings. This analysis is then discussed and best practices are suggested to help professionals, health systems and policy makers to improve their local procedures or to develop new proposals for early detection and intervention programmes.
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Affiliation(s)
- María Magán-Maganto
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
| | - Álvaro Bejarano-Martín
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
| | - Clara Fernández-Alvarez
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
| | | | | | - Rafal Kawa
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183 Warszawa, Poland.
| | - Manuel Posada
- IIER, Instituto de Salud Carlos III, 28029 Madrid, Spain.
| | - Ricardo Canal-Bedia
- INICO, Instituto Universitario de Integración en la Comunidad, Universidad de Salamanca, 37005 Salamanca, Spain.
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Sturner R, Howard B, Bergmann P, Stewart L, Afarian TE. Comparison of Autism Screening in Younger and Older Toddlers. J Autism Dev Disord 2017; 47:3180-3188. [PMID: 28733850 PMCID: PMC5711534 DOI: 10.1007/s10803-017-3230-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study examined the effect of age at completion of an autism screening test on item failure rates contrasting older (>20 months) with younger (<20 months) toddlers in a community primary care sample of 73,564 children. Items related to social development were categorized into one of three age sets per criteria from Inada et al. (Research in Autism Spectrum Disorders 4(4):605-611, 2010). Younger toddlers produced higher rates of item failure than older toddlers and items in both of the later acquired item sets had higher probability rates for failure than the earliest acquired item set (prior to 8 months). Use of the same items and the same scoring throughout the target age range for autism screening may not be the best strategy for identifying the youngest toddlers at risk for autism.
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Affiliation(s)
- Raymond Sturner
- Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Barbara Howard
- Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Paul Bergmann
- Foresight Logic, Inc., Saint Paul, MN, USA
- PrairieCare Institute, Minneapolis, MN, USA
| | - Lydia Stewart
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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40
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Willig TN, Blanc JP, Assathiany R. [The private pediatrician in the clinical care pathway for children affected by specific learning disorders in France]. Arch Pediatr 2017; 24:1088-1095. [PMID: 28970040 DOI: 10.1016/j.arcped.2017.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 07/11/2017] [Accepted: 08/30/2017] [Indexed: 11/29/2022]
Abstract
The clinical care pathway for children presenting specific learning disorders, including language, motor coordination, and attention disorders is based on different levels of assessment by the professionals involved. In France, a first step of organization was established in 2002 by founding of a network of structures devoted to clinical assessment of complex cases, research, and teaching for the professionals involved. Although this organization proved to contribute an essential service, the demand largely exceeded the availability of access. A three-level organization was therefore suggested in 2013 including a first-level devoted to clinical analysis of simple cases, together with the professionals involved in rehabilitation (i.e., speech therapists, occupational therapists, psychologists), a second-level in charge of analyzing complex situations, involving comorbidities and failure of first-level care, together with the already structured third level of assessment devoted to genetic disorders, severe situations, and association with neurological conditions. To plan the practical application of these different levels, we assessed the situation of ambulatory pediatricians working in private practice, because this network appeared to be the most available in France to play these roles. A survey was therefore conducted among the main representative association of pediatricians (Association française de pédiatrie ambulatoire), including 1565 members of the 2700 in activity in France, on their level of knowledge and clinical expertise, and the drawbacks encountered in their practice in this field. Of the 481 respondents (36%), 25% were not yet in 2016 self-confident in assuming a first-level role, while 56% were ready to participate in a first-level response and 18% in a second-level response. In the 5 upcoming years, the vast majority of pediatricians intended to progress in their involvement, which should provide all regions in France with a network of professionals able to respond to the specific needs of children (48% in the first-level and 43.5% in the second-level of expertise). Specific obstacles have already been encountered by professionals who wish to play a full role in this domain: insufficient funding for medical evaluations and lack of access to specialized evaluations. This survey emphasizes the need for obtaining access to both practical and theoretical professional development programs (77.5%), funding of clinical assessment time (76%), all of which need to be answered by the French health authorities. To date, very few nationwide programs of clinical care pathways in these fields have been developed, but examples are available in France on Alzheimer disease and elderly populations, providing a model for children affected by specific development and learning difficulties. Setting up a clinical care pathway by the French Ministry of Health (Haute Autorité de santé) assumes that the needs expressed by ambulatory pediatricians will be taken into account, including the design and implementation of Medical Education programs according to the level of expertise, together with the adequate funding of diagnosis, follow-up, and care pathway coordination time.
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Affiliation(s)
- T-N Willig
- Clinique Ambroise-Paré, 387, route de Saint-Simon, 31082 Toulouse cedex 01, France; Réseau Ptitmip, troubles des apprentissages, 330, avenue de Grande-Bretagne, 31059 Toulouse, France; Association française de pédiatrie ambulatoire, 54, rue Léon-Desoyer, 78100 Saint-Germain-en-Laye, France.
| | - J P Blanc
- Association française de pédiatrie ambulatoire, 54, rue Léon-Desoyer, 78100 Saint-Germain-en-Laye, France; 17, rue Nicolas-Chaize, 42100 Saint-Étienne, France
| | - R Assathiany
- Association française de pédiatrie ambulatoire, 54, rue Léon-Desoyer, 78100 Saint-Germain-en-Laye, France; 30, avenue Victor-Cresson, 92130 Issy-les-Moulineaux, France
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41
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Rescorla LA, Winder-Patel BM, Paterson SJ, Pandey J, Wolff JJ, Schultz RT, Piven J. Autism spectrum disorder screening with the CBCL/1½-5: Findings for young children at high risk for autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:29-38. [PMID: 28931307 DOI: 10.1177/1362361317718482] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The screening power of the CBCL/1½-5's Withdrawn and Diagnostic and Statistical Manual of Mental Disorders-Pervasive Developmental Problems (DSM-PDP) scales to identify children diagnosed with autism spectrum disorder at 24 months was tested in a longitudinal, familial high-risk study. Participants were 56 children at high risk for autism spectrum disorder due to an affected older sibling (high-risk group) and 26 low-risk children with a typically developing older sibling (low-risk group). At 24 months, 13 of the 56 high-risk children were diagnosed with autism spectrum disorder, whereas the other 43 were not. The high-risk children diagnosed with autism spectrum disorder group had significantly higher scores on the CBCL/1½-5's Diagnostic and Statistical Manual of Mental Disorders-Pervasive Developmental Problems and Withdrawn scales than children in the low-risk and high-risk children not diagnosed with autism spectrum disorder groups (ηp2>0.50). Receiver operating characteristic analyses yielded very high area under the curve values (0.91 and 0.89), and a cut point of T ⩾ 60 yielded sensitivity of 77% and specificity of 97% to 99% between the high-risk children diagnosed with autism spectrum disorder and the combination of low-risk and high-risk children not diagnosed with autism spectrum disorder. Consistent with several previous studies, the CBCL/1½-5's Diagnostic and Statistical Manual of Mental Disorders-Pervasive Developmental Problems scale and the Withdrawn syndrome differentiated well between children diagnosed with autism spectrum disorder and those not diagnosed.
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Affiliation(s)
| | | | | | | | | | | | - Joseph Piven
- The University of North Carolina at Chapel Hill, USA
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42
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Advanced Social Communication Skills for Young Children with Autism: a Systematic Review of Single-Case Intervention Studies. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0110-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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43
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Beaudet AL. Brain carnitine deficiency causes nonsyndromic autism with an extreme male bias: A hypothesis. Bioessays 2017; 39. [PMID: 28703319 DOI: 10.1002/bies.201700012] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Could 10-20% of autism be prevented? We hypothesize that nonsyndromic or "essential" autism involves extreme male bias in infants who are genetically normal, but they develop deficiency of carnitine and perhaps other nutrients in the brain causing autism that may be amenable to early reversal and prevention. That brain carnitine deficiency might cause autism is suggested by reports of severe carnitine deficiency in autism and by evidence that TMLHE deficiency - a defect in carnitine biosynthesis - is a risk factor for autism. A gene on the X chromosome (SLC6A14) likely escapes random X-inactivation (a mixed epigenetic and genetic regulation) and could limit carnitine transport across the blood-brain barrier in boys compared to girls. A mixed, common gene variant-environment hypothesis is proposed with diet, minor illnesses, microbiome, and drugs as possible risk modifiers. The hypothesis can be tested using animal models and by a trial of carnitine supplementation in siblings of probands. Perhaps the lack of any Recommended Dietary Allowance for carnitine in infants should be reviewed. Also see the video abstract here: https://youtu.be/BuRH_jSjX5Y.
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Affiliation(s)
- Arthur L Beaudet
- Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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44
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Loomes R, Hull L, Mandy WPL. What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry 2017; 56:466-474. [PMID: 28545751 DOI: 10.1016/j.jaac.2017.03.013] [Citation(s) in RCA: 1167] [Impact Index Per Article: 166.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/17/2017] [Accepted: 03/29/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To derive the first systematically calculated estimate of the relative proportion of boys and girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies conducted since the introduction of the DSM-IV and the International Classification of Diseases, Tenth Revision. METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The Medline, Embase, and PsycINFO databases were searched, and study quality was rated using a risk-of-bias tool. Random-effects meta-analysis was used. The pooled outcome measurement was the male-to-female odds ratio (MFOR), namely the odds of being male in the group with ASD compared with the non-ASD group. In effect, this is the ASD male-to-female ratio, controlling for the male-to-female ratio among participants without ASD. RESULTS Fifty-four studies were analyzed, with 13,784,284 participants, of whom 53,712 had ASD (43,972 boys and 9,740 girls). The overall pooled MFOR was 4.20 (95% CI 3.84-4.60), but there was very substantial between-study variability (I2 = 90.9%). High-quality studies had a lower MFOR (3.32; 95% CI 2.88-3.84). Studies that screened the general population to identify participants regardless of whether they already had an ASD diagnosis showed a lower MFOR (3.25; 95% CI 2.93-3.62) than studies that only ascertained participants with a pre-existing ASD diagnosis (MFOR 4.56; 95% CI 4.10-5.07). CONCLUSION Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis.
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45
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Morales-Hidalgo P, Roigé-Castellví J, Vigil-Colet A, Canals Sans J. The Childhood Autism Spectrum Test (CAST): Spanish adaptation and validation. Autism Res 2017; 10:1491-1498. [PMID: 28383173 DOI: 10.1002/aur.1793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/06/2017] [Accepted: 03/10/2017] [Indexed: 11/09/2022]
Abstract
The Childhood Autism Spectrum Test (CAST; Scott, Baron-Cohen, Bolton & Brayne, 2002) has proved to be a good test for screening autism spectrum disorders (ASD) and social communication problems. This study provides evidence on its psychometric properties, describe its validity for screening and provides data on its discriminative capabilities in a Spanish sample of 4-12 year-old children from community and clinical settings (N = 1460 and 36, respectively). Factorial and convergent validity is also assessed. The full Spanish version with a cut-off score of 15 presented a high sensitivity (83.9%) and specificity (92.5%), a positive predictive value (PPV) of .63 and an internal consistency (α) of .826. Some items showed low discriminating power and these results led us to propose a reduced version with 28 items and a cut-off score of 13, which presented a high sensitivity (85.7%) and specificity (91.16%), a PPV of .61 and an α of .839. Correlations were high between the Spanish full and reduced versions of the CAST, and ADI-R (Autism Diagnostic Interview Revised) and ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition). Like previous adaptation studies, a two-factor structure was found. The data show that the CAST can be a valid and reliable questionnaire for ASD screening in Spanish clinical and community populations. Autism Res 2017, 10: 1491-1498. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Paula Morales-Hidalgo
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Joana Roigé-Castellví
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Andreu Vigil-Colet
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain
| | - Josefa Canals Sans
- Research Center for Behavioral Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Spain.,Nutrition and Mental Health Research Group (NUTRISAM), Department of Psychology, Universitat Rovira i Virgili, Spain
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46
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Nickel RE, Huang-Storms L. Early Identification of Young Children with Autism Spectrum Disorder. Indian J Pediatr 2017; 84:53-60. [PMID: 26411730 DOI: 10.1007/s12098-015-1894-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/19/2015] [Indexed: 12/16/2022]
Abstract
Early identification and treatment of children with autism and other developmental disorders is an international priority. Currently there is great interest in lowering the age of identification. Attention has been focused on public awareness campaigns and the regular use of developmental screening tests by health care providers, health workers and others. In this article the authors discuss the rationale for the use of autism specific screening tests, review the characteristics of selected tools, and make recommendations for the diagnostic evaluation of young children for autism spectrum disorder in an international context.
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Affiliation(s)
- Robert E Nickel
- Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines, Portland, OR, 97349, USA
| | - Lark Huang-Storms
- Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines, Portland, OR, 97349, USA.
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47
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Rudra A, Ram JR, Loucas T, Belmonte MK, Chakrabarti B. Bengali translation and characterisation of four cognitive and trait measures for autism spectrum conditions in India. Mol Autism 2016; 7:50. [PMID: 27980709 PMCID: PMC5135772 DOI: 10.1186/s13229-016-0111-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 11/08/2016] [Indexed: 12/21/2022] Open
Abstract
Background Autism is characterised by atypical social-communicative behaviour and restricted range of interests and repetitive behaviours. These features exist in a continuum in the general population. Behavioural measures validated across cultures and languages are required to quantify the dimensional traits of autism in these social and non-social domains. Bengali is the seventh most spoken language in the world. However, there is a serious dearth of data on standard measures of autism-related social and visual cognition in Bengali. Methods Bengali translations of two measures related to social-communicative functioning (the Children’s Reading the Mind in the Eyes Test (RMET) and a facial emotion recognition test with stimuli taken from the Karolinska Directed Emotional Faces database), one measure of visual perceptual disembedding (the Embedded Figures Test), and a questionnaire measure (the Children’s Empathy Quotient) were tested in 25 children with autism spectrum conditions (ASC) and 26 control children (mean age = 10.7 years) in Kolkata, India. Group differences were analysed by t test and multiple regression (after accounting for potential effects of gender, IQ, and age). Results Behavioural and trait measures were associated with group differences in the expected directions: ASC children scored lower on the Children’s Empathy Quotient and the RMET, as well as on facial emotion recognition, but were faster and more accurate on the Embedded Figures Test. Distributional properties of these measures within groups are similar to those reported in Western countries. Conclusions These results provide an empirical demonstration of cross-cultural generalisability and applicability of these standard behavioural and trait measures related to autism, in a major world language.
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Affiliation(s)
- Alokananda Rudra
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK ; Ben Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Tom Loucas
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Matthew K Belmonte
- The Com DEALL Trust, Bangalore, India ; Nottingham Trent University, Nottingham, UK
| | - Bhismadev Chakrabarti
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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48
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Yin J, Schaaf CP. Autism genetics - an overview. Prenat Diagn 2016; 37:14-30. [DOI: 10.1002/pd.4942] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/04/2016] [Accepted: 10/11/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Jiani Yin
- Department of Molecular and Human Genetics; Baylor College of Medicine; Houston TX USA
- Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston TX USA
| | - Christian P. Schaaf
- Department of Molecular and Human Genetics; Baylor College of Medicine; Houston TX USA
- Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston TX USA
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49
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Reduced saccadic inhibition of return to moving eyes in autism spectrum disorders. Vision Res 2016; 127:115-121. [DOI: 10.1016/j.visres.2016.07.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 07/14/2016] [Accepted: 07/14/2016] [Indexed: 11/17/2022]
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50
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Abstract
Mitochondrial diseases are a clinically heterogeneous group of disorders that ultimately result from dysfunction of the mitochondrial respiratory chain. There is some evidence to suggest that mitochondrial dysfunction plays a role in neuropsychiatric illness; however, the data are inconclusive. This article summarizes the available literature published in the area of neuropsychiatric manifestations in both children and adults with primary mitochondrial disease, with a focus on autism spectrum disorder in children and mood disorders and schizophrenia in adults.
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Affiliation(s)
- Samantha E Marin
- Department of Neurosciences, University of California, San Diego (UCSD), 9500 Gilman Drive #0935, La Jolla, CA 92093-0935, USA
| | - Russell P Saneto
- Department of Neurology, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA; Department of Pediatrics, Seattle Children's Hospital, University of Washington, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA.
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