1
|
Sacrey LAR, Zwaigenbaum L, Elshamy Y, Smith IM, Brian JA, Wass S. Comparative strengths and challenges on face-to-face and computer-based attention tasks in autistic and neurotypical toddlers. Autism Res 2023; 16:1501-1511. [PMID: 37448306 DOI: 10.1002/aur.2983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
The objectives were to compare patterns of visual attention in toddlers diagnosed with autism spectrum disorder (ASD) as compared to their sex- and age-matched neurotypical (NT) peers. Participants included 23 toddlers with ASD and 19 NT toddlers (mean age: 25.52 versus 25.21 months, respectively) assessed using computerized tasks to measure sustained attention, disengaging attention, and cognitive control, as well as an in-person task to assess joint attention. Toddlers in the ASD group showed increased looking durations on the sustained attention task, as well as reduced frequencies of responding to and initiating joint attention compared to NT peers, but showed no differences on tasks of disengaging attention and cognitive control. The results suggest that toddlers with ASD have attentional strengths that may provide a foundation for building attention, communicative, and ultimately, academic skills.
Collapse
Affiliation(s)
- Lori-Ann R Sacrey
- Autism Research Centre, Glenrose Rehabilitation Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Glenrose Rehabilitation Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Yomna Elshamy
- Autism Research Centre, Glenrose Rehabilitation Hospital and Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Isabel M Smith
- IWK Health Centre and Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jessica A Brian
- Bloorview Research Institute and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Sam Wass
- Department of Psychological Sciences, University of East London, London, UK
| |
Collapse
|
2
|
Garrido D, Carballo G. Linguistic and motor profiles in preschool and school-age children with an older sibling with autism spectrum disorder. JOURNAL OF CHILD LANGUAGE 2022:1-19. [PMID: 36472207 DOI: 10.1017/s0305000922000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This study examines receptive-expressive language, gross-fine motor skills, and IQ abilities in 78 children, 43 children with an older sibling with autism spectrum disorder (Sibs-ASD) and 35 children with an older sibling with typical development, ranging from 4 to 11 years of age. Depending on age, both groups were divided in preschool and school groups. The results show that more than 76% of Sibs-ASD performed at least one language and/or motor skill under 25th percentile. Significant differences were described at preschool stage in three aspects: grammatical comprehension, ball skills, and global motor skills. At school age, significant differences were found in two aspects: expressive language, and ball skills. Some differences seem to decrease over time; meanwhile others seem to increase; and others remain stable. Thus, it seems that vulnerability continues in unaffected Sibs-ASD and suggest that this population may benefit from continued screening and monitoring into the preschool and school-age stages.
Collapse
Affiliation(s)
- Dunia Garrido
- University of Granada, Faculty of Psychology Granada18071Spain
| | - Gloria Carballo
- University of Granada, Faculty of Psychology Granada18071Spain
| |
Collapse
|
3
|
Talbott MR, Lang E, Avila F, Dufek S, Young G. Short report: Experiences of Caregivers Participating in a Telehealth Evaluation of Development for Infants (TEDI). J Autism Dev Disord 2022; 52:5266-5273. [PMID: 35945386 PMCID: PMC9362962 DOI: 10.1007/s10803-022-05607-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 11/02/2022]
Abstract
A growing literature supports the feasibility and validity of telehealth-based assessments for autism spectrum disorder (ASD). Better understanding families' experiences is crucial for sustained use beyond the COVID-19 pandemic. This study qualitatively examines caregiver experiences with the Telehealth Evaluation of Development for Infants (TEDI) protocol to better understand benefits and challenges of telehealth-based evaluations. Caregivers (N = 32) completed an online survey following a telehealth-based evaluation with their 6-12 month-old infants. Open-ended text responses to queries about perceived benefits, challenges, and suggestions for future adaptations were coded. Most caregivers reported positive experiences with minor feedback relating to tailoring of individual needs. Responses suggest the TEDI is a feasible approach and provide guidance for components of successful telehealth evaluations more broadly.
Collapse
Affiliation(s)
- Meagan R Talbott
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States.
- Department of Psychiatry and Behavioral Science, University of California Davis, Sacramento, USA.
| | - Ellisa Lang
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
| | - Felipe Avila
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
| | - Sarah Dufek
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
- Department of Psychiatry and Behavioral Science, University of California Davis, Sacramento, USA
| | - Gregory Young
- MIND Institute, University of California Davis, 2825 50th Street, 95817, Sacramento, CA, United States
- Department of Psychiatry and Behavioral Science, University of California Davis, Sacramento, USA
| |
Collapse
|
4
|
Sobieski M, Sobieska A, Sekułowicz M, Bujnowska-Fedak MM. Tools for early screening of autism spectrum disorders in primary health care – a scoping review. BMC PRIMARY CARE 2022; 23:46. [PMID: 35291950 PMCID: PMC8925080 DOI: 10.1186/s12875-022-01645-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/21/2022] [Indexed: 12/30/2022]
Abstract
Abstract
Background
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests itself in early childhood. Early diagnosis of these disorders allows for the initiation of early therapy, which is crucial for the child's further functioning in society.
Objectives
This review aims to gather and present the existing ASD screening tools that can be used in primary care and adapted to different countries conditions linguistically and culturally.
Eligibility criteria
We searched for English-language publications on ASD screening tools for children aged 0–3 years suitable for use in primary care (i.e. free, requiring no additional training or qualifications).
Sources of evidence
Four databases were explored to find English studies on ASD screening tools intended for the rapid assessment of children aged 0–3.
Charting methods
The information sought (specific features of the questionnaires relevant to primary health care workers, psychometric and diagnostic values of a given cultural adaptation of screening tools, and the linguistic and cultural changes made) were extracted and collected to create profiles of these tools.
Results
We found 81 studies which met inclusion criteria and underwent full data extraction. Three additional data sources were included. These allowed to create 75 profiles of adaptations for 26 different screening tools and collect data on their psychometric values and characteristic features.
Conclusions
The results of our study indicate the availability of several diagnostic tools for early ASD screening in primary care setting concordant culturally and linguistically with a given population. They could be an effective method of accelerating the diagnostic process and starting personalized therapy faster. However, most tools have significant limitations – some are only available for research purposes, while others do not have scientific evidence to prove their effectiveness.
Collapse
|
5
|
Sung S, Fenoglio A, Wolff JJ, Schultz RT, Botteron KN, Dager SR, Estes AM, Hazlett HC, Zwaigenbaum L, Piven J, Elison JT. Examining the factor structure and discriminative utility of the Infant Behavior Questionnaire-Revised in infant siblings of autistic children. Child Dev 2022; 93:1398-1413. [PMID: 35485579 PMCID: PMC9544485 DOI: 10.1111/cdev.13781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Using the Infant Behavior Questionnaire-Revised in a longitudinal sample of infant siblings of autistic children (HR; n = 427, 171 female, 83.4% White) and a comparison group of low-risk controls (LR, n = 200, 86 female, 81.5% White), collected between 2007 and 2017, this study identified an invariant factor structure of temperament traits across groups at 6 and 12 months. Second, after partitioning the groups by familial risk and diagnostic outcome at 24 months, results reveal an endophenotypic pattern of Positive Emotionality at both 6 and 12 months, (HR-autism spectrum disorder [ASD] < HR-no-ASD < LR). Third, increased 'Duration of Orienting' at 12 months was associated with lower scores on the 24-month developmental outcomes in HR infants. These findings may augment efforts for early identification of ASD.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Joseph Piven
- University of North Carolina—Chapel HillChapel HillNorth CarolinaUSA
| | | |
Collapse
|
6
|
"Going Mobile"-increasing the reach of parent-mediated intervention for toddlers with ASD via group-based and virtual delivery. J Autism Dev Disord 2022; 52:5207-5220. [PMID: 35608785 PMCID: PMC9128315 DOI: 10.1007/s10803-022-05554-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/06/2022]
Abstract
Evidence supports early intervention for toddlers with ASD, but barriers to access remain, including system costs, workforce constraints, and a range of family socio-demographic factors. An urgent need exists for innovative models that maximize resource efficiency and promote widespread timely access. We examined uptake and outcomes from 82 families participating in a parent-mediated intervention comprising group-based learning and individual coaching, delivered either in-person (n = 45) or virtually (n = 37). Parents from diverse linguistic, ethnic, and educational backgrounds gained intervention skills and toddlers evidenced significant social-communication gains. Few differences emerged across socio-demographic factors or delivery conditions. Findings highlight the feasibility, acceptability, and promise of group-based learning when combined with individual coaching, with added potential to increase program reach via virtual delivery.
Collapse
|
7
|
Chaxiong P, Burrows C, Botteron KN, Dager SR, Estes AM, Hazlett HC, Schultz RT, Zwaigenbaum L, Piven J, Wolff J. Relations of Restricted and Repetitive Behaviors to Social Skills in Toddlers with Autism. J Autism Dev Disord 2022; 52:1423-1434. [PMID: 33956255 PMCID: PMC8571122 DOI: 10.1007/s10803-021-05014-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2021] [Indexed: 12/21/2022]
Abstract
We examined the relations of restricted and repetitive behaviors (RRB; insistence on sameness, repetitive sensory-motor, self-injurious behavior) to social skills overall and aspects that comprise social skills as measured by the VABS-II (coping skills, play/leisure time, interpersonal relationships) in 24- (n = 63) and 36-month old (n = 35), high-familial-risk toddlers with ASD. Hierarchical linear regression results indicated that repetitive sensory-motor was the best predictor of social skills overall. Secondary results indicated that all three RRB subtypes were associated with each subdomain of social skills; however, repetitive sensory-motor was the strongest and most consistent among these effects. While our results suggests a general negative relation of subtypes of RRB to aspects of adaptive social function, repetitive sensory-motor behaviors may be of particular relevance to the development of social skills during toddlerhood.
Collapse
Affiliation(s)
- Pang Chaxiong
- University of Minnesota, 56 East River Road, Minneapolis, MN, 55455, USA
| | - Catherine Burrows
- University of Minnesota, 56 East River Road, Minneapolis, MN, 55455, USA
| | - Kelly N Botteron
- Washington University in St. Louis, 660 S Euclid Ave, St. Louis, MO, 63110, USA
| | - Stephen R Dager
- University of Washington, 1701 NE Columbia Rd, Seattle, WA, 98195, USA
| | - Annette M Estes
- University of Washington, 1701 NE Columbia Rd, Seattle, WA, 98195, USA
| | - Heather C Hazlett
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27516, USA
| | - Robert T Schultz
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | | | - Joseph Piven
- University of North Carolina at Chapel Hill, 321 S Columbia St, Chapel Hill, NC, 27516, USA
| | - Jason Wolff
- University of Minnesota, 56 East River Road, Minneapolis, MN, 55455, USA.
| | | |
Collapse
|
8
|
Salgado-Cacho JM, Moreno-Jiménez MDP, Ríos-Rodríguez ML. Intensive Family Intervention as Support for Professional Treatment: Evolution of Symptoms in a Diagnosed Case of Autism Spectrum Disorder. CHILDREN (BASEL, SWITZERLAND) 2022; 9:400. [PMID: 35327776 PMCID: PMC8946976 DOI: 10.3390/children9030400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
This article shows the progress achieved in a child who has received professional treatment combined with a family intervention at home. It discusses a 22-month-old patient identified as showing warning signs of autism spectrum disorder (ASD), a diagnosis that was subsequently confirmed through a standardized ADOS-2 test at 31 months of age. To establish the initial working objectives, a functional diagnosis was carried out at 23 months of age using the Battelle Developmental Inventory; a maturational delay was detected, situating the child at an age equivalent to 16 months. A professional intervention was designed in an early childhood care center, complemented by family intervention, so that the hours in which the child participated in learning experiences were increased. Notable advances were made in the areas of cognitive and motor skills, with more standard scores than when initially evaluated. Progress was also observed (though to a lesser extent) in other developmental areas such as language total, adaptive behavior, and self-help, while slight delays in the areas of socio-emotional development and reasoning and academic skills were found.
Collapse
Affiliation(s)
- José María Salgado-Cacho
- Faculty of Psychology, University of Málaga, 29010 Málaga, Spain; (M.d.P.M.-J.); (M.L.R.-R.)
- Hogar Abierto Foundation, 29001 Málaga, Spain
| | | | | |
Collapse
|
9
|
Bradshaw J, McCracken C, Pileggi M, Brane N, Delehanty A, Day T, Federico A, Klaiman C, Saulnier C, Klin A, Wetherby A. Early social communication development in infants with autism spectrum disorder. Child Dev 2021; 92:2224-2234. [PMID: 34786700 DOI: 10.1111/cdev.13683] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Social-communication differences are a robust and defining feature of autism spectrum disorder (ASD) but identifying early points of divergence in infancy has been a challenge. The current study examines social communication in 9- to 12-month-old infants who develop ASD (N = 30; 23% female; 70% white) compared to typically developing (TD) infants (N = 94, 38% female; 88% white). Results demonstrate that infants later diagnosed with ASD were already exhibiting fewer social-communication skills using eye gaze, facial expression, gestures, and sounds at 9 months (effect size: 0.42-0.89). Moreover, three unique patterns of change across distinct social-communication skills were observed within the ASD group. This study documents that observable social-communication differences for infants with ASD are unfolding by 9 months, pointing to a critical window for targeted intervention.
Collapse
Affiliation(s)
| | | | - Moira Pileggi
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Natalie Brane
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Abigail Delehanty
- John G. Rangos, Sr. School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Taylor Day
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Cheryl Klaiman
- Emory University School of Medicine, Atlanta, Georgia, USA.,Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Celine Saulnier
- Emory University School of Medicine, Atlanta, Georgia, USA.,Neurodevelopmental Assessment & Consulting Services, Atlanta, Georgia, USA
| | - Ami Klin
- Emory University School of Medicine, Atlanta, Georgia, USA.,Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Amy Wetherby
- Autism Institute, Florida State University, Tallahassee, Florida, USA.,Florida State University College of Medicine, Tallahassee, Florida, USA
| |
Collapse
|
10
|
Grzadzinski R, Amso D, Landa R, Watson L, Guralnick M, Zwaigenbaum L, Deák G, Estes A, Brian J, Bath K, Elison J, Abbeduto L, Wolff J, Piven J. Pre-symptomatic intervention for autism spectrum disorder (ASD): defining a research agenda. J Neurodev Disord 2021; 13:49. [PMID: 34654371 PMCID: PMC8520312 DOI: 10.1186/s11689-021-09393-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022] Open
Abstract
Autism spectrum disorder (ASD) impacts an individual's ability to socialize, communicate, and interact with, and adapt to, the environment. Over the last two decades, research has focused on early identification of ASD with significant progress being made in understanding the early behavioral and biological markers that precede a diagnosis, providing a catalyst for pre-symptomatic identification and intervention. Evidence from preclinical trials suggest that intervention prior to the onset of ASD symptoms may yield more improved developmental outcomes, and clinical studies suggest that the earlier intervention is administered, the better the outcomes. This article brings together a multidisciplinary group of experts to develop a conceptual framework for behavioral intervention, during the pre-symptomatic period prior to the consolidation of symptoms into diagnosis, in infants at very-high-likelihood for developing ASD (VHL-ASD). The overarching goals of this paper are to promote the development of new intervention approaches, empirical research, and policy efforts aimed at VHL-ASD infants during the pre-symptomatic period (i.e., prior to the consolidation of the defining features of ASD).
Collapse
Affiliation(s)
- Rebecca Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA.
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA.
| | - Dima Amso
- Department of Psychology, Columbia University, New York, NY, USA
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Linda Watson
- Program for Early Autism Research Leadership and Service (PEARLS), University of North Carolina, Chapel Hill, NC, USA
- Division of Speech and Hearing Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - Michael Guralnick
- Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | | | - Gedeon Deák
- Department of Cognitive Science, University of California, San Diego, San Diego, CA, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington Autism Center, University of Washington, Seattle, WA, USA
| | - Jessica Brian
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Kevin Bath
- Department of Neuroscience, Brown University, Providence, RI, USA
| | - Jed Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Leonard Abbeduto
- University of California, Davis, MIND Institute, University of California, Davis, Sacramento, CA, USA
| | - Jason Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
11
|
Talbott MR, Dufek S, Young G, Rogers SJ. Leveraging telehealth to evaluate infants with prodromal autism spectrum disorder characteristics using the telehealth evaluation of development for infants. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1242-1254. [PMID: 34549613 DOI: 10.1177/13623613211045596] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Many families seeking early evaluations for autism spectrum disorder face long waitlists, must often travel to centers with appropriate expertise, and are frequently told by providers to "wait and see." This results in significant stress for families and delayed supports to infants and their caregivers who could benefit. This study evaluated whether telehealth could be used to identify and evaluate infants with early autism spectrum disorder characteristics in the first year of life. In this study, we evaluated 41 infants via telehealth using a standard set of probes and scored behavior related to social communication, play, imitation, and other developmental domains. We found the majority of infants demonstrated elevated likelihood of autism spectrum disorder on both parent-reported questionnaires and examiner-rated behavior. Caregiver ratings of the overall utility of the protocol used in this study were high. Overall, this study demonstrates the feasibility for telehealth-based approaches to evaluate infants' with elevated likelihood of autism spectrum disorder in the first year of life, which could help to improve families' access to care and to expand our capacity to conduct studies evaluating possible intervention supports.
Collapse
|
12
|
Wolff JJ, Piven J. Predicting Autism in Infancy. J Am Acad Child Adolesc Psychiatry 2021; 60:958-967. [PMID: 33161062 PMCID: PMC8158398 DOI: 10.1016/j.jaac.2020.07.910] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/09/2020] [Accepted: 10/28/2020] [Indexed: 12/17/2022]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication and interaction deficits and restricted, repetitive patterns of interests and behavior that are evident in early childhood. Its prevalence has grown substantially over the past several decades, with current estimates ranging from 1.7% to 2.5% in the United States.1,2 This represents more than 1.5 million children with ASD, the vast majority of whom receive or will receive specialized services.2 Each year, approximately 100,000 (and growing) individuals with ASD reach adulthood, and many face myriad challenges related to employment, housing, mental health, and overburdened or insufficient support services.3-5 A host of significant costs can be associated with ASD, from direct costs related to the provision of special education programs, housing, and medical care to indirect costs, such as loss of productivity affecting both individuals with ASD and their families.6 Currently, overall lifetime cost of care per person with ASD can exceed $3 million, totaling more than $265 billion annually in the United States and rising to an estimated $1 trillion by 2025.7,8.
Collapse
Affiliation(s)
- Jason J. Wolff
- Department of Educational Psychology, University of Minnesota
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| |
Collapse
|
13
|
Meera SS, Donovan K, Wolff JJ, Zwaigenbaum L, Elison JT, Kinh T, Shen MD, Estes AM, Hazlett HC, Watson LR, Baranek GT, Swanson MR, St John T, Burrows CA, Schultz RT, Dager SR, Botteron KN, Pandey J, Piven J. Towards a Data-Driven Approach to Screen for Autism Risk at 12 Months of Age. J Am Acad Child Adolesc Psychiatry 2021; 60:968-977. [PMID: 33161063 PMCID: PMC8127075 DOI: 10.1016/j.jaac.2020.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 07/19/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to develop a classifier for infants at 12 months of age based on a parent-report measure (the First Year Inventory 2.0 [FYI]), for the following reasons: (1) to classify infants at elevated risk, above and beyond that attributable to familial risk status for ASD; and (2) to serve as a starting point to refine an approach for risk estimation in population samples. METHOD A total of 54 high-familial risk (HR) infants later diagnosed with ASD (HR-ASD), 183 HR infants not diagnosed with ASD at 24 months of age (HR-Neg), and 72 low-risk controls participated in the study. All infants contributed FYI data at 12 months of age and had a diagnostic assessment for ASD at age 24 months. A data-driven, cross-validated analytic approach was used to develop a classifier to determine screening accuracy (eg, sensitivity) of the FYI to classify HR-ASD and HR-Neg. RESULTS The newly developed FYI classifier had an estimated sensitivity of 0.71 (95% CI: 0.50, 0.91) and specificity of 0.72 (95% CI: 0.49, 0.91). CONCLUSION This classifier demonstrates the potential to improve current screening for ASD risk at 12 months of age in infants already at elevated familial risk for ASD, increasing opportunities for detection of autism risk in infancy. Findings from this study highlight the utility of combining parent-report measures with machine learning approaches.
Collapse
Affiliation(s)
- Shoba S Meera
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill; The National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Kevin Donovan
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | | | - Lonnie Zwaigenbaum
- University of Alberta, Edmonton, Canada; and the Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, Canada
| | | | - Truong Kinh
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | | | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | - Linda R Watson
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| | | | | | | | | | | | | | | | - Juhi Pandey
- Children's Hospital of Philadelphia, University of Pennsylvania
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill
| |
Collapse
|
14
|
Torabi R, Jenkins S, Harker A, Whishaw IQ, Gibb R, Luczak A. A Neural Network Reveals Motoric Effects of Maternal Preconception Exposure to Nicotine on Rat Pup Behavior: A New Approach for Movement Disorders Diagnosis. Front Neurosci 2021; 15:686767. [PMID: 34354562 PMCID: PMC8329707 DOI: 10.3389/fnins.2021.686767] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/25/2021] [Indexed: 11/13/2022] Open
Abstract
Neurodevelopmental disorders can stem from pharmacological, genetic, or environmental causes and early diagnosis is often a key to successful treatment. To improve early detection of neurological motor impairments, we developed a deep neural network for data-driven analyses. The network was applied to study the effect of maternal nicotine exposure prior to conception on 10-day-old rat pup motor behavior in an open field task. Female Long-Evans rats were administered nicotine (15 mg/L) in sweetened drinking water (1% sucralose) for seven consecutive weeks immediately prior to mating. The neural network outperformed human expert designed animal locomotion measures in distinguishing rat pups born to nicotine exposed dams vs. control dams (87 vs. 64% classification accuracy). Notably, the network discovered novel movement alterations in posture, movement initiation and a stereotypy in "warm-up" behavior (repeated movements along specific body dimensions) that were predictive of nicotine exposure. The results suggest novel findings that maternal preconception nicotine exposure delays and alters offspring motor development. Similar behavioral symptoms are associated with drug-related causes of disorders such as autism spectrum disorder and attention-deficit/hyperactivity disorder in human children. Thus, the identification of motor impairments in at-risk offspring here shows how neuronal networks can guide the development of more accurate behavioral tests to earlier diagnose symptoms of neurodevelopmental disorders in infants and children.
Collapse
Affiliation(s)
| | | | | | | | | | - Artur Luczak
- Canadian Centre for Behavioural Neuroscience, University of Lethbridge, Lethbridge, AB, Canada
| |
Collapse
|
15
|
Parikh C, Iosif AM, Ozonoff S. Brief Report: Use of the Infant-Toddler Checklist in Infant Siblings of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:1007-1012. [PMID: 32219636 PMCID: PMC7529925 DOI: 10.1007/s10803-020-04468-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Few studies have explored autism spectrum disorder (ASD) screening in the first year of life. The current investigation examines the psychometric properties of the Infant-Toddler Checklist starting in the first year of life in a sample at elevated and average risk for ASD based on family history. 283 participants were followed from 6 to 36 months, when diagnostic outcome was determined. The results indicated low to moderate sensitivity, specificity, and positive predictive value across ages for broadly distinguishing any delays from typical development, as well as for more narrowly discriminating children with ASD from those who were typically developing. Implications for utilizing ASD screening tools in the first year of life with high risk samples are discussed.
Collapse
Affiliation(s)
- Chandni Parikh
- Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California-Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA.
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California-Davis, Davis, CA, USA
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences, MIND Institute, University of California-Davis Health, 2825 50th Street, Sacramento, CA, 95817, USA
| |
Collapse
|
16
|
Detection of Early Warning Signs in Autism Spectrum Disorders: A Systematic Review. CHILDREN-BASEL 2021; 8:children8020164. [PMID: 33671540 PMCID: PMC7926898 DOI: 10.3390/children8020164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 12/03/2022]
Abstract
Due to the exponential increase of autism spectrum disorders’ prevalence in Western countries, it is necessary to improve early detection and intervention to enhance developmental milestones. This systematic review identified the most effective screening instrument, which can be used at an early age and which identifies the maximum number of autism cases. We identified several instruments with adequate predictive properties—the Autism Parent Screen for Infants (APSI), Battelle Development Inventory, second edition (BDI-2); Brief Infant-Toddler Social and Emotional Assessment (BITSEA); First Year Inventory (FYI); Infant-Toddler Checklist/Communication and Symbolic Behavior Scales Developmental Profile (ITC/CSBS-DP); Program of Research and Studies on AUTISM (PREAUT-Grid); Checklist for Early Signs of Developmental Disorders (CESDD); Social Attention and Communication Study (SACS); and the Screening Tool for Autism in Toddlers and Young Children (STAT)—that can be applied from 12 months of age in Western countries. The ITC/CSBS-DP has been proposed for universal screening from 12 months of age onwards, complemented by the Modified Checklist for Autism in Toddlers, Revised/Revised with Follow-Up (M-CHAT-R/F), which can be used from 15 months of age onwards. This strategy could improve early detection in at-risk children within the current health system, thus allowing for early intervention.
Collapse
|
17
|
Kong XJ, Sherman HT, Tian R, Koh M, Liu S, Li AC, Stone WS. Validation of Rapid Interactive Screening Test for Autism in Toddlers Using Autism Diagnostic Observation Schedule™ Second Edition in Children at High-Risk for Autism Spectrum Disorder. Front Psychiatry 2021; 12:737890. [PMID: 34658971 PMCID: PMC8517472 DOI: 10.3389/fpsyt.2021.737890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/06/2021] [Indexed: 11/29/2022] Open
Abstract
The Rapid Interactive screening Test for Autism in Toddlers (RITA-T) is a fast and inexpensive early screening measure for autism spectrum disorder (ASD) that was tested previously in children 18-36 months-old; the current validation study compared the RITA-T with the Autism Diagnostic Observation Schedule™ Second Edition (ADOS-2). The hypothesis is to validate the RITA-T with comparison to the ADOS-2. Thirty-five individuals (18-84 months-old) identified as at risk for ASD received the RITA-T and the ADOS-2 during a single visit. Participants were split into two age groups and both whole-group and sub-group data analysis were conducted. With all participants, RITA-T scores correlated significantly with ADOS-2 total scores (P < 0.001), social affect (SA) sub-scores (P < 0.001), and restrictive and repetitive behavior (RRB) sub-scores (P < 0.05). Similarly, ADOS-2 total and SA scores were significantly correlated in both age groups, while the RRB sub-score was only significant in females (P < 0.05). Lastly, correlations using subgroups based on ethnicity were only significant in the minority ("Other") group for ADOS-2 total scores and in the Asian group for SA sub-scores (P < 0.05). Our receiver operating characteristic analysis showed that the optimal cut-off score of the RITA-T was consistently at 14, with a sensitivity of 81% and a specificity of 89% in the combined age group with the ADOS-2 and with a sensitivity 74% and specificity 50% with the DSM-5; The area under the curve was 0.84 (95%CI: 0.69-0.99) for ASD classified by ADOS-2 and 0.89 (95%CI: 0.79-0.99) for ASD diagnosed by DSM-5. The RITA-T performed similarly to the ADOS-2 when both were administered in a single visit. Significant correlations between the measures help validate the potential usefulness of the RITA-T as a rapid early screening measure of ASD. This study helps to show that the RITA-T may be used in a larger age range than originally reported and in different ethnic groups. The study involves human participants and was reviewed and approved by the Institutional Review Board (IRB) of Massachusetts General Hospital (MGH, 2017P0000857).
Collapse
Affiliation(s)
- Xue-Jun Kong
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States.,Department of Psychiatry, Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Hannah Tayla Sherman
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Ruiyi Tian
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Madelyn Koh
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Siyu Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Alice Chukun Li
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - William S Stone
- Department of Psychiatry, Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Boston, MA, United States
| |
Collapse
|
18
|
Zwaigenbaum L, Bryson SE, Brian J, Smith IM, Sacrey L, Armstrong V, Roberts W, Szatmari P, Garon N, Vaillancourt T, Roncadin C. Assessment of Autism Symptoms From 6 to 18 Months of Age Using the Autism Observation Scale for Infants in a Prospective High-Risk Cohort. Child Dev 2020; 92:1187-1198. [PMID: 33368222 DOI: 10.1111/cdev.13485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objectives were to characterize behavioral signs of autism spectrum disorder (ASD) in younger siblings of diagnosed children (high-risk; HR) and examine classification features of the Autism Observation Scale for Infants (AOSI). Participants (501 HR and 180 low-risk [LR]) were assessed between 6 and 18 months using the AOSI and at age 3 for ASD diagnoses. Total AOSI scores differentiated HR infants later diagnosed with ASD starting at 12 months. ROC analyses identified 12- and 18-month cutoff scores associated with 0.52 sensitivity and 0.74 specificity and 0.73 sensitivity and 0.65 specificity, respectively. Although classification accuracy does not support use as a standalone screen, the AOSI identifies features associated with ASD starting at 6 months and differentiates HR infants with ASD by 12 months.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Wendy Roberts
- Integrated Services for Autism and Neurodevelopmental Disorders
| | | | | | | | | |
Collapse
|
19
|
Talbott MR, Dufek S, Zwaigenbaum L, Bryson S, Brian J, Smith IM, Rogers SJ. Brief Report: Preliminary Feasibility of the TEDI: A Novel Parent-Administered Telehealth Assessment for Autism Spectrum Disorder Symptoms in the First Year of Life. J Autism Dev Disord 2020; 50:3432-3439. [PMID: 31776881 DOI: 10.1007/s10803-019-04314-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Families with early concerns about infant symptoms of ASD have limited access to experienced professionals for screening and guidance. Telehealth has been used to reduce access disparities in other pediatric populations and has shown promise in parent-implemented interventions for ASD. We investigated the feasibility of a novel level-2 telehealth assessment of infants' early social communication and ASD symptoms, the Telehealth Evaluation of Development for Infants (TEDI). Parents of eleven infants aged 6-12 months were coached to administer specific semi-structured behavioral probes. Initial feasibility, reliability, and acceptability benchmarks were met. These findings suggest the feasibility of screening infants via telehealth, and are supportive of further large-scale efforts to validate this method for longitudinal monitoring of symptomatic infants in community settings.
Collapse
Affiliation(s)
- Meagan R Talbott
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, 2825 50th Street, Sacramento, CA, 95820, USA.
| | - Sarah Dufek
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, 2825 50th Street, Sacramento, CA, 95820, USA
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.,Autism Research Centre, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada
| | - Susan Bryson
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Jessica Brian
- Bloorview Research Institute, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada
| | - Isabel M Smith
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Sally J Rogers
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, 2825 50th Street, Sacramento, CA, 95820, USA
| |
Collapse
|
20
|
The association between social emotional development and symptom presentation in autism spectrum disorder. Dev Psychopathol 2020; 32:1206-1216. [PMID: 32753081 DOI: 10.1017/s0954579420000711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Understanding differences in social-emotional behavior can help identify atypical development. This study examined the differences in social-emotional development in children at increased risk of an autism spectrum disorder (ASD) diagnosis (infant siblings of children diagnosed with the disorder). Parents completed the Brief Infant-Toddler Social-Emotional Assessment (BITSEA) to determine its ability to flag children with later-diagnosed ASD in a high-risk (HR) sibling population. Parents of HR (n = 311) and low-risk (LR; no family history of ASD; n = 127) children completed the BITSEA when their children were 18 months old and all children underwent a diagnostic assessment for ASD at age 3 years. All six subscales of the BITSEA (Problems, Competence, ASD Problems, ASD Competence, Total ASD Score, and Red Flags) distinguished between those in the HR group who were diagnosed with ASD (n = 84) compared to non-ASD-diagnosed children (both HR-N and LR). One subscale (BITSEA Competence) differentiated between the HR children not diagnosed with ASD and the LR group. The results suggest that tracking early social-emotional development may have implications for all HR children, as they are at increased risk of ASD but also other developmental or mental health conditions.
Collapse
|
21
|
Winters KL, Byrd CT. Pediatrician Referral Practices for Children Who Stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1404-1422. [PMID: 32464074 DOI: 10.1044/2020_ajslp-19-00058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Given the marked increase in evidence-based information regarding the nature/treatment of stuttering, coupled with the fact that pediatricians tend to be one of the initial points of contact for parents who suspect their preschool-age child may stutter, this study explored pediatricians' (a) accuracy in identifying children who may stutter and (b) likelihood of referring children who present with a profile indicative of stuttering to speech-language pathologists. Method Pediatricians recruited nationally through professional organizations completed a 5- to 7-min online survey that probed stuttering identification and referral practices via responses to experimental case vignettes. Each vignette featured a 4-year-old boy with a family history of stuttering whose mother reported signs of stuttering and manipulation of two factors: stuttering during the pediatrician visit (or not) and negative communication attitude (or not). Results Our findings suggest pediatricians' identification and referral of children who may stutter is largely prompted by observation of overt speech behaviors and/or negative communication attitude. Participants' gender, years in practice, and experience working with children who stutter did not influence likelihood of referral. Conclusions Results indicate pediatricians are less likely to implement a "wait and see" approach with young children who stutter today than in the past. Unlike other common child onset diagnoses, however, parent report of atypical behavior does not yield pediatrician referral to a specialist. Future education and advocacy efforts directed toward pediatricians should emphasize inclusion of factors other than direct observation of stuttering behavior that may warrant referral (e.g., parent report).
Collapse
Affiliation(s)
- Katherine L Winters
- Department of Communication Sciences and Disorders, The University of Texas at Austin
| | - Courtney T Byrd
- Department of Communication Sciences and Disorders, The University of Texas at Austin
| |
Collapse
|
22
|
Geng X, Kang X, Wong PCM. Autism spectrum disorder risk prediction: A systematic review of behavioral and neural investigations. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2020; 173:91-137. [PMID: 32711819 DOI: 10.1016/bs.pmbts.2020.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
A reliable diagnosis of autism spectrum disorder (ASD) is difficult to make until after toddlerhood. Detection in an earlier age enables early intervention, which is typically more effective. Recent studies of the development of brain and behavior in infants and toddlers have provided important insights in the diagnosis of autism. This extensive review focuses on published studies of predicting the diagnosis of autism during infancy and toddlerhood younger than 3 years using behavioral and neuroimaging approaches. After screening a total of 782 papers, 17 neuroimaging and 43 behavioral studies were reviewed. The features for prediction consist of behavioral measures using screening tools, observational and experimental methods, brain volumetric measures, and neural functional activation and connectivity patterns. The classification approaches include logistic regression, linear discriminant function, decision trees, support vector machine, and deep learning based methods. Prediction performance has large variance across different studies. For behavioral studies, the sensitivity varies from 20% to 100%, and specificity ranges from 48% to 100%. The accuracy rates range from 61% to 94% in neuroimaging studies. Possible factors contributing to this inconsistency may be partially due to the heterogeneity of ASD, different targeted populations (i.e., high-risk group for ASD and general population), age when the features were collected, and validation procedures. The translation to clinical practice requires extensive further research including external validation with large sample size and optimized feature selection. The use of multi-modal features, e.g., combination of neuroimaging and behavior, is worth further investigation to improve the prediction accuracy.
Collapse
Affiliation(s)
- Xiujuan Geng
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Xin Kang
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong; Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Shatin, Hong Kong.
| | - Patrick C M Wong
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong; Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Shatin, Hong Kong; Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| |
Collapse
|
23
|
Barbaro J, Yaari M. Study protocol for an evaluation of ASDetect - a Mobile application for the early detection of autism. BMC Pediatr 2020; 20:21. [PMID: 31952489 PMCID: PMC6969425 DOI: 10.1186/s12887-019-1888-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 12/15/2019] [Indexed: 11/18/2022] Open
Abstract
Background Autism Spectrum Conditions (ASC) can be reliably diagnosed by 24 months of age. However, despite the well-known benefits of early intervention, there is still a research-practice gap in the timely identification of ASC, particularly in low-resourced settings. The Social Attention and Communication Surveillance (SACS) tool, which assesses behavioural markers of autism between 12 to 24 months of age, has been implemented in Maternal and Child Health (MCH) settings, with excellent psychometric properties. ASDetect is a free mobile application based on the SACS, which is designed to meet the need for an effective, evidence-based tool for parents, to learn about children’s early social-communication development and assess their child’s ‘likelihood’ for ASC. Study aims The primary aim of this study is to evaluate the psychometric properties of ASDetect in the early detection of children with ASC. A secondary aim is to assess ASDetect’s acceptability and parental user experience with the application. Methods Families are recruited to download the application and participate in the study via social media, health professionals (e.g., MCH nurses, paediatricians) and word of mouth. All participating caregivers complete a demographic questionnaire, survey regarding their user experience, and the Social Responsiveness Scale-2 (SRS-2), an autism screening questionnaire; they are also invited to participate in focus groups. Children identified at ‘high likelihood’ for ASC based on the ASDetect results, the SRS-2 or parental and/or professional concerns undergo a formal, gold-standard, diagnostic assessment. Receiver Operating Characteristic analyses will be used to assess psychometric properties of ASDetect. Thematic analyses will be used to explore themes arising in the focus groups to provide insights regarding user experiences with the app. Multiple regression analyses will be carried out to determine the extent to which demographic factors, parental stress and beliefs on health surveillance and child results on ASDetect are associated with the parental user-experience of the application. Discussion With a strong evidence-base and global access, ASDetect has the potential to empower parents by providing them with knowledge of their child’s social-communication development, validating and reassuring any parental concerns, and supporting them in communicating with other health professionals, ultimately enhancing child and family outcomes and well-being.
Collapse
Affiliation(s)
- Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health. College of Science, Heath & Engineering. La Trobe University, Melbourne, Victoria, 3086, Australia.
| | - Maya Yaari
- Olga Tennison Autism Research Centre, School of Psychology and Public Health. College of Science, Heath & Engineering. La Trobe University, Melbourne, Victoria, 3086, Australia.,Goshen - Community Child Health and Well-Being. Haruv Campus for Children. Mount Scopus, 9765418, Jerusalem, Israel
| |
Collapse
|
24
|
Abstract
OBJECTIVE Most autism spectrum disorder (ASD) screening measures have been developed for use with low-risk (LR) children; however, measures may perform differently in high-risk (HR) younger sibling populations. The current study sought to investigate the performance of an ASD screening measure, the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F), in a sample of HR younger siblings and directly compared its performance with that in an LR sample. METHODS High-risk younger siblings (n = 187) and LR children (n = 15,848) were screened using the M-CHAT-R/F. Screen-positive children completed comprehensive evaluations. The M-CHAT-R/F psychometric properties and clinical characteristics were compared across the samples. RESULTS The M-CHAT-R/F demonstrated a significantly higher screen-positive rate and ASD detection rate in the HR sample compared with the LR sample. Children with ASD in the HR sample had stronger verbal, nonverbal, and overall cognitive abilities compared with children with ASD in the LR sample despite comparable ASD severity and adaptive functioning. High positive predictive value of the M-CHAT-R at initial screen, with only incremental change after Follow-Up, suggests that Follow-Up is less critical in HR than LR samples. A significantly lower number of changed responses during Follow-Up further supports improved reporting accuracy of parents with ASD experience compared with parents less familiar with ASD. CONCLUSION The findings suggest that the M-CHAT-R/F can distinguish between ASD and non-ASD at 18 to 24 months in an HR sibling sample, with performance comparable with or better than its performance in the general population.
Collapse
|
25
|
Pasco G, Davies K, Ribeiro H, Tucker L, Allison C, Baron-Cohen S, Johnson MH, Charman T. Comparison of Parent Questionnaires, Examiner-Led Assessment and Parents' Concerns at 14 Months of Age as Indicators of Later Diagnosis of Autism. J Autism Dev Disord 2019; 51:804-813. [PMID: 31845131 PMCID: PMC7954743 DOI: 10.1007/s10803-019-04335-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parents participating in a prospective longitudinal study of infants with older siblings with autism completed an autism screening questionnaire and were asked about any concerns relating to their child’s development, and children were administered an interactive assessment conducted by a researcher at 14 months. Scores on the parent questionnaire were highest for children later diagnosed with autism. Parental concerns and scores from the examiner-led assessment distinguished children with later developmental difficulties (both autism and other developmental atypicalities) from those who were developing typically. Children about whom parents expressed concern scored higher on both the questionnaire and the interactive assessment than those without concerns. There were no significant associations between total or individual item scores from the questionnaire and interactive assessment.
Collapse
Affiliation(s)
- Greg Pasco
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Henry Wellcome Building, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Kim Davies
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK
| | - Helena Ribeiro
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK
| | - Leslie Tucker
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK
| | - Carrie Allison
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK
| | - Simon Baron-Cohen
- Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK
| | - Mark H Johnson
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, UK.,Department of Psychology, University of Cambridge, Cambridge, UK
| | - Tony Charman
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, Henry Wellcome Building, 16 De Crespigny Park, London, SE5 8AF, UK
| | | |
Collapse
|
26
|
Lee HY, Vigen C, Zwaigenbaum L, Bryson S, Smith I, Brian J, Watson LR, Crais ER, Turner-Brown L, Reznick JS, Baranek GT. The Performance of the First Year Inventory (FYI) Screening on a Sample of High-Risk 12-Month-Olds Diagnosed with Autism Spectrum Disorder (ASD) at 36 Months. J Autism Dev Disord 2019; 49:4957-4973. [DOI: 10.1007/s10803-019-04208-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
de Diego-Otero Y, Salgado-Cacho JM. Early detection in autism spectrum disorders. Med Clin (Barc) 2019; 152:307-309. [PMID: 30678884 DOI: 10.1016/j.medcli.2018.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/27/2018] [Accepted: 11/28/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Yolanda de Diego-Otero
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, España; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
| | - José María Salgado-Cacho
- Unidad de Gestión Clínica de Salud Mental, Hospital Regional Universitario de Málaga, Málaga, España; Hogar Abierto, Málaga, España; Universidad de Málaga, Málaga, España
| |
Collapse
|