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Ke F, Moon J, Sokolikj Z. Designing and deploying a virtual social sandbox for autistic children. Disabil Rehabil Assist Technol 2024; 19:1178-1209. [PMID: 36524469 DOI: 10.1080/17483107.2022.2156630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This exploratory study was intended to investigate the design and feasibility of using a web virtual reality based social learning space for autistic children at home. MATERIALS AND METHODS The researchers of the current study developed and implemented an open-source, web virtual reality based learning program for children with autism. Endorsing mixed-method convergent parallel design, we collected both qualitative and quantitative data from four autistic children, including repeated measures of social skills performance, self- and parent-reported social and communication competence, observation notes, and individual interviews. RESULTS The study found preliminary evidence for a positive impact of deploying a virtual reality-based social sandbox on the practice and development of complex social skills for autistic children. All participants showed significant reduced social communication impairments from the pre- to the post-intervention phases. Nevertheless, participants' social skills performance in the virtual world was mediated by two social task design features-external goal structure and individualization. CONCLUSIONS Play- and design-oriented social tasks in the three-dimensional virtual world framed meaningful social experiences or the naturalistic intervention for social skills development.
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Affiliation(s)
- Fengfeng Ke
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Jewoong Moon
- Department of Educational Leadership, Policy, and Technology Studies, University of Alabama, Tuscaloosa, AL, USA
| | - Zlatko Sokolikj
- Department of Scientific Computing, Florida State University, Tallahassee, FL, USA
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Mo K, Anagnostou E, Lerch JP, Taylor MJ, VanderLaan DP, Szatmari P, Crosbie J, Nicolson R, Georgiadis S, Kelley E, Ayub M, Brian J, Lai MC, Palmert MR. Gender diversity is correlated with dimensional neurodivergent traits but not categorical neurodevelopmental diagnoses in children. J Child Psychol Psychiatry 2024. [PMID: 38433429 DOI: 10.1111/jcpp.13965] [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] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Gender clinic and single-item questionnaire-based data report increased co-occurrence of gender diversity and neurodevelopmental conditions. The nuances of these associations are under-studied. We used a transdiagnostic approach, combining categorical and dimensional characterization of neurodiversity, to further the understanding of its associations with gender diversity in identity and expression in children. METHODS Data from 291 children (Autism N = 104, ADHD N = 104, Autism + ADHD N = 17, neurotypical N = 66) aged 4-12 years enrolled in the Province of Ontario Neurodevelopmental Network were analyzed. Gender diversity was measured multi-dimensionally using a well-validated parent-report instrument, the Gender Identity Questionnaire for Children (GIQC). We used gamma regression models to determine the significant correlates of gender diversity among age, puberty, sex-assigned-at-birth, categorical neurodevelopmental diagnoses, and dimensional neurodivergent traits (using the Social Communication Questionnaire and the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scales). Internalizing and externalizing problems were included as covariates. RESULTS Neither a categorical diagnosis of autism nor ADHD significantly correlated with current GIQC-derived scores. Instead, higher early-childhood dimensional autistic social-communication traits correlated with higher current overall gender incongruence (as defined by GIQC-14 score). This correlation was potentially moderated by sex-assigned-at-birth: greater early-childhood autistic social-communication traits were associated with higher current overall gender incongruence in assigned-males-at-birth, but not assigned-females-at-birth. For fine-grained gender diversity domains, greater autistic restricted-repetitive behavior traits were associated with greater diversity in gender identity across sexes-assigned-at-birth; greater autistic social-communication traits were associated with lower stereotypical male expression across sexes-assigned-at-birth. CONCLUSIONS Dimensional autistic traits, rather than ADHD traits or categorical neurodevelopmental diagnoses, were associated with gender diversity domains across neurodivergent and neurotypical children. The association between early-childhood autistic social-communication traits and overall current gender diversity was most evident in assigned-males-at-birth. Nuanced interrelationships between neurodivergence and gender diversity should be better understood to clarify developmental links and to offer tailored support for neurodivergent and gender-diverse populations.
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Affiliation(s)
- Kelly Mo
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Jason P Lerch
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Oxford, Oxford, UK
| | - Margot J Taylor
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Doug P VanderLaan
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Peter Szatmari
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | | | | - Jessica Brian
- University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
- University of Cambridge, Cambridge, UK
- National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Mark R Palmert
- University of Toronto, Toronto, Ontario, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
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Taylor SC, Gehringer BN, Dow HC, Langer A, Rawot E, Smernoff Z, Steeman S, Almasy L, Rader DJ, Bučan M, Brodkin ES. Contrasting Views of Autism Spectrum Traits in Adults, Especially in Self-Reports vs. Informant-Reports for Women High in Autism Spectrum Traits. J Autism Dev Disord 2024; 54:1088-1100. [PMID: 36484966 PMCID: PMC9734875 DOI: 10.1007/s10803-022-05822-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 12/13/2022]
Abstract
There is uncertainty among researchers and clinicians about how to best measure autism spectrum dimensional traits in adults. In a sample of adults with high levels of autism spectrum traits and without intellectual disability (probands, n = 103) and their family members (n = 96), we sought to compare self vs. informant reports of autism spectrum-related traits and possible effects of sex on discrepancies. Using correlational analysis, we found poor agreement between self- and informant-report measures for probands, yet moderate agreement for family members. We found reporting discrepancy was greatest for female probands, often self-reporting more autism-related behaviors. Our findings suggest that autism spectrum traits are often underrecognized by informants, making self-report data important to collect in clinical and research settings.
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Affiliation(s)
- Sara C Taylor
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brielle N Gehringer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Holly C Dow
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Allison Langer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Eric Rawot
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Zoe Smernoff
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Samantha Steeman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Daniel J Rader
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Maja Bučan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
- Department of Genetics, Perelman School of Medicine, Clinical Research Building, 415 Curie Boulevard, University of Pennsylvania, Philadelphia, PA, 19104-6145, USA
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA.
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Hong JS, Perrin J, Singh V, Kalb L, Cross EA, Wodka E, Richter C, Landa R. Psychometric Evaluation of the Autism Spectrum Rating Scales (6-18 Years Parent Report) in a Clinical Sample. J Autism Dev Disord 2024; 54:1024-1035. [PMID: 36571625 PMCID: PMC9791153 DOI: 10.1007/s10803-022-05871-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 12/27/2022]
Abstract
ASD is a neurodevelopmental disorder impacting 1 in 44 children and early identification of children with ASD is critical for the intervention. Several screening measures have been developed for early identification, including the Autism Spectrum Rating Scales, 6-18 years Parent Report (ASRS). The ASRS has been understudied, and the current study assessed the validity of the ASRS in a clinical sample of 490 children at a tertiary ASD-specialty clinic. Results indicated that the ASRS demonstrated favorable sensitivity, but poor specificity. True positive screening results were more likely to occur for children with a multiracial background, while they were less likely to occur for children with a high social capital. Overall, though the ASRS has clinical utility as a screening measure, it did not perform effectively to differentiate ASD from Non-ASD clinical disorders.
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Affiliation(s)
- Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA.
| | - Jeremy Perrin
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
| | - Luke Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
| | - Elizabeth A Cross
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
| | - Ericka Wodka
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Chana Richter
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Ave, 21211, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
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Gajre MP, Shah M, Pradhan SV, Aseri H. Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years. Cureus 2024; 16:e53376. [PMID: 38435203 PMCID: PMC10907971 DOI: 10.7759/cureus.53376] [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] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional study where 30 verbal autistic children, aged eight to 15 years, with intelligence quotient (IQ) > 70 were enrolled after utilizing the Binet Kamat Test of Intelligence (BKT) to assess IQ and the Indian Scale for Assessment of Autism (ISAA) to grade severity of autism. The children received GSSI from interdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2): T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3 indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 = 64.30 (p < 0.0001). This declining trend at T1, T2, and T3 suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention for adolescents with ASD, with effects lasting up to three months post-intervention.
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Affiliation(s)
- Mona P Gajre
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
| | - Mansi Shah
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
| | - Shreeya V Pradhan
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
| | - Harshna Aseri
- Department of Pediatrics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, IND
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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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Nwokolo EU, Murphy GH, Langdon PE. Validation of the social communication questionnaire amongst Nigerian adolescents. Autism Res 2024; 17:66-77. [PMID: 37795675 DOI: 10.1002/aur.3038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
Few autism spectrum disorder (ASD) screening tools have been developed and validated in Africa. This study aimed to examine the psychometric properties of the Social Communication Questionnaire (SCQ) when used with Nigerian adolescents. Parents and caregivers of two hundred and five adolescents completed the SCQ Lifetime form while the adolescents were assessed for ASD using the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2). Factor structure and convergent and discriminative validity were examined, along with the sensitivity and specificity of the SCQ in identifying participants with an autism spectrum disorder. The confirmatory factor analysis (CFA) was used to examine the factor structure, while logistic regression and Pearson's correlation coefficient were used to examine the validities. The SCQ had good internal consistency, discriminative, and convergent validity. A cut-off score of 10 revealed sensitivity = 0.81 and specificity = 0.88 for the identification of autism spectrum disorder. AUC was 0.83, p < 0.001, 95% CI [0.77, 0.90]. The results of this study provide evidence to support the retention of the original four factors of the SCQ. The SCQ has good psychometric properties when used with Nigerian adolescents.
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Affiliation(s)
| | | | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR), and Centre for Mental Health and Wellbeing Research, University of Warwick and Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
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Hegemann L, Bugge Askeland R, Barbo Valand S, Øyen AS, Schjølberg S, Bal VH, Bishop SL, Stoltenberg C, von Soest T, Hannigan LJ, Havdahl A. Measuring autism-associated traits in the general population: Factor structure and measurement invariance across sex and diagnosis status of the Social Communication Questionnaire. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613231219306. [PMID: 38159069 DOI: 10.1177/13623613231219306] [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: 01/03/2024]
Abstract
LAY ABSTRACT Using questionnaires in research relies on the expectation that they measure the same things across different groups of individuals. If this is not true, then interpretations of results can be misleading when researchers compare responses across different groups of individuals or use in it a group that differs from that in which the questionnaire was developed. For the questionnaire we investigated, the Social Communication Questionnaire (SCQ), we found that parents of boys and girls responded to questionnaire items in largely the same way but that the SCQ measured traits and behaviors slightly differently depending on whether the children had autism. Based on these results, we concluded that researchers using this questionnaire should carefully consider these differences when deciding how to interpret findings. SCQ scores as a reflection of "autism-associated traits" in samples that are mostly or entirely made up of individuals without an autism diagnosis may be misleading and we encourage a more precise interpretation of scores as a broader indication of social-communicative and behavioral traits.
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Affiliation(s)
- Laura Hegemann
- Department of Psychology, University of Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Norway
- Norwegian Institute of Public Health, Norway
| | | | - Stian Barbo Valand
- Department of Psychology, University of Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Norway
- Norwegian Institute of Public Health, Norway
| | - Anne-Siri Øyen
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Norway
| | | | - Vanessa H Bal
- Graduate School of Applied and Professional Psychology, Rutgers University, USA
| | - Somer L Bishop
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, USA
| | - Camilla Stoltenberg
- Norwegian Institute of Public Health, Norway
- Department of Global Public health and Primary Care, University of Bergen, Norway
| | | | - Laurie J Hannigan
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Norway
- Norwegian Institute of Public Health, Norway
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, UK
| | - Alexandra Havdahl
- Department of Psychology, University of Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Norway
- Norwegian Institute of Public Health, Norway
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Joels H, Benny A, Sharpe A, Postigo B, Joseph B, Piantino C, Marshall A, Hewertson V, Hill CM. Sleep related rhythmic movement disorder: phenotypic characteristics and treatment response in a paediatric cohort. Sleep Med 2023; 112:21-29. [PMID: 37804714 DOI: 10.1016/j.sleep.2023.09.020] [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] [Received: 08/01/2023] [Revised: 09/07/2023] [Accepted: 09/17/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To describe phenotypic, polysomnographic characteristics, impact, and treatment response in children with sleep related rhythmic movement disorder (SR-RMD). BACKGROUND There is limited research on SR-RMD. We have developed a systematic clinical evaluation of children with SR-RMD to improve understanding and treatment. METHODS A retrospective chart review of 66 children at a UK tertiary hospital. Baseline assessment included validated screening questionnaires to study autism spectrum characteristics, general behaviour and sensory profile. A standardised questionnaire assessed impact on sleep quality and daytime wellbeing of child and family. Polysomnography data were collated. RESULTS Children were aged 0.9-16.3 years (78.8% male). 51.5% had a neurodevelopmental disorder, most commonly autism spectrum disorder. High rates of behavioural disturbance and sensory processing differences were reported, not confined to children with neurodevelopmental disorders. Parents reported concerns about risk of injury, loss of sleep and persistence into adulthood. Daytime wellbeing was affected in 72% of children and 75% of other family members. Only 31/48 children demonstrated rhythmic movements during video-polysomnography, occupying on average 6.1% of time in bed. Most clusters occurred in the settling period but also arose from N1, N2 and REM sleep and wake after sleep onset. Melatonin was prescribed to 52 children, all but one were extended-release preparations. 24/27 children with available data were reported to improve with melatonin. CONCLUSIONS SR-RMD places a significant burden on child and family wellbeing. Our novel findings of sensory processing differences in this population and parent reported therapeutic response to extended-release melatonin offer potential avenues for future research.
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Affiliation(s)
- H Joels
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - A Benny
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - A Sharpe
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - B Postigo
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom
| | - B Joseph
- Department of Sleep Medicine (Neurological), Southampton Children's Hospital, United Kingdom
| | - C Piantino
- Department of Sleep Medicine (Neurological), Southampton Children's Hospital, United Kingdom
| | - A Marshall
- Department of Sleep Medicine (Neurological), Southampton Children's Hospital, United Kingdom
| | - V Hewertson
- Department of Sleep Medicine (Neurological), Southampton Children's Hospital, United Kingdom
| | - C M Hill
- School of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, United Kingdom; Department of Sleep Medicine (Neurological), Southampton Children's Hospital, United Kingdom.
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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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11
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Emerson LM, Adams D. Brief Report: Family Accommodation is Associated with the Impact of Childhood Anxiety in Autism. J Autism Dev Disord 2023; 53:3710-3716. [PMID: 35362802 DOI: 10.1007/s10803-022-05534-x] [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: 03/15/2022] [Indexed: 10/18/2022]
Abstract
Anxiety is commonly experienced by children on the autism spectrum, and can negatively impact their lives. Family accommodation has been linked to the impact of anxiety on the child's life in non-autistic children. This study tested whether the same relationship holds for children on the autism spectrum. A community sample (n = 118) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and severity and impact of their child's anxiety, their own anxiety and family accommodation behaviours. Family accommodation was associated with the impact of child anxiety, over and above anxiety severity of the child and parent. Findings support the involvement of parents in psychosocial support for children on the autism spectrum experiencing anxiety.
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Affiliation(s)
- Lisa Marie Emerson
- School of Health Sciences, University of Canterbury, Kirkwood Avenue, Christchurch, 8041, New Zealand.
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Brisbane, Australia
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12
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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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13
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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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14
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A Parental-Report Questionnaire for Language Abilities and Pragmatics in Children and Adolescents with Autism Spectrum Disorders. Brain Sci 2023; 13:brainsci13020196. [PMID: 36831739 PMCID: PMC9953798 DOI: 10.3390/brainsci13020196] [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: 12/14/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
The aim of this study was to test and validate a parental-report questionnaire, which assesses language abilities and pragmatics, in children with Autism Spectrum Disorders (ASD). We report two experiments: The first served as the initial test and the second sought to provide the first assessment of convergent validity. In total, we recruited 230 parents, where approximately two-thirds had a child with ASD. Results of factor analyses showed a consistent factor structure within each subscale, and the internal consistency was excellent for both sub-scales (Cronbach's alpha >0.90). Convergent validity was assessed by correlating the results of the questionnaire with two sub-scales of the Autism Quotient questionnaire. The correlations were all greater than 0.60. The final version of the questionnaire (following exclusion of problematic items) contains 30 items (12 for language abilities and 18 for pragmatics). We conclude that the questionnaire is a concise and practical instrument for use in a variety of contexts for assessing language functioning and communication in children with ASD.
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15
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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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16
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Post EM, Kraemer WJ, Kackley ML, Caldwell LK, Volek JS, Sanchez BN, Focht BC, Newton RU, Häkkinen K, Maresh CM. The Effects of Resistance Training on Physical Fitness and Neuromotor-Cognitive Functions in Adults With Down Syndrome. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:927629. [PMID: 36189007 PMCID: PMC9397808 DOI: 10.3389/fresc.2022.927629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022]
Abstract
Adults with Down syndrome are an underserved population at high risk for a host of different pathologies from aging and lack of activity.
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Affiliation(s)
- Emily M. Post
- Department of Exercise Science, Ohio Dominican University, Columbus, OH, United States
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - William J. Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
- Exercise Medicine Research Institute, and School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- *Correspondence: William J. Kraemer
| | - Madison L. Kackley
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Lydia K. Caldwell
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
- Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX, United States
| | - Jeff S. Volek
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Barbara N. Sanchez
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Brian C. Focht
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
| | - Robert U. Newton
- Exercise Medicine Research Institute, and School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Keijo Häkkinen
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Carl M. Maresh
- Department of Human Sciences, The Ohio State University, Columbus, OH, United States
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17
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Diamond G, Badir E, Almog S, Badir G, Jaoussy L, Akawi A, Jaber L. Characteristic Neuro-Linguistic Styles in Young Arabic Speaking Children Diagnosed with ASD. Child Neurol Open 2022; 9:2329048X221080271. [PMID: 35340453 PMCID: PMC8951048 DOI: 10.1177/2329048x221080271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
Evaluations of all Arabic speaking children age 3–9.0 years with significant
speech delays or impairments, referred to a community based, child development
center in the public health care system during a 5-year period were
reviewed. Use of an inordinate degree of words and expressions in Fossha version of
classical Arabic, mainly used in the media, children's literature and formalized
venues, as well as in English, was highly associated with ASD, especially among
those who were both more intelligent (IQ> 70), as well as older (greater than
4 years), (Pearson 7.29, Fisher 2-tailed test, p = 0.015). The use of "out of context" speech embedded in ordinary Arabic vernacular was
associated with a higher degree of speech stereotypy (p < 0.001) among
children with ASD, and unrelated statistically to the number of hours of screen
viewing time, jargoning or associative speech. Idiosyncratic speech choices reflect neuro-linguistic mechanisms in social
communication- impaired youngsters.
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Affiliation(s)
- Gary Diamond
- Alyn Hospital for Children’s Rehabilitation, Jerusalem
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
- Tel Aviv University, Tel Aviv, Israel
| | - Eman Badir
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | - Shelly Almog
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | - Gumma Badir
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
| | | | - Ashraf Akawi
- Clalit Dan Petah Tiqva Region, Kfar Kassem center
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18
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Jacques C, Courchesne V, Mineau S, Dawson M, Mottron L. Positive, negative, neutral-or unknown? The perceived valence of emotions expressed by young autistic children in a novel context suited to autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1833-1848. [PMID: 35168392 PMCID: PMC9483191 DOI: 10.1177/13623613211068221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Starting early in life, autistics are characterized as having atypical facial expressions, as well as decreased positive and increased negative affect. The literature on autistic facial expressions remains small, however, with disparate methods and results suggesting limited understanding of common autistic emotions. Furthermore, unlike non-autistics’ emotions, autistics’ emotions have been assessed without considering this population’s characteristics. In this study, the valence of young children’s facial expressions was thus rated as positive, negative, neutral, or “unknown”—a term for perceived emotions observers do not understand. Facial expressions were assessed using the Montreal Stimulating Play Situation, a context incorporating potential autistic interests. Comparing 37 autistic and 39 typical young (27–56 months) age-matched children, we found no group differences in expressed positive, negative, and neutral emotions. We did find differences in unknown emotions, which were unique to the autistic group. Preliminary data also showed that autistic children’s repetitive behaviors co-occurred with positive, neutral, and unknown emotions, but not with negative emotions. In a novel context that considers their characteristics, we did not find decreased positive or increased negative emotions in young autistic children. Instead, they uniquely expressed emotions perceived as unknown, showing the need to improve our understanding of their full emotional repertoire.
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Affiliation(s)
- Claudine Jacques
- Université du Québec en Outaouais, Canada.,CIUSSS du Nord-de-l'Île-de-Montréal, Canada
| | | | | | | | - Laurent Mottron
- CIUSSS du Nord-de-l'Île-de-Montréal, Canada.,Université de Montréal, Canada
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19
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Victor AK, Donaldson M, Johnson D, Miller W, Reiter LT. Molecular Changes in Prader-Willi Syndrome Neurons Reveals Clues About Increased Autism Susceptibility. Front Mol Neurosci 2021; 14:747855. [PMID: 34776864 PMCID: PMC8586424 DOI: 10.3389/fnmol.2021.747855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Prader-Willi syndrome (PWS) is a neurodevelopmental disorder characterized by hormonal dysregulation, obesity, intellectual disability, and behavioral problems. Most PWS cases are caused by paternal interstitial deletions of 15q11.2-q13.1, while a smaller number of cases are caused by chromosome 15 maternal uniparental disomy (PW-UPD). Children with PW-UPD are at higher risk for developing autism spectrum disorder (ASD) than the neurotypical population. In this study, we used expression analysis of PW-UPD neurons to try to identify the molecular cause for increased autism risk. Methods: Dental pulp stem cells (DPSC) from neurotypical control and PWS subjects were differentiated to neurons for mRNA sequencing. Significantly differentially expressed transcripts among all groups were identified. Downstream protein analysis including immunocytochemistry and immunoblots were performed to confirm the transcript level data and pathway enrichment findings. Results: We identified 9 transcripts outside of the PWS critical region (15q11.2-q13.1) that may contribute to core PWS phenotypes. Moreover, we discovered a global reduction in mitochondrial transcripts in the PW-UPD + ASD group. We also found decreased mitochondrial abundance along with mitochondrial aggregates in the cell body and neural projections of +ASD neurons. Conclusion: The 9 transcripts we identified common to all PWS subtypes may reveal PWS specific defects during neurodevelopment. Importantly, we found a global reduction in mitochondrial transcripts in PW-UPD + ASD neurons versus control and other PWS subtypes. We then confirmed mitochondrial defects in neurons from individuals with PWS at the cellular level. Quantification of this phenotype supports our hypothesis that the increased incidence of ASD in PW-UPD subjects may arise from mitochondrial defects in developing neurons.
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Affiliation(s)
- A Kaitlyn Victor
- IPBS Program, Neuroscience Institute, University of Tennessee Health Science Center, Memphis, TN, United States.,Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Martin Donaldson
- Department of Pediatric Dentistry and Community Oral Health, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Daniel Johnson
- Molecular Bioinformatics Core, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Winston Miller
- Molecular Bioinformatics Core, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Lawrence T Reiter
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, United States
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20
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[Heterogeneous neuropsychiatric phenotypes in two adult patients with 22q11.2 deletion syndrome (DiGeorge's syndrome): a case for RDoC?]. DER NERVENARZT 2021; 93:483-487. [PMID: 34735587 PMCID: PMC9061649 DOI: 10.1007/s00115-021-01226-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/22/2022]
Abstract
Das DiGeorge-Syndrom ist eines der häufigsten Mikrodeletionssyndrome und bedingt ein erhöhtes Risiko für neuropsychiatrische Störungen der Intelligenz, der sozialen Kommunikation und der Exekutivfunktionen sowie psychotische Störungen. Im Falle des vorgestellten männlichen Patienten handelt es sich um die seltene Beschreibung eines Tourette-Syndroms auf der Grundlage eines 22q11.2-Mikrodeletionssyndroms. Die folgenden zwei Fallbeispiele demonstrieren die Vielfalt assoziierter klinischer Präsentationen, selbst auf der Grundlage einer übereinstimmenden und umschriebenen genetischen Aberration. Eine Charakterisierung solcher Patient*innen im Kontext der klinisch-wissenschaftlichen Praxis anhand der Research Domain Criteria (RDoC) ermöglicht eine transdiagnostische Beschreibung der überlappenden wie auch spezifischen neuropsychiatrischen Funktionseinschränkungen. Eine solche dimensionale Charakterisierung erlaubt somit potenziell auch eine genauere Differenzierung pleiotroper Assoziationen zwischen Genotyp und Phänotyp.
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21
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Martínez-González AE, Cervin M, Piqueras JA. Relationships Between Emotion Regulation, Social Communication and Repetitive Behaviors in Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:4519-4527. [PMID: 34709530 PMCID: PMC8551658 DOI: 10.1007/s10803-021-05340-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 01/26/2023]
Abstract
The relationship between emotion regulation, social interaction and different types of restricted and repetitive behaviors is poorly understood. In the present study, structural equation modeling based on information about 239 individuals with autism was used to examine whether emotion regulation and social communication were associated with self-injury and stereotyped behaviors. Results showed that poor emotion regulation had a unique association with self-injury while difficulties with social communication was uniquely associated with stereotyped behaviors. Emotion regulation and social communication were strongly associated and self-injury and stereotyped behaviors moderately associated. This implies that these types of behaviors are often expressions of broader negative emotional states in autism. Treatments that help improve coping and social communication strategies may benefit individuals with autism.
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Affiliation(s)
- Agustín E Martínez-González
- Department of Developmental Psychology and Didactics, University of Alicante. Education Faculty, Carretera San Vicente del Raspeig s/n, Campus San Vicente del Raspeig, Edificio Facultad de Educación, Apdo. Correos, PO 99, 03080, Alicante, Spain.
| | - Matti Cervin
- Lund University and Skane Child and Adolescent Psychiatry, Lund, Sweden
| | - Jose A Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche, Edificio Altamira, Avda. de La Universidad, s/n Elche, 03202, Alicante, Spain
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22
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Fombonne E, Coppola L, Mastel S, O'Roak BJ. Validation of Autism Diagnosis and Clinical Data in the SPARK Cohort. J Autism Dev Disord 2021; 52:3383-3398. [PMID: 34328611 DOI: 10.1007/s10803-021-05218-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2021] [Indexed: 01/24/2023]
Abstract
The SPARK cohort was established to facilitate recruitment in studies of large numbers of participants with autism spectrum disorder (ASD). Online registration requires participants to have received a lifetime professional diagnosis by health or school providers although diagnoses are not independently verified. This study was set to examine the validity of self- and caregiver-reported autism diagnoses. Electronic medical records (EMR) of 254 SPARK participants (77.6% male, age 10.7 years) were abstracted. Using two different methods, confirmation of ASD diagnosis in EMRs was obtained in 98.8% of cases. Core clinical features recorded in EMRs were typical of autism samples and showed very good agreement with SPARK cohort data, providing further evidence of the validity of clinical information in the SPARK database.
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Affiliation(s)
- Eric Fombonne
- Department of Psychiatry, Oregon Health & Science University, Mail code: GH254, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA. .,Department of Pediatrics, Oregon Health & Science University, Portland, USA.
| | - Leigh Coppola
- Department of Psychiatry, Oregon Health & Science University, Mail code: GH254, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Sarah Mastel
- Department of Psychiatry, Oregon Health & Science University, Mail code: GH254, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Brian J O'Roak
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, USA
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23
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Adams D. Child and Parental Mental Health as Correlates of School Non-Attendance and School Refusal in Children on the Autism Spectrum. J Autism Dev Disord 2021; 52:3353-3365. [PMID: 34331173 PMCID: PMC8323746 DOI: 10.1007/s10803-021-05211-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/28/2022]
Abstract
Children on the autism spectrum miss more school than their peers, but limited work has explored why this may be. This study aimed to document the frequency at which children on the autism spectrum miss half and full days of school and the reasons for these absences. Parents of 106 school-aged children on the autism spectrum completed online questionnaires on rates of school non-attendance, family factors, child anxiety, and parental mental health. On average across a four week period, children missed 6 full days of school. The most common reason for full-day absences was school refusal and for half-day absences was medical/therapy appointments. Parental employment status, increased child age, child anxiety, and differing aspects of parental mental health were identified as correlates of specific subtypes of school non-attendance.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD, 4122, Australia. .,Griffith Institute of Educational Research, Griffith University, Brisbane, Australia.
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24
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Taylor SC, Steeman S, Gehringer BN, Dow HC, Langer A, Rawot E, Perez L, Goodman M, Smernoff Z, Grewal M, Eshraghi O, Pallathra AA, Oksas C, Mendez M, Gur RC, Rader DJ, Bucan M, Almasy L, Brodkin ES. Heritability of quantitative autism spectrum traits in adults: A family-based study. Autism Res 2021; 14:1543-1553. [PMID: 34245229 DOI: 10.1002/aur.2571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/27/2021] [Accepted: 06/06/2021] [Indexed: 11/12/2022]
Abstract
Autism spectrum disorder (ASD) comprises a multi-dimensional set of quantitative behavioral traits expressed along a continuum in autistic and neurotypical individuals. ASD diagnosis-a dichotomous trait-is known to be highly heritable and has been used as the phenotype for most ASD genetic studies. But less is known about the heritability of autism spectrum quantitative traits, especially in adults, an important prerequisite for gene discovery. We sought to measure the heritability of many autism-relevant quantitative traits in adults high in autism spectrum traits and their extended family members. Among adults high in autism spectrum traits (n = 158) and their extended family members (n = 245), we calculated univariate and bivariate heritability estimates for 19 autism spectrum traits across several behavioral domains. We found nearly all tested autism spectrum quantitative traits to be significantly heritable (h2 = 0.24-0.79), including overall ASD traits, restricted repetitive behaviors, broader autism phenotype traits, social anxiety, and executive functioning. The degree of shared heritability varied based on method and specificity of the assessment measure. We found high shared heritability for the self-report measures and for most of the informant-report measures, with little shared heritability among performance-based cognition tasks. These findings suggest that many autism spectrum quantitative traits would be good, feasible candidates for future genetics studies, allowing for an increase in the power of autism gene discovery. Our findings suggest that the degree of shared heritability between traits depends on the assessment method (self-report vs. informant-report vs. performance-based tasks), as well as trait-specificity. LAY SUMMARY: We found that the scores from questionnaires and tasks measuring different types of behaviors and abilities related to autism spectrum disorder (ASD) were heritable (strongly influenced by gene variants passed down through a family) among autistic adults and their family members. These findings mean that these scores can be used in future studies interested in identifying specific genes and gene variants that are associated with different behaviors and abilities related with ASD.
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Affiliation(s)
- Sara C Taylor
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States.,Neuroscience Graduate Group, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Samantha Steeman
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Brielle N Gehringer
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Holly C Dow
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Allison Langer
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Eric Rawot
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Leat Perez
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Matthew Goodman
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Zoe Smernoff
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Mahip Grewal
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Oceania Eshraghi
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Ashley A Pallathra
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Catherine Oksas
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA
| | - Melissa Mendez
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA
| | - Daniel J Rader
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Maja Bucan
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Laura Almasy
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States.,Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Lifespan Brain Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Translational Research Laboratory, Philadelphia, Pennsylvania, USA
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Abstract
The recognition of anxiety as one of the most commonly co-occurring diagnoses for individuals on the autism spectrum has led to increased research on symptomatology and treatment, but there is limited research documenting the impact of this anxiety. To address this, this study reports on the Child Anxiety Life Interference Scale (CALIS, parent version) in a community sample of 121 parents of children on the autism spectrum. Scores indicate that the anxiety is impacting upon the child's engagement in activities both in and outside of home as well as impacting upon parent life. Explanatory variables differed for CALIS subscales. As the child's difficulties with uncertainty and parent level of anxiety were the variables that explained the most variance, these may be important foci for effective interventions.
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26
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Long M, Register-Brown K. Autism Spectrum Disorder. Pediatr Rev 2021; 42:360-374. [PMID: 34210755 DOI: 10.1542/pir.2020-000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Kelly Register-Brown
- Division of Psychiatry and Behavioral Health Sciences, Children's National Hospital, Washington, DC
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27
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Pulsipher DT, Lieb RW. Using latent profile analysis to evaluate the utility of a DSM-5 symptom checklist in screening children for autism spectrum disorder. Clin Neuropsychol 2021; 36:874-898. [PMID: 34080494 DOI: 10.1080/13854046.2021.1929495] [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: 10/21/2022]
Abstract
Objective: Currently available screening measures for Autism Spectrum Disorder (ASD) typically do not reflect DSM-5 diagnostic criteria and generally have weak positive predictive values. These factors result in missed opportunities for early intervention, delays in diagnosis, and contribute to inefficient usage of healthcare resources by inadequately discerning those in need of comprehensive assessment. This study examined a DSM-5 ASD symptom checklist to determine whether parent-report response patterns could accurately identify which children received an ASD diagnosis. Method: Data were examined from 376 ASD evaluations in a three-year period. Latent profile analysis was used to determine if subgroups could be identified according to parent response patterns, and network analysis was implemented to examine the relationship among DSM-5 ASD criteria within each latent profile. Results: A four-profile model was best supported based on fit indices and high probability classifications. The model was largely a product of how parents responded regarding their child's sensory behavior and minimally reflected other symptomatology. Subsequent network analyses by profile indicated weak coherence among DSM-5 symptoms within all profiles. Overall, direct assessment of DSM-5 criteria based on parent report did not add diagnostic value beyond that reflected in base rates. Conclusions: Although continued refinement of ASD screening tools is needed to improve accuracy of referrals for evaluations and reduce wait time for diagnosis, this study continues to support the need for behavioral observation and formal assessment by trained clinicians. Continued development of sensitive and specific screening tools, likely with embedded behavioral and/or objective observation, is needed.
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Affiliation(s)
- Dalin T Pulsipher
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Rebecca W Lieb
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA.,Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
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28
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Schiltz HK, Magnus BE. Differential Item Functioning Based on Autism Features, IQ, and Age on the Screen for Child Anxiety Related Disorders (SCARED) Among Youth on the Autism Spectrum. Autism Res 2021; 14:1220-1236. [PMID: 33543824 DOI: 10.1002/aur.2481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/04/2021] [Accepted: 01/21/2021] [Indexed: 12/28/2022]
Abstract
Anxiety commonly occurs among youth on the autism spectrum, yet measurement of anxiety in this population is complicated by a number of factors, including potentially overlapping symptomatology, the child's intellectual functioning, and changes in anxiety across development. Moreover, few studies have examined the psychometric properties of anxiety measures in this population, and no study to date has tested whether there are systematic differences in the measurement of anxiety, or differential item functioning (DIF), across the high degree of heterogeneity and the developmental course of autism. To test this possibility, data were combined across multiple studies using the National Database for Autism Research, an NIH-funded data repository. Parent-report on the Screen for Child Anxiety Related Disorders (SCARED) and Social Communication Questionnaire (SCQ) were used as measures of anxiety and autism features, respectively. A confirmatory factor analysis indicated good fit of the literature standard five-factor structure. Moderated nonlinear factor analysis (MNLFA) revealed multiple items with intercept and loading DIF based on level of autism features, IQ, and age, especially for items related to social behavior. Therefore, although the measure's factor structure is consistent with that found in the general population, the SCARED may not capture differences in anxiety equivalently for all children on the spectrum and across their development. Clinicians and researchers need to be especially vigilant in measuring anxiety symptoms in children with autism by removing items flagged for DIF from the SCARED and/or by using multiple measures and informants. LAY ABSTRACT: Autistic youth often experience clinical levels of anxiety. Many tools used to measure anxiety were developed for the general population, but not for use with autistic youth. This study found that the Screen for Child Anxiety Related Disorders (SCARED) measures the same five dimensions of anxiety as in the general population. Parents, however, may respond differently to questions on the SCARED based on their child's autism features, intellectual functioning, and age, which impacts our ability to accurately measure anxiety among autistic youth.
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Affiliation(s)
- Hillary K Schiltz
- Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA
| | - Brooke E Magnus
- Department of Psychology and Neuroscience, Boston College, Chestnut Hill, Massachusetts, USA
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29
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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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30
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Prieto A, Martins almeida Ayupe K, Nemetala Gomes L, Saúde AC, Gutierres Filho P. Effects of equine-assisted therapy on the functionality of individuals with disabilities: systematic review and meta-analysis. Physiother Theory Pract 2020; 38:1091-1106. [DOI: 10.1080/09593985.2020.1836694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Alessandra Prieto
- Adapted Motor Activity Laboratory, College of Physical Education, University of Brasília, Brasília, Brazil
| | | | | | | | - Paulo Gutierres Filho
- Adapted Motor Activity Laboratory, College of Physical Education, University of Brasília, Brasília, Brazil
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31
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Uematsu M, Numata-Uematsu Y, Aihara Y, Kobayashi T, Fujikawa M, Togashi N, Shiihara T, Ohashi K, Hattori A, Saitoh S, Kure S. Behavioral problems and family distress in tuberous sclerosis complex. Epilepsy Behav 2020; 111:107321. [PMID: 32698109 DOI: 10.1016/j.yebeh.2020.107321] [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] [Received: 05/15/2020] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tuberous sclerosis complex (TSC)-associated neuropsychiatric disorders (TAND) have a large impact on patients and their families. Improving intellectual ability outcomes using preventive vigabatrin (VGB) treatment has recently been reported. AIM The aim of this study was to investigate the severity of behavioral problems and degree of distress among families of patients with TSC with and without a history of VGB treatment. METHOD The study enrolled 21 children and adolescents who were patients with TSC from four hospitals: 14 in the VGB group and 7 in the no-VGB group. To evaluate patients' psychiatric and neurological symptoms, we used the TAND Checklist, Aberrant Behavior Checklist (ABC), Social Communication Questionnaire (SCQ), and Social Responsive Scale-2nd edition (SRS-2). RESULTS All VGB-group patients were administered VGB after the onset of epileptic seizures. No obvious differences were observed between the VGB and no-VGB groups in behavioral problem scores on the TAND Checklist, or on the ABC, SCQ, and SRS-2 total scores. Behavioral problem scores were lower in patients with normal intelligence than in those with mild intellectual disability (ID; P = 0.042). Degrees of family distress assessed with the TAND Checklist were not correlated with the intelligence quotient/developmental quotient (IQ/DQ) or seizure frequency but were correlated with the total SRS-2 scores (P = 0.022). For several patients, there were large discrepancies between familial and physician ratings of the TAND impact score. CONCLUSION Children and adolescents with TSC may present with significant behavioral difficulties and family distress, regardless of whether they were treated with VGB or not after the onset of seizures. Difficulties in social communication may have the strongest "TAND impact" on families.
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Affiliation(s)
- Mitsugu Uematsu
- Department of Pediatrics, Tohoku University School of Medicine, 980-8574, Japan.
| | | | - Yu Aihara
- Department of Pediatrics, Tohoku University School of Medicine, 980-8574, Japan
| | - Tomoko Kobayashi
- Department of Pediatrics, Tohoku University School of Medicine, 980-8574, Japan
| | - Mayu Fujikawa
- Department of Neuropsychiatry, Keio University School of Medicine, 160-8582, Japan; Department of Epileptology, Tohoku University School of Medicine, 980-8574, Japan
| | - Noriko Togashi
- Department of Pediatric Neurology, Miyagi Children's Hospital, 989-3126, Japan
| | - Takashi Shiihara
- Department of Neurology, Gunma Children's Medical Center, 377-8577, Japan
| | - Kei Ohashi
- Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, 467-8602, Japan
| | - Ayako Hattori
- Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, 467-8602, Japan
| | - Shinji Saitoh
- Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Sciences, 467-8602, Japan
| | - Shigeo Kure
- Department of Pediatrics, Tohoku University School of Medicine, 980-8574, Japan
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32
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Digitally-Mediated Social Stories Support Children on the Autism Spectrum Adapting to a Change in a 'Real-World' Context. J Autism Dev Disord 2020; 51:514-526. [PMID: 32519189 PMCID: PMC7835189 DOI: 10.1007/s10803-020-04558-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Social Stories™ (SS) is a widely used intervention for children on the autism spectrum. A preliminary survey of 103 practitioners highlighted that SS are often used to support adapting to a change. This study investigated the use of digitally-mediated SS to support ten children on the autism spectrum attending a school summer camp. Teacher perceptions of anxiety, understanding and closeness to the goal of the SS were assessed before and after the intervention (prior to the event). The pre- post-intervention comparisons highlighted significant improvements in child understanding, anxiety, and closeness to goal with medium-large effect sizes. The child’s understanding and closeness to SS goal post-intervention related to their difficulties with the SS goal and their anxiety during the event.
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33
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Family accommodation of anxiety in a community sample of children on the autism spectrum. J Anxiety Disord 2020; 70:102192. [PMID: 31972299 DOI: 10.1016/j.janxdis.2020.102192] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/22/2019] [Accepted: 01/15/2020] [Indexed: 12/28/2022]
Abstract
Anxiety is recognised as one of the most common co-occurring conditions for individuals with a diagnosis on the autism spectrum, with approximately 40 % of children on the spectrum receiving a clinical diagnosis of an anxiety disorder. To date, research has tended to focus upon understanding presentation and evaluating treatment, with little focus on assessing systemic factors, such as the way that family members accommodate the anxiety. This study aimed to investigate the relationship between parent and child anxiety levels and child autism characteristics on the four domains of family accommodation; Participation, Modification, Distress, and Consequence. A community sample (n = 132) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and anxiety symptomatology as well as their own levels of anxiety and family accommodation behaviours. Regression models identified specific aspects of child anxiety as well as parent anxiety as predictive of family accommodation, with the child's difficulties with uncertainty being a consistent predictor of all four domains. Clinical and research implications of this study, including the importance of understanding similarities or differences in the nature and consequence of family accommodation in children on the autism spectrum, are discussed.
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34
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Hyman SL, Levy SE, Myers SM. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics 2020; 145:peds.2019-3447. [PMID: 31843864 DOI: 10.1542/peds.2019-3447] [Citation(s) in RCA: 464] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with reported prevalence in the United States of 1 in 59 children (approximately 1.7%). Core deficits are identified in 2 domains: social communication/interaction and restrictive, repetitive patterns of behavior. Children and youth with ASD have service needs in behavioral, educational, health, leisure, family support, and other areas. Standardized screening for ASD at 18 and 24 months of age with ongoing developmental surveillance continues to be recommended in primary care (although it may be performed in other settings), because ASD is common, can be diagnosed as young as 18 months of age, and has evidenced-based interventions that may improve function. More accurate and culturally sensitive screening approaches are needed. Primary care providers should be familiar with the diagnostic criteria for ASD, appropriate etiologic evaluation, and co-occurring medical and behavioral conditions (such as disorders of sleep and feeding, gastrointestinal tract symptoms, obesity, seizures, attention-deficit/hyperactivity disorder, anxiety, and wandering) that affect the child's function and quality of life. There is an increasing evidence base to support behavioral and other interventions to address specific skills and symptoms. Shared decision making calls for collaboration with families in evaluation and choice of interventions. This single clinical report updates the 2007 American Academy of Pediatrics clinical reports on the evaluation and treatment of ASD in one publication with an online table of contents and section view available through the American Academy of Pediatrics Gateway to help the reader identify topic areas within the report.
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Affiliation(s)
- Susan L Hyman
- Golisano Children's Hospital, University of Rochester, Rochester, New York;
| | - Susan E Levy
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Scott M Myers
- Geisinger Autism & Developmental Medicine Institute, Danville, Pennsylvania
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35
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Uljarević M, McCabe KL, Angkustsiri K, Simon TJ, Hardan AY. Interrelationship Between Cognitive Control, Anxiety, and Restricted and Repetitive Behaviors in Children with 22q11.2 Deletion Syndrome. Autism Res 2019; 12:1737-1744. [PMID: 31433576 PMCID: PMC6927400 DOI: 10.1002/aur.2194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 12/19/2022]
Abstract
Restricted and repetitive behaviors (RRB) are common in individuals with 22q11.2 microdeletion syndrome (22q11.2DS), yet the underlying mechanisms of these behaviors remain poorly characterized. In the present pilot investigation, we aimed to further our understanding of RRB in 22q11.2DS by exploring their relationship with cognitive control and anxiety as well as with sex, chronological age, and full-scale IQ. Parents of 38 children with 22q11.2DS (17 females; Mage = 11.15 years, SD = 2.46) completed the Social Communication Questionnaire as a measure of RRB and social and communication (SC) problems and the Behavioral Assessment System for Children-2 as a measure of anxiety and cognitive control. Higher RRB scores were significantly associated with higher anxiety levels (r = 0.44, P = 0.006), more impairments in cognitive control (r = 0.56, P < 0.001), and higher SC scores (r = 0.43, P = 0.011). In the first step of the hierarchical regression model, anxiety accounted for 24.5% of variance (F = 10.05, P = 0.003); cognitive control accounted for an additional 18.1% of variance (Fchange = 11.15, P < 0.001) in the second step; SC score accounted for only 0.8% of additional variance in the third step (Fchange = 0.40, P = 0.53). The final model explained 43.4% of variance (F = 7.42, P = 0.001), with cognitive control as a unique independent predictor of RRB score (t = 2.52, P = 0.01). The current study provides the first exploration of the cognitive control-anxiety-RRB link in individuals with 22q11.2DS and points to cognitive control as a potentially viable target for treatments aimed at reducing RRB. Autism Res 2019, 12: 1737-1744. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: People with 22q11.2 deletion syndrome show high levels of repetitive behaviors, however, the previous research has not explored why people with this syndrome exhibit high rates of repetitive behaviors. Understanding the reasons for the high levels of repetitive behaviors is important given that these behaviors can be highly impairing. Our study found that repetitive behaviors were associated with impaired ability to self-regulate and high levels of anxiety. These findings need to be further replicated; however, they are important as they suggest potentially promising ways of reducing these behaviors.
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Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kathryn L McCabe
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
- MIND (Medical Investigation of Neurodevelopmental Disorders) Institute, University of California, Davis, California
| | - Kathleen Angkustsiri
- MIND (Medical Investigation of Neurodevelopmental Disorders) Institute, University of California, Davis, California
- Department of Pediatrics, University of California, Davis, Sacramento, California
| | - Tony J Simon
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California
- MIND (Medical Investigation of Neurodevelopmental Disorders) Institute, University of California, Davis, California
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
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36
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Improvement in Impaired Social Cognition but Not Seizures by Everolimus in a Child with Tuberous Sclerosis-Associated Autism through Increased Serum Antioxidant Proteins and Oxidant/Antioxidant Status. Case Rep Pediatr 2019; 2019:2070619. [PMID: 31871809 PMCID: PMC6907049 DOI: 10.1155/2019/2070619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/11/2019] [Accepted: 08/01/2019] [Indexed: 12/23/2022] Open
Abstract
We investigated the effect of the mammalian target of rapamycin (mTOR) inhibitor everolimus on tuberous sclerosis complex- (TSC-) associated autistic symptoms and focal seizures with impaired awareness in a female child with TSC. We further evaluated the relationship between improved autistic symptoms and seizures and increased the serum levels of the antioxidant proteins, ceruloplasmin (Cp) and transferrin (Tf), and oxidant-antioxidant status indicated by the oxidant marker oxidized low-density lipoprotein (ox-LDL) and the antioxidant marker total antioxidant power (TAP). Everolimus treatment improved impaired social cognition and autistic behaviors; however, seizure and epileptic activity persisted. Serum Cp and Tf levels gradually increased in response to improved autistic symptoms. Serum TAP levels gradually decreased from baseline to the lowest value at 16 weeks and then increased at 24 weeks, showing a trend toward decreased total score of the Aberrant Behavior Checklist. This study revealed that everolimus treatment improved impaired social cognition with increased serum levels of the copper mediator (Cp) and iron mediator (Tf) via homeostatic control of mTOR activity accompanied by overlap of the oxidant-antioxidant system. Everolimus had no effect on TSC-related epileptiform discharges, and thus, the autistic symptoms and epileptic activity may be two independent end results of a common central nervous system disorder including mTOR hyperactivity. This trial is registered with JMAS-IIA00258.
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The Developmental Behaviour Checklist (DBC) Profile in Young Children on the Autism Spectrum: The Impact of Child and Family Factors. J Autism Dev Disord 2019; 49:3426-3439. [PMID: 31115773 DOI: 10.1007/s10803-019-04067-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
High levels of emotional/behavioural difficulties are frequently reported in children on the autism spectrum. However, given the diversity in profiles, there is a need to explore such behaviours in relation to individual factors. Parents of 130 children aged 4-5 on the autism spectrum completed measures of behaviour and adaptive behaviour. Hierarchical multiple regressions explored child and family characteristics in relation to children's emotional/behavioural presentation. Different aspects of the behavioural profile were associated with different factors, with child autism characteristics, medication use, and parent mental health making significant unique contributions to a range of behavioural subscales. Understanding individual profiles beyond total scores is therefore needed to truly understand the emotional and behavioural profile of specific subgroups.
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Brief Report: An Evaluation of the Social Communication Questionnaire as a Screening Tool for Autism Spectrum Disorder in Young People Referred to Child & Adolescent Mental Health Services. J Autism Dev Disord 2019; 49:2618-2623. [PMID: 30972651 DOI: 10.1007/s10803-019-03982-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The SCQ is a widely used screening measure for the assessment of autism spectrum disorder (ASD). However, its sensitivity and specificity when used with older children in the context of community Child & Adolescent Mental Health services is unclear. Seventy-seven (Mean age = 12.8 years) young people with suspected ASD were screened using parent- and teacher-reported SCQ's before completing a comprehensive diagnostic assessment. Of the 77 young people included, 44 (57%) met criteria for an ASD diagnosis. Our results indicated that regardless of informant, SCQ scores did not significantly predict the outcome of the diagnostic assessment. Based on the published cut-off score for the SCQ, Receiver Operating Characteristic curve analyses revealed a lower than expected sensitivity and specificity. This suggests that the SCQ is not an effective screening tool when used in the context of community Child & Adolescent Mental Health services.
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Barnard-Brak L, Richman D, Almekdash MH. How many girls are we missing in ASD? An examination from a clinic- and community-based sample. ADVANCES IN AUTISM 2019. [DOI: 10.1108/aia-11-2018-0048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Research has indicated that males diagnosed with autism spectrum disorder (ASD) outnumber females diagnosed with ASD, which has been attributed to a number of potential biological and genetic risk factors. The purpose of this paper is to estimate how many girls may be missing from ASD via a two-study format, comparing two distinct data sets to Centers for Disease Control and Prevention population estimates for sex distribution of males vs females in ASD.
Design/methodology/approach
In Study 1, the authors utilized data from the National Database for Autism Research as a clinic-based sample. In Study 2, the authors utilized data from the National Survey of Children’s Health as a community-based sample.
Findings
The current study estimates that approximately 39 percent more girls should be diagnosed with ASD. The authors estimate that the sex distribution in ASD should be approximately 28 percent female and 72 percent male based upon current practices. Thus, it appears that more females are being identified as potentially having ASD but were not subsequently being diagnosed with ASD as compared to their male counterparts.
Originality/value
These results could suggest that a leaky pipeline in the assessment of girls with ASD may exist along one or more points in the ASD diagnostic process, with one potential point at the level of ASD-specific screening (i.e. the SCQ in Study 1) in the clinic setting and another in the community setting as a whole for universal screening (i.e. NSCH data in Study 2).
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Adams D, Clark M, Keen D. Using self‐report to explore the relationship between anxiety and quality of life in children on the autism spectrum. Autism Res 2019; 12:1505-1515. [DOI: 10.1002/aur.2155] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/27/2019] [Indexed: 12/28/2022]
Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, School of Education and Professional StudiesGriffith University Brisbane Australia
- Griffith Institute of Educational Research, Griffith University Brisbane Australia
- Cooperative Research Centre for Living with Autism (Autism CRC) Brisbane Australia
| | - Megan Clark
- Autism Centre of Excellence, School of Education and Professional StudiesGriffith University Brisbane Australia
- Griffith Institute of Educational Research, Griffith University Brisbane Australia
- Cooperative Research Centre for Living with Autism (Autism CRC) Brisbane Australia
| | - Deb Keen
- Autism Centre of Excellence, School of Education and Professional StudiesGriffith University Brisbane Australia
- Griffith Institute of Educational Research, Griffith University Brisbane Australia
- Cooperative Research Centre for Living with Autism (Autism CRC) Brisbane Australia
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Zhou H, Li CP, Wang TQ, Long SS, DU XN, Ma Y, Wang Y. [Autism spectrum disorder-like symptoms in the population with intellectual disability aged 6 to 18 years]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2019; 21:445-449. [PMID: 31104660 PMCID: PMC7389423 DOI: 10.7499/j.issn.1008-8830.2019.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate the incidence of autism spectrum disorder (ASD)-like symptoms in the population with intellectual disability (ID). METHODS The students with ASD or ID, aged 6-18 years, who studied in a special school in Shanghai from January to June, 2017, as well as the typically developing (TD) population of the same age, who studied in a general school in Shanghai during the same period, were enrolled. Social Responsiveness Scale (SRS) was completed by their parents or other guardians, and the ASD-like symptoms were evaluated. RESULTS A total of 69 subjects with ASD, 74 subjects with ID and 177 TD subjects were enrolled. The ID group had a significantly higher SRS-positive rate than the TD group (47.3% vs 1.7%; P<0.001) and a significantly lower SRS-positive rate than the ASD group (47.3% vs 87.0%; P<0.001). The total score of SRS was 114±26 in the ASD group, 80±24 in the ID group and 38±19 in the TD group. The ID group had a significantly higher total score of SRS than the TD group (P<0.05), and the score on the subscale of social cognition showed the most significant difference between the two groups (Cohen's d=2.00). There were no significant differences in the total score of SRS and the scores on each subscale of SRS between the mild-to-moderate ID and severe-to-extremely severe ID groups (P>0.05), and there was no significant correlation between SRS score and IQ (P>0.05). CONCLUSIONS The ID population aged 6-18 years has more ASD-like symptoms than the general population, and ASD screening and intervention should be performed for the ID population as early as possible.
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Affiliation(s)
- Hao Zhou
- Department of Neurology, Children's Hospital of Fudan University, Shanghai 201102, China.
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Adams D, Clark M, Simpson K. The Relationship Between Child Anxiety and the Quality of Life of Children, and Parents of Children, on the Autism Spectrum. J Autism Dev Disord 2019; 50:1756-1769. [DOI: 10.1007/s10803-019-03932-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Miranda A, Berenguer C, Roselló B, Baixauli I. Relationships between the social communication questionnaire and pragmatic language, socialization skills, and behavioral problems in children with autism spectrum disorders. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 9:141-152. [PMID: 30638069 DOI: 10.1080/21622965.2018.1550403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The Social Communication Questionnaire (SCQ) is one of the most widely used screening instruments for autism spectrum disorder (ASD). This study examined the relationships between the reciprocal social interaction, communication, and repetitive/stereotyped factors on the Strength and Difficulties Questionnaire (SDQ) and pragmatic, socialization, and behavioral problems in children with ASD and children with typical development (TD). Participants were seven- to 11-year-old children with ASD without intellectual disability (n = 52) and with TD (n = 37). The two groups were matched on age and intelligence quotient. Significant differences were found between the two groups on the SCQ domains and the outcome measures (pragmatic language, socialization skills, and behavioral problems). Furthermore, multiple regression analysis exploring the relationships between the SCQ and the criterion variables showed that reciprocal social interaction and repetitive/stereotyped behaviors had an important weight in the prediction of daily life social skills in typically developing children (34%). However, the model with the highest percentage of explained variance in children with ASD involved pragmatic language, with reciprocal social interaction as the best predictor, even reaching 41%. The findings highlight the suitability of routinely including the SCQ in the first stage of assessment protocols for ASD, and, in particular, they show its capacity to predict a valuable repertoire of behaviors.
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Affiliation(s)
- Ana Miranda
- Department of Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Carmen Berenguer
- Department of Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Belén Roselló
- Department of Educational Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Inmaculada Baixauli
- Department of Occupational Sciences, Speech Therapy, Evolutionary and Educational Psychology, Faculty of Psychology Teaching and Education Sciences, Catholic University of Valencia "San Vicente Mártir", Valencia, Spain
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Adams D, Simpson K, Keen D. School-related anxiety symptomatology in a community sample of primary-school-aged children on the autism spectrum. J Sch Psychol 2018; 70:64-73. [DOI: 10.1016/j.jsp.2018.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/07/2018] [Accepted: 07/26/2018] [Indexed: 12/28/2022]
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Prevalence of Autism Spectrum Disorder in a large Italian catchment area: a school-based population study within the ASDEU project. Epidemiol Psychiatr Sci 2018; 29:e5. [PMID: 30187843 PMCID: PMC8061252 DOI: 10.1017/s2045796018000483] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIMS This study aims to estimate Autism Spectrum Disorders (ASD) prevalence in school-aged children in the province of Pisa (Italy) using the strategy of the ASD in the European Union (ASDEU) project. METHODS A multistage approach was used to identify cases in a community sample (N = 10 138) of 7-9-year-old children attending elementary schools in Pisa - Italy. First, the number of children with a disability certificate was collected from the Local Health Authority and an ASD diagnosis was verified by the ASDEU team. Second, a Teacher Nomination form (TN) to identify children at risk for ASD was filled in by teachers who joined the study and the Social Communication Questionnaire (SCQ) was filled in by the parents of children identified as positive by the TN; a comprehensive assessment, which included the Autism Diagnostic Observation Schedule-Second Edition, was performed for children with positive TN and SCQ⩾9. RESULTS A total of 81 children who had a disability certificate also had ASD (prevalence: 0.79%, i.e. 1/126). Specifically, 66 children (57 males and nine females; 62% with intellectual disability -ID-) were certified with ASD, whereas another 15 (11 males and four females; 80% with ID) were recognised as having ASD among those certified with another neurodevelopmental disorder. Considering the population of 4417 (children belonging to schools which agreed to participate in the TN/SCQ procedure) and using only the number of children certified with ASD, the prevalence (38 in 4417) was 0.86%, i.e. one in 116. As far as this population is concerned, the prevalence rises to 1% if we consider the eight new cases (six males and two females; no subject had ID) identified among children with no pre-existing diagnoses and to 1.15%, i.e., one in 87, if probabilistic estimation is used. CONCLUSIONS This is the first population-based ASD prevalence study conducted in Italy so far and its results indicate a prevalence of ASD in children aged 7-9 years of about one in 87. This finding may help regional, national and international health planners to improve ASD policies for ASD children and their families in the public healthcare system.
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Adams D, Young K, Simpson K, Keen D. Parent descriptions of the presentation and management of anxiousness in children on the autism spectrum. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:980-992. [DOI: 10.1177/1362361318794031] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The complex interaction between anxiety and autism has led to debate about the presentation of anxiety in individuals on the spectrum and questions about the extent to which traditional checklists assess the entire range of symptomatology. Moreover, studies to date have not explored how the presentation of anxiety may differ between settings. Through a combination of open-ended questions, closed questions and standardised measures, parents of 173 children (aged 6–13) on the autism spectrum provided (1) descriptors of their child’s anxiety at home, school and in the community and (2) strategies used to reduce their child’s anxiety in each setting. Over half (52.6%) felt their child was anxious at home, 77.6% at school and 76.2% in the community. Parents reported differing presentations of anxiety between settings, with the majority of descriptions relating to observable, behavioural changes (e.g. hides/shuts down, repetitive behaviours) rather than cognitive or physiological signs. Parents also reported using different strategies across settings. The use of open-ended questions allowed the identification of signs of anxiety not explored within traditional questionnaires and highlighted the potential for signs to vary across settings. This knowledge is critical to inform the development or adaptations of anxiety measures and interventions.
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Affiliation(s)
- Dawn Adams
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | | | - Kate Simpson
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Deb Keen
- Griffith University, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Li C, Zhou H, Wang T, Long S, Du X, Xu X, Yan W, Wang Y. Performance of the Autism Spectrum Rating Scale and Social Responsiveness Scale in Identifying Autism Spectrum Disorder Among Cases of Intellectual Disability. Neurosci Bull 2018; 34:972-980. [PMID: 29808467 DOI: 10.1007/s12264-018-0237-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 04/08/2018] [Indexed: 11/24/2022] Open
Abstract
The Autism Spectrum Rating Scale (ASRS) and the Social Responsiveness Scale (SRS) have been widely used for screening autism spectrum disorder (ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability (ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6-18 years from special education schools, and 402 typically developing (TD) children in the same age span from a community-based population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales (P < 0.05) but higher than TD children (P < 0.05). Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS (area under the curve (AUC) = 0.709, sensitivity = 77.0%, specificity = 52.1%, positive predictive value (PPV) = 82.2%) and the SRS (AUC = 0.742, sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%). The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.
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Affiliation(s)
- Chunpei Li
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Hao Zhou
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China.,Department of Pediatrics, Guizhou Provincial People's Hospital, Medical College of Guizhou University, Guiyang, 558200, China
| | - Tianqi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Shasha Long
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiaonan Du
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiu Xu
- Department of Child Health, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Weili Yan
- Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yi Wang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai, 201102, China. .,State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, 201132, China.
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Cross-Cultural Validity of the Social Communication Questionnaire for Adults with Intellectual Developmental Disorder. J Autism Dev Disord 2016; 47:393-404. [DOI: 10.1007/s10803-016-2967-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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