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Shiota Y, Nishiyama T, Yokoyama S, Yoshimura Y, Hasegawa C, Tanaka S, Iwasaki S, Kikuchi M. Association of genetic variants with autism spectrum disorder in Japanese children revealed by targeted sequencing. Front Genet 2024; 15:1352480. [PMID: 39280100 PMCID: PMC11395840 DOI: 10.3389/fgene.2024.1352480] [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: 12/08/2023] [Accepted: 03/04/2024] [Indexed: 09/18/2024] Open
Abstract
Introduction Autism spectrum disorders (ASD) represent a heterogeneous group of neurodevelopmental disorders with strong genetic predispositions. Although an increasing number of genetic variants have been implicated in the pathogenesis of ASD, little is known about the relationship between ASD-associated genetic variants and individual ASD traits. Therefore, we aimed to investigate these relationships. Methods Here, we report a case-control association study of 32 Japanese children with ASD (mainly with high-functioning autism [HFA]) and 36 with typical development (TD). We explored previously established ASD-associated genes using a next-generation sequencing panel and determined the association between Social Responsiveness Scale (SRS) T-scores and intelligence quotient (IQ) scores. Results In the genotype-phenotype analyses, 40 variants of five genes (SCN1A, SHANK3, DYRK1A, CADPS, and SCN2A) were associated with ASD/TD phenotypes. In particular, 10 SCN1A variants passed permutation filtering (false discovery rate <0.05). In the quantitative association analyses, 49 variants of 12 genes (CHD8, SCN1A, SLC6A1, KMT5B, CNTNAP2, KCNQ3, SCN2A, ARID1B, SHANK3, DYRK1A, FOXP1, and GRIN2B) and 50 variants of 10 genes (DYRK1A, SCN2A, SLC6A1, ARID1B, CNTNAP2, SHANK3, FOXP1, PTEN, SCN1A, and CHD8) were associated with SRS T- and IQ-scores, respectively. Conclusion Our data suggest that these identified variants are essential for the genetic architecture of HFA.
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Affiliation(s)
- Yuka Shiota
- Japan Society for the Promotion of Science, Tokyo, Japan
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Tomoaki Nishiyama
- Research Center for Experimental Modeling of Human Disease, Kanazawa University, Kanazawa, Japan
| | - Shigeru Yokoyama
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Kanazawa, Japan
| | - Yuko Yoshimura
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Kanazawa, Japan
- Institute of Human and Social Sciences, Kanazawa University, Kanazawa, Japan
| | - Chiaki Hasegawa
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Kanazawa, Japan
| | - Sanae Tanaka
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Kanazawa, Japan
| | - Sumie Iwasaki
- Japan Society for the Promotion of Science, Tokyo, Japan
- Institute of Human and Social Sciences, Kanazawa University, Kanazawa, Japan
| | - Mitsuru Kikuchi
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Kanazawa, Japan
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Alehagen L, Bölte S, Black MH. Application of the international classification of functioning, disability, and health in autism and attention-deficit hyperactivity disorder: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241272044. [PMID: 39183470 DOI: 10.1177/13623613241272044] [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: 08/27/2024]
Abstract
LAY ABSTRACT The International Classification of Functioning, Disability, and Health (ICF) is a framework designed by the World Health Organization (WHO) to help different sectors, such as healthcare, social services, education, and policy, understand how people with health-related issues function (do the things they want to and need to do) in their daily lives. This framework has also been used to guide clinical practice and research in autism and attention-deficit hyperactivity disorder (ADHD). To make it more practical, shorter versions of the ICF called Core Sets have been developed. We wanted to explore how the ICF and the ICF Core Sets have been used in research relating to autism and ADHD. We looked at the research that had been previously published on this topic by conducting a systematic search and review. Seventy-eight studies meeting our criteria were included in our review. Results show that the ICF has been applied in many ways across various contexts. However, most of the research has focused on autism, mainly involving children. The review highlights that although the ICF was used in some studies, the underlying philosophies of the framework were not always followed. The medical perspective still influenced the way research was done and interpreted. Nevertheless, using the ICF in the right way can help shift research on neurodevelopmental conditions like autism and ADHD toward a more holistic approach, moving away from solely focusing on medical aspects.
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Affiliation(s)
| | - Sven Bölte
- Karolinska Institutet and Region Stockholm, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
- Curtin University, Australia
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Wang SH, Zhou Q, Chen KY, Ceng CQ, Zhan GD, You C, Xing Y, Zou YY, Deng HZ. Cognitive-adaptive Functioning Gap and Mediating Factors that Impact Adaptive Functioning in Chinese Preschool-aged Children with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:3107-3121. [PMID: 37326789 DOI: 10.1007/s10803-023-06029-z] [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] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
This study aimed to investigate the gap between adaptive functioning and cognitive functioning, especially verbal and nonverbal intelligence quotient (IQ) in Chinese children with ASD. We systematically explored cognitive functioning, ASD severity, early signs of developmental abnormalities, and socioeconomic factors as mediating factors of adaptive functioning. We enrolled 151 children (age: 2.5?6 years) with ASD and categorized them into one group with IQ ≥ 70 and another with IQ < 70. The two groups were calibrated for age, age at diagnosis, and IQ, and the relationship of adaptive skills with vocabulary acquisition index (VAI) and nonverbal index (NVI) were separately analyzed. Results show that the gap between IQ and adaptive functioning was significant in children with ASD having IQ ≥ 70, with both VAI and NVI showing statistically significant differences (all P < 0.001). VAI correlated positively with scores for overall adaptive skills and specific domains, whereas NVI had no significant correlations with adaptive skill scores. Age of first walking unaided had an independent positive correlation (all P < 0.05) with scores of adaptive skills and specific domains. IQ-adaptive functioning gap is significant in children with ASD having IQ ≥ 70, suggesting that defining "high-functioning autism" merely on the basis of IQ is not appropriate. Verbal IQ and early signs of motor development are specific and possible predictors of adaptive functioning in children with ASD, respectively.
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Affiliation(s)
- Shi-Huan Wang
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China.
| | - Qing Zhou
- Department of Nursing, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, 510630, China
| | - Kai-Yun Chen
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China
| | - Chao-Qun Ceng
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China
| | - Guo-Dong Zhan
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China
| | - Cong You
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China
| | - Yu Xing
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China
| | - Yuan-Yuan Zou
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China
| | - Hong-Zhu Deng
- Child Developmental and Behavioral Center, the Third Affiliated Hospital of Sun Yat-sen University, No.600, Tianhe Road, Guangzhou, 510630, China.
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Sterrett K, Clarke E, Nofer J, Piven J, Lord C. Toward a functional classification for autism in adulthood. Autism Res 2024. [PMID: 39031157 DOI: 10.1002/aur.3201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/06/2024] [Indexed: 07/22/2024]
Abstract
Autism spectrum disorder (ASD) is a heterogeneous condition that affects development and functioning from infancy through adulthood. Efforts to parse the heterogeneity of the autism spectrum through subgroups such as Asperger's and Profound Autism have been controversial, and have consistently struggled with issues of reliability, validity, and interpretability. Nonetheless, methods for successfully identifying clinically meaningful subgroups within autism are needed to ensure that research, interventions, and services address the range of needs experienced by autistic individuals. The purpose of this study was to generate and test whether a simple set of questions, organized in a flowchart, could be used in clinical practice and research to differentiate meaningful subgroups based on individuals' level of functioning. Once generated, subgroups could also be compared to the recently proposed administrative category of Profound Autism and to groupings based on standardized adaptive measures. Ninety-seven adults with autism or related neurodevelopmental disorders participating in a longstanding longitudinal study, or their caregivers if they could not answer for themselves, completed phone interviews when the participants were ~30 years old. Information from these phone interviews was used to generate vignettes summarizing characteristics and aspects of the daily lives of each participant (e.g., language level, vocational activities, and social relationships). Three expert clinicians then used these vignettes to classify each participant based on their level of support needs. Meaningfully distinct subgroups within the sample were identified which could be reliably distinguished from one another. Implications of such categorizations and future directions are discussed.
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Affiliation(s)
- Kyle Sterrett
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elaine Clarke
- Department of Psychiatry, University of California, Los Angeles, California, USA
| | - Jane Nofer
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine Lord
- Department of Psychiatry, University of California, Los Angeles, California, USA
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Cohen TD, Koller J, Duku E, Kata A, Anderson C, Bennett T, Cauwenbergs A, Dekker K, DiRezze B, Drmic I, Eerkes J, Gentles SJ, Georgiades K, Hoult L, De Camargo OK, Mahoney B, Mesterman R, Ng O, Robertson S, Roncadin C, Georgiades S. The Association Between Autism Symptomatology and Adaptive Functioning Over Six Months: Findings from the Pilot Phase of the PARC Study. J Autism Dev Disord 2024:10.1007/s10803-024-06460-w. [PMID: 38990370 DOI: 10.1007/s10803-024-06460-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE In the context of developmental trajectories, the association between adaptive functioning and core autism symptomatology remains unclear. The current study examines the associations of adaptive behavior with autism symptom sub-domains and with different facets of symptom expression. METHODS Participants include 36 children with a recent diagnosis of autism (33 males; mean age = 56.4 months; SD = 9 months). Families were recruited in the context of the Pediatric Autism Research Cohort (PARC) project. Parents filled out questionnaires at two time points, six months apart, regarding their child's autism symptoms and adaptive functioning. The longitudinal relationship between adaptive functioning and autism symptoms was investigated using Mixed Linear Model analyses: one assessing the relationship between general symptom levels and adaptive functioning, and another examining the associations between symptom frequency and impact with adaptive functioning. We conducted Pearson correlation tests at both time points to assess the associations between symptom sub-domains and adaptive functioning. RESULTS Findings showed that higher autism symptoms associated with lower adaptive behavior skills, and that this association remained stable over time. Autism impact scores did not significantly relate to adaptive skills, as opposed to frequency scores. Associations between adaptive functioning and autism symptom sub-domains strengthened over time. CONCLUSION These findings suggest that adaptive functioning is associated with parent-report autism symptomatology, and that this association changes and, on average, becomes stronger over time. Findings may indicate that frequency and impact of symptoms have differential roles in the development of adaptive skills and are worthy of further exploration.
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Affiliation(s)
- Tamar David Cohen
- Hebrew University of Jerusalem, Seymour Fox School of Education, Jerusalem, Israel.
| | - Judah Koller
- Hebrew University of Jerusalem, Seymour Fox School of Education, Jerusalem, Israel
| | - Eric Duku
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Anna Kata
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | - Teresa Bennett
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | | | - Kathleen Dekker
- Autism Program, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Briano DiRezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Irene Drmic
- Autism Program, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Judy Eerkes
- Autism Program, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Stephen J Gentles
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Kathy Georgiades
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Lorraine Hoult
- Autism Program, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Olaf Kraus De Camargo
- McMaster University, Pediatrics, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Bill Mahoney
- McMaster University, Pediatrics, Hamilton, ON, Canada
| | | | - Olivia Ng
- Developmental Pediatrics and Rehabilitation Program, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Sue Robertson
- Developmental Pediatrics and Rehabilitation Program, McMaster Children's Hospital, Hamilton, ON, Canada
| | | | - Stelios Georgiades
- Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
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Liu F, Fan C, Yao B, Liu H, Wang H, Ye J, Wang G. Factors linked to prognosis in children with provisional tic disorder: a prospective cohort study. Eur J Pediatr 2024:10.1007/s00431-024-05651-y. [PMID: 38951254 DOI: 10.1007/s00431-024-05651-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 07/03/2024]
Abstract
The purpose of the present study was to estimate the factors linked to the prognosis of children with provisional tic disorder (PTD). We conducted a prospective cohort study enrolled children with PTD who were subsequently followed-up at three-month intervals for 1 year post-enrolment. A total of 259 PTD patients were included in the final analysis. At the end of the follow-up period, 77 (30%) of the patients had achieved clinical remission. Result of the LASSO logistic regression analysis revealed that a disease duration >3 months (OR=4.20, 95% CI 1.20-14.73), moderate/severe tic severity (OR=5.57, 95% CI 2.26-13.76), and comorbid behavioral problems (OR=2.78, 95% CI 1.15-6.69) were significant factors linked to remission in the PTD patients. The path analysis model showed that comorbid behavioral problems and recurrence partially mediated the association between tic severity and remission, with a mediating effect of 37%. Conclusions: We have identified several significant factors linked to prognosis in children with PTD, including comorbid behavioral problems and recurrence, which were found to be important mediators. These findings provide new insights for the clinical management of patients with PTD.
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Affiliation(s)
- Fang Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Chuangang Fan
- Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, 430079, China
| | - Baozhen Yao
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Hong Liu
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Huaqian Wang
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China
| | - Jingping Ye
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei, 430060, China.
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Marinopoulou M, Åsberg Johnels J, Bornehag CG, Unenge Hallerbäck M, Billstedt E. Do Wechsler intelligence scales predict academic achievement in children with ADHD or autism? A systematic review and meta-analysis. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-15. [PMID: 38850546 DOI: 10.1080/21622965.2024.2361022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
Intelligence tests predict academic achievement in typically developed children, however if this is the case also in children with attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) is not clear. This systematic review and meta-analysis examined if Wechsler intelligence scales predict academic achievement and/or grades in children, ages 6-16 years, with ADHD and/or ASD. We searched the databases PubMed, PsycINFO and Education Research Complete for studies published between 2000 and 2023. We used the Newcastle-Ottawa Scale to assess risk of bias. Narrative synthesis and meta-analysis were performed. Twelve studies (ADHD n = 1,834, ASD n = 176) were included in the review, and six samples (ADHD n = 1,112) of those were included in the meta-analyses. The results of the meta-analyses showed moderate overall weighted correlations between IQ and word reading, written language, and mathematics respectively. Similarly, the overall weighted correlations between processing speed and the aforementioned domains of academic achievement were moderate. Meta-analysis with additional Wechsler scales composite scores could not be conducted. In the narrative synthesis, Full Scale IQ was associated with academic achievement in both ADHD and ASD, and grades in ADHD. The limited number of ASD participants and the heterogeneity of the samples need to be considered when interpreting results. Generally, the results indicate that Wechsler scales are valuable in predicting academic achievement in children with ADHD or ASD. Motivation and other factors related with academic achievement need to be further explored in these groups.
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Affiliation(s)
- Maria Marinopoulou
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Habilitation, Region Värmland, Karlstad, Sweden
| | - Jakob Åsberg Johnels
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatric Clinic, Queen Silvia's Childrens Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
- Speech and language pathology unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Unenge Hallerbäck
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatric Clinic, Queen Silvia's Childrens Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
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Bottini SB, Morton HE, Buchanan KA, Gould K. Moving from Disorder to Difference: A Systematic Review of Recent Language Use in Autism Research. AUTISM IN ADULTHOOD 2024; 6:128-140. [PMID: 39144072 PMCID: PMC11319857 DOI: 10.1089/aut.2023.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background The neurodiversity paradigm positions autism as a neurological difference that is disabling in the societal context, shifting away from the traditional medical view of a disorder. Several recent publications recommend use of alternative neuro-affirming language (ANL) instead of traditional medical language (TML) with the aim to increase acceptance of autistic people and reduce prejudice. Examining language use within recent autism literature, including by journal and study characteristics, may offer insight into the influence of these recommendations and current disability discourse. Methods A systematic review was conducted using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines in autism research from 2021 (n = 2322 articles; 394 journals). Articles were coded according to topic, participants, and use of self-report. Journals were coded by topic, geographic region, and language guidelines. Terminology use was extracted using QDA Miner software. Results Many articles primarily used TML with a smaller subset primarily using ANL. There was a positive correlation between ANL use and publication date. More ANL was associated with articles on topics of autistic traits, diversity, equity, and inclusion (DEI), or lifespan and that included autistic adults or autistic self-report. More ANL was also found in journals from Australasia or Europe or those that had identify-first language (IFL) guidelines. Less ANL (more TML) was associated with articles on biology/causes or treatment and that included autistic or non-autistic parents, autistic youth, siblings, or other clinical groups, and were published in medical journals. Conclusion TML continues to largely dominate language choices in autism research, with an emerging shift toward ANL in recent literature. Increased ANL may be facilitated by journal and article language recommendations. Neuro-affirming language was also more likely in articles on topics prioritized by the autistic community, that included autistic adults, and may also be driven by cultural differences. Researchers and practitioners should consider the potential for their language use to impact individual and societal views of autistic people.
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Affiliation(s)
- Summer B. Bottini
- Marcus Autism Center, Atlanta, Georgia, USA
- Emory University School of Medicine, Atlanta, Georgia, USA
| | | | | | - Kait Gould
- The College of Saint Rose, Albany, New York, USA
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Chen Y, Duku E, Szatmari P, Salt M, Smith I, Richard A, Zwaigenbaum L, Vaillancourt T, Zaidman‐Zait A, Bennett T, Elsabbagh M, Kerns C, Georgiades S. Trajectories of adaptive functioning from early childhood to adolescence in autism: Identifying turning points and key correlates of chronogeneity. JCPP ADVANCES 2024; 4:e12212. [PMID: 38827978 PMCID: PMC11143958 DOI: 10.1002/jcv2.12212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/29/2023] [Indexed: 06/05/2024] Open
Abstract
Background Previous research has demonstrated heterogeneous adaptive outcomes across the autism spectrum; however, the current literature remains limited in elucidating turning points and associated factors for longitudinal variability (chronogeneity). To address these empirical gaps, we aimed to provide a finer-grained characterization of trajectories of adaptive functioning from early childhood to adolescence in autism. Methods Our sample (N = 406) was drawn from an inception cohort of children diagnosed Autistic at ages 2-5. Adaptive functioning was assessed with Vineland Adaptive Behavior Scales (VABS, 2nd Edition) across 6 visits from the time of diagnosis by age 18. Parallel-process latent growth curve modeling were used to estimate domain-level VABS trajectories, followed by latent class growth analysis to identify trajectory subgroups. Child characteristics at diagnosis, family demographics, and participation outcomes at adolescence were compared across subgroups. Results Piecewise latent growth models best described VABS trajectories with two turning points identified at around ages 5-6 and 9-10, respectively reflecting transitions into school age and early adolescence. We parsed four VABS trajectory subgroups that vary by level of functioning and change rate for certain domains and periods. Around 16% of the sample exhibited overall adequate functioning (standard score >85) with notable early growth and social adaptation during adolescence. About 21% showed low adaptive functioning (standard score ≤70), with decreasing slopes by age 6 followed by improvements in communication and daily-living skills by age 10. The other two subgroups (63% in total) were characterized by adaptive functioning between low and adequate levels, with relatively stable trajectories entering school age. These subgroups differed most in their cognitive ability at diagnosis, household income, and social participation in adolescence. Conclusions We identified key individual and family characteristics and time windows associated with distinct adaptive functioning trajectories, which have important implications for providing timely and tailored supports to Autistic people across developmental stages.
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Affiliation(s)
| | | | - Peter Szatmari
- Centre for Addiction and Mental HealthThe Hospital for Sick ChildrenUniversity of TorontoTorontoONCanada
| | - Mackenzie Salt
- McMaster UniversityHamiltonONCanada
- Autism Alliance of CanadaTorontoONCanada
| | - Isabel Smith
- Dalhousie UniversityHalifaxNSCanada
- Autism Research CentreIWK Health CentreHalifaxNSCanada
| | - Annie Richard
- Autism Research CentreIWK Health CentreHalifaxNSCanada
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Cervantes PE, Palinkas LA, Conlon GR, Richards-Rachlin S, Sullivan KA, Baroni A, Horwitz SM. Improving Emergency Department Care for Suicidality in Autism: Perspectives from Autistic Youth, Caregivers, and Clinicians. J Autism Dev Disord 2024:10.1007/s10803-024-06364-9. [PMID: 38819705 DOI: 10.1007/s10803-024-06364-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 06/01/2024]
Abstract
ABSTRACT: Purpose: Emergency department (ED) visits for suicidal ideation and self-harm are more prevalent in autistic than non-autistic youth. However, providers are typically offered insufficient guidance for addressing suicide risk in autistic youth, likely impacting confidence and care. METHODS In this pilot study, we conducted semi-structured interviews with 17 key members of the autism community (i.e., autistic youth with a history of suicidality, caregivers of autistic youth with a history of suicidality, autism specialist clinicians, ED clinicians) to inform the development of recommendations for modifying ED care for autistic patients, with a focus on suicide risk screening and management. RESULTS Participants reported on challenges they encountered receiving or providing care and/or recommendations for improving care. Participant perspectives were aligned, and four main categories emerged: accounting for autism features, connection and youth engagement in care, caregiver and family involvement, and service system issues. CONCLUSION As research continues in the development of autism-specific suicide risk assessment tools and management strategies, it is essential we better equip providers to address suicide risk in autistic patients, particularly in ED settings.
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Affiliation(s)
- Paige E Cervantes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
| | - Lawrence A Palinkas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Greta R Conlon
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Katherine A Sullivan
- Department of Child and Adoelscent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Argelinda Baroni
- Department of Child and Adoelscent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
- Child and Adolescent Psychiatry, Bellevue Hospital Center, New York, NY, USA
| | - Sarah M Horwitz
- Department of Child and Adoelscent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
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Lemay KR, Kogan CS, Rebello T, Keeley JW, Bhargava R, Buono S, Cooray S, Ginige P, Kishore MT, Kommu JVS, Recupero M, Roy A, Sharan P, Reed GM. Implementation of the International Classification of Diseases 11th revision behavioural indicators for disorders of intellectual development with co-occurring autism spectrum disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 38733333 DOI: 10.1111/jir.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND The classification of mental, behavioural and neurodevelopmental disorders in the World Health Organization's International Classification of Diseases 11th revision (ICD-11) includes a comprehensive set of behavioural indicators (BIs) within the neurodevelopmental disorders grouping. BIs can be used to assess the severity of disorders of intellectual development in situations in which standardised measures of intellectual functioning and adaptive behaviours are not available or feasible. This international study examines the implementation characteristics of the BIs and compares them to standardised measures for assessing the severity of intellectual impairment and adaptive behaviours in disorders of intellectual development and autism spectrum disorder (ASD). The clinical utility of the ICD-11 and the fidelity of its application in international clinical settings were also assessed. METHODS A total of 116 children and adolescents (5-18 years old) with a suspected or established diagnosis of disorders of intellectual development were included across four sites [Italy (n = 18), Sri Lanka (n = 19) and two sites in India (n = 79)]. A principal component analysis was conducted to evaluate the application of the ICD-11 guidance for combining severity levels. RESULTS Assessment using the BIs showed a higher proportion of individuals classified with mild severity, whereas the standardised measures indicated a higher proportion of severe ratings. Additionally, individuals with co-occurring ASD tended to have more severe impairments compared with those without ASD, as indicated by both BIs and standardised measures. Overall, the BIs were considered clinically useful, although more time and consideration were required when applying the guidelines for individuals with a co-occurring disorder of intellectual development and ASD. The principal component analysis revealed one principal component representing overall disorders of intellectual development severity levels. CONCLUSIONS The ICD-11 BIs can be implemented as intended in international clinical settings for a broad range of presentations of individuals with neurodevelopmental disorders. Use of the BIs results in similar severity diagnoses to those made using standardised measures. The BIs are expected to improve the reliability of severity assessments in settings where appropriate standardised measures for intellectual and adaptive behaviours are not available or feasible.
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Affiliation(s)
- K R Lemay
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - C S Kogan
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - T Rebello
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
- Department of Psychiatry, Research Foundation for Mental Hygiene, New York, NY, USA
| | - J W Keeley
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - R Bhargava
- Department of Psychiatry and National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - S Buono
- Department of Psychology, Oasi Research Institute-IRCCS, Troina, Italy
| | - S Cooray
- Faculty of Psychiatry of Learning Disability, Royal College of Psychiatrists, London, UK
| | - P Ginige
- Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - M T Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | - J V S Kommu
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - M Recupero
- Department of Psychology, Oasi Research Institute-IRCCS, Troina, Italy
| | - A Roy
- Coventry and Warwickshire Partnership NHS Trust, Birmingham, UK
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - P Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - G M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Kim Y, Munsell EGS, Coster WJ, Orsmond GI. Age-Related Changes in Functional Skills and Daily Life Task Management Among Autistic Youth. Am J Occup Ther 2024; 78:7803205180. [PMID: 38758763 PMCID: PMC11117464 DOI: 10.5014/ajot.2024.050624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
IMPORTANCE Autistic youth who graduate with a high school diploma may experience challenges in acquiring functional skills for everyday independence. Few studies have focused on how their functional and self-management skills change during the transition to adulthood. OBJECTIVE To examine cross-sectional differences and longitudinal changes in the functional and self-management skills of transition-age autistic youth. DESIGN Exploratory longitudinal study (18-mo follow-up). SETTING Community. PARTICIPANTS Autistic high school students who graduated with a high school diploma and their parents (N = 50). OUTCOMES AND MEASURES Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (ASD). RESULTS Older youth (ages 18-20 yr) had significantly lower normative Social/Cognitive and Responsibility domain scores (i.e., self-management) than youth ages 14-17 yr. Approximately 2 yr later, youth in both age groups significantly improved in scaled scores on the Daily Activities and Responsibility domains. CONCLUSIONS AND RELEVANCE Autistic youth's functional and self-management skills fell below those of nonautistic peers; however, these skills do change over time and are therefore appropriate targets for intervention. Plain-Language Summary: The findings of this study highlight the importance of focusing on the functional and self-management skills of autistic youth as part of their transition to adulthood. Occupational therapists can play a valuable role in helping autistic youth to achieve independence as adults by assessing their functional needs and strengths and by providing client-centered interventions.
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Affiliation(s)
- Yeook Kim
- Yeook Kim, CScD, OTR/L, is PhD Student, Department of Occupational Therapy, Boston University, Boston, MA;
| | - Elizabeth G S Munsell
- Elizabeth G. S. Munsell, PhD, OTR/L, is Research Director, Pearson Clinical Assessments, San Antonio, TX
| | - Wendy J Coster
- Wendy J. Coster, PhD, OTR/L, FAOTA, is Professor Emerita, Department of Occupational Therapy, Boston University, Boston, MA
| | - Gael I Orsmond
- Gael I. Orsmond, PhD, is Professor and Associate Dean of Academic Affairs, Department of Occupational Therapy, Boston University, Boston, MA
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13
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Furnier SM, Ellis Weismer S, Rubenstein E, Gangnon R, Rosenberg S, Nadler C, Wiggins LD, Durkin MS. Using adaptive behavior scores to convey level of functioning in children with autism spectrum disorder: Evidence from the Study to Explore Early Development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1135-1149. [PMID: 37609907 PMCID: PMC10884350 DOI: 10.1177/13623613231193194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
LAY ABSTRACT Autistic people are often described as "low-" or "high-functioning" based on their scores on cognitive tests. These terms are common in publications and in everyday communication. However, recent research and feedback from the autistic community suggests that relying on cognitive ability alone to describe functioning may miss meaningful differences in the abilities of autistic children and adults and in the kinds of support they may need. Additional methods are needed to describe "functioning" in autistic children. We examined whether scores from a test measuring adaptive behaviors would provide information on the functional abilities of children with autism that is different from cognitive ability and autism symptom severity. Adaptive behaviors include age-appropriate skills that allow people to function in their everyday lives and social interactions. We found that a large amount of the variation in adaptive behavior scores was not explained by cognitive development, autism symptom severity, and behavioral and emotional problems. In addition, there was a wide range of adaptive ability levels in children with autism in our study, including in those with low, average, or high cognitive scores. Our results suggest that adaptive behavior scores could provide useful information about the strengths and support needs of autistic children above and beyond measures of cognitive ability and autism symptom severity. Adaptive behavior scores provide important information on the needs of autistic people.
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14
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Sohl K, Oberweiser C, Ranum E, Oberweiser C, Cornell W. A Pediatrician's Practical Guide for Navigating Transition to Adulthood with Autistic Youth and Their Caregivers. Pediatr Clin North Am 2024; 71:315-326. [PMID: 38423723 DOI: 10.1016/j.pcl.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
When pediatricians, autistic people, and their families carefully consider and plan for the transition from pediatric care to adult care, there are better outcomes for patients. Pediatricians see their patients over time and are uniquely positioned to help prepare for the changes that come with the transition through adolescents to adulthood. Although programs such as Got Transition offer some guidance on how to navigate the transition from pediatric care to adult care, there is less information on how to help those on the autism spectrum and their families transition to adulthood in other ways.
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Affiliation(s)
- Kristin Sohl
- Department of Pediatrics, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA; ECHO Autism Communities, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA.
| | | | - Elly Ranum
- Department of Pediatrics, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA
| | - Charles Oberweiser
- Schlief School of Accountancy, Stephen F. Austin State University, 1936 North Street, Nacogdoches, TX, USA
| | - Wendy Cornell
- ECHO Autism Communities, University of Missouri School of Medicine, 400 North Keene Street, Columbia, MO 65211, USA; Department of Special Education, College of Education and Human Development, 611 Conley Avenue, Columbia, MO 65211, USA
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15
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Keates N, Martin F, Waldock KE. Autistic People's Perspectives on Functioning Labels and Associated Reasons, and Community Connectedness. J Autism Dev Disord 2024:10.1007/s10803-024-06316-3. [PMID: 38507152 DOI: 10.1007/s10803-024-06316-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
PURPOSE Functioning labels have been used in relation to autistic people and differentiating between support needs. The main purpose of our study was to identify perspectives regarding language about being autistic. In regard to themselves and functioning. Furthermore, we investigated the influential factor of community connectedness on use of language acceptability and functioning labels. METHODS 516 autistic respondents completed our survey. We asked about demographic characteristics, how respondents would like autistic people to be termed in the survey, and their acceptability (person with autism, Aspergers, disorder, conditions, living with autism, autistic). We also asked about respondents? Autistic Community Connectedness, acknowledging the implicit nature of language and identity (Stets & Serpe in New directions in identity theory and research, Oxford University Press, 2016). The main focus of our survey was whether or not to use functioning labels, and the supporting rationale. RESULTS 97% of respondents stated that they find the term 'autistic' acceptable. Respondents who did see merit in using functioning labels to describe autistic people also reported not necessarily using them about themselves. Community membership was found to impact the participants' language preferences to describe the support needs of autistic people, including the use of functioning labels. CONCLUSION The proposed best option for language preferences is not to find consensus but instead, opt for the optimal choice that people find the least offensive or disagreeable. This means using identity-first language and not using functioning labels.
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Affiliation(s)
- Nathan Keates
- University of Sunderland in London, 197 Marsh Wall, Docklands, London, E14 9SG, UK.
| | - Farradeh Martin
- School of History, University of Kent, Canterbury, Kent, CT2 7NZ, UK
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16
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Donoso J, Rattray F, de Bildt A, Tillmann J, Williams P, Absoud M, Totsika V. Association of cognitive and adaptive skills with internalizing and externalizing problems in autistic children and adolescents. Autism Res 2024; 17:596-609. [PMID: 38031634 DOI: 10.1002/aur.3056] [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: 11/14/2022] [Accepted: 10/30/2023] [Indexed: 12/01/2023]
Abstract
The presence of an intellectual disability (ID) alongside autism is considered to increase the risk for mental health and behavior problems in children and adolescents. Existing evidence is restricted by looking at ID as a categorical classification. The study aimed to examine the association of cognitive and adaptive behavior skills with internalizing and externalizing problems in a large sample of autistic children and adolescents, across a wide range of cognitive skills. Participants were 2759 children and adolescents aged between 4 and 18 years recruited as part of the Simons Simplex Collection (SSC), of whom 709 (approximately 25%) had ID. Multiple regression models examined associations of internalizing and externalizing problems with cognitive and adaptive skills (communication, daily living, and socialization skills). Cognitive skills were not associated with externalizing problems but were associated with more internalizing problems in autistic children without ID (Cog β: 0.126). All adaptive skill domains were inversely associated with externalizing (Communication β: -0.145; Daily-Living β: -0.132; Socialization β: -0.289) and internalizing problems (Communication β: -0.074; Daily-Living β: -0.064; Socialization β: -0.213) in those without ID. Daily living (β: -0.158) and socialization skills (β: -0.104) were inversely correlated with externalizing problems in autistic children with ID, while only socialization problems (β: -0.099) were associated with internalizing problems in this group. Socialization skills were systematically associated with internalizing and externalizing problems across all levels of cognitive functioning. Supporting social skills development may benefit all aspects of child mental health, while recognizing that children with higher cognitive skills are more vulnerable to internalizing problems might assist with earlier identification of these problems.
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Affiliation(s)
- Javiera Donoso
- Division of Psychiatry, University College London, London, UK
| | - Fiona Rattray
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Annelies de Bildt
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
| | - Julian Tillmann
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Penny Williams
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Michael Absoud
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
- Tavistock and Portman NHS Foundation Trust, London, UK
- Millenium Institute for Care Research (MICARE), Santiago, Chile
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17
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Huang Y, Arnold SRC, Foley KR, Trollor JN. A Qualitative Study of Adults' and Support Persons' Experiences of Support After Autism Diagnosis. J Autism Dev Disord 2024; 54:1157-1170. [PMID: 36484961 PMCID: PMC9734854 DOI: 10.1007/s10803-022-05828-0] [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] [Accepted: 11/11/2022] [Indexed: 12/13/2022]
Abstract
Adulthood autism diagnosis has become increasingly common, but little is known about post-diagnosis support experiences and needs. We interviewed 19 autistic adults and 4 support persons on experiences of formal and informal post-diagnosis support. Reflexive thematic analysis was used to identify themes. Participants reported difficulties accessing suitable formal support, especially regarding education and employment. Informal support was helpful but created challenges in the relationships between autistic adults and support persons. For autistic adults, support from autistic peers fostered belonging and self-acceptance. We also identified complex interactions between adults' post-diagnosis identity development and support experiences as they resolved the dilemma between self-acceptance and a desire to change. Findings have important implications for services working with autistic adults and their families.
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Affiliation(s)
- Yunhe Huang
- Department of Developmental Disability Neuropsychiatry (3DN), Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
| | - Samuel R C Arnold
- Department of Developmental Disability Neuropsychiatry (3DN), Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
- The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia.
| | - Kitty-Rose Foley
- Department of Developmental Disability Neuropsychiatry (3DN), Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry (3DN), Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, QLD, Australia
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18
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Furnier SM, Gangnon R, Daniels JL, Ellis Weismer S, Nadler C, Pazol K, Reyes NM, Rosenberg S, Rubenstein E, Wiggins LD, Yeargin-Allsopp M, Durkin MS. Racial and ethnic disparities in the co-occurrence of intellectual disability and autism: Impact of incorporating measures of adaptive functioning. Autism Res 2024; 17:650-667. [PMID: 38415400 PMCID: PMC11151777 DOI: 10.1002/aur.3107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/27/2024] [Indexed: 02/29/2024]
Abstract
Intellectual disability (ID) commonly co-occurs in children with autism. Although diagnostic criteria for ID require impairments in both cognitive and adaptive functioning, most population-based estimates of the frequency of co-occurring ID in children with autism-including studies of racial and ethnic disparities in co-occurring autism and ID-base the definition of ID solely on cognitive scores. The goal of this analysis was to examine the effect of including both cognitive and adaptive behavior criteria on estimates of co-occurring ID in a well-characterized sample of 2- to 5-year-old children with autism. Participants included 3264 children with research or community diagnoses of autism enrolled in the population-based Study to Explore Early Development (SEED) phases 1-3. Based only on Mullen Scales of Early Learning (MSEL) composite cognitive scores, 62.9% (95% confidence interval [CI]: 61.1, 64.7%) of children with autism were estimated to have co-occurring ID. After incorporating Vineland Adaptive Behavior Scales, Second Edition (VABS-II) composite or domains criteria, co-occurring ID estimates were reduced to 38.0% (95% CI: 36.2, 39.8%) and 45.0% (95% CI: 43.1, 46.9%), respectively. The increased odds of meeting ID criteria observed for non-Hispanic (NH) Black and Hispanic children relative to NH White children when only MSEL criteria were used were substantially reduced, though not eliminated, after incorporating VABS-II criteria and adjusting for selected socioeconomic variables. This study provides evidence for the importance of considering adaptive behavior as well as socioeconomic disadvantage when describing racial and ethnic disparities in co-occurring ID in epidemiologic studies of autism.
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Affiliation(s)
- Sarah M. Furnier
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julie L. Daniels
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Susan Ellis Weismer
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Cy Nadler
- Division of Developmental and Behavioral Health, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nuri M. Reyes
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Steven Rosenberg
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric Rubenstein
- Department of Epidemiology, Boston University, Boston, Massachusetts, USA
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maureen S. Durkin
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Waisman Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
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19
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Pollak RM, Burrell TL, Cubells JF, Klaiman C, Murphy MM, Saulnier CA, Walker EF, White SP, Mulle JG. Adaptive behaviour deficits in individuals with 3q29 deletion syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:113-127. [PMID: 37740553 PMCID: PMC10843465 DOI: 10.1111/jir.13094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/28/2023] [Accepted: 09/02/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND 3q29 deletion syndrome (3q29del) is associated with a significantly increased risk for neurodevelopmental and neuropsychiatric phenotypes. Mild to moderate intellectual disability (ID) is common in this population, and previous work by our team identified substantial deficits in adaptive behaviour. However, the full profile of adaptive function in 3q29del has not been described nor has it been compared with other genomic syndromes associated with elevated risk for neurodevelopmental and neuropsychiatric phenotypes. METHODS Individuals with 3q29del (n = 32, 62.5% male) were evaluated using the Vineland Adaptive Behaviour Scales, Third Edition, Comprehensive Parent/Caregiver Form (Vineland-3). We explored the relationship between adaptive behaviour and cognitive function, executive function, and neurodevelopmental and neuropsychiatric comorbidities in our 3q29del study sample, and we compared subjects with 3q29del with published data on fragile X syndrome, 22q11.2 deletion syndrome and 16p11.2 deletion and duplication syndromes. RESULTS Individuals with 3q29del had global deficits in adaptive behaviour that were not driven by specific weaknesses in any given domain. Individual neurodevelopmental and neuropsychiatric diagnoses had a small effect on adaptive behaviour, and the cumulative number of comorbid diagnoses was significantly negatively associated with Vineland-3 performance. Both cognitive ability and executive function were significantly associated with adaptive behaviour, and executive function was a better predictor of Vineland-3 performance than cognitive ability. Finally, the severity of adaptive behaviour deficits in 3q29del was distinct from previously published data on comparable genomic disorders. CONCLUSIONS Individuals with 3q29del have significant deficits in adaptive behaviour, affecting all domains assessed by the Vineland-3. Executive function is a better predictor of adaptive behaviour than cognitive ability in this population and suggests that interventions targeting executive function may be an effective therapeutic strategy.
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Affiliation(s)
- R M Pollak
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
| | - T L Burrell
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - J F Cubells
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - C Klaiman
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - M M Murphy
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - C A Saulnier
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Neurodevelopmental Assessment & Consulting Services, Atlanta, GA, USA
| | - E F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - S P White
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University, Atlanta, GA, USA
| | - J G Mulle
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ, USA
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20
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Brandt AE, Rø TB, Finnanger TG, Hypher RE, Lien E, Lund B, Catroppa C, Andersson S, Risnes K, Stubberud J. Intelligence and executive function are associated with age at insult, time post-insult, and disability following chronic pediatric acquired brain injury. Front Neurol 2024; 14:1192623. [PMID: 38249741 PMCID: PMC10796693 DOI: 10.3389/fneur.2023.1192623] [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: 03/23/2023] [Accepted: 12/05/2023] [Indexed: 01/23/2024] Open
Abstract
Background Pediatric acquired brain injury (pABI) profoundly affects cognitive functions, encompassing IQ and executive functions (EFs). Particularly, young age at insult may lead to persistent and debilitating deficits, affecting daily-life functioning negatively. This study delves into the intricate interplay of age at insult, time post-insult, and their associations with IQ and EFs during chronic (>1 year) pABI. Additionally, we investigate cognitive performance across different levels of global function, recognizing the multifaceted nature of developmental factors influencing outcomes. Methods Drawing upon insult data and baseline information analyzing secondary outcomes from a multicenter RCT, including comprehensive medical and neuropsychological assessments of participants aged 10 to 17 years with pABI and parent-reported executive dysfunctions. The study examined associations between age at insult (early, EI; ≤7y vs. late, LI; > 7y) and time post-insult with IQ and EFs (updating, shifting, inhibition, and executive attention). Additionally, utilizing the Pediatric Glasgow Outcome Scale-Extended, we explored cognitive performance across levels of global functioning. Results Seventy-six participants, median 8 years at insult and 5 years post-insult, predominantly exhibiting moderate disability (n = 38), were included. Notably, participants with LI demonstrated superior IQ, executive attention, and shifting compared to EI, [adjusted mean differences with 95% Confidence Intervals (CIs); 7.9 (1.4, 14.4), 2.48 (0.71, 4.24) and 1.73 (0.03, 3.43), respectively]. Conversely, extended post-insult duration was associated with diminished performances, evident in mean differences with 95% CIs for IQ, updating, shifting, and executive attention compared to 1-2 years post-insult [-11.1 (-20.4, -1.7), -8.4 (-16.7, -0.1), -2.6 (-4.4, -0.7), -2.9 (-4.5, -1.2), -3.8 (-6.4, -1.3), -2.6 (-5.0, -0.3), and -3.2 (-5.7, -0.8)]. Global function exhibited a robust relationship with IQ and EFs. Conclusion Early insults and prolonged post-insult durations impose lasting tribulations in chronic pABI. While confirmation through larger studies is needed, these findings carry clinical implications, underscoring the importance of vigilance regarding early insults. Moreover, they dispel the notion that children fully recover from pABI; instead, they advocate equitable rehabilitation offerings for pABI, tailored to address cognitive functions, recognizing their pivotal role in achieving independence and participation in society. Incorporating disability screening in long-term follow-up assessments may prove beneficial.
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Affiliation(s)
- Anne Elisabeth Brandt
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torstein B. Rø
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Torun G. Finnanger
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ruth E. Hypher
- Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Espen Lien
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Bendik Lund
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cathy Catroppa
- Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, VIC, Australia
- Department of Psychology, Royal Children’s Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Kari Risnes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jan Stubberud
- Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
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21
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Duncan A, Meinzen-Derr J, Ruble L, Fassler C, Stark LJ. A Randomized Clinical Trial Targeting Daily Living Skills in Autistic Adolescents Without an Intellectual Disability Before the Transition to Adulthood. J Dev Behav Pediatr 2023; 44:e590-e596. [PMID: 37862694 PMCID: PMC10843140 DOI: 10.1097/dbp.0000000000001222] [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: 02/03/2023] [Accepted: 08/07/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVES In the United States, more than 75,000 autistic adolescents graduate from high school each year, and many lack the skills to successfully transition to college, work, and independent living. Daily living skills (DLS) in autistic adolescents without an intellectual disability (ID) fall 6 to 8 years behind peers. Better DLS are linked to more positive adult outcomes for autistic individuals. Surviving and Thriving in the Real World (STRW) is the only known evidence-based intervention that targets age-appropriate DLS in autistic adolescents without ID. The study objective was to evaluate STRW's efficacy compared with an active comparator (Program for the Evaluation and Enrichment of Relational Skills [PEERS]). METHOD Autistic adolescents in their last 2 years of high school were randomized to STRW or PEERS. Outcome measures were the Vineland Adaptive Behavior Scales, Third Edition (VABS-3), DLS domain and subdomains (Personal, Domestic, Community), and DLS Goal Attainment Scaling (DLS-GAS) areas (Morning Routine, Cooking, Laundry, Money). RESULTS Adolescents were randomly assigned to STRW (n = 34) or PEERS (n = 30). Owing to COVID-19, 28.1% received in-person intervention and 71.9% received telehealth intervention. STRW youth made significant gains on the VABS-3 DLS domain ( p = 0.01) and Domestic subdomain ( p = 0.005) and DLS-GAS Total, Laundry, and Money areas (all p 's < 0.05) compared with PEERS. CONCLUSION STRW shows promise for acquiring age-appropriate DLS compared with PEERS. Adolescents in STRW progressed toward achieving DLS in the average range and closing the gap between chronological age and DLS. By improving DLS, STRW may facilitate more successful adult outcomes.
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Affiliation(s)
- Amie Duncan
- Division of Behavioral Medicine and Clinical Psychology
| | - Jareen Meinzen-Derr
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Lisa Ruble
- Teacher's College, Ball State University, Muncie, IN
| | | | - Lori J Stark
- Division of Behavioral Medicine and Clinical Psychology
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22
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Lai MC, Amestoy A, Bishop S, Brown HM, Giwa Onaiwu M, Halladay A, Harrop C, Hotez E, Huerta M, Kelly A, Miller D, Nordahl CW, Ratto AB, Saulnier C, Siper PM, Sohl K, Zwaigenbaum L, Goldman S. Improving autism identification and support for individuals assigned female at birth: clinical suggestions and research priorities. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:897-908. [PMID: 37973254 DOI: 10.1016/s2352-4642(23)00221-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 11/19/2023]
Abstract
Emerging evidence suggests that the higher prevalence of autism in individuals who are assigned male than assigned female at birth results from both biological factors and identification biases. Autistic individuals who are assigned female at birth (AFAB) and those who are gender diverse experience health disparities and clinical inequity, including late or missed diagnosis and inadequate support. In this Viewpoint, an international panel of clinicians, scientists, and community members with lived experiences of autism reviewed the challenges in identifying autism in individuals who are AFAB and proposed clinical and research directions to promote the health, development, and wellbeing of autistic AFAB individuals. The recognition challenges stem from the interplay between cognitive differences and nuanced or different presentations of autism in some AFAB individuals; expectancy, gender-related, and autism-related biases held by clinicians; and social determinants. We recommend that professional development for clinicians be supported by health-care systems, professional societies, and governing bodies to improve equitable access to assessment and earlier identification of autism in AFAB individuals. Autistic AFAB individuals should receive tailored support in education, identity development, health care, and social and professional sense of belonging.
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Affiliation(s)
- Meng-Chuan Lai
- Child and Youth Mental Health Collaborative at the Centre for Addiction and Mental Health and The Hospital for Sick Children, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, ON, Canada; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Anouck Amestoy
- Centre for Autism Spectrum Disorders, Aquitaine Institute for Cognitive and Integrative Neurosciences, Charles Perrens Hospital, University of Bordeaux, Bordeaux, France
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Heather M Brown
- Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Morénike Giwa Onaiwu
- Autistic Women & Nonbinary Network, Lincoln, NE, USA; Rice University Center for the Study of Women, Gender, and Sexuality, School of Humanities, Houston, TX, USA
| | - Alycia Halladay
- Autism Science Foundation, Scarsdale, NY, USA; Department of Pharmacology and Toxicology, Rutgers University, Piscataway, NJ, USA
| | - Clare Harrop
- Department of Health Sciences and TEACCH Autism Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Emily Hotez
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Marisela Huerta
- Felicity House, New York, NY, USA; Weill Cornell Medicine, New York, NY, USA
| | - Amy Kelly
- Devereux Advanced Behavioral Health, Villanova, PA, USA
| | - Dylan Miller
- Auxiliary Enterprises, University of Massachusetts, Amherst, MA, USA
| | - Christine Wu Nordahl
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California at Davis, Davis, CA, USA
| | - Allison B Ratto
- Center for Autism Spectrum Disorders, Division of Neuropsychology, Children's National Hospital, Washington, DC, USA
| | - Celine Saulnier
- Neurodevelopmental Assessment and Consulting Services, Decatur, GA, USA
| | - Paige M Siper
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristin Sohl
- ECHO Autism Communities, Department of Child Health, University of Missouri School of Medicine, Columbia, MO, USA
| | | | - Sylvie Goldman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
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23
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Ryu S, Lee T, Lim Y, Kim H, Yu GE, Kim S, Kim HW. Psychoeducational Profile-Revised, Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition, and the Vineland Adaptive Behavior Scale, Second Edition: Comparison of Utility for Developmental Disabilities in Preschool Children. Soa Chongsonyon Chongsin Uihak 2023; 34:258-267. [PMID: 37841486 PMCID: PMC10568195 DOI: 10.5765/jkacap.230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives This study aimed to compare the utility of the Psychoeducational Profile-Revised (PEP-R), Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (K-WPPSI-IV), and Vineland Adaptive Behavior Scale, Second Edition (VABS-II) for evaluating developmental disabilities (DD) in preschool children. Additionally, we examined the correlations between the PEP-R, KWPPSI- IV, and VABS-II. Methods A total of 164 children aged 37-84 months were assessed. Children's development was evaluated using the PEP-R, K-WPPSIIV, VABS-II, Preschool Receptive-Expressive Language Scale, and Korean Childhood Autism Rating Scale, Second Edition. Results Of the 164 children, 103 had typical development (TD) and 61 had DD. The mean of the PEP-R Developmental Quotient (DQ), K-WPPSI-IV Full-Scale Intelligence Quotient (FSIQ), and VABS-II Adaptive Behavior Composite (ABC) scores were significantly higher in the TD group than in the DD group (p<0.001). The estimated area under the curve of the PEP-R DQ, K-WPPSI-IV FSIQ, and VABS-II ABC scores was 0.953 (95% confidence interval [CI]=0.915-0.992), 0.955 (95% CI=0.914-0.996), and 0.961 (95% CI=0.932- 0.991), respectively, which did not indicate a statistically significant difference. The PEP-R DQ scores were positively correlated with the K-WPPSI-IV FSIQ (r=0.90, p<0.001) and VABS-II ABC scores (r=0.84, p<0.001). A strong correlation was observed between the KWPPSI- IV FSIQ and VABS-II ABC scores (r=0.89, p<0.001). Conclusion This study found that the PEP-R, K-WPPSI-IV, and VABS-II effectively distinguished DD from TD in preschool children, and no significant differences in utility were observed between them.
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Affiliation(s)
- Sumi Ryu
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Taeyeop Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunshin Lim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Haejin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Go-eun Yu
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seonok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyo-Won Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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24
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Guillén VM, Verdugo MÁ, Jiménez P, Aguayo V, Amor AM. Support Needs of Children with Autism Spectrum Disorders: Implications for Their Assessment. Behav Sci (Basel) 2023; 13:793. [PMID: 37887443 PMCID: PMC10604162 DOI: 10.3390/bs13100793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/16/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
The construct of support needs has become a key aspect for the diagnostics, classification, and interventional management of autism spectrum disorders (ASDs). However, instruments specifically designed to assess support needs in this population are not available. Currently, the Supports Intensity Scale for Children (SIS-C), which could be administered to assess students with any type of intellectual disability (ID), is the only valid tool able to assess support needs in Spain. Our aim was to verify whether the SIS-C is useful for assessing the support needs of students with ASD, regardless of whether or not they present ID. The participants were subdivided into two groups. One group included students with ASD and ID (n = 248), and the other comprised participants with ASD without an ID (n = 44). The results of the two groups were compared with those reported in the original validation sample of the SIS-C, which involved participants with ID without ASD (n = 566). The results showed that this scale could be useful for assessing support needs in the three subgroups, but it appeared that different standardized norms based on the characteristics of each specific population would be appropriate.
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Affiliation(s)
| | - Miguel Á. Verdugo
- Institute for Community Inclusion and Department of Personality, Assessment, and Psychological Treatments, Universidad de Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (V.A.); (A.M.A.)
| | - Pedro Jiménez
- Institute for Community Inclusion, Universidad de Salamanca, 37005 Salamanca, Spain;
| | - Virginia Aguayo
- Institute for Community Inclusion and Department of Personality, Assessment, and Psychological Treatments, Universidad de Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (V.A.); (A.M.A.)
| | - Antonio M. Amor
- Institute for Community Inclusion and Department of Personality, Assessment, and Psychological Treatments, Universidad de Salamanca, 37005 Salamanca, Spain; (M.Á.V.); (V.A.); (A.M.A.)
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25
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Capp SJ, Agnew-Blais J, Lau-Zhu A, Colvert E, Tye C, Aydin Ü, Lautarescu A, Ellis C, Saunders T, O'Brien L, Ronald A, Happé F, McLoughlin G. Is quality of life related to high autistic traits, high ADHD traits and their Interaction? Evidence from a Young-Adult Community-Based twin sample. J Autism Dev Disord 2023; 53:3493-3508. [PMID: 35802291 PMCID: PMC10465683 DOI: 10.1007/s10803-022-05640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
This study explored whether high autistic traits, high attention deficit hyperactivity disorder (ADHD) traits and their interaction were associated with quality of life (QoL) in a sample of 556 of young-adult twins (Mean age 22 years 5 months, 52% Female). Four participant groups were created: high autistic traits, high ADHD traits, high autistic/ADHD traits, and low ADHD/autistic traits. High autistic traits were associated with lower QoL across domains (physical, psychological, social, and environmental). High ADHD traits associated with lower physical, psychological, and environmental QoL. The interaction of autistic and ADHD traits was not significant in any domain. While mental health difficulties were associated with lower QoL, after accounting for mental health, most relationships between autistic traits, ADHD traits and QoL remained.
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Affiliation(s)
- Simone J Capp
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
- Medical Sciences Division, Oxford Institute for Clinical Psychology Training and Research, University of Oxford, Oxford, UK.
| | - Jessica Agnew-Blais
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, School of School of Biological and Chemical Sciences, Queen Mary University London, London, UK
| | - Alex Lau-Zhu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Colvert
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Tye
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ümit Aydin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alexandra Lautarescu
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Claire Ellis
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tyler Saunders
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University of Edinburgh, Edinburgh, UK
| | - Lucy O'Brien
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, University of London, Birkbeck, London, UK
| | - Francesca Happé
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Gráinne McLoughlin
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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26
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Geelhand P, Papastamou F, Belenger M, Clin E, Hickman L, Keating CT, Sowden S. Autism-Related Language Preferences of French-Speaking Autistic Adults: An Online Survey. AUTISM IN ADULTHOOD 2023; 5:275-288. [PMID: 37711584 PMCID: PMC10499185 DOI: 10.1089/aut.2022.0056] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background In recent years, there have been increasing discussions surrounding the appropriate terminology to talk about autism. Initially, this debate revolved around the use of person-first language (e.g., person with autism) versus identity-first language (IFL; e.g., autistic person) but has recently expanded to other autism-related terms (e.g., deficits). However, to date, studies investigating autism-related language preferences have been limited to English-speaking countries, and little is known about preferences in other languages. This study addresses this gap by investigating the language preferences of French-speaking autistic adults. Methods Five hundred and forty-one French-speaking autistic adults (formal diagnosis and self-identified) completed an online survey where they selected terms they preferred to use to talk about: (1) the nomenclature of autism; (2) an autistic person; (3) someone's autistic identity; (4) autism more broadly; (5) the abilities of autistic people; and (6) people without a diagnosis of autism. Participants also revealed more about their language preferences via an open-text response. Results The most preferred terms were "Autisme," "Personne autiste," "Autiste," "Est Autiste," "Différence neurologique/cérébrale," "Différences," "Difficultés," "Personne neurotypique," "Neurotypique," and "Personne non-autiste." To better understand these preferences, participants' open comments were analyzed, revealing further support for IFL and the social model of disability, and a preference for simple, precise, and validated terms. Conclusions These results are consistent with autism terminology preferences in English-speaking countries and provide additional insight into the reasons underlying these preferences. Such work has implications for informing the language of researchers, clinicians, and other professionals in the field, as well as the general public.
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Affiliation(s)
- Philippine Geelhand
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Fanny Papastamou
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
- Center for Research in Cognition & Neurosciences (CRCN), Université libre de Bruxelles, Brussels, Belgium
| | - Marie Belenger
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Elise Clin
- ACTE at LaDisco and ULB Neuroscience Institute, Université libre de Bruxelles, Brussels, Belgium
| | - Lydia Hickman
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Connor T. Keating
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Sophie Sowden
- Centre for Developmental Science, School of Psychology, University of Birmingham, Birmingham, United Kingdom
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Wong OWH, Barzilay R, Lam AMW, Chan S, Calkins ME, Gur RE, Gur RC. Executive function as a generalized determinant of psychopathology and functional outcome in school-aged autism spectrum disorder: a case-control study. Psychol Med 2023; 53:4788-4798. [PMID: 35912846 PMCID: PMC10388326 DOI: 10.1017/s0033291722001787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) are challenged not only by the defining features of social-communication deficits and restricted repetitive behaviors, but also by a myriad of psychopathology varying in severity. Different cognitive deficits underpin these psychopathologies, which could be subjected to intervention to alter the course of the disorder. Understanding domain-specific mediating effects of cognition is essential for developing targeted intervention strategies. However, the high degree of inter-correlation among different cognitive functions hinders elucidation of individual effects. METHODS In the Philadelphia Neurodevelopmental Cohort, 218 individuals with ASD were matched with 872 non-ASD controls on sex, age, race, and socioeconomic status. Participants of this cohort were deeply and broadly phenotyped on neurocognitive abilities and dimensional psychopathology. Using structural equation modeling, inter-correlation among cognitive domains were adjusted before mediation analysis on outcomes of multi-domain psychopathology and functional level. RESULTS While social cognition, complex cognition, and memory each had a unique pattern of mediating effect on psychopathology domains in ASD, none had significant effects on the functional level. In contrast, executive function was the only cognitive domain that exerted a generalized negative impact on every psychopathology domain (p factor, anxious-misery, psychosis, fear, and externalizing), as well as functional level. CONCLUSIONS Executive function has a unique association with the severity of comorbid psychopathology in ASD, and could be a target of interventions. As executive dysfunction occurs variably in ASD, our result also supports the clinical utility of assessing executive function for prognostic purposes.
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Affiliation(s)
- Oscar W. H. Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Ran Barzilay
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Angela M. W. Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Sandra Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Monica E. Calkins
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Raquel E. Gur
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Ruben C. Gur
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
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28
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Scaffei E, Mazziotti R, Conti E, Costanzo V, Calderoni S, Stoccoro A, Carmassi C, Tancredi R, Baroncelli L, Battini R. A Potential Biomarker of Brain Activity in Autism Spectrum Disorders: A Pilot fNIRS Study in Female Preschoolers. Brain Sci 2023; 13:951. [PMID: 37371429 DOI: 10.3390/brainsci13060951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/29/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Autism spectrum disorder (ASD) refers to a neurodevelopmental condition whose detection still remains challenging in young females due to the heterogeneity of the behavioral phenotype and the capacity of camouflage. The availability of quantitative biomarkers to assess brain function may support in the assessment of ASD. Functional Near-infrared Spectroscopy (fNIRS) is a non-invasive and flexible tool that quantifies cortical hemodynamic responses (HDR) that can be easily employed to describe brain activity. Since the study of the visual phenotype is a paradigmatic model to evaluate cerebral processing in many neurodevelopmental conditions, we hypothesized that visually-evoked HDR (vHDR) might represent a potential biomarker in ASD females. We performed a case-control study comparing vHDR in a cohort of high-functioning preschooler females with ASD (fASD) and sex/age matched peers. We demonstrated the feasibility of visual fNIRS measurements in fASD, and the possibility to discriminate between fASD and typical subjects using different signal features, such as the amplitude and lateralization of vHDR. Moreover, the level of response lateralization was correlated to the severity of autistic traits. These results corroborate the cruciality of sensory symptoms in ASD, paving the way for the validation of the fNIRS analytical tool for diagnosis and treatment outcome monitoring in the ASD population.
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Affiliation(s)
- Elena Scaffei
- Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, 50135 Florence, Italy
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
| | - Raffaele Mazziotti
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
- Institute of Neuroscience, National Research Council, Via Moruzzi 1, 56124 Pisa, Italy
| | - Eugenia Conti
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
| | - Valeria Costanzo
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
| | - Sara Calderoni
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Andrea Stoccoro
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56100 Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | | | - Laura Baroncelli
- Institute of Neuroscience, National Research Council, Via Moruzzi 1, 56124 Pisa, Italy
| | - Roberta Battini
- IRCCS Stella Maris Foundation, Viale del Tirreno, 56128 Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126 Pisa, Italy
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29
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Pretzsch CM, Floris DL, Schäfer T, Bletsch A, Gurr C, Lombardo MV, Chatham CH, Tillmann J, Charman T, Arenella M, Jones E, Ambrosino S, Bourgeron T, Dumas G, Cliquet F, Leblond CS, Loth E, Oakley B, Buitelaar JK, Baron-Cohen S, Beckmann CF, Persico AM, Banaschewski T, Durston S, Freitag CM, Murphy DGM, Ecker C. Cross-sectional and longitudinal neuroanatomical profiles of distinct clinical (adaptive) outcomes in autism. Mol Psychiatry 2023; 28:2158-2169. [PMID: 36991132 PMCID: PMC10575772 DOI: 10.1038/s41380-023-02016-z] [Citation(s) in RCA: 3] [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: 09/16/2022] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/31/2023]
Abstract
Individuals with autism spectrum disorder (henceforth referred to as autism) display significant variation in clinical outcome. For instance, across age, some individuals' adaptive skills naturally improve or remain stable, while others' decrease. To pave the way for 'precision-medicine' approaches, it is crucial to identify the cross-sectional and, given the developmental nature of autism, longitudinal neurobiological (including neuroanatomical and linked genetic) correlates of this variation. We conducted a longitudinal follow-up study of 333 individuals (161 autistic and 172 neurotypical individuals, aged 6-30 years), with two assessment time points separated by ~12-24 months. We collected behavioural (Vineland Adaptive Behaviour Scale-II, VABS-II) and neuroanatomical (structural magnetic resonance imaging) data. Autistic participants were grouped into clinically meaningful "Increasers", "No-changers", and "Decreasers" in adaptive behaviour (based on VABS-II scores). We compared each clinical subgroup's neuroanatomy (surface area and cortical thickness at T1, ∆T (intra-individual change) and T2) to that of the neurotypicals. Next, we explored the neuroanatomical differences' potential genomic associates using the Allen Human Brain Atlas. Clinical subgroups had distinct neuroanatomical profiles in surface area and cortical thickness at baseline, neuroanatomical development, and follow-up. These profiles were enriched for genes previously associated with autism and for genes previously linked to neurobiological pathways implicated in autism (e.g. excitation-inhibition systems). Our findings suggest that distinct clinical outcomes (i.e. intra-individual change in clinical profiles) linked to autism core symptoms are associated with atypical cross-sectional and longitudinal, i.e. developmental, neurobiological profiles. If validated, our findings may advance the development of interventions, e.g. targeting mechanisms linked to relatively poorer outcomes.
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Affiliation(s)
- Charlotte M Pretzsch
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Dorothea L Floris
- Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Tim Schäfer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Anke Bletsch
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Caroline Gurr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michael V Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Chris H Chatham
- F. Hoffmann La Roche, Innovation Center Basel, Basel, Switzerland
| | - Julian Tillmann
- F. Hoffmann La Roche, Innovation Center Basel, Basel, Switzerland
| | - Tony Charman
- Clinical Child Psychology, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Martina Arenella
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Emily Jones
- Centre for Brain & Cognitive Development, University of London, London, UK
| | - Sara Ambrosino
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Guillaume Dumas
- CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Freddy Cliquet
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Claire S Leblond
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Antonio M Persico
- Child and Adolescent Neuropsychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sarah Durston
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Declan G M Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
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Hwang G, Wen J, Sotardi S, Brodkin ES, Chand GB, Dwyer DB, Erus G, Doshi J, Singhal P, Srinivasan D, Varol E, Sotiras A, Dazzan P, Kahn RS, Schnack HG, Zanetti MV, Meisenzahl E, Busatto GF, Crespo-Facorro B, Pantelis C, Wood SJ, Zhuo C, Shinohara RT, Shou H, Fan Y, Di Martino A, Koutsouleris N, Gur RE, Gur RC, Satterthwaite TD, Wolf DH, Davatzikos C. Assessment of Neuroanatomical Endophenotypes of Autism Spectrum Disorder and Association With Characteristics of Individuals With Schizophrenia and the General Population. JAMA Psychiatry 2023; 80:498-507. [PMID: 37017948 PMCID: PMC10157419 DOI: 10.1001/jamapsychiatry.2023.0409] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/22/2022] [Indexed: 04/06/2023]
Abstract
Importance Autism spectrum disorder (ASD) is associated with significant clinical, neuroanatomical, and genetic heterogeneity that limits precision diagnostics and treatment. Objective To assess distinct neuroanatomical dimensions of ASD using novel semisupervised machine learning methods and to test whether the dimensions can serve as endophenotypes also in non-ASD populations. Design, Setting, and Participants This cross-sectional study used imaging data from the publicly available Autism Brain Imaging Data Exchange (ABIDE) repositories as the discovery cohort. The ABIDE sample included individuals diagnosed with ASD aged between 16 and 64 years and age- and sex-match typically developing individuals. Validation cohorts included individuals with schizophrenia from the Psychosis Heterogeneity Evaluated via Dimensional Neuroimaging (PHENOM) consortium and individuals from the UK Biobank to represent the general population. The multisite discovery cohort included 16 internationally distributed imaging sites. Analyses were performed between March 2021 and March 2022. Main Outcomes and Measures The trained semisupervised heterogeneity through discriminative analysis models were tested for reproducibility using extensive cross-validations. It was then applied to individuals from the PHENOM and the UK Biobank. It was hypothesized that neuroanatomical dimensions of ASD would display distinct clinical and genetic profiles and would be prominent also in non-ASD populations. Results Heterogeneity through discriminative analysis models trained on T1-weighted brain magnetic resonance images of 307 individuals with ASD (mean [SD] age, 25.4 [9.8] years; 273 [88.9%] male) and 362 typically developing control individuals (mean [SD] age, 25.8 [8.9] years; 309 [85.4%] male) revealed that a 3-dimensional scheme was optimal to capture the ASD neuroanatomy. The first dimension (A1: aginglike) was associated with smaller brain volume, lower cognitive function, and aging-related genetic variants (FOXO3; Z = 4.65; P = 1.62 × 10-6). The second dimension (A2: schizophrenialike) was characterized by enlarged subcortical volumes, antipsychotic medication use (Cohen d = 0.65; false discovery rate-adjusted P = .048), partially overlapping genetic, neuroanatomical characteristics to schizophrenia (n = 307), and significant genetic heritability estimates in the general population (n = 14 786; mean [SD] h2, 0.71 [0.04]; P < 1 × 10-4). The third dimension (A3: typical ASD) was distinguished by enlarged cortical volumes, high nonverbal cognitive performance, and biological pathways implicating brain development and abnormal apoptosis (mean [SD] β, 0.83 [0.02]; P = 4.22 × 10-6). Conclusions and Relevance This cross-sectional study discovered 3-dimensional endophenotypic representation that may elucidate the heterogeneous neurobiological underpinnings of ASD to support precision diagnostics. The significant correspondence between A2 and schizophrenia indicates a possibility of identifying common biological mechanisms across the 2 mental health diagnoses.
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Affiliation(s)
- Gyujoon Hwang
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Junhao Wen
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Laboratory of AI & Biomedical Science (LABS), Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Marina del Rey
| | - Susan Sotardi
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Edward S. Brodkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ganesh B. Chand
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Radiology, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Dominic B. Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Guray Erus
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jimit Doshi
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Pankhuri Singhal
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Dhivya Srinivasan
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Erdem Varol
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Statistics, Zuckerman Institute, Columbia University, New York, New York
| | - Aristeidis Sotiras
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Radiology, School of Medicine, Washington University in St Louis, St Louis, Missouri
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Rene S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Hugo G. Schnack
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marcus V. Zanetti
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
| | - Eva Meisenzahl
- LVR-Klinikum Düsseldorf, Kliniken der Heinrich-Heine-Universität, Düsseldorf, Germany
| | - Geraldo F. Busatto
- Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Benedicto Crespo-Facorro
- University Hospital Virgen del Rocio, Department of Psychiatry, School of Medicine, IBiS-CIBERSAM, University of Sevilla, Seville, Spain
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - Stephen J. Wood
- Orygen, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimaging-Genetics and Co-morbidity Laboratory, Tianjin Anding Hospital, Tianjin, China
- Department of Psychiatry, Tianjin Medical University, Tianjin, China
| | - Russell T. Shinohara
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Haochang Shou
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Yong Fan
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Adriana Di Martino
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience at the New York University Child Study Center, New York
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian University, Munich, Germany
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Theodore D. Satterthwaite
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Daniel H. Wolf
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christos Davatzikos
- AID Center for Data Science for Integrated Diagnostics, and Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Pollak RM, Burrell TL, Cubells JF, Klaiman C, Murphy MM, Saulnier CA, Walker EF, White SP, Mulle JG. Adaptive behavior deficits in individuals with 3q29 deletion syndrome. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.31.23288022. [PMID: 37066139 PMCID: PMC10104221 DOI: 10.1101/2023.03.31.23288022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Background 3q29 deletion syndrome (3q29del) is associated with a significantly increased risk for neurodevelopmental and neuropsychiatric phenotypes. Mild to moderate intellectual disability (ID) is common in this population, and previous work by our team identified substantial deficits in adaptive behavior. However, the full profile of adaptive function in 3q29del has not been described, nor has it been compared to other genomic syndromes associated with elevated risk for neurodevelopmental and neuropsychiatric phenotypes. Methods Individuals with 3q29del (n=32, 62.5% male) were evaluated using the Vineland Adaptive Behavior Scales, Third Edition, Comprehensive Parent/Caregiver Form (Vineland-3). We explored the relationship between adaptive behavior and cognitive function, executive function, and neurodevelopmental and neuropsychiatric comorbidities in our 3q29del study sample, and we compared subjects with 3q29del to published data on Fragile X syndrome, 22q11.2 deletion syndrome, and 16p11.2 deletion and duplication syndromes. Results Individuals with 3q29del had global deficits in adaptive behavior that were not driven by specific weaknesses in any given domain. Individual neurodevelopmental and neuropsychiatric diagnoses had a small effect on adaptive behavior, and the cumulative number of comorbid diagnoses was significantly negatively associated with Vineland-3 performance. Both cognitive ability and executive function were significantly associated with adaptive behavior, and executive function was a better predictor of Vineland-3 performance than cognitive ability. Finally, the severity of adaptive behavior deficits in 3q29del was distinct from previously published data on comparable genomic disorders. Conclusions Individuals with 3q29del have significant deficits in adaptive behavior, affecting all domains assessed by the Vineland-3. Executive function is a better predictor of adaptive behavior than cognitive ability in this population and suggests that interventions targeting executive function may be an effective therapeutic strategy.
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Affiliation(s)
- Rebecca M Pollak
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University
| | | | - Joseph F Cubells
- Department of Human Genetics, School of Medicine, Emory University
- Department of Psychiatry and Behavioral Science, School of Medicine, Emory University
| | - Cheryl Klaiman
- Department of Pediatrics, School of Medicine, Emory University
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University
| | | | - Celine A Saulnier
- Department of Pediatrics, School of Medicine, Emory University
- Neurodevelopmental Assessment & Consulting Services
| | | | - Stormi Pulver White
- Department of Pediatrics, School of Medicine, Emory University
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University
| | - Jennifer G Mulle
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University
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Hudry K, Smith J, Pillar S, Varcin KJ, Bent CA, Boutrus M, Chetcuti L, Clark A, Dissanayake C, Iacono T, Kennedy L, Lant A, Robinson Lake J, Segal L, Slonims V, Taylor C, Wan MW, Green J, Whitehouse AJO. The Utility of Natural Language Samples for Assessing Communication and Language in Infants Referred with Early Signs of Autism. Res Child Adolesc Psychopathol 2023; 51:529-539. [PMID: 36602626 DOI: 10.1007/s10802-022-01010-3] [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] [Accepted: 12/15/2022] [Indexed: 01/06/2023]
Abstract
Natural Language Sampling (NLS) offers clear potential for communication and language assessment, where other data might be difficult to interpret. We leveraged existing primary data for 18-month-olds showing early signs of autism, to examine the reliability and concurrent construct validity of NLS-derived measures coded from video-of child language, parent linguistic input, and dyadic balance of communicative interaction-against standardised assessment scores. Using Systematic Analysis of Language Transcripts (SALT) software and coding conventions, masked coders achieved good-to-excellent inter-rater agreement across all measures. Associations across concurrent measures of analogous constructs suggested strong validity of NLS applied to 6-min video clips. NLS offers benefits of feasibility and adaptability for validly quantifying emerging skills, and potential for standardisation for clinical use and rigorous research design.
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Affiliation(s)
- Kristelle Hudry
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia.
| | - Jodie Smith
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Sarah Pillar
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
| | - Kandice J Varcin
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Catherine A Bent
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Maryam Boutrus
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
- Cooperative Research Centre for Living With Autism, Brisbane, QLD, 4068, Australia
| | - Lacey Chetcuti
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
- Cooperative Research Centre for Living With Autism, Brisbane, QLD, 4068, Australia
| | - Alena Clark
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Teresa Iacono
- Living with Disability Research Centre, La Trobe University, Bendigo, VIC, 3550, Australia
| | - Lyndel Kennedy
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia
| | - Alicia Lant
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
| | - Jemima Robinson Lake
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
| | - Leonie Segal
- Australian Centre for Precision Health Sciences, School of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia
| | - Vicky Slonims
- Children's Neurosciences, Evelina London Children's Hospital, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, SE5 8AF, UK
| | - Carol Taylor
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, M13 PL9, UK
| | - Ming Wai Wan
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, M13 PL9, UK
| | - Jonathan Green
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, M13 PL9, UK
- Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Greater Manchester Mental Health NHS Foundation Trust, Manchester, M25 3BL, UK
| | - Andrew J O Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth, WA, 6009, Australia
- Cooperative Research Centre for Living With Autism, Brisbane, QLD, 4068, Australia
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Loubersac J, Michelon C, Ferrando L, Picot MC, Baghdadli A. Predictors of an earlier diagnosis of Autism Spectrum Disorder in children and adolescents: a systematic review (1987-2017). Eur Child Adolesc Psychiatry 2023; 32:375-393. [PMID: 33909143 DOI: 10.1007/s00787-021-01792-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/19/2021] [Indexed: 01/11/2023]
Abstract
Autism Spectrum Disorder (ASD) is an early onset neurodevelopmental disorder in which the first signs generally emerge at approximately 12 months of age but its diagnosis is feasible only from the age of 18 months. According to the literature, the average age of diagnosis ranges from 2.7 to 7.2 years, which raises the question of factors associated with early diagnosis as a condition for early intervention. In this systematic review, we aim to identify clinical, social, and environmental factors associated with the age at which the diagnosis of ASD is confirmed in children. A literature search was performed in the Pubmed, Web of Sciences, PsycInfo, and Cochrane databases. Among the 530 publications identified, 50 were selected according to the inclusion criteria. This review focuses on studies conducted in 21 countries using data collected over a period from 1987 to 2017. These studies were published before December 31st, 2019. The results suggest that the diagnosis of ASD occurs earlier if there is a delay in social communication or the presence of intellectual disability. There is a low level of evidence concerning associations between the age at diagnosis and sex, race, parental education, or socioeconomic status and accessibility to health care. Further studies using large and well-characterized data sets are needed to simultaneously explore clinical and socio-environmental factors involved in early diagnosis.
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Affiliation(s)
- Julie Loubersac
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
| | - Laetitia Ferrando
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France
| | - Marie-Christine Picot
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
- Department of Medical Information, University Hospital, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles Neuro-Développementaux (CeAND), CHU Montpellier, 39 Avenue Charles Flahaut, 34295, Montpellier Cedex 05, France.
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
- Faculté de Médecine, Université de Montpellier, Montpellier, France.
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Semovski V, King C, Lapshina N, Stewart SL. A cross-sectional examination of service complexity in youths with co-occurring autism spectrum disorder and psychiatric or medical diagnoses across service sectors. Front Psychol 2023; 13:1027373. [PMID: 36817386 PMCID: PMC9930473 DOI: 10.3389/fpsyg.2022.1027373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/28/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a heterogeneous, life-long, and complex condition. Youth diagnosed with ASD require several supports addressing core symptoms associated with the disorder, but also those resulting from co-occurring mental and physical health conditions. As a result, their care is overseen by numerous professionals spanning various service sectors, but communication between sectors is hindered due to the absence of a standardized assessment system to identify and triage youth to services. A paucity of information surrounding this population's service use lingers and a siloed delivery system persists. Methods Using archival data collected from 1,020 youth between 12 and 18 years of age, this study explored service complexity among autistic youth with and without psychiatric and medical co-occurring conditions in Ontario, Canada. In doing so, a negative binomial regression was utilized to investigate which predisposing, enabling, and need variables were associated with service complexity. Results Results revealed that experiencing financial difficulties was not associated with service complexity. However, age, sex, caregiver distress, comorbidity, intellectual disability, and evaluated health status were significant predictors. More specifically, female youth and youth with distressed caregivers had greater mental health service complexity scores. Additionally, youth diagnosed with two or more conditions in addition to ASD who required longer durations of programming, controlling for other predictors, had greater mental health service complexity scores. Yet, youth with an intellectual disability had lower service complexity scores. Discussion Clinical implications of this study are discussed to inform future investments into mental health efforts for autistic youth.
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Bölte S. A more holistic approach to autism using the International Classification of Functioning: The why, what, and how of functioning. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:3-6. [PMID: 36330803 DOI: 10.1177/13623613221136444] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fries J, Baudson TG, Kovacs K, Pietschnig J. Bright, but allergic and neurotic? A critical investigation of the "overexcitable genius" hypothesis. Front Psychol 2022; 13:1051910. [PMID: 36619122 PMCID: PMC9817003 DOI: 10.3389/fpsyg.2022.1051910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/01/2022] [Indexed: 12/25/2022] Open
Abstract
Introduction Higher intelligence has been associated with improved health and longevity. However, recent findings have claimed that exceptional intelligence may come at a cost. Individuals at the upmost end of the intelligence distribution are reported to be disproportionately afflicted by a set of stress-related physical and mental health conditions: so-called overexcitabilities. Few accounts have investigated this issue and no studies are available for non-US samples yet. Here, we aimed to replicate and extend previous work by examining hitherto unaddressed overexcitabilities in a European high-IQ sample. Methods We carried out a preregistered survey among members of MENSA, the world's largest high-IQ society. In total, 615 (307 male) members from Austria, Germany, Hungary, Switzerland, and the United Kingdom participated. Results and Discussion Compared to the general population, our sample exhibited considerably elevated prevalences in autism spectrum disorders (risk ratio/RR = 2.25), chronic fatigue syndrome (RR = 5.69), depression (RR = 4.38), generalized anxiety (RR = 3.82), and irritable bowel syndrome (RR = 3.76). Contrary to previous accounts, neither asthma, allergies, nor autoimmune diseases were elevated. We show that this subsample of intellectually gifted persons faces specific health challenges compared to the general population. The reasons for this remain speculative, as we find little evidence for previously proposed immunological explanations. However, it is possible that the effects are caused by sample selectiveness (i.e., membership in a high-IQ society) rather than high IQ itself.
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Affiliation(s)
- Jonathan Fries
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Tanja Gabriele Baudson
- Department of Human Sciences, Institute of Psychology, Vinzenz Pallotti University, Vallendar, Germany
- Institute for Globally Distributed Open Research and Education (IGDORE), Vallendar, Germany
- Department of Science and Research, Mensa in Germany, Cham, Germany
| | - Kristof Kovacs
- Institute of Psychology, ELTE Eotvos Lorand University Budapest, Budapest, Hungary
| | - Jakob Pietschnig
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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Bury SM, Jellett R, Haschek A, Wenzel M, Hedley D, Spoor JR. Understanding language preference: Autism knowledge, experience of stigma and autism identity. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221142383. [PMID: 36510834 DOI: 10.1177/13623613221142383] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
LAY ABSTRACT There is ongoing discussion around what language is acceptable when talking about someone with an autism diagnosis, especially regarding person-first (e.g. person with autism) or identity-first (e.g. autistic person) language. We asked 198 Australian adults with an autism diagnosis what terminology they prefer and what they find offensive. We also asked questions to understand their experience of stigma, their autism knowledge and how much they endorse an autism identity, to investigate if these factors were associated with their language preferences. Overall, there was no significant association between these three factors and person-first terminology. For identity-first terms, those who endorse a stronger autism identity tended to find identity-first terms more preferable and less offensive, whereas those who reported greater experiences and internalisation of stigma tended to find identity-first terms less preferable and more offensive. Previous research has tended to ask what language participants prefer. The findings of this work help provide some context as to why people prefer or find offensive specific terms, at least for identity-first language.
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Abstract
PURPOSE OF REVIEW The goal of this paper is to provide an overview of profiles of adaptive behavior in autism spectrum disorder and highlight the importance of these everyday skills in optimizing self-sufficiency throughout life. RECENT FINDINGS Research has clearly confirmed that adaptive deficits exist in ASD, particularly in social skills. These impairments are highly associated with co-occurring conditions such as executive functioning impairments, psychiatric conditions, and even psychosis. There tends to be a discrepancy between intellectual capacity and adaptive functioning, particularly in autistic individuals without cognitive and language delays, with this gap widening between childhood and adulthood. Although cognition and language skills are associated with good outcome in ASD, they are insufficient in the absence of intact adaptive behavior. There is a critical need to emphasize the importance of adaptive functioning in diagnostic evaluations and treatment/intervention programs to ensure that every autistic individual has the potential for success.
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Munsell EGS, Orsmond GI, Fulford D, Coster WJ. Self-management of daily life tasks in diploma-track youth with disabilities. Disabil Rehabil 2022; 44:8011-8021. [PMID: 34877919 DOI: 10.1080/09638288.2021.2008524] [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: 01/18/2023]
Abstract
PURPOSE Youth with disabilities who graduate with a regular high school diploma often continue to have difficulties in their daily functioning that ultimately impact adulthood outcomes. To better understand these functional difficulties and determine how best to address them, it is important to distinguish deficits in discrete skills from difficulty organizing skills to self-manage complex tasks associated with adult roles. The purpose of this study was to explore the extent to which challenges in social, executive function and behavior management factors relate to these two aspects of daily functioning. METHODS This is a secondary analysis of the National Longitudinal Transition Study 2 funded by the United States Department of Education. The direct and indirect associations between youth underlying factors and self-management of daily life tasks (SMDLT) versus discrete functional skills were modelled using structural equation modelling. RESULTS A model incorporating social skills, communication, and behavior regulation explained 55% of the variance in SMDLT. In contrast, the model predicting discrete functional skills had fewer significant associations and described less variance (37%) in the outcome. CONCLUSIONS Findings suggest that using measures of SMDLT and designing targeted interventions for SMDLT might help improve participation in independent living and productivity for diploma-track youth with disabilities.Implications for rehabilitationSuccessful transition from high school to adult roles requires the ability to self-manage the daily life tasks required for those roles, such as employment, post-secondary education, and independent living.The ability to self-manage daily tasks is distinct from mastery of discrete functional skills and should be assessed with measures that uniquely examine this domain.Social and communication skills, executive functioning, and behavioral regulation, are important contributors to the ability to self-manage life tasks for diploma-track youth with disabilities and should be incorporated into multifaceted interventions.Interventions to improve self-management of tasks should include teaching strategies and practice coordinating underlying skills in flexible ways that meet the varying demands of tasks and diverse environments.
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Affiliation(s)
- Elizabeth G S Munsell
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Gael I Orsmond
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Daniel Fulford
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA.,Department of Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - Wendy J Coster
- Occupational Therapy Department, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
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Gonzales L, Kois LE, Chen C, López-Aybar L, McCullough B, McLaughlin KJ. Reliability of the Term "Serious Mental Illness": A Systematic Review. Psychiatr Serv 2022; 73:1255-1262. [PMID: 35895839 DOI: 10.1176/appi.ps.202100661] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The term "serious mental illness" (SMI) is widely used across research, practice, and policy settings. However, there is no consistent operational definition, and its reliability has not been systematically evaluated. The purpose of this review was to provide a comprehensive qualitative content analysis of "SMI" empirical research, including study and sample characteristics and SMI operational definitions. These data can provide important considerations for how stakeholders conceptualize SMI. METHODS Systematic review of PsycInfo, PsycArticles, and PubMed databases from January 1, 2015, to December 31, 2019, identified 788 original empirical studies that characterized the sample as having "SMI." RESULTS Descriptive content analysis indicated that most studies (85%) provided no operational definition for SMI. Only 15% defined the term, and an additional 26% provided examples of SMI that included only psychiatric diagnostic categories (e.g., SMI, such as schizophrenia). Of the 327 studies that provided any description of SMI, variability was noted regarding whether criteria included any mental health diagnosis (N=31) or only specified diagnoses (N=289), functional impairment (N=73), or any specified duration of symptoms (N=39). Across all studies that characterized samples as having SMI, substantial variability was noted regarding included diagnostic classifications. CONCLUSIONS Referencing "SMI" is second nature for many stakeholders. Findings suggest that evidence-based practice and policy efforts should weigh the level of research support indicating that the construct and the term "SMI" lacks generalizability. Researchers and stakeholders are encouraged to develop precise and agreed-upon diagnostic language in their efforts to support and advocate for people with mental illnesses.
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Affiliation(s)
- Lauren Gonzales
- Derner School of Psychology, Adelphi University, Garden City, New York (Gonzales, Chen, López-Aybar, McCullough); Department of Psychology, University of Alabama, Tuscaloosa (Kois); Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal (McLaughlin)
| | - Lauren E Kois
- Derner School of Psychology, Adelphi University, Garden City, New York (Gonzales, Chen, López-Aybar, McCullough); Department of Psychology, University of Alabama, Tuscaloosa (Kois); Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal (McLaughlin)
| | - Crystal Chen
- Derner School of Psychology, Adelphi University, Garden City, New York (Gonzales, Chen, López-Aybar, McCullough); Department of Psychology, University of Alabama, Tuscaloosa (Kois); Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal (McLaughlin)
| | - Laura López-Aybar
- Derner School of Psychology, Adelphi University, Garden City, New York (Gonzales, Chen, López-Aybar, McCullough); Department of Psychology, University of Alabama, Tuscaloosa (Kois); Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal (McLaughlin)
| | - Brittany McCullough
- Derner School of Psychology, Adelphi University, Garden City, New York (Gonzales, Chen, López-Aybar, McCullough); Department of Psychology, University of Alabama, Tuscaloosa (Kois); Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal (McLaughlin)
| | - Kendra J McLaughlin
- Derner School of Psychology, Adelphi University, Garden City, New York (Gonzales, Chen, López-Aybar, McCullough); Department of Psychology, University of Alabama, Tuscaloosa (Kois); Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal (McLaughlin)
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Gilmore D, Longo A, Krantz M, Radford D, Hand BN. Five Ways Providers Can Improve Mental Healthcare for Autistic Adults: A Review of Mental Healthcare Use, Barriers to Care, and Evidence-Based Recommendations. Curr Psychiatry Rep 2022; 24:565-571. [PMID: 35969335 PMCID: PMC9376572 DOI: 10.1007/s11920-022-01362-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF REVIEW We reviewed the literature from 2017 to 2022 on autistic adults' use of mental healthcare and barriers to care. To encourage immediate improvement in mental healthcare, we provide five strategies mental health providers can use to better care for autistic adults. RECENT FINDINGS Most autistic adults use mental healthcare and use it more often than non-autistic adults. Autistic adults' experiences with mental healthcare are characterized by (1) lack of providers knowledgeable about autism, (2) use of treatments that may not be accommodating to individual needs, and (3) difficulty navigating the complex healthcare system. These barriers contribute to prevalent unmet needs for mental healthcare. Autistic adults use mental healthcare frequently but have unmet mental health needs. As necessary systemic changes develop, providers can begin immediately to better care for autistic adults by learning about their needs and taking personalized care approaches to meet those needs.
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Affiliation(s)
- Daniel Gilmore
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Anne Longo
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Morgan Krantz
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Deondray Radford
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
| | - Brittany N. Hand
- The Ohio State University, 228E Atwell Hall, 453 W 10th Ave., Columbus, OH 43210 USA
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Chandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, Pickles A, Simonoff E, Charman T. Pathways to adaptive functioning in autism from early childhood to adolescence. Autism Res 2022; 15:1883-1893. [PMID: 35899846 PMCID: PMC9796413 DOI: 10.1002/aur.2785] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. This study examines longitudinal and contemporaneous associations of adaptive functioning in autistic youth across a wide ability range. Parent-reported autism symptoms, co-occurring emotional, behavioral and attention deficit hyperactivity disorder (ADHD) symptoms, and IQ were assessed in early childhood (M age 7 years; T1) and 6 years later in adolescence (M age 13 years; T2) in 179 autistic youth. Adaptive functioning was assessed at T2. Structural equation modeling estimated pathways to adaptive functioning from autism, and psychiatric symptoms at T1 and T2, testing whether associations were driven by continuity of behaviors from T1 to T2 or their contemporaneous effect at T2, or both, controlling for T1 IQ. Lower adaptive functioning at T2 was associated with higher T1 and T2 ADHD symptoms (β = -0.14, and β = -0.21) but not behavioral nor emotional symptoms at either timepoint. Lower adaptive functioning at T2 was also associated with lower T1 IQ (β = 0.43) and higher social communication symptoms (β = -0.37) at T2 but not T1, but the relationship with ADHD symptoms remained. Paths were not moderated by sex or IQ. Increased symptoms of ADHD, both in early childhood and contemporaneously, were associated with reduced adaptive functioning in adolescence. Co-occurring ADHD may be a modifiable risk factor for adaptive function impairments and should be routinely assessed and when present evidence-based treatments initiated which may benefit adaptive functioning outcomes. LAY SUMMARY: Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. In a community sample higher attention deficit/hyperactivity disorder (ADHD) symptoms, but not emotional or behavioral symptoms, in both early childhood and contemporaneously were associated with lower adaptive functioning in autistic adolescents. Co-occurring ADHD may be a modifiable risk factor for adaptive function difficulties in autism.
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Affiliation(s)
- Susie Chandler
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Philippa White
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Isabel Yorke
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Matthew J. Hollocks
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK
| | | | - Andrew Pickles
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Maudsley Biomedical Research Centre for Mental HealthLondonUK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK,Maudsley Biomedical Research Centre for Mental HealthLondonUK
| | - Tony Charman
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK
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43
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Monk R, Whitehouse AJO, Waddington H. The use of language in autism research. Trends Neurosci 2022; 45:791-793. [PMID: 36184384 DOI: 10.1016/j.tins.2022.08.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 08/30/2022] [Indexed: 12/21/2022]
Abstract
The past three decades have seen a major shift in our understanding of the strong links between autism and identity. These developments have called for careful consideration of the language used to describe autism. Here, we briefly discuss some of these deliberations and provide guidance to researchers around language use in autism research.
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Affiliation(s)
- Ruth Monk
- Autism New Zealand Community Advisory Group, New Zealand/School of Medical Sciences, University of Auckland, Auckland, New Zealand
| | | | - Hannah Waddington
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Song C, Jiang ZQ, Hu LF, Li WH, Liu XL, Wang YY, Jin WY, Zhu ZW. A machine learning-based diagnostic model for children with autism spectrum disorders complicated with intellectual disability. Front Psychiatry 2022; 13:993077. [PMID: 36213933 PMCID: PMC9533131 DOI: 10.3389/fpsyt.2022.993077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background Early detection of children with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) can help in individualized intervention. Appropriate assessment and diagnostic tools are lacking in primary care. This study aims to explore the applicability of machine learning (ML) methods in diagnosing ASD comorbid ID compared with traditional regression models. Method From January 2017 to December 2021, 241 children with ASD, with an average age of 6.41 ± 1.96, diagnosed in the Developmental Behavior Department of the Children's Hospital Affiliated with the Medical College of Zhejiang University were included in the analysis. This study trained the traditional diagnostic models of Logistic regression (LR), Support Vector Machine (SVM), and two ensemble learning algorithms [Random Forest (RF) and XGBoost]. Socio-demographic and behavioral observation data were used to distinguish whether autistic children had combined ID. The hyperparameters adjustment uses grid search and 10-fold validation. The Boruta method is used to select variables. The model's performance was evaluated using discrimination, calibration, and decision curve analysis (DCA). Result Among 241 autistic children, 98 (40.66%) were ASD comorbid ID. The four diagnostic models can better distinguish whether autistic children are complicated with ID, and the accuracy of SVM is the highest (0.836); SVM and XGBoost have better accuracy (0.800, 0.838); LR has the best sensitivity (0.939), followed by SVM (0.952). Regarding specificity, SVM, RF, and XGBoost performed significantly higher than LR (0.355). The AUC of ML (SVM, 0.835 [95% CI: 0.747-0.944]; RF, 0.829 [95% CI: 0.738-0.920]; XGBoost, 0.845 [95% CI: 0.734-0.937]) is not different from traditional LR (0.858 [95% CI: 0.770-0.944]). Only SVM observed a good calibration degree. Regarding DCA, LR, and SVM have higher benefits in a wider threshold range. Conclusion Compared to the traditional regression model, ML model based on socio-demographic and behavioral observation data, especially SVM, has a better ability to distinguish whether autistic children are combined with ID.
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Affiliation(s)
- Chao Song
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | | | - Li-Fei Hu
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Wen-Hao Li
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Xiao-Lin Liu
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Yan-Yan Wang
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Wen-Yuan Jin
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
| | - Zhi-Wei Zhu
- Department of Developmental and Behavioral Pediatrics, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, China
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Losada-Puente L, Baña M. Assessment of Adaptive Behavior in People with Autism Spectrum Disorders through the ICAP. Behav Sci (Basel) 2022; 12:333. [PMID: 36135137 PMCID: PMC9495773 DOI: 10.3390/bs12090333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/23/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Evaluating adaptive behavior in people with Autism Spectrum Disorder (ASD) requires attending to a set of cognitive processes associated with social interaction skills and functional communication that are altered. This paper presents the analysis of an instrument to assess and diagnose adaptive behavior in people with Autism Spectrum Disorder (ASD), given the need for rigorous, standardized, and statistically reliable tools to address this dimension, incorporated into the diagnosis since 1992. The Inventory for Service Planning and Individual Programming (ICAP) was applied to n = 209 children with ASD. Its psychometric properties were studied to provide statistical criteria for its usefulness in assessing adaptive behavior. Results highlighted variations in its original structure, reducing the number of items from 77 to 60 by eliminating those with little discriminative power, and of dimensions from four to three given their greater congruence with the results of the exploratory analysis: daily life skills (α = 0.892-0.935), communication and linguistic skills (α = 0.860-0.931), and motor skills (α = 0.828-0.857). This again raises questions about the use of instruments similar in their dimensions, and about the interaction between variables and items, a frequent issue in the field of mind, social, and health sciences.
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Affiliation(s)
- Luisa Losada-Puente
- Department of Methods of Research and Diagnosis in Education, Faculty of Educational Sciences, University of A Coruña, 15071 A Coruña, Spain
| | - Manoel Baña
- Department of Developmental and Educational Psychology, Faculty of Teachers Training, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum's capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives.
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Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Unsa Fatima
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
- Reframing Autism, Sydney, New South Wales Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Marc Stears
- UCL Policy Lab, University College London, London, UK
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Hadjikhani N, Galazka M, Kenet T, Joseph R, Åsberg Johnels J. Discrepancy between high non-verbal intelligence and low accuracy at reading emotional expressions in the eyes reflects the magnitude of social-emotional difficulties in autism. Eur Arch Psychiatry Clin Neurosci 2022; 273:755-759. [PMID: 35980452 PMCID: PMC10085919 DOI: 10.1007/s00406-022-01471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022]
Abstract
Many so-called "high functioning" autistic individuals struggle with daily living skills, and have poorer than expected adult outcomes in employment, relationships, and quality of life. Significant discrepancies between non-verbal intelligence and emotional processing can be observed in autism, but the role of the magnitude of this gap in achieving potential psychosocial outcome is not known. Here, we show in a large group of participants (n = 107), that only among those with an autism diagnosis (n = 33), the gap between non-verbal intelligence (as measured by Raven's matrices) and the ability to perform the Reading the Mind in the Eyes test significantly predicts self-perceived emotional/social difficulties as assessed by the Empathy Quotient. Our results suggest that it is specifically the magnitude of the gap between (high) levels of abstract reasoning skills and poor proficiency in reading emotions expressed by the eyes that predicts self-perceived difficulties in emotional and social interactions among adults with autism. A better understanding of the underlying causes of the discrepancy between potential and actual psychosocial outcomes is the first step toward developing the most appropriate support for this vulnerable population, and our study offers some potentially important insights in this regard.
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Affiliation(s)
- Nouchine Hadjikhani
- Harvard/MGH Martinos Center for Biomedical Imaging, Boston, MA, USA. .,Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden.
| | - Martyna Galazka
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
| | - Tal Kenet
- Harvard/MGH Martinos Center for Biomedical Imaging, Boston, MA, USA
| | - Robert Joseph
- Boston University School of Medicine, Boston, MA, USA
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48
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Keeratitanont K, Theerakulpisut D, Auvichayapat N, Suphakunpinyo C, Patjanasoontorn N, Tiamkao S, Tepmongkol S, Khiewvan B, Raruenrom Y, Srisuruk P, Paholpak S, Auvichayapat P. Brain laterality evaluated by F-18 fluorodeoxyglucose positron emission computed tomography in autism spectrum disorders. Front Mol Neurosci 2022; 15:901016. [PMID: 36034502 PMCID: PMC9399910 DOI: 10.3389/fnmol.2022.901016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 07/13/2022] [Indexed: 12/04/2022] Open
Abstract
Background and rationale Autism spectrum disorder (ASD) is a neuropsychiatric disorder that has no curative treatment. Little is known about the brain laterality in patients with ASD. F-18 fluorodeoxyglucose positron emission computed tomography (F-18 FDG PET/CT) is a neuroimaging technique that is suitable for ASD owing to its ability to detect whole brain functional abnormalities in a short time and is feasible in ASD patients. The purpose of this study was to evaluate brain laterality using F-18 FDG PET/CT in patients with high-functioning ASD. Materials and methods This case-control study recruited eight ASD patients who met the DSM-5 criteria, the recorded data of eight controls matched for age, sex, and handedness were also enrolled. The resting state of brain glucose metabolism in the regions of interest (ROIs) was analyzed using the Q.Brain software. Brain glucose metabolism and laterality index in each ROI of ASD patients were compared with those of the controls. The pattern of brain metabolism was analyzed using visual analysis and is reported in the data description. Results The ASD group’s overall brain glucose metabolism was lower than that of the control group in both the left and right hemispheres, with mean differences of 1.54 and 1.21, respectively. We found statistically lower mean glucose metabolism for ASD patients than controls in the left prefrontal lateral (Z = 1.96, p = 0.049). The left laterality index was found in nine ROIs for ASD and 11 ROIs for the control. The left laterality index in the ASD group was significantly lower than that in the control group in the prefrontal lateral (Z = 2.52, p = 0.012), precuneus (Z = 2.10, p = 0.036), and parietal inferior (Z = 1.96, p = 0.049) regions. Conclusion Individuals with ASD have lower brain glucose metabolism than control. In addition, the number of ROIs for left laterality index in the ASD group was lower than control. Left laterality defects may be one of the causes of ASD. This knowledge can be useful in the treatment of ASD by increasing the left-brain metabolism. This trial was registered in the Thai Clinical Trials Registry (TCTR20210705005).
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Affiliation(s)
- Keattichai Keeratitanont
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Daris Theerakulpisut
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Narong Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chanyut Suphakunpinyo
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Niramol Patjanasoontorn
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somsak Tiamkao
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supatporn Tepmongkol
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Chulalongkorn University Biomedical Imaging Group (CUBIG), Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Benjapa Khiewvan
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yutapong Raruenrom
- Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Piyawan Srisuruk
- Department of Educational Psychology and Counseling, Faculty of Education, Khon Kaen University, Khon Kaen, Thailand
- Research and Service Institute for Autism, Khon Kaen University, Khon Kaen, Thailand
| | - Suchat Paholpak
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Service Institute for Autism, Khon Kaen University, Khon Kaen, Thailand
| | - Paradee Auvichayapat
- Noninvasive Brain Stimulation Research Group of Thailand, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Service Institute for Autism, Khon Kaen University, Khon Kaen, Thailand
- *Correspondence: Paradee Auvichayapat,
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Yang YJ, Chung KM. Pilot Randomized Control Trial of an App-Based CBT Program for Reducing Anxiety in Individuals with ASD without Intellectual Disability. J Autism Dev Disord 2022; 53:1331-1346. [PMID: 35689137 DOI: 10.1007/s10803-022-05617-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
This study developed and tested the effectiveness of an app-based cognitive behavioral therapy (CBT) program in alleviating anxiety among adolescents and adults with autism without co-occurring intellectual disability. Thirty participants from 15 to 35 years old were randomly assigned to either the intervention or waitlist control group, and self- and caregiver proxy report questionnaires were administered, accompanied by direct behavior observation before and after the intervention period. There was a significant decrease in anxiety level, an increase in positive affect, and a decline in stereotypic behaviors, hyperactivity, noncompliance, and inappropriate speech in proxy reports for the intervention group, compared to the control group. A significant rise in passive response in the direct observation was also seen in the intervention group.
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Affiliation(s)
- Yoon Jung Yang
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Kyong-Mee Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea.
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50
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Dale BA, Finch WH, Shellabarger KAR, Davis A. Comparison of Verbal Performance of Children with Autism Spectrum Disorder on the WISC-V. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2022. [DOI: 10.1177/07342829221106592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with autism spectrum disorder (ASD) display variable verbal cognitive profiles despite a historical requirement for a language delay in autistic disorder. This study compared the Verbal Comprehension Index (VCI) to the newly created ancillary index score, the Verbal Expanded Crystallized Index (VECI) of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) in a group of children with ASD. Using the ASD sample from the standardization data of the WISC-V, results indicated the VCI and VECI were significantly different for the ASD group but not for the matched controls. Follow up analysis of the ASD group revealed the VCI and VECI were significantly different for those with language impairment but not for those without language impairment. Psychologists should consider administering all verbal subtests of the WISC-V to children with ASD given the VECI may better capture the language impairment seen in this population.
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Affiliation(s)
- Brittany A. Dale
- Department of Special Education, Ball State University, Muncie, IN, USA
| | - W. Holmes Finch
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
| | | | - Andrew Davis
- Department of Educational Psychology, Ball State University, Muncie, IN, USA
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