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Nuske HJ, Smith T, Levato L, Bronstein B, Sparapani N, Garcia C, Castellon F, Lee HS, Vejnoska SF, Hochheimer S, Fitzgerald AR, Chiappe JC, Nunnally AD, Li J, Shih W, Brown A, Cullen M, Hund LM, Stahmer AC, Iadarola S, Mandell DS, Hassrick EM, Kataoka S, Kasari C. Building Better Bridges: Outcomes of a Community-Partnered New School Transition Intervention for Students on the Autism Spectrum. J Autism Dev Disord 2024:10.1007/s10803-024-06285-7. [PMID: 38865033 DOI: 10.1007/s10803-024-06285-7] [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] [Accepted: 02/12/2024] [Indexed: 06/13/2024]
Abstract
New school transitions can be challenging for students on the autism spectrum. No published, evidence-based interventions exist to support families and teachers of students transitioning to elementary and secondary school during this critical period. Using Community Partnered Participatory Research, we developed Building Better Bridges (BBB), a caregiver coaching intervention that includes training on effective school communication, educational rights, advocacy, and child preparation strategies. We compared BBB (n = 83) to a module/resources-only comparison (n = 87) in a four-site randomized controlled trial in racially and ethnically diverse, under-resourced communities. In our intent-to-treat analysis, caregivers and teachers in BBB rated students' transitions to the new classroom as more positive, relative to the comparison group. Results suggest this low-cost intervention can improve the transition process for families and students at high risk of poor transitions.
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Affiliation(s)
- Heather J Nuske
- Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Tristram Smith
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Lynne Levato
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Briana Bronstein
- Center for Education, College of Health & Human Services, Widener University, Chester, PA, USA
| | - Nicole Sparapani
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Consuelo Garcia
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Fernanda Castellon
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Hyon Soo Lee
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Sarah F Vejnoska
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Samantha Hochheimer
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Amber R Fitzgerald
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jenny C Chiappe
- Teacher Education Division, Special Education, College of Education, California State University, Dominguez Hills, Carson, CA, USA
| | - Amanda Dimachkie Nunnally
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jennica Li
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Wendy Shih
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Ashlee Brown
- Professional Development and Research, Early Learning Services, Elwyn, Philadelphia, PA, USA
| | - Michelle Cullen
- Special Education Department, Rochester City School District, Rochester, NY, USA
| | - Lisa M Hund
- Health Resources and Services Administration, Division of Healthy Start and Perinatal Services, Maternal and Child Health Bureau, Rockville, MD, USA
| | - Aubyn C Stahmer
- Departments of Psychiatry and Behavioral Sciences, Psychology, and Education, UC Davis MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Suzannah Iadarola
- Division of Developmental and Behavioral Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - David S Mandell
- Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Sheryl Kataoka
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
| | - Connie Kasari
- Department of Psychiatry, Center for Autism Research & Treatment, UCLA Semel Institute, Los Angeles, University of California, Los Angeles, CA, USA
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Kipkemoi P, Savage JE, Gona J, Rimba K, Kombe M, Mwangi P, Kipkoech C, Posthuma D, Newton CRJC, Abubakar A. Evaluation of the Psychometric Properties of the Social Communication Questionnaire in Rural Kenya. J Autism Dev Disord 2024:10.1007/s10803-024-06380-9. [PMID: 38816602 DOI: 10.1007/s10803-024-06380-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/01/2024]
Abstract
Children can be reliably diagnosed with autism as early as 3 years of age, and early interventions are initiated. There is often a significant gap between the age of onset of symptoms (2-3 years) and diagnosis (8-10 years) in Africa. We conducted a study to validate the Social Communication Questionnaire (SCQ) as a screening instrument in a rural setting in Kenya. The study was conducted along the Kenyan Coast. Study participants included 172 children with a neurodevelopmental disorder (NDD) diagnosis (84 of which were autism) and 112 controls. Internal consistency was evaluated through the use of Cronbach's alpha, confirmatory factor analysis (CFA) with maximum likelihood procedure to assess the conceptual model for the SCQ. Additionally, the sensitivity and specificity of cut-off scores using ROC analysis and item difficulties and discrimination quality using an IRT framework were also assessed. Factor analysis revealed an adequate fitting model for the three-factor DSM-IV-TR (root mean squared error of approximation (RMSEA) = 0.050; Comparative Fit Index (CFI) = 0.974; Tucker-Lewis Index (TLI) = 0.973) and two-factor DSM-5 factor structure (RMSEA = 0.050; CFI = 0.972; TLI = 0.974). The reliability coefficient alphas for the whole group for all items (Cronbach's α = 0.90) and all three domains (Cronbach's α = 0.68-0.84) were acceptable to excellent. The recommended cut-off score of 15 yielded 72% sensitivity and 100% specificity in the ASD group compared to the typically developing group. We provide early evidence of the adequate factor structure and good internal consistency of the SCQ. We also note that the recommended cut-off yielded sufficient predictive validity.
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Affiliation(s)
- Patricia Kipkemoi
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya.
- Complex Trait Genetics Department, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Jeanne E Savage
- Complex Trait Genetics Department, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Joseph Gona
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
| | - Kenneth Rimba
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
| | - Martha Kombe
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
| | - Paul Mwangi
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
| | - Collins Kipkoech
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
| | - Danielle Posthuma
- Complex Trait Genetics Department, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Department of Child and Adolescent Psychology and Psychiatry, Complex Trait Genetics, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Charles R J C Newton
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX, UK
- Department of Public Health, Pwani University, P.O. BOX, Kilifi, 195-80108, Kenya
- Institute for Human Development, Aga Khan University, P.O. BOX, Nairobi, 30270-00100, Kenya
| | - Amina Abubakar
- Neuroscience Unit, KEMRI-Wellcome Trust Research Programme, P.O Box 230-80108, Kilifi, Kenya
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Ln, Oxford, OX3 7JX, UK
- Department of Public Health, Pwani University, P.O. BOX, Kilifi, 195-80108, Kenya
- Institute for Human Development, Aga Khan University, P.O. BOX, Nairobi, 30270-00100, Kenya
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Corbett BA, Muscatello RA, McGonigle T, Vandekar S, Burroughs C, Sparks S. Trajectory of depressive symptoms over adolescence in autistic and neurotypical youth. Mol Autism 2024; 15:18. [PMID: 38698474 PMCID: PMC11064411 DOI: 10.1186/s13229-024-00600-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Adolescence coincides with a dramatic rise in the onset of psychiatric conditions including depression. Depression symptoms may be particularly prevalent and impairing for youth with autism spectrum disorder (ASD). While prior research suggests adolescence is associated with worsening depression symptoms for typically developing (TD) and autistic youth, it is unclear if they follow a similar course. METHOD The study examined the trajectory of depressive symptoms in autistic and neurotypical youth over a 4-year longitudinal study using linear and logistic mixed effects models. In youth with clinically relevant depressive scores (t-score > 65), moderating factors (i.e., diagnosis, age, puberty, sex) were explored. During Year 1, the sample included 244 youth 10-to-13 years: 140 in the ASD group (36 females) and 104 in the TD group (46 females). RESULTS Autistic youth had elevated depression scores compared to TD peers (p < 0.001) and females were higher than males in both groups (p = 0.001). There was significant diagnosis by age (p < 0.001) and diagnosis by pubertal stage (p < 0.05) interactions. In the ASD group, elevated depressive scores presented in early adolescence and decreased during middle adolescence and puberty, whereas the TD group showed the opposite trend with an increase in depression symptoms with advancing development. LIMITATIONS Limitations include an unequal sex distribution (fewer females), non-representative autistic sample (e.g., cognition and race/ethnicity), and potential confound of the COVID-19 pandemic. CONCLUSIONS Autistic youth present with higher rates of depressive symptoms early in development; yet, approaching middle adolescence and puberty, the symptom trajectory in the autistic youth declines coinciding with an increase in the TD youth. While group trajectories are divergent, they lead to similar levels of depression in late adolescence with higher symptoms in females. Findings suggest a period of quiescence in depressive symptomology influenced by biopsychosocial factors impacting affective profiles.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN, 37212, USA.
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Psychology, Vanderbilt University, Nashville, TN, USA.
| | - Rachael A Muscatello
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN, 37212, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Trey McGonigle
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina Burroughs
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN, 37212, USA
| | - Sloane Sparks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN, 37212, USA
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Arunachalam S, Steele A, Pelletier T, Luyster R. Do focused interests support word learning? A study with autistic and nonautistic children. Autism Res 2024; 17:955-971. [PMID: 38468449 PMCID: PMC11102331 DOI: 10.1002/aur.3121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
Although focused interests are often associated with a diagnosis of autism, they are common in nonautistic individuals as well. Previous studies have explored how these interests impact cognitive, social, and language development. While some research has suggested that strong interests can detract from learning (particularly for autistic children), newer research has indicated that they can be advantageous. In this pre-registered study, we asked whether focused interests support word learning in 44 autistic children and a vocabulary-matched sample of 44 nonautistic children (mean ages 58 and 34 months respectively). In a word-learning task administered over Zoom, children were exposed to an action labeled by a novel word. The action was either depicted by their focused interest or by a neutral image; stimuli were personalized for each child. At test, they were asked to identify the referent of the novel word, and their eye gaze was evaluated as a measure of learning. The preregistered analyses revealed an effect of focused interests, and post-hoc analyses clarified that autistic children learned the novel word in both the focused interest and neutral conditions, while nonautistic children only showed evidence of learning in the neutral condition. These results suggest that focused interests are not disruptive for vocabulary learning in autism, and thus they could be utilized in programming that supports early language learning in this population.
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Affiliation(s)
- S Arunachalam
- Communicative Sciences and Disorders, New York University, New York, New York, USA
| | - A Steele
- Communication Sciences and Disorders, Emerson College, Boston, Massachusetts, USA
| | - T Pelletier
- Communicative Sciences and Disorders, New York University, New York, New York, USA
| | - R Luyster
- Communication Sciences and Disorders, Emerson College, Boston, Massachusetts, USA
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5
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La Valle C, Shen L, Butler LK, Tager-Flusberg H. Are minimally verbal autistic children's modality and form of communication associated with parent responsivity? Autism Res 2024; 17:989-1000. [PMID: 38690644 DOI: 10.1002/aur.3131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
Prior work examined how minimally verbal (MV) children with autism used their gestural communication during social interactions. However, interactions are exchanges between social partners. Examining parent-child social interactions is critically important given the influence of parent responsivity on children's communicative development. Specifically, parent responses that are semantically contingent to the child's communication plays an important role in further shaping children's language learning. This study examines whether MV autistic children's (N = 47; 48-95 months; 10 females) modality and form of communication are associated with parent responsivity during an in-home parent-child interaction (PCI). The PCI was collected using natural language sampling methods and coded for child modality and form of communication and parent responses. Findings from Kruskal-Wallis H tests revealed that there was no significant difference in parent semantically contingent responses based on child communication modality (spoken language, gesture, gesture-speech combinations, and AAC) and form of communication (precise vs. imprecise). Findings highlight the importance of examining multiple modalities and forms of communication in MV children with autism to obtain a more comprehensive understanding of their communication abilities; and underscore the inclusion of interactionist models of communication to examine children's input on parent responses in further shaping language learning experiences.
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Affiliation(s)
- Chelsea La Valle
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Lue Shen
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA
| | - Lindsay K Butler
- Department of Speech, Language, & Hearing Sciences, University of Connecticut, Storrs, Connecticut, USA
- Institute for the Brain & Cognitive Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Helen Tager-Flusberg
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, USA
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Wallis KE, Guthrie W. Screening for Autism: A Review of the Current State, Ongoing Challenges, and Novel Approaches on the Horizon. Pediatr Clin North Am 2024; 71:127-155. [PMID: 38423713 DOI: 10.1016/j.pcl.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Screening for autism is recommended in pediatric primary care. However, the median age of autism spectrum disorder (ASD) diagnosis is substantially higher than the age at which autism can reliably be identified, suggesting room for improvements in autism recognition at young ages, especially for children from minoritized racial and ethnic groups, low-income families, and families who prefer a language other than English. Novel approaches are being developed to utilize new technologies in aiding in autism recognition. However, attention to equity is needed to minimize bias. Additional research on the benefits and potential harms of universal autism screening is needed. The authors provide suggestions for pediatricians who are considering implementing autism-screening programs.
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Affiliation(s)
- Kate E Wallis
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Whitney Guthrie
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Clinical Futures, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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7
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Boettcher J, Orm S, Fjermestad KW. Autism traits, social withdrawal, and behavioral and emotional problems in a Norwegian cohort of adolescents with rare genetic disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2024; 147:104699. [PMID: 38367299 DOI: 10.1016/j.ridd.2024.104699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Adolescents with rare genetic disorders represent a population that can be at risk in psychosocial terms. Despite its importance, the association of autism traits and social withdrawal in behavioral and emotional problems in adolescents with rare genetic disorders remains understudied. AIM The study aimed to empirically examine the clinical characteristics of adolescents with rare genetic disorders with a behavior theory-driven approach. METHOD We investigated the behavioral and emotional problems and current and lifetime autistic traits in a sample of 93 Norwegian adolescents (Mage = 13.2 years, SDage = 2.4, rangeage 10-17, 62.4% females, 37.6% males) with various rare genetic disorders. The adolescents were investigated cross-sectionally utilizing standardized psychometric questionnaires rated by their parents. RESULTS More current and lifetime autistic traits and social withdrawal were all associated with more internalizing problems. Further analyses demonstrated that social withdrawal partially mediated the positive association between current autistic traits and internalizing problems. In contrast, social withdrawal fully mediated the positive association between lifetime autistic traits and internalizing problems. CONCLUSION AND IMPLICATIONS Our results demonstrate important characteristics of adolescents with rare genetic disorders that may guide clinicians and future interventions. Social withdrawal may be prodromal to internalizing problems such as anxiety and depression. Thus, clinically addressing social withdrawal can represent a means to prevent internalizing problems in adolescents with rare genetic disorders and autistic traits.
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Affiliation(s)
- Johannes Boettcher
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg, Eppendorf, Germany.
| | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Norway; Department of Psychology, Inland Norway University of Applied Sciences, Norway
| | - Krister Westlye Fjermestad
- Frambu Resource Centre for Rare Disorders, Siggerud, Norway; Department of Psychology, University of Oslo, Norway
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Neece CL, Fenning RM, Morrell HER, Benjamin LR. Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:985-998. [PMID: 37555286 PMCID: PMC10853488 DOI: 10.1177/13623613231191558] [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: 08/10/2023]
Abstract
LAY ABSTRACT Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.
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Affiliation(s)
- Cameron L. Neece
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Rachel M. Fenning
- Department of Psychological Science and The Claremont Autism Center, Claremont McKenna College; 850 Columbia Avenue, Claremont, CA 91711, United States
| | - Holly E. R. Morrell
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Laurel R. Benjamin
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
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Sommers L, Papadopoulos N, Fuller-Tyszkiewicz M, Sciberras E, McGillivray J, Howlin P, Rinehart N. The Connection Between Sleep Problems and Emotional and Behavioural Difficulties in Autistic Children: A Network Analysis. J Autism Dev Disord 2024:10.1007/s10803-024-06298-2. [PMID: 38526802 DOI: 10.1007/s10803-024-06298-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/27/2024]
Abstract
The interactions between sleep problems, autism symptoms and emotional and behavioural difficulties were explored using network analysis in 240 autistic children (mean age: 8.8 years, range 5-13 years) with moderate to severe sleep problems. Findings revealed a highly connected and interpretable network, with three separate clusters identified of the modelled variables. Depression, anxiety and behavioural difficulties were the most central variables of the network. Depression, anxiety and restricted repetitive and stereotyped patterns behaviours (RRBs) were the strongest bridging variables in the network model, transmitting activation both within and between other symptom clusters. The results highlight that depression and anxiety were highly connected symptoms within the network, suggesting support in these areas could be helpful, as well as future research.
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Affiliation(s)
- Lucy Sommers
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Nicole Papadopoulos
- Monash Krongold Clinic, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Emma Sciberras
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
- Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Jane McGillivray
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Nicole Rinehart
- Monash Krongold Clinic, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, VIC, 3800, Australia
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Terner M, Israel-Yaacov S, Golan O. Sex differences in autism screening: An examination of the Childhood Autism Spectrum Test-Hebrew version. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241235053. [PMID: 38465585 DOI: 10.1177/13623613241235053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
LAY ABSTRACT Autism is a neurodevelopmental condition, characterized by social communication alterations and restricted, repetitive behaviors. Typically diagnosed in early childhood, screening and diagnosis at a later age can be challenging, particularly in girls who exhibit a wider range of behaviors and characteristics. Our study set out to examine the effectiveness of the Hebrew translation of the Childhood Autism Spectrum Test, a parent report questionnaire, in identifying these diverse characteristics of autism within an Israeli sample of boys and girls. We examined parent reports on 403 (211 autistic, 192 non-autistic) children, aged 4-12 years. Results revealed the Childhood Autism Spectrum Test-Hebrew version was a valuable tool in differentiating between autistic and typically developing children, correctly identifying 93% of children with autism and 82% of typically developing children. In addition, specific items of the Childhood Autism Spectrum Test-Hebrew version were particularly useful in differentiating between autistic and non-autistic boys and autistic and non-autistic girls. Using these items, in addition to the overall score of the questionnaire, increased the correct identification of children as autistic or typically developing, especially in girls. The Childhood Autism Spectrum Test-Hebrew version test results corresponded well with the Autism Diagnostic Interview-Revised, which relies on parental input, but not with the clinician-administered Autism Diagnostic Observation Schedule-2. Our findings highlight the potential benefits of gender-specific tools to better support correct identification of autism in boys and in girls. More research is recommended to further explore these gender differences and to validate our findings with a larger, diverse group.
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Affiliation(s)
| | | | - Ofer Golan
- Bar-Ilan University, Israel
- OTI - The Israeli Autism Association, Israel
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11
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Clyde A, Bismar D, Agnew G, Kuper LE. Autism Spectrum Disorder and Anxiety Among Transgender Youth: Use of the Social Communication Questionnaire (SCQ). J Autism Dev Disord 2024; 54:615-627. [PMID: 36422761 DOI: 10.1007/s10803-022-05814-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/26/2022]
Abstract
Autism spectrum disorder (ASD) and ASD symptoms are overrepresented among gender-diverse youth across studies. Gender-diverse and ASD youth are at risk for anxiety, but anxiety is unclear among gender-diverse youth with ASD. The Social Communication Questionnaire (SCQ) is a commonly used ASD screener, including in multidisciplinary gender-affirming programs, but scholars have disagreed on the most optimal cut-off score. To date, no study has investigated the sensitivity and specificity of its established cut-off score of 15 with a sample of transgender youth. Gaining more accurate information about the utility of ASD screening tools with gender diverse youth is critical in order to help refer youth to needed services. Among a sample of 325 transgender youth, this study sought to determine an optimal cut-off score for the SCQ, the prevalence of ASD and ASD symptoms, and the relationship between ASD and anxiety within this population. The current study found that a lower cut-off score of 11 yielded optimal sensitivity and specificity (i.e., the best balance of accurately identifying individuals with ASD based on the screener), and analyses found an overrepresentation of ASD (5.2%) and ASD traits (12.1%). Transgender youth with ASD or ASD symptoms had higher anxiety, and all youth perceived themselves as more anxious than their parents. Future research is needed to identify the needs of this population, with particular consideration for the lived experiences of gender diverse and transgender youth.
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Affiliation(s)
- Alexis Clyde
- Children's Health System of Texas, 1935 Medical District Dr., Mail Code CH 12.01, Dallas, TX, 75235, USA.
- University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | | | - Gabrielle Agnew
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Laura E Kuper
- Children's Health System of Texas, 1935 Medical District Dr., Mail Code CH 12.01, Dallas, TX, 75235, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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12
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Scattoni ML, Fatta LM, Micai M, Sali ME, Bellomo M, Salvitti T, Fulceri F, Castellano A, Molteni M, Gambino G, Posada M, Romano G, Puopolo M. Autism spectrum disorder prevalence in Italy: a nationwide study promoted by the Ministry of Health. Child Adolesc Psychiatry Ment Health 2023; 17:125. [PMID: 37898807 PMCID: PMC10613370 DOI: 10.1186/s13034-023-00673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 10/15/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND This nationwide study aimed to estimate Autism Spectrum Disorder (ASD) prevalence in 7-9-year-old Italian children. Promoted by Italy's Ministry of Health and coordinated by the National Observatory for Autism at the National Institute of Health, it covered schools in northern (Lecco and Monza-Brianza), central (Rome and its province), and southern (Palermo and its province) regions from February 24, 2016, to February 23, 2018, using a multi-stage approach defined by the European Union's ASD network. METHODS Phase one identified ASD-diagnosed children in mainstream schools through local Ministry of Education (MoE) disability registries. Phase two had a subset of schools screen 7-9-year-olds using the Social Communication Questionnaire-Life version (SCQ-L). Those with SCQ-L scores of 15 + underwent clinical consultation for ASD symptoms, cognitive abilities, and life skills. To counter potential false negatives, 20% scoring 11-14 were randomly assessed via Autism Diagnostic Interview-Revised (ADI-R). RESULTS MoE data revealed 9.8 per 1000 certified ASD children in the north, 12.2 in the central, and 10.3 in the south. In phase two, 35,823 SCQ-L questionnaires were distributed across 198 schools (northern: 11,190 in 49 schools, central: 13,628 in 87 schools, southern: 11,005 in 62 schools). Of SCQ-L respondents, 2.4% (n = 390) scored above the 15 cutoff. Among these, 100 had ASD diagnoses, and 50 had other diagnoses. Among 115 families assessed, 16.5% (n = 19) received ASD diagnoses. CONCLUSIONS The estimated prevalence of ASD in Italy was 13.4 (11.3-16.0) per 1,000 children aged 7-9 years, with a male-to-female ratio of 4.4:1. It will guide national policies in enhancing services tailored to the specific needs of autistic children.
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Affiliation(s)
- Maria Luisa Scattoni
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy.
| | - Laura Maria Fatta
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Martina Micai
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | | | | | - Tommaso Salvitti
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | - Francesca Fulceri
- Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
| | | | | | | | | | | | - Maria Puopolo
- Department of Neuroscience, Istituto Superiore di Sanità, Rome, Italy
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13
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Lee CM, Altschuler MR, Esler AN, Burrows CA, Hudock RL. Why are only some children with autism spectrum disorder misclassified by the social communication questionnaire? An empirical investigation of individual differences in sensitivity and specificity in a clinic-referred sample. J Neurodev Disord 2023; 15:28. [PMID: 37608249 PMCID: PMC10463287 DOI: 10.1186/s11689-023-09497-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/26/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The Social Communication Questionnaire (SCQ) is a checklist for autism spectrum disorder (ASD) commonly used in research and clinical practice. While the original validation study suggested that the SCQ was an accurate ASD screener with satisfactory sensitivity and specificity, subsequent studies have yielded mixed results, with some revealing low sensitivity, low specificity, and low utility in some settings. METHOD The present study examined the psychometric properties of the SCQ as well as the individual difference characteristics of 187 individuals with and without autism spectrum disorder (ASD) who were misclassified or accurately classified by the SCQ in a clinic-referred sample. RESULTS The SCQ showed suboptimal sensitivity and specificity, regardless of age and sex. Compared to true positives, individuals classified as false positives displayed greater externalizing and internalizing problems, whereas individuals classified as false negatives displayed better social communication and adaptive skills. CONCLUSIONS The findings suggest that non-autistic developmental and behavioral individual difference characteristics may explain high rates of misclassification using the SCQ. Clinicians and researchers could consider using the SCQ in combination with other tools for young children with internalizing and externalizing symptoms and other more complex clinical presentations.
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Affiliation(s)
- Chimei M Lee
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA.
| | | | - Amy N Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA
| | - Catherine A Burrows
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA
| | - Rebekah L Hudock
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN, 55414, USA
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14
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Kurtz-Nelson EC, Rea HM, Petriceks AC, Hudac CM, Wang T, Earl RK, Bernier RA, Eichler EE, Neuhaus E. Characterizing the autism spectrum phenotype in DYRK1A-related syndrome. Autism Res 2023; 16:1488-1500. [PMID: 37497568 PMCID: PMC10530559 DOI: 10.1002/aur.2995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
Likely gene-disrupting (LGD) variants in DYRK1A are causative of DYRK1A syndrome and associated with autism spectrum disorder (ASD) and intellectual disability (ID). While many individuals with DYRK1A syndrome are diagnosed with ASD, they may present with a unique profile of ASD traits. We present a comprehensive characterization of the ASD profile in children and young adults with LGDs in DYRK1A. Individuals with LGD variants in DYRK1A (n = 29) were compared to children who had ASD with no known genetic cause, either with low nonverbal IQ (n = 14) or average or above nonverbal IQ (n = 41). ASD was assessed using the ADOS-2, ADI-R, SRS-2, SCQ, and RBS-R. Quantitative score comparisons were conducted, as were qualitative analyses of clinicians' behavioral observations. Diagnosis of ASD was confirmed in 85% and ID was confirmed in 89% of participants with DYRK1A syndrome. Individuals with DYRK1A syndrome showed broadly similar social communication behaviors to children with idiopathic ASD and below-average nonverbal IQ, with specific challenges noted in social reciprocity and nonverbal communication. Children with DYRK1A syndrome also showed high rates of sensory-seeking behaviors. Phenotypic characterization of individuals with DYRK1A syndrome may provide additional information on mechanisms contributing to co-occurring ASD and ID and contribute to the identification of genetic predictors of specific ASD traits.
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Affiliation(s)
| | - Hannah M. Rea
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Aiva C. Petriceks
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Caitlin M. Hudac
- Department of Psychology, University of South Carolina, Columbia, South Carolina, USA
- Carolina Autism and Neurodevelopment Research Center, Columbia, South Carolina, USA
| | - Tianyun Wang
- Department of Medical Genetics, Center for Medical Genetics, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
- Neuroscience Research Institute, Peking University; Key Laboratory for Neuroscience, Ministry of Education of China & National Health Commission of China, Beijing, China
- Autism Research Center, Peking University Health Science Center, Beijing, China
| | - Rachel K. Earl
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Raphael A. Bernier
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Evan E. Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, Washington, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, Washington, USA
| | - Emily Neuhaus
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
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15
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Iwamoto BK, Neece CL, Nair A, Rockwood NJ, Fenning RM, Krantz ML, Van Dyk TR. Exploring Bidirectional Relationships: Child Sleep Duration, Child Behavior Problems, and Parenting Stress in Families of Children with Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 106:102197. [PMID: 37484880 PMCID: PMC10358315 DOI: 10.1016/j.rasd.2023.102197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Background Youth with Autism Spectrum Disorder (ASD) are at-risk for sleep and behavior problems, and their parents are at-risk for high stress. Child sleep duration, behavior problems, and parenting stress are interrelated; however, directionality of these associations is unclear and research including youth with ASD is lacking. Using a day-to-day, within-person design, this study explores the directionality of these relationships in families of children with ASD. Method Twenty-six children (ages 3-5, 73.1% male, 65.4% Hispanic/Latino) with ASD and their mothers participated in a 14-day study. Child sleep duration (parent-report and actigraphy), behavior problems, and parenting stress were measured daily. Constructs were decomposed into their within- and between-person components and analyzed with random intercept cross-lagged panel models. Results While between-person relationships were directionally expected in that shorter sleep, more behavior problems, and greater parenting stress were associated, within-person relationships were complicated. Better-than-average child behavior was associated with less next-day parenting stress, yet more parenting stress than average was associated with better next-day child behavior. As expected, longer-than-average child sleep was associated with less next-day parenting stress, while greater child behavior problems were associated with less sleep that night. Conclusions Understanding the directionality of associations between child and parent factors allows for the optimization of interventions to improve the quality of life for families of children with ASD. Interventions that target child behavior and/or help parents manage stress while maintaining effective parenting strategies for sleep and behavior may be useful.
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Affiliation(s)
- Brooke K. Iwamoto
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Cameron L. Neece
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Aarti Nair
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Nicholas J. Rockwood
- Division of Interdisciplinary Studies, Loma Linda University; 11065 Campus Street, Loma Linda, CA 92350, United States
| | - Rachel M. Fenning
- Department of Psychological Science and The Claremont Autism Center, Claremont McKenna College; 850 Columbia Avenue, Claremont, CA 91711, United States
| | - Megan L. Krantz
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
| | - Tori R. Van Dyk
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Loma Linda, CA 92354, United States
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16
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Martin AM, McIntyre LL, Neece C. Examining the Impact of COVID-19 on Education and Service Access for Diverse Families of Young Children With and Without Developmental Delays. FAMILY JOURNAL (ALEXANDRIA, VA.) 2023; 31:417-425. [PMID: 38602907 PMCID: PMC10015280 DOI: 10.1177/10664807231163261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The rapid transition to virtual learning due to the COVID-19 pandemic created unprecedented challenges that significantly impacted caregivers of young children, particularly those with developmental delays and children from non-English speaking households (Valicenti-McDermott et al., 2022). The current study aims to describe caregivers' concerns regarding the COVID-19 pandemic in general and specific educational concerns following school closures, and to determine whether their concerns varied as a function of whether the child had a developmental delay or the parent's ethnicity. Results revealed that caregivers of children with DD endorsed a greater number of general and education-specific COVID-19 concerns compared to caregivers of TD children, and non-Latinx caregivers of children with DD reported more general COVID-19 concerns compared to Latinx caregivers of children with DD. With respect to education-specific concerns, caregivers of children with DD reported a greater impact from the loss and/or delay of services and reported feeling significantly less capable of conducting educational activities in the home compared to caregivers of TD children. However, almost all caregivers in the study endorsed some level of stress from remote instruction. These findings suggest there is a specific need for attention to caregiver mental health and an examination of long-term educational outcomes resulting from extended school closures during the COVID-19 pandemic.
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Affiliation(s)
| | | | - Cameron Neece
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA
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17
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Araújo M, Jorge JC, do Carmo Santos M, Vilhena E, Oliveira P, Freitas PP. Screening for Autism Spectrum Disorders - Validation of the Portuguese Version of the Social Communication Questionnaire. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01535-8. [PMID: 37079183 DOI: 10.1007/s10578-023-01535-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 04/21/2023]
Abstract
There are no assessment and screening tools for Autism Spectrum Disorders (ASD) validated for the Portuguese population. The Social Communication Questionnaire (SCQ) is an useful screening tool of ASD diagnosis. The main objectives of our study were to produce a Portuguese version of the SCQ (SCQ-PF), study its internal consistency, sensitivity and specificity in order to evaluate its validity as a screening instrument for ASD. We also wanted to study the impact of intellectual disability and verbal impairment and other mental disorders on SCQ-PF psychometric properties. The study included 211 children and adolescents, aged 4-17, divided in three groups: ASD Group (n = 96), Other Mental Disorders Group (OMD) (n = 63) and No Mental Disorders (NMD) Group (n = 52). Parents or other primary caregiver provided information on the SCQ items. The SCQ-PF score was significantly higher in the ASD group than in the other groups (p < 0.001). As to internal consistency, Cronbach's alpha was 87%. ASD subjects were distinguished from subjects without ASD (OMD and NMD Groups) and the area under the curve (AUC) was 0.897 (95% Confidence Interval: 0.852-0.943), for a cutoff of 14, which yielded the highest AUC, with values of sensitivity and specificity 0.76 and 0.93, respectively. These findings show that SCQ- PF with a cutoff of 14 is an acceptable and useful screening tool for ASD in the Portuguese population.
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Affiliation(s)
- Manuela Araújo
- Departamento de Psiquiatria da Infância e Adolescência - Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Joana Calejo Jorge
- Departamento de Psiquiatria da Infância e Adolescência - Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Maria do Carmo Santos
- Departamento de Psiquiatria da Infância e Adolescência - Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Estela Vilhena
- 2Ai - School of Technology, IPCA, Barcelos, Portugal
- LASI - Associate Laboratory of Intelligent Systems, Guimarães, Portugal
| | - Pedro Oliveira
- Instituto Ciências Biomédicas Abel Salazar-Universidade do Porto, Porto, Portugal
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Paula Pinto Freitas
- 2Ai - School of Technology, IPCA, Barcelos, Portugal.
- Center for Health Technology and Services Research (CINTESIS.ICBAS), Rua de Jorge Viterbo Ferreira, 228, Porto, 4050-313, Portugal.
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18
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Chan N, Fenning RM, Neece CL. Prevalence and Phenomenology of Anxiety in Preschool-Aged Children with Autism Spectrum Disorder. Res Child Adolesc Psychopathol 2023; 51:33-45. [PMID: 36048376 DOI: 10.1007/s10802-022-00964-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2022] [Indexed: 10/14/2022]
Abstract
Individuals with autism spectrum disorder (ASD) are at a higher risk for developing co-occurring anxiety symptoms and diagnosable anxiety disorders compared to children with neurotypical development (NTD). The objective of the current study was to characterize the prevalence and phenomenology of anxiety in preschool-aged children with ASD. Our sample consisted of preschoolers (M = 52.8 months, SD = 10.8 months) with ASD (n = 77, 66% with co-occurring intellectual disability, ID) and NTD (n = 55). We employed multi-method (questionnaire and semi-structured diagnostic interview) and multi-informant (parent- and teacher-report) assessments of anxiety. Children with ASD were significantly more likely to meet criteria for an anxiety disorder than children with NTD. Over 70% of our sample with ASD met DSM-5 criteria for an anxiety disorder, with Specific Phobia and Separation Anxiety Disorder being the most prevalent. A range of specific fears was endorsed in the group with ASD, many of which overlapped with ASD symptoms. Parents, but not teachers, also reported greater anxiety symptoms for children with ASD relative to the comparison sample. Prevalence and phenomenology of anxiety in our sample with ASD generally did not differ between those with and without co-occurring ID, with the exception of higher rates of generalized anxiety in those without ID. Results showed poor concordance between parent questionnaires and a semi-structured diagnostic interview in detecting clinically-elevated anxiety in children with ASD. Implications for clinical practice and research are discussed.
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Affiliation(s)
| | - Rachel M Fenning
- Claremont McKenna College, Claremont, CA, USA.,California State University, Fullerton, Fullerton, CA, USA
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19
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Staton A, Dawson D, Moghaddam N, McGrath B. Specificity and sensitivity of the social communication questionnaire lifetime screening tool for autism spectrum disorder in a UK CAMHS service. Clin Child Psychol Psychiatry 2022:13591045221137196. [PMID: 36472121 DOI: 10.1177/13591045221137196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The Social Communication Questionnaire is used to identify children and young people (CYP) who may require formal ASD assessment. However, there is a paucity of research on its utility in Children and Adolescent Mental Health Services. This evaluation aimed to determine the sensitivity and specificity of the Social Communication Questionnaire (SCQ) in a UK, Midlands CAMHS service. METHOD Forty young people (mean age 13.75 years) were screened using the caregiver reported SCQ before completing 'gold standard' assessment. RESULTS The SCQ had a sensitivity of 80% and a specificity of 25.7%. ROC curve analysis indicated low diagnostic accuracy. Differences in predictive accuracy of SCQ and diagnostic standard were statistically significant (p < 0.0001). CONCLUSION This evaluation builds on previous research suggesting that the SCQ may not be an efficient screening tool in CAMHS settings.
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Affiliation(s)
- Amelia Staton
- 6123University of Nottingham, UK
- 4547University of Lincoln, UK
- 5314Nottinghamshire Healthcare NHS Foundation Trust, UK
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20
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Air Pollution and Maximum Temperature Are Associated with Neurodevelopmental Regressive Events in Autism Spectrum Disorder. J Pers Med 2022; 12:jpm12111809. [PMID: 36579525 PMCID: PMC9696106 DOI: 10.3390/jpm12111809] [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: 09/05/2022] [Revised: 10/18/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Neurodevelopmental regression (NDR) is an enigmatic event associated with autism spectrum disorder (ASD) during which a child loses previously acquired skills and develops ASD symptoms. In some, a trigger which precedes the NDR event, such as a fever, can be identified, but in many cases no trigger is obvious. We hypothesize that air pollution (PM2.5) may trigger NDR, especially in those children without an identified trigger. Average daily PM2.5, ozone, precipitation and maximum temperature (Tmax) were derived from Environmental Protection Agency models and National Oceanic and Atmospheric Administration monitors based on zip-code information from 83 ASD participants during the six-weeks following the onset month of an NDR event and a reference period defined as one year before and one year after the event. Seasonally adjusted logistic regression (LR) and linear mixed models (LMM) compared cases (with a history of NDR) and matched controls (without a history of NDR). LR models found that the risk of NDR was related to higher PM2.5 during 3 to 6 weeks of the NDR event period, particularly in those without a trigger. Overall, both models converged on NDR being related to a higher PM2.5 and lower Tmax both during the NDR event period as well as the reference period, particularly in those without a known trigger. This temporal pattern suggests that environmental triggers, particularly PM2.5, could be related to NDR, especially in those without an identifiable trigger. Further studies to determine the underlying biological mechanism of this observation could help better understand NDR and provide opportunities to prevent NDR.
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21
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He AX, Luyster RJ, Arunachalam S. Parental tuning of language input to autistic and nonspectrum children. Front Psychol 2022; 13:954983. [PMID: 36211865 PMCID: PMC9537044 DOI: 10.3389/fpsyg.2022.954983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
Caregivers’ language input supports children’s language development, and it is often tuned to the child’s current level of skill. Evidence suggests that parental input is tuned to accommodate children’s expressive language levels, but accommodation to receptive language abilities is less understood. In particular, little is known about parental sensitivity to children’s abilities to process language in real time. Compared to nonspectrum children, children on the spectrum are slower to process language. In this study, we ask: Do parents of autistic children and those of nonspectrum children tune their language input to accommodate children’s different language processing abilities? Children with and without a diagnosis of autism (ages 2–6 years, N = 35) and their parents viewed a display of six images, one of which was the target. The parent labeled the target to direct the child’s attention to it. We first examined children’s language processing abilities by assessing their latencies to shift gaze to the labeled referent; from this, we found slower latencies in the autistic group than in the nonspectrum group, in line with previous findings. We then examined features of parents’ language and found that parents in both groups produced similar language, suggesting that parents may not adjust their language input according to children’s speed of language processing. This finding suggests that (1) capturing parental sensitivity to children’s receptive language, and specifically language processing, may enrich our models of individual differences in language input, and (2) future work should investigate if supporting caregivers in tuning their language use according to children’s language processing can improve children’s language outcomes.
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Affiliation(s)
- Angela Xiaoxue He
- Department of English and Literature, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Rhiannon J. Luyster
- Department of Communication Sciences and Disorders, Emerson College, Boston, MA, United States
| | - Sudha Arunachalam
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- *Correspondence: Sudha Arunachalam,
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22
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Screening for Intellectual Disabilities and/or Autism Amongst Older Children and Young Adults: a Systematic Review of Tools for Use in Africa. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
There are many well-developed screening tools for both intellectual disabilities and autism, but they may not be culturally appropriate for use within Africa. Our specific aims were to complete a systematic review to (1) describe and critically appraise short screening tools for the detection of intellectual disabilities and autism for older children and young adults, (2) consider the psychometric properties of these tools, and (3) judge the cultural appropriateness of these tools for use within Africa. Six screening tools for intellectual disabilities and twelve for autism were identified and appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. We identified two screening tools which appeared appropriate for validation for use within African nations.
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The mediating role of the gut microbiome in the association between ambient air pollution and autistic traits. Int J Hyg Environ Health 2022; 246:114047. [DOI: 10.1016/j.ijheh.2022.114047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
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Karaminis T, Stavrakaki S. The psychometric properties of the Greek version of the Social Communication Questionnaire. Autism Res 2022; 15:1768-1780. [PMID: 36056649 PMCID: PMC9546128 DOI: 10.1002/aur.2790] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 08/01/2022] [Indexed: 11/25/2022]
Abstract
There is a scarcity of diagnostic assessments and screening tools for autism spectrum disorders (ASD) in Greek. In this study, we examined the psychometric properties of the recently developed Greek version of the Social Communication Questionnaire (SCQ). We used parental responses for 311 children (mean age: 7.54 years old, SD = 1.92), 122 with a diagnosis of ASD (93 boys, 29 girls) and 189 neurotypical children (104 boys, 85 girls), with 167 responses referring to the Lifetime and 144 to the Current form of the SCQ. Both forms presented adequate construct validity based on the four‐factor model, while in both forms, autistic children presented higher SCQ total and subscale scores (four factors) than typical children. The forms had excellent internal reliability. An item‐response‐theory analysis suggested that over 80% of test items fitted adequately a Rasch model, while a preliminary analysis of gender biases suggested that a small number of items (Lifetime: five; Current: six out of 39) were differentially sensitive to autistic symptomatology in boys and girls. A receiver‐operating‐characteristic analysis showed excellent diagnostic performance based on the SCQ total score (Lifetime: area‐under‐the‐curve/AUC = 0.937, Current: AUC = 0.963), and acceptable to excellent discrimination for the four subscales (AUCs between 0.737 and 0.955). Our preliminary results suggest that the Greek SCQ presents satisfactory psychometric properties and can be used for differentiating children with ASD from typical children in initial assessments within clinical and research settings.
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Affiliation(s)
| | - Stavroula Stavrakaki
- Department of Italian Language and Literature, School of PhilosophyAristotle University of ThessalonikiThessalonikiGreece
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Zheng S, Kaat A, Farmer C, Thurm A, Burrows CA, Kanne S, Georgiades S, Esler A, Lord C, Takahashi N, Nowell KP, Will E, Roberts J, Bishop SL. Bias in measurement of autism symptoms by spoken language level and non-verbal mental age in minimally verbal children with neurodevelopmental disorders. Front Psychol 2022; 13:927847. [PMID: 35967726 PMCID: PMC9372407 DOI: 10.3389/fpsyg.2022.927847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Increasing numbers of children with known genetic conditions and/or intellectual disability are referred for evaluation of autism spectrum disorder (ASD), highlighting the need to refine autism symptom measures to facilitate differential diagnoses in children with cognitive and language impairments. Previous studies have reported decreased specificity of ASD screening and diagnostic measures in children with intellectual disability. However, little is known about how cognitive and language abilities impact the measurement of specific ASD symptoms in this group. We aggregated a large sample of young children (N = 1196; aged 31-119 months) to examine measurement invariance of ASD symptoms among minimally verbal children within the context of the Autism Diagnostic Observation Schedule (ADOS) Module 1. Using confirmatory factor analysis (CFA) and moderated non-linear factor analysis (MNLFA), we examined how discrete behaviors were differentially associated with the latent symptom domains of social communication impairments (SCI) and restricted and repetitive behaviors (RRB) across spoken language levels and non-verbal mental age groupings. While the two-factor structure of SCI and RRB held consistently across language and cognitive levels, only partial invariance was observed for both ASD symptom domains of SCI and RRB. Specifically, four out of the 15 SCI items and one out of the three RRB items examined showed differential item functioning between children with "Few to No Words" and those with "Some Words"; and one SCI item and one RRB item showed differential item functioning across non-verbal mental age groups. Moreover, even after adjusting for the differential item functioning to reduce measurement bias across groups, there were still differences in ASD symptom domain scores across spoken language levels. These findings further underscore the influence of spoken language level on measurement of ASD symptoms and the importance of measuring ASD symptoms within refined spoken language levels, even among those with minimal verbal abilities.
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Affiliation(s)
- Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Aaron Kaat
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, United States
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, United States
| | - Catherine A. Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Stephen Kanne
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, NY, United States
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Amy Esler
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Catherine Lord
- UCLA Semel Institute for Neuroscience & Human Behavior, Center for Autism Research and Treatment, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicole Takahashi
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO, United States
| | - Kerri P. Nowell
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO, United States
- Department of Health Psychology, University of Missouri, Columbia, MO, United States
| | - Elizabeth Will
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Jane Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Somer L. Bishop
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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A Randomized Trial of Direct Instruction Language for Learning in Children With Autism Spectrum Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:772-781. [PMID: 35093490 DOI: 10.1016/j.jaac.2021.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/28/2021] [Accepted: 01/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare Direct Instruction Language for Learning (DI) plus treatment as usual (TAU) with TAU alone in children with autism spectrum disorder and moderate language delay. METHOD In this study, 83 children (age range, 4 years to 7 years 11 months) were randomly assigned to DI+TAU (n = 42) or TAU (n = 41) for 6 months. Trained therapists delivered DI in twice-weekly, 90-minute sessions for 24 weeks. The primary outcome was the standard score on the age-appropriate version of the Clinical Evaluation of Language Fundamentals (CELF). The key secondary measure was the proportion of children rated by a clinician blinded to treatment as "much improved" or "very much improved" on the Clinical Global Impressions-Improvement (CGI-I) scale. RESULTS Attrition was 12%. At end point, DI+TAU participants showed a 4.8-point (8.1%) increase on CELF vs 2.3 points (4.1%) in TAU participants (difference = 2.55, p = .14, effect size = 0.25), rendering this a negative trial on the prespecified primary outcome. In post hoc analysis that adjusted for IQ, mean difference was 3.5 (p = .04, effect size = 0.33). On CGI-I, 54.8% (23/42) of DI+TAU participants were rated much improved or very much improved compared with 21.9% (9/41) of TAU participants (χ2 = 9.4, p = .002). On the clinically meaningful threshold of >5 points on CELF, 55.5% of DI+TAU participants achieved this benchmark vs 29.3% of TAU participants (χ2 = 3.6, p = .06). Complete CELF data were available for 72 participants. In the combined sample, baseline CELF scores ≤50 were associated with no improvement. CONCLUSION On CELF, DI+TAU did not meet the prespecified difference from TAU. When adjusted for IQ, DI+TAU was superior to TAU on CELF at end point. DI+TAU was superior to TAU on CGI-I. CLINICAL TRIAL REGISTRATION INFORMATION Direct Instruction Language for Learning in Autism Spectrum Disorder; https://clinicaltrials.gov/; NCT02483910.
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Luallin S, Hulac D, Pratt AA. Standardized administration of the Autism Diagnostic Observation Schedule, Second Edition across treatment settings. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Stephanie Luallin
- Department of School Psychology University of Northern Colorado Greeley Colorado USA
| | - David Hulac
- Department of School Psychology University of Northern Colorado Greeley Colorado USA
| | - April A. Pratt
- Department of School Psychology University of Northern Colorado Greeley Colorado USA
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Christopher K, Lord C. Best practice assessments for autism spectrum disorders in schools. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kourtney Christopher
- Departments of Psychiatry and School of Education University of California Los Angeles California USA
| | - Catherine Lord
- Departments of Psychiatry and School of Education University of California Los Angeles California USA
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Kim JI, Lee J, Lee KS, Lee YA, Shin CH, Hong YC, Kim BN, Lim YH. Association of phthalate exposure with autistic traits in children. ENVIRONMENT INTERNATIONAL 2021; 157:106775. [PMID: 34314979 DOI: 10.1016/j.envint.2021.106775] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 05/23/2023]
Abstract
BACKGROUND Phthalates are synthetic chemicals with endocrine-disrupting properties. They are reportedly associated with various neurotoxic outcomes. Studies on exposure to phthalates and children's autistic traits have shown inconsistent results with respect to sex and susceptible time periods. We investigated the association of phthalate exposure during the prenatal period and childhood with autistic traits over time using a birth cohort in South Korea. METHODS Five phthalate metabolites were measured during mid-term pregnancy and children's follow-up at ages of 4, 6, and 8 years among a total of 547 mother-child pairs. The social communication questionnaire (SCQ) was used to assess autistic traits of children at each time point. The relationship between phthalate metabolites and SCQ scores were analyzed by exposure windows and sex. RESULTS A 2.7 fold increase in di-(2-ethylhexyl) phthalate metabolite levels, mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP) during pregnancy was associated with increased SCQ scores at 4 years by 8.5% (95% confidence intervals [CI]: 1.9%, 15.5%) and 7.4% (95% CI: 0.3%, 15.0%), respectively, but not at the age of 6 or 8 years. Moreover, MEHHP levels at ages of 4 and 8 years were associated with increased SCQ scores at 8 years by 9.9% (95% CI: 1.8%, 18.6%) and 9.6% (95% CI: 1.3%, 18.6%), respectively. Boys showed stronger associations between phthalate exposure and SCQ scores than girls. CONCLUSION The study suggested different susceptible time windows of phthalate exposure: exposure during pregnancy is associated with autistic traits in young children, whereas exposure during early childhood years leads to autistic traits in school-aged children, particularly boys.
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Affiliation(s)
- Johanna Inhyang Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Jung Lee
- Integrative Care Hub, Children's Hospital, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Shin Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, South Korea
| | - Bung-Nyun Kim
- Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Youn-Hee Lim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
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30
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Frye RE, Lionnard L, Singh I, Karim MA, Chajra H, Frechet M, Kissa K, Racine V, Ammanamanchi A, McCarty PJ, Delhey L, Tippett M, Rose S, Aouacheria A. Mitochondrial morphology is associated with respiratory chain uncoupling in autism spectrum disorder. Transl Psychiatry 2021; 11:527. [PMID: 34645790 PMCID: PMC8514530 DOI: 10.1038/s41398-021-01647-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/20/2021] [Accepted: 09/29/2021] [Indexed: 12/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is associated with unique changes in mitochondrial metabolism, including elevated respiration rates and morphological alterations. We examined electron transport chain (ETC) complex activity in fibroblasts derived from 18 children with ASD as well as mitochondrial morphology measurements in fibroblasts derived from the ASD participants and four typically developing controls. In ASD participants, symptoms severity was measured by the Social Responsiveness Scale and Aberrant Behavior Checklist. Mixed-model regression demonstrated that alterations in mitochondrial morphology were associated with both ETC Complex I+III and IV activity as well as the difference between ETC Complex I+III and IV activity. The subgroup of ASD participants with relative elevation in Complex IV activity demonstrated more typical mitochondrial morphology and milder ASD related symptoms. This study is limited by sample size given the invasive nature of obtaining fibroblasts from children. Furthermore, since mitochondrial function is heterogenous across tissues, the result may be specific to fibroblast respiration. Previous studies have separately described elevated ETC Complex IV activity and changes in mitochondrial morphology in cells derived from children with ASD but this is the first study to link these two findings in mitochondrial metabolism. The association between a difference in ETC complex I+III and IV activity and normal morphology suggests that mitochondrial in individuals with ASD may require ETC uncoupling to function optimally. Further studies should assess the molecular mechanisms behind these unique metabolic changes.Trial registration: Protocols used in this study were registered in clinicaltrials.gov as NCT02000284 and NCT02003170.
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Affiliation(s)
- Richard E Frye
- Phoenix Children's Hospital, Phoenix, AZ, USA.
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.
| | - Loïc Lionnard
- Institut des Sciences de l'Evolution de Montpellier, UMR 5554 CNRS, UM, IRD, EPHE, Université de Montpellier, Place Eugène Bataillon, 34095, Montpellier cedex 05, France
| | - Indrapal Singh
- Phoenix Children's Hospital, Phoenix, AZ, USA
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Mohammad A Karim
- Phoenix Children's Hospital, Phoenix, AZ, USA
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Hanane Chajra
- Clariant Active ingredients, 195 Route d'Espagne, 31036, Toulouse Cedex 1, France
| | - Mathilde Frechet
- Clariant Active ingredients, 195 Route d'Espagne, 31036, Toulouse Cedex 1, France
| | - Karima Kissa
- LPHI, CNRS, INSERM, Emergence of Haematopoietic Stem Cells and Cancer, Univ Montpellier, Montpellier, France
| | - Victor Racine
- QuantaCell SAS, 2 allée du Doyen Georges Brus, 33600, Pessac, France
| | - Amrit Ammanamanchi
- Phoenix Children's Hospital, Phoenix, AZ, USA
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Patrick John McCarty
- Phoenix Children's Hospital, Phoenix, AZ, USA
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Leanna Delhey
- Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Marie Tippett
- Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Shannon Rose
- Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Abdel Aouacheria
- Institut des Sciences de l'Evolution de Montpellier, UMR 5554 CNRS, UM, IRD, EPHE, Université de Montpellier, Place Eugène Bataillon, 34095, Montpellier cedex 05, France
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31
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Havdahl A, Farmer C, Schjølberg S, Øyen AS, Surén P, Reichborn-Kjennerud T, Magnus P, Bresnahan M, Hornig M, Susser E, Lipkin WI, Lord C, Stoltenberg C, Thurm A, Bishop S. Age of walking and intellectual ability in autism spectrum disorder and other neurodevelopmental disorders: a population-based study. J Child Psychol Psychiatry 2021; 62:1070-1078. [PMID: 33369747 PMCID: PMC8236490 DOI: 10.1111/jcpp.13369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Delayed walking is common in intellectual disability (ID) but may be less common when ID occurs with autism spectrum disorder (ASD). Previous studies examining this were limited by reliance on clinical samples and exclusion of children with severe motor deficits. OBJECTIVE To examine in a population-based sample if age of walking is differentially related to intellectual ability in children with ASD versus other neurodevelopmental disorders (NDD). METHODS Participants were from the nested Autism Birth Cohort Study of the Norwegian Mother, Father and Child Cohort Study (MoBa). Cox proportional hazards regression assessed if diagnosis (ASD n = 212 vs. NDD n = 354), continuous nonverbal IQ, and their interaction, were associated with continuous age of walking. RESULTS The relationship between nonverbal IQ and age of walking was stronger for NDD than for ASD (Group × nonverbal IQ interaction, χ2 = 13.93, p = .0002). This interaction was characterized by a 21% decrease in the likelihood of walking onset at any given time during the observation period per 10-point decrease in nonverbal IQ (hazard ratio = 0.79, 95% CI: 0.78-0.85) in the NDD group compared to 8% (hazard ratio = 0.92, 95% CI: 0.86-0.98) in the ASD group. CONCLUSIONS The finding that age of walking is less strongly related to low intellectual ability in children with ASD than in children without other NDDs supports the hypothesis that ID in ASD may result from heterogeneous developmental pathways. Late walking may be a useful stratification variable in etiological research focused on ASD and other NDDs.
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Affiliation(s)
- Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway.,MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Cristan Farmer
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, MD, USA
| | | | - Anne-Siri Øyen
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Pål Surén
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Per Magnus
- Norwegian Institute of Public Health, Oslo, Norway
| | - Michaeline Bresnahan
- New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Mady Hornig
- Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Ezra Susser
- New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA.,Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - W Ian Lipkin
- Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.,Center for Infection and Immunity, Mailman School of Public Health and Departments of Neurology and Pathology, Vagelos College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Catherine Lord
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Audrey Thurm
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Somer Bishop
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
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Reyes NM, Moody E, Hightshoe K, Davidon S, Rosenberg S, Dahl E, Kubicek LF. Factors That May Influence Social Communication Questionnaire (SCQ) Scores: An Examination of the Spanish and English SCQ in School-Aged Students. SCHOOL PSYCHOLOGY REVIEW 2021. [DOI: 10.1080/2372966x.2021.1927830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Guttentag S, Bishop S, Doggett R, Shalev R, Kaplan M, Dyson M, Cohen M, Lord C, Di Martino A. The utility of parent-report screening tools in differentiating autism versus attention-deficit/hyperactivity disorder in school-age children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:473-487. [PMID: 34219504 DOI: 10.1177/13623613211030071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview - School-Age, the Social Responsiveness Scale - 2nd Edition, and the Social Communication Questionnaire - Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire - Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.
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Affiliation(s)
- Sara Guttentag
- Child Mind Institute, USA.,Ferkauf Graduate School of Psychology, Yeshiva University, USA.,Hassenfeld Children's Hospital at NYU Langone, USA
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Duvall S, Armstrong K, Shahabuddin A, Grantz C, Fein D, Lord C. A road map for identifying autism spectrum disorder: recognizing and evaluating characteristics that should raise red or "pink" flags to guide accurate differential diagnosis. Clin Neuropsychol 2021; 36:1172-1207. [PMID: 34121610 DOI: 10.1080/13854046.2021.1921276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Objective: Given the high population prevalence of Autism Spectrum Disorder (ASD) and overlapping symptoms with medically complex groups, ASD is a common rule out diagnosis for neuropsychologists even when not identified in the referral or initial presenting concerns. This paper presents practical guidance to support neuropsychologists in their ability to accurately assess, diagnose, and/or rule out ASD, especially in patients with more subtle presentations. Method: This paper combines clinical experience and empirical literature to highlight important assessment measures and related considerations, differential diagnostic considerations, common misconceptions about ASD and person/family characteristics, as well as variability in presentation and comorbidities that can obscure the diagnosis. Characteristics that may be considered "red flags" (clearly diagnostic, classic symptoms) and "pink flags" (associated features and symptoms that are suggestive of ASD but not quite definitive and that may overlap with symptoms seen in other neurodevelopmental or psychiatric diagnoses) will be discussed. Conclusions: Neuropsychologists in all clinical settings should be able to effectively screen for and/or diagnose ASD, even when its presentation is more subtle and/or when symptoms are masked by patient strengths in a way that makes their clinical presentation less obvious. Practical strategies for communicating the diagnosis and next steps/recommendations for interventions are reviewed.
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Affiliation(s)
- Susanne Duvall
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
| | | | - Ambreen Shahabuddin
- Department of Pediatrics & Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
| | - Caroline Grantz
- Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, USA
| | - Deborah Fein
- Departments of Psychological Sciences and Pediatrics, University of Connecticut, Storrs, CT, USA
| | - Catherine Lord
- Department of Psychiatry and Education, Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles, CA, USA
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35
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Kuru Y, Nishiyama T, Sumi S, Suzuki F, Shiino T, Kimura T, Hirai K, Kuroda M, Kamio Y, Kikuchi S. Practical applications of brief screening questionnaires for autism spectrum disorder in a psychiatry outpatient setting. Int J Methods Psychiatr Res 2021; 30:e1857. [PMID: 33216391 PMCID: PMC8170580 DOI: 10.1002/mpr.1857] [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: 04/22/2020] [Revised: 08/13/2020] [Accepted: 10/05/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES This study was designed to examine the diagnostic performance of the social and communication disorders checklist (SCDC) and strength and difficulties questionnaire (SDQ) to detect autism spectrum conditions (ASC), along with the social responsiveness scale-second edition (SRS-2) as reference, in a psychiatry outpatient setting. METHODS We translated the SCDC into Japanese since its Japanese version was unavailable. We examined its test-retest reliability as well as the internal consistency reliability and diagnostic performance of the three questionnaires among 41 Japanese psychiatric outpatients, using the best-estimate diagnosis of ASC based on the diagnostic interview for social and communication disorders, as a gold standard. RESULTS The test-retest reliability was high for the SCDC. Although the internal consistency reliability was high for the SCDC and SRS-2, that was low for the prosocial and peer problem subscales of the SDQ. The performance of the SCDC, SDQ, and SRS-2 to detect ASC was moderate: the area under the ROC curve of 0.78, 0.78, and 0.84, respectively. CONCLUSIONS Although questionnaires to detect ASC, including the three examined, generally have only moderate performance in this setting, these can be successfully applied to high-risk populations such as psychiatry outpatients, when multi-level rather than dichotomous likelihood ratios are used.
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Affiliation(s)
- Yukiko Kuru
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medicine, Nagoya, Japan.,Department of Child and Adolescent Psychiatry, Kamibayashi Memorial Hospital, Ichinomiya, Japan
| | - Satoshi Sumi
- Department of Child and Adolescent Psychiatry, Kamibayashi Memorial Hospital, Ichinomiya, Japan
| | - Futoshi Suzuki
- Department of Child and Adolescent Psychiatry, Kamibayashi Memorial Hospital, Ichinomiya, Japan.,Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Tomoko Shiino
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Takuma Kimura
- Department of Early Childhood Education and Care, Nagoya Management Junior College, Owariasahi, Japan
| | - Kou Hirai
- Department of Child and Adolescent Psychiatry, Kamibayashi Memorial Hospital, Ichinomiya, Japan
| | - Miho Kuroda
- Department of Human Care, Nagoya University of Arts and Sciences, Nagoya, Japan
| | - Yoko Kamio
- Institute of Education and Human Development, Ochanomizu University, Tokyo, Japan.,National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shogo Kikuchi
- Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan
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Finkelman MD, Wei T, Lowe SR. Computer-Based Testing to Shorten the Social Communication Questionnaire (SCQ): a Proof- of-Principle Study of the Lifetime and Current Forms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-020-09853-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Frye RE, Cakir J, Rose S, Delhey L, Bennuri SC, Tippett M, Melnyk S, James SJ, Palmer RF, Austin C, Curtin P, Arora M. Prenatal air pollution influences neurodevelopment and behavior in autism spectrum disorder by modulating mitochondrial physiology. Mol Psychiatry 2021; 26:1561-1577. [PMID: 32963337 PMCID: PMC8159748 DOI: 10.1038/s41380-020-00885-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/03/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023]
Abstract
We investigate the role of the mitochondrion, an organelle highly sensitive to environmental agents, in the influence of prenatal air pollution exposure on neurodevelopment and behavior in 96 children with autism spectrum disorder (ASD) [45 with neurodevelopmental regression (NDR); 76% Male; mean (SD) age 10 y 9 m (3 y 9 m)]. Mitochondrial function was assessed using the Seahorse XFe96 in fresh peripheral blood mononuclear cells. Second and third trimester average and maximal daily exposure to fine air particulate matter of diameter ≤2.5 µm (PM2.5) was obtained from the Environmental Protection Agency's Air Quality System. Neurodevelopment was measured using the Vineland Adaptive Behavior Scale 2nd edition and behavior was assessed using the Aberrant Behavior Checklist and Social Responsiveness Scale. Prenatal PM2.5 exposure influenced mitochondrial respiration during childhood, but this relationship was different for those with (r = 0.25-0.40) and without (r = -0.07 to -0.19) NDR. Mediation analysis found that mitochondrial respiration linked to energy production accounted for 25% (SD = 2%) and 10% (SD = 2%) of the effect of average prenatal PM2.5 exposure on neurodevelopment and behavioral symptoms, respectively. Structural equation models estimated that PM2.5 and mitochondrial respiration accounted for 34% (SD = 4%) and 36% (SD = 3%) of the effect on neurodevelopment, respectively, and that behavior was indirectly influenced by mitochondrial respiration through neurodevelopment but directly influenced by prenatal PM2.5. Our results suggest that prenatal exposure to PM2.5 disrupts neurodevelopment and behavior through complex mechanisms, including long-term changes in mitochondrial respiration and that patterns of early development need to be considered when studying the influence of environmental agents on neurodevelopmental outcomes.
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Affiliation(s)
- Richard E Frye
- Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA.
| | - Janet Cakir
- North Carolina State University, Raleigh, NC, USA
| | - Shannon Rose
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Leanna Delhey
- Arkansas Children's Research Institute, Little Rock, AR, USA
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sirish C Bennuri
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Marie Tippett
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Stepan Melnyk
- Arkansas Children's Research Institute, Little Rock, AR, USA
| | - S Jill James
- Arkansas Children's Research Institute, Little Rock, AR, USA
| | - Raymond F Palmer
- Department of Family and Community Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Arinda A, Nakasujja N, Odokonyero R. Prevalence of autism spectrum disorder symptoms in a paediatric neurology clinic at a tertiary hospital in Uganda. S Afr J Psychiatr 2021; 27:1548. [PMID: 33604074 PMCID: PMC7876953 DOI: 10.4102/sajpsychiatry.v27i0.1548] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/29/2020] [Indexed: 12/27/2022] Open
Abstract
Background Children with neurological disorders are more likely to present with autism spectrum disorder (ASD) symptoms and get an ASD diagnosis. Despite the large burden of childhood neurological disorders in Uganda, there is limited information on ASD amongst children with neurological disorders in Uganda. Aim The aim of this study was to determine the prevalence and factors associated with ASD symptoms amongst children attending the paediatric neurology clinic. Setting The study was conducted at the paediatric neurology clinic of Mulago National Referral Hospital in Uganda. Methods This was a cross-sectional study of 318 children aged 2–9 years. After obtaining consent, a socio-demographic questionnaire and the Social Communication Questionnaire were administered to the caregivers of the children. Additional questions were administered to assess the prenatal, birth and postnatal characteristics of the children. Sample characteristics were described using frequencies and means. Bivariate analysis was carried out using chi-square test and Fisher’s exact test. Multiple logistic regression models were used to assess which factors were independently associated with ASD symptoms. Results The mean age of the children was 5 years and 58.2% were males. The prevalence of significant ASD symptoms was found to be 45%. Factors negatively associated with significant ASD symptoms were female sex (odds ratio [OR] 0.48 [95% CI 0.24, 0.98]) and ability to speak (OR 0.09 [95% CI 0.04, 0.2]). The history of delayed developmental milestones was positively associated with significant ASD symptoms (OR 3.3 [95% CI 1.59, 6.84]). Conclusion The prevalence of ASD symptoms is high in children with neurological disorders. Children, especially those with delayed developmental milestones, should routinely be screened for ASD.
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Affiliation(s)
- Anita Arinda
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Noeline Nakasujja
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Raymond Odokonyero
- Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Wright B, Konstantopoulou K, Sohal K, Kelly B, Morgan G, Hulin C, Mansoor S, Mon-Williams M. Systematic approach to school-based assessments for autism spectrum disorders to reduce inequalities: a feasibility study in 10 primary schools. BMJ Open 2021; 11:e041960. [PMID: 33455935 PMCID: PMC7813406 DOI: 10.1136/bmjopen-2020-041960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This was a pilot study to explore whether the Early Years Foundation Stage Profile (EYFSP) carried out by UK teachers within the 'reception' year, combined with the Social Communication Questionnaire (SCQ), can lead to early identification of children with autism spectrum disorders (ASD) and early access to intervention and can reduce inequity in access to assessment and intervention. DESIGN Pragmatic prospective cohort. SETTING Ten primary schools from the SHINE project in Bradford. PARTICIPANTS 587 pupils from 10 schools who transitioned from reception to year 1 in July 2017 and had the EYFSP completed were included in the final study. INTERVENTIONS The assessment involved a multidisciplinary team of three staff who completed Autism Diagnostic Interview-Revised, Autism Diagnostic Observation Schedule Version 2, classroom observations with an ASD checklist, a teacher-based ASD questionnaire and a final consensus meeting. PRIMARY OUTCOME MEASURE National Institute for Health and Care Excellence guideline-compliant clinical diagnosis of ASD. SECONDARY OUTCOME MEASURES Age of diagnosis, demographic data and feasibility parameters. RESULTS Children with low scores on the EYFSP were more likely to score above the SCQ threshold of 12, indicating potential autism (50% compared with 19% of children with high scores on the EYFSP (p<0.001)). All children scoring above the SCQ threshold received a full autism assessment; children who scored low on the EYFSP were more likely to be diagnosed with autism (and other developmental issues) compared with those who did not. CONCLUSIONS We identified nine new children with a diagnosis of ASD, all from ethnic minorities, suggesting that this process may be addressing the inequalities in early diagnosis found in previous studies. All children who scored above the SCQ threshold required support (ie, had a neurodevelopmental disorder), indicating the EYFSP questionnaire captured 'at-risk' children.
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Affiliation(s)
- Barry Wright
- Hull York medical School and Department of Health Sciences, University of York, York, UK
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | | | - Kuldeep Sohal
- Born in Bradford Research Team, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Brian Kelly
- Born in Bradford Research Team, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Geoff Morgan
- Educational Psychology Team, City of Bradford, Metropolitan District Council, Bradford, UK
| | - Cathy Hulin
- Born in Bradford Research Team, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - Sara Mansoor
- Child and Adolescent Psychiatry, Bradford District Care NHS Foundation Trust, Saltaire, Bradford, UK
| | - Mark Mon-Williams
- Born in Bradford Research Team, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- Department of Psychology, University of Leeds, Leeds, UK
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, West Yorkshire, UK
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Lærerskoleveien, Norway
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40
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Harris JF, Coffield CN, Janvier YM, Mandell D, Cidav Z. Validation of the Developmental Check-In Tool for Low-Literacy Autism Screening. Pediatrics 2021; 147:peds.2019-3659. [PMID: 33303635 DOI: 10.1542/peds.2019-3659] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Persistent disparities exist in early identification of autism spectrum disorder (ASD) among children from low-income families who are racial and/or ethnic minorities and where English is not the primary language. Parental literacy and level of maternal education may contribute to disparities. The Developmental Check-In (DCI) is a visually based ASD screening tool created to reduce literacy demands and to be easily administered and scored across settings. In a previous study, the DCI showed acceptable discriminative ability between ASD versus non-ASD in a young, underserved sample at high-risk for ASD. In this study, we tested the DCI among an unselected, general sample of young underserved children. METHODS Six hundred twenty-four children ages 24 to 60 months were recruited through Head Start and Early Head Start. Parents completed the DCI, Modified Checklist for Autism in Toddlers, Revised with Follow-Up, and Social Communication Questionnaire. Children scoring positive on any measure received evaluation for ASD. Those screening negative on both Modified Checklist for Autism in Toddlers, Revised with Follow-Up and Social Communication Questionnaire were considered non-ASD. RESULTS Parents were primarily Hispanic, reported high school education or less, and had public or no insurance. The DCI demonstrated good discriminative power (area under the curve = 0.80), performing well across all age groups, genders, levels of maternal education, primary language, and included ethnic and racial groups. Item-level analyses indicated that 24 of 26 DCI items discriminated ASD from non-ASD. CONCLUSIONS The DCI is a promising ASD screening tool for young, underserved children and may be of particular value in screening for ASD for those with low literacy levels or with limited English proficiency.
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Affiliation(s)
- Jill F Harris
- Children's Specialized Hospital, New Brunswick, New Jersey;
| | | | | | - David Mandell
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Zuleyha Cidav
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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41
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Conner CM, Golt J, Shaffer R, Righi G, Siegel M, Mazefsky CA. Emotion Dysregulation is Substantially Elevated in Autism Compared to the General Population: Impact on Psychiatric Services. Autism Res 2020; 14:169-181. [PMID: 33815651 DOI: 10.1002/aur.2450] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Emerging evidence suggests that emotion regulation (ER) impairment in those with ASD is associated with poor mental health. This study used the Emotion Dysregulation Inventory, a new norm-referenced ER measure with clinical cut-offs, developed and validated in ASD and non-ASD samples, to establish rates of ER impairment and understand its association with psychiatric service use in ASD. Parents of 6-17 year olds in three well-characterized samples (nationally representative US n = 1,000; community ASD n = 1,169; inpatient ASD n = 567) completed a battery of questionnaires about their child. The prevalence of ER impairment was significantly higher in the ASD groups compared to the nationally representative sample and highest in the psychiatric Inpatient ASD group. The community ASD and inpatient ASD samples were four and seven times more likely, respectively, to exceed clinical cutoffs for emotional reactivity than the general US sample. Similarly, history of psychiatric hospitalization, recent emergency services use (police contact, emergency room visits, or in-home crisis evaluations for emotional or behavioral concerns in the past 2 months), and psychotropic medication prescriptions were significantly higher in the ASD groups. ER impairment was significantly associated with all forms of psychiatric service use, after controlling for demographics (age, sex, race), co-occurring intellectual disability, and ADHD symptoms. This is the first large-scale study to document substantially higher rates of ER impairment in youth with ASD compared to the general population. The importance of ER impairment is underscored by its association with higher utilization of inpatient, emergency, and medication services in ASD, after accounting for demographics and ADHD-related symptoms.
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Affiliation(s)
- Caitlin M Conner
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Josh Golt
- University of Alabama, Tuscaloosa, Alabama, USA
| | | | | | | | - Carla A Mazefsky
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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42
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Shulman C, Rice CE, Morrier MJ, Esler A. The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:605-628. [PMID: 33126998 DOI: 10.1016/j.psc.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.
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Affiliation(s)
- Cory Shulman
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel.
| | - Catherine E Rice
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Michael J Morrier
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Amy Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota 2540 Riverside Ave S., RPB 550, Minneapolis, MN 55454, USA
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43
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Improving the Diagnosis of Autism Spectrum Disorder in Fragile X Syndrome by Adapting the Social Communication Questionnaire and the Social Responsiveness Scale-2. J Autism Dev Disord 2020; 50:3276-3295. [PMID: 31342442 DOI: 10.1007/s10803-019-04148-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We carried out a psychometric assessment of the Social Communication Questionnaire (SCQ) and the Social Responsiveness Scale (SRS-2) in fragile X syndrome (FXS), relative to clinician DSM5-based diagnosis of autism spectrum disorder (ASD) in FXS. This was followed by instrument revisions that included: removal of non-discriminating and/or low face validity items for FXS; use of receiver operating characteristic (ROC) curves to determine optimal cut points for the original and revised measures; an exploratory factor analysis to outline subscales better representing ASD in FXS; and creation of a "triple criteria" diagnosis to better delineate ASD subgroups in FXS. These methods improved the sensitivity and/or specificity of the SCQ and SRS-2, but diagnostic accuracy of ASD remains problematic in FXS.
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44
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Qi S, Morris R, Turner JA, Fu Z, Jiang R, Deramus TP, Zhi D, Calhoun VD, Sui J. Common and unique multimodal covarying patterns in autism spectrum disorder subtypes. Mol Autism 2020; 11:90. [PMID: 33208189 PMCID: PMC7673101 DOI: 10.1186/s13229-020-00397-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/05/2020] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The heterogeneity inherent in autism spectrum disorder (ASD) presents a substantial challenge to diagnosis and precision treatment. Heterogeneity across biological etiologies, genetics, neural systems, neurocognitive attributes and clinical subtypes or phenotypes has been observed across individuals with ASD. METHODS In this study, we aim to investigate the heterogeneity in ASD from a multimodal brain imaging perspective. The Autism Diagnostic Observation Schedule (ADOS) was used as a reference to guide functional and structural MRI fusion. DSM-IV-TR diagnosed Asperger's disorder (n = 79), pervasive developmental disorder-not otherwise specified [PDD-NOS] (n = 58) and Autistic disorder (n = 92) from ABIDE II were used as discovery cohort, and ABIDE I (n = 400) was used for replication. RESULTS Dorsolateral prefrontal cortex and superior/middle temporal cortex are the primary common functional-structural covarying cortical brain areas shared among Asperger's, PDD-NOS and Autistic subgroups. Key differences among the three subtypes are negative functional features within subcortical brain areas, including negative putamen-parahippocampus fractional amplitude of low-frequency fluctuations (fALFF) unique to the Asperger's subtype; negative fALFF in anterior cingulate cortex unique to PDD-NOS subtype; and negative thalamus-amygdala-caudate fALFF unique to the Autistic subtype. Furthermore, each subtype-specific brain pattern is correlated with different ADOS subdomains, with social interaction as the common subdomain. The identified subtype-specific patterns are only predictive for ASD symptoms manifested in the corresponding subtypes, but not the other subtypes. CONCLUSIONS Although ASD has a common neural basis with core deficits linked to social interaction, each ASD subtype is strongly linked to unique brain systems and subdomain symptoms, which may help to better understand the underlying mechanisms of ASD heterogeneity from a multimodal neuroimaging perspective. LIMITATIONS This study is male based, which cannot be generalized to the female or the general ASD population.
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Affiliation(s)
- Shile Qi
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA
| | - Robin Morris
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, GA, 30302, USA
| | - Jessica A Turner
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, GA, 30302, USA
| | - Zening Fu
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA
| | - Rongtao Jiang
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Thomas P Deramus
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA
| | - Dongmei Zhi
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Vince D Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA.
| | - Jing Sui
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA, 30303, USA.
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
- University of Chinese Academy of Sciences, Beijing, 100190, China.
- Institute of Automation, Chinese Academy of Sciences Center for Excellence in Brain Science, Beijing, 100190, China.
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45
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Predictive Processing during a Naturalistic Statistical Learning Task in ASD. eNeuro 2020; 7:ENEURO.0069-19.2020. [PMID: 33199412 PMCID: PMC7729300 DOI: 10.1523/eneuro.0069-19.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/11/2020] [Accepted: 10/01/2020] [Indexed: 11/21/2022] Open
Abstract
Children’s sensitivity to regularities within the linguistic stream, such as the likelihood that syllables co-occur, is foundational to speech segmentation and language acquisition. Yet, little is known about the neurocognitive mechanisms underlying speech segmentation in typical development and in neurodevelopmental disorders that impact language acquisition such as autism spectrum disorder (ASD). Here, we investigate the neural signals of statistical learning in 15 human participants (children ages 8–12) with a clinical diagnosis of ASD and 14 age-matched and gender-matched typically developing peers. We tracked the evoked neural responses to syllable sequences in a naturalistic statistical learning corpus using magnetoencephalography (MEG) in the left primary auditory cortex, posterior superior temporal gyrus (pSTG), and inferior frontal gyrus (IFG), across three repetitions of the passage. In typically developing children, we observed a neural index of learning in all three regions of interest (ROIs), measured by the change in evoked response amplitude as a function of syllable surprisal across passage repetitions. As surprisal increased, the amplitude of the neural response increased; this sensitivity emerged after repeated exposure to the corpus. Children with ASD did not show this pattern of learning in all three regions. We discuss two possible hypotheses related to children’s sensitivity to bottom-up sensory deficits and difficulty with top-down incremental processing.
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46
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Stephens K, Silk TJ, Anderson V, Hazell P, Enticott PG, Sciberras E. Associations Between Limbic System White Matter Structure and Socio-Emotional Functioning in Children with ADHD + ASD. J Autism Dev Disord 2020; 51:2663-2672. [PMID: 33043414 DOI: 10.1007/s10803-020-04738-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) combined with autism spectrum disorder (ASD) symptoms (ADHD + ASD) have poorer social and emotional functioning than those with ADHD alone. However, no studies have specifically examined the associations between ASD symptoms, measures of social and emotional functioning and limbic system white matter microstructure. Tractography on the cingulum, uncinate fasciculus and fornix were performed for 151 children with (N = 78) and without (N = 73) ADHD. Participants in the ADHD group who scored 11 or above on the Social Communication Questionnaire were classified as the ADHD + ASD group (N = 16). Significant differences in mean cingulum FA were present between the control group and the ADHD (all) group, however, no significant differences were seen between the ADHD and ADHD + ASD groups. Despite this, significant associations were seen between mean FA of the left cingulum and emotional problems for the ADHD + ASD group. Results give greater insights into the specific biological basis of emotional problems in the ADHD + ASD group, indicating that the cingulum may play a role.
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Affiliation(s)
- Kate Stephens
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Timothy J Silk
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Murdoch Children's Research Institute, Parkville, Vic, Australia.,University of Melbourne, Parkville, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Parkville, Vic, Australia.,University of Melbourne, Parkville, Australia.,The Royal Children's Hospital, Parkville, Vic, Australia
| | | | - Peter G Enticott
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Emma Sciberras
- School of Psychology, Deakin University, Geelong, VIC, Australia. .,Murdoch Children's Research Institute, Parkville, Vic, Australia. .,University of Melbourne, Parkville, Australia.
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47
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Associations Between Child Sleep Problem Severity and Maternal Well-Being in Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 51:2500-2510. [PMID: 33033970 DOI: 10.1007/s10803-020-04726-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study investigated whether sleep problem severity in children with autism spectrum disorder was associated with maternal well-being. Mothers of 234 children reported on their mental health (Kessler Psychological Distress Scale), parenting stress (Parenting Stress Index-4-SF), health-related quality of life (HRQoL; Assessment of Quality of Life-4D) and their child's sleep (Children's Sleep Habits Questionnaire-ASD). Analyses revealed sleep initiation and duration problem severity scores were associated with increased mental health difficulties. Specific child sleep problems were not associated with parenting stress or HRQoL. This study revealed the importance of considering sleep and the family system when assessing maternal well-being. Future research considering parent, child and family factors will be important to informing a family focused approach to mental health.
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48
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Shared and distinct developmental pathways to ASD and ADHD phenotypes among infants at familial risk. Dev Psychopathol 2020; 32:1323-1334. [PMID: 32933597 PMCID: PMC7891894 DOI: 10.1017/s0954579420000735] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are believed to share partially overlapping causal mechanisms suggesting that early risk markers may also overlap. Using latent profile analysis (LPA) in a sample of infants enriched for ASD and ADHD, we first examined the number of distinct groups of 3-year-old children, based on ADHD and ASD symptomatology. To investigate early predictors of ASD and ADHD symptom profiles, we next examined differences in trajectories of infant behaviors among the LPA classes spanning general development, negative affect, attention, activity level, impulsivity, and social behavior. Participants included 166 infants at familial risk for ASD (n = 89), ADHD (n = 38), or low-risk for both (n = 39) evaluated at 12, 18, 24, and 36 months of age. A three-class solution was selected reflecting a Typically Developing (TD) class (low symptoms; n = 108), an ADHD class (high ADHD/low ASD symptoms; n = 39), and an ASD class (high ASD/ADHD symptoms; n = 19). Trajectories of infant behaviors were generally suggestive of a gradient pattern of differences, with the greatest impairment within the ASD class followed by the ADHD class. These findings indicate a mixture of overlapping and distinct early markers of preschool ASD- and ADHD-like profiles that can be difficult to disentangle early in life.
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49
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Weiss JA, Lai JKY, Lee V, Lunsky Y. Predictors of Changes in Daily Activity in Transition-Age Autistic Youth. Autism Res 2020; 14:324-332. [PMID: 32902130 DOI: 10.1002/aur.2371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/04/2020] [Accepted: 07/21/2020] [Indexed: 11/06/2022]
Abstract
Transitioning into adulthood is fraught with challenges for autistic youth. A greater understanding of the facilitators of community involvement in school and employment during this period is warranted. The current study examines changes in service need and receipt, and the stability of accessing daily structured activities, for autistic young adults over their transition period compared to adolescents and adults that did not enter the transition period. Baseline caregiver survey data were taken from the Canadian Autism Spectrum Disorders Alliance National Autism Needs Assessment Survey in 2014, and caregivers (n = 304) completed the same set of questions in 2017 about sociodemographic factors, clinical need, service receipt and typical weekday activities. Three cohorts were compared: (1) pretransition age youth, (2) transition-age youth, and (3) young adults who were past transition age. Results suggest that transition-age youth were found to have a unique set of priority service needs compared to pre transition-age adolescent and to adult groups, and both transition-age and adult groups had lower levels of priority service receipt compared to pretransition-age adolescents. The transition-age group experienced the greatest loss of structured weekday activity between time points, and were more likely than pretransition-age adolescents to not have structured weekday activities at Time 2. A recovery of structured daily activity was not observed in young adults. Our results highlight the tumultuous nature of the transition period for autistic youth, which continues into adulthood, and the urgent need for supports during this time. LAY SUMMARY: This research highlights that autistic young people who are transitioning to adulthood are at greatest risk of losing structured weekday activities, and that once in adulthood, many continue to struggle to obtain meaningful community engagement. These results can help guide the design of adolescent and young adult transition programs.
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Affiliation(s)
- Jonathan A Weiss
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Jonathan K Y Lai
- Canadian Autism Spectrum Disorder Alliance, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vivian Lee
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Reindal L, Nærland T, Weidle B, Lydersen S, Andreassen OA, Sund AM. Age of First Walking and Associations with Symptom Severity in Children with Suspected or Diagnosed Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:3216-3232. [PMID: 31278523 PMCID: PMC7434723 DOI: 10.1007/s10803-019-04112-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Age of first walking (AOW) is reported to be later in autism spectrum disorder (ASD) compared with typical development. However, the relationship between AOW and variations in ASD symptoms across different neurodevelopmental disorders is largely unknown. This study investigated AOW and its association with autism symptom severity in a large sample of children (N = 490, 23% females) clinically evaluated for suspected ASD, differentiated into ASD (n = 376) and non-ASD (n = 114) diagnoses. Children with ASD achieved independent walking significantly later than children with non-ASD diagnoses. AOW was significantly associated with ASD symptom severity, and females had a non-significant later AOW. The current findings suggest that in cases with delayed AOW, ASD should be considered as an actual differential diagnosis, perhaps particularly in girls.
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Affiliation(s)
- Lise Reindal
- Department of Child and Adolescent Psychiatry, Møre og Romsdal Hospital Trust, Volda Hospital, Pb 113, 6101, Volda, Norway.
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Terje Nærland
- NevSom, Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, University of Oslo, Oslo, Norway
| | - Bernhard Weidle
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ole A Andreassen
- NORMENT Centre, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim, Norway
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