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Rubio-Martín S, García-Ordás MT, Bayón-Gutiérrez M, Prieto-Fernández N, Benítez-Andrades JA. Enhancing ASD detection accuracy: a combined approach of machine learning and deep learning models with natural language processing. Health Inf Sci Syst 2024; 12:20. [PMID: 38455725 PMCID: PMC10917721 DOI: 10.1007/s13755-024-00281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/04/2024] [Indexed: 03/09/2024] Open
Abstract
Purpose The main aim of our study was to explore the utility of artificial intelligence (AI) in diagnosing autism spectrum disorder (ASD). The study primarily focused on using machine learning (ML) and deep learning (DL) models to detect ASD potential cases by analyzing text inputs, especially from social media platforms like Twitter. This is to overcome the ongoing challenges in ASD diagnosis, such as the requirement for specialized professionals and extensive resources. Timely identification, particularly in children, is essential to provide immediate intervention and support, thereby improving the quality of life for affected individuals. Methods We employed natural language processing (NLP) techniques along with ML models like decision trees, extreme gradient boosting (XGB), k-nearest neighbors algorithm (KNN), and DL models such as recurrent neural networks (RNN), long short-term memory (LSTM), bidirectional long short-term memory (Bi-LSTM), bidirectional encoder representations from transformers (BERT and BERTweet). We extracted a dataset of 404,627 tweets from Twitter users using the platform's API and classified them based on whether they were written by individuals claiming to have ASD (ASD users) or by those without ASD (non-ASD users). From this dataset, we used a subset of 90,000 tweets (45,000 from each classification group) for the training and testing of these models. Results The application of our AI models yielded promising results, with the predictive model reaching an accuracy of almost 88% when classifying texts that potentially originated from individuals with ASD. Conclusion Our research demonstrated the potential of using AI, particularly DL models, in enhancing the accuracy of ASD detection and diagnosis. This innovative approach signifies the critical role AI can play in advancing early diagnostic techniques, enabling better patient outcomes and underlining the importance of early identification of ASD, especially in children.
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Affiliation(s)
- Sergio Rubio-Martín
- SALBIS Research Group, Dept. of Electric, Systems and Automatics Engineering, Universidad de León, Campus of Vegazana s/n, 24071 León, León Spain
| | - María Teresa García-Ordás
- SECOMUCI Research Group, Dept. of Electric, Systems and Automatics Engineering, Universidad de León, Campus of Vegazana s/n, 24071 León, León Spain
| | - Martín Bayón-Gutiérrez
- SECOMUCI Research Group, Dept. of Electric, Systems and Automatics Engineering, Universidad de León, Campus of Vegazana s/n, 24071 León, León Spain
| | - Natalia Prieto-Fernández
- SECOMUCI Research Group, Dept. of Electric, Systems and Automatics Engineering, Universidad de León, Campus of Vegazana s/n, 24071 León, León Spain
| | - José Alberto Benítez-Andrades
- SALBIS Research Group, Dept. of Electric, Systems and Automatics Engineering, Universidad de León, Campus of Vegazana s/n, 24071 León, León Spain
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Yeung TS, Greene RK, Dick CC, Duvall SW. Females evaluated for autism: characteristics and co-occurring and differential DSM-5 diagnoses. Clin Neuropsychol 2024; 38:1481-1500. [PMID: 38037328 DOI: 10.1080/13854046.2023.2281709] [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: 06/27/2023] [Accepted: 11/03/2023] [Indexed: 12/02/2023]
Abstract
Objective: While sex differences in autism spectrum disorder (ASD) have been identified in areas such as neurocognitive functioning, behavior patterns, and diagnostic criteria, less work has focused on differences within females referred for ASD evaluation, including those who did not go on to receive a diagnosis. This study examined psychological and behavioral characteristics and co-occurring and differential DSM-5 diagnoses between pediatric female participants who received an ASD diagnosis (ASD+) and those who did not (ASD-). Method: Data on cognitive functioning, adaptive functioning, internalizing symptoms, externalizing symptoms, and ADOS-2 scores were analyzed among 137 3- to 20-year-old patients. The sample was divided into two age groups (ages 3-8 and ages 9-20) for analyses of between-group differences (ASD+ vs. ASD-) and predictors of group membership. Results: Females in the ASD+ group were significantly younger, had lower cognitive scores, lower internalizing and externalizing symptoms, and had higher Autism Diagnostic Observation Schedule-2 (ADOS-2) scores than those in the ASD- group. ADOS-2 scores were also the only significant predictor of ASD group membership across age groups. The ASD+ group had a higher percentage of intellectual disability while the ASD- group had higher percentages of anxiety disorder, attention-deficit/hyperactivity disorder, and disruptive behavior disorders. Conclusions: Psychological and behavioral presentations among females referred for ASD evaluation varied with age and ASD diagnostic groups. These results highlight potential female differences in ASD referrals and identification of ASD and the need to improve care for females in consideration of demographic factors.
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Affiliation(s)
- Tat Shing Yeung
- Division of Pediatric Psychology, Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University and Doernbecher Children's Hospital, Portland, OR, USA
| | - Rachel K Greene
- Division of Pediatric Psychology, Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University and Doernbecher Children's Hospital, Portland, OR, USA
| | - Catherine C Dick
- Division of Pediatric Psychology, Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University and Doernbecher Children's Hospital, Portland, OR, USA
| | - Susanne W Duvall
- Division of Pediatric Psychology, Department of Pediatrics, Institute on Development and Disability, Oregon Health & Science University and Doernbecher Children's Hospital, Portland, OR, USA
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McGrew J, Yu Y, Ruble L, Murray DS. Predictive Analysis of Parent Activation and Autism. J Autism Dev Disord 2024; 54:2471-2483. [PMID: 37133611 DOI: 10.1007/s10803-023-05985-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: 04/03/2023] [Indexed: 05/04/2023]
Abstract
We examined parent activation in families with autistic children over time. Activation is one's belief, knowledge, and persistence in obtaining and managing one's care (e.g., patient activation) and others (e.g., parent activation) and is associated with better outcomes. Four aims were examined: the associations between baseline parent activation and follow up treatment/outcome, between changes in activation and changes in treatment/outcome, differences in activation and treatment/outcome across demographic groups (e.g., gender, race, ethnicity, and income) and comparison of results using three different assessment approaches of parent activation, the Guttman scale (standard approach) and two factor subscales (Yu et al., in J Autism Dev Disord 53:110-120, 2023). The first factor tapped into behaviors aligned with highly active, assertive parental actions (Factor 1: Activated). The second tapped into behaviors representative of uncertainty, passivity, being overwhelmed, with growing awareness of the need for activation (Factor 2: Passive). Findings varied with assessment methods applied. The two subscales assessment approach produced the strongest effect sizes. Baseline activation was related to improved child outcomes at follow-up for Factor 1: Activated and to poorer child outcomes at follow-up for Factor 2: Passive. Changes in activation were unrelated to changes in treatment/outcomes. Outcomes differed based on the activation assessment approach used. Against expectations, activation remained the same over time. Further, no differences in outcomes were observed based on race, ethnicity, or family income. The results suggest that parent activation may behave differently than patient activation based on prior studies. More research is warranted on activation of parents of autistic children.
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Affiliation(s)
- John McGrew
- Department of Psychology, Indiana University Purdue University Indianapolis, 402 N. Blackford St., LD124, Indianapolis, IN, 46202, USA
| | - Yue Yu
- MIND Institute, University of California-Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Lisa Ruble
- Teachers College, TC745, Ball State University, Muncie, IN, 47306, USA.
| | - Donna S Murray
- Autism Speaks, 88 Broad Street, 5th Floor, Boston, MA, 02110, USA
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 4002, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA
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Yanchik A, Vietze P, Lax LE. The Effects of Discrete Trial and Natural Environment Teaching on Adaptive Behavior in Toddlers With Autism Spectrum Disorder. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2024; 129:263-278. [PMID: 38917993 DOI: 10.1352/1944-7558-129.4.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/12/2023] [Indexed: 06/27/2024]
Abstract
The literature has yet to review the differential effects of Natural Environment Teaching (NET) and Discrete Trial Teaching (DTT) on adaptive skills. A sample of 142 children diagnosed with ASD between the ages of 16 and 35 months received either DTT, NET, or both interventions (NET+ DTT). The Bayley Scales of Infant and Toddler Development (BSID) Adaptive Subscale and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Barriers Assessment were used as baseline and posttest measures. Children who received NET and NET+DTT conditions showed significant improvements compared to the DTT condition indicating that the addition of NET leads to increased adaptive skills and decreased barrier behaviors in participants. DTT may also play a necessary foundational role for children with more significant delays. These results provide support for the use of a combination of teaching strategies in community-based early intervention and refine protocols for teaching adaptive skills to toddlers with ASD.
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Affiliation(s)
| | - Peter Vietze
- Peter Vietze, Montclair State University and CARES, Inc
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5
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Gatica-Bahamonde G, Mendez-Fadol A, Sánchez-Sepúlveda F, Peñailillo-Diaz C, van Kessel R, Czabanowska K, Roman-Urrestarazu A. Testing an online screening for autism in the COVID-19 pandemic: a psychometric study of the Q-CHAT-24 in Chilean toddlers. Front Psychiatry 2024; 15:1363976. [PMID: 38952633 PMCID: PMC11215167 DOI: 10.3389/fpsyt.2024.1363976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
Background The aim of this study was to examine some psychometric characteristics of the Chilean-adapted version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT-24) (24) in a group of unselected children (community sample). This version was administered remotely through an online version during the pandemic period to caregivers of children, aged 18-24 months, registered in four primary care polyclinics of the Health Service Araucanía Sur, Chile. Methods An intentional non-probabilistic sampling was used. Three hundred and thirteen toddlers were examined. Participants completed an online version of the Q-CHAT-24 which was disseminated through the REDCap platform. Evidence of reliability through internal consistency and evidence of predictive validity through ROC curve analysis were realized. Results The mean age of the children evaluated was 21.16 months. The Shapiro-Wilk test revealed that Q-CHAT-24 scores was normally distributed. 71 cases (23.12%) scored 38 points or more on the Q-CHAT-24, qualifying as Autistic Risk. 48 cases (15.63%) were confirmed as autistic through the ADOS-2 Module T. All items were positively correlated with Q-CHAT-24 total score. All items were positively correlated with Q-CHAT-24 total score. Internal consistency was acceptable for the Q-CHAT-24 (Cronbach ´s α=0.78). The internal consistencies were analyzed for the Q-CHAT-24 Factors, and they were good for factor 1 "Communication and Social Interaction" (Cronbach ´s α=0.85) and acceptable for factor 2 "Restrictive and Repetitive Patterns" (Cronbach ´s α=0.74). Receiver operating characteristic (ROC) curve analyses were performed. The AUC values were 0.93 with statistical significance (p<0.01). For the cut-off point of 38, the Sensitivity, Specificity and Youden index values were 0.89, 0.8 and 0.7, respectively. The Positive Predictive Value (PPV) was 86% and the Negative Predictive Value (NPV) was 85%. Conclusions In accordance with the objectives of this study, evidence of reliability and predictive validity was demonstrated for the Q-CHAT-24 in this Chilean population. More importantly, this study provides Sensitivity and Specificity data for a remote application version of an autism screening tool already validated in Chile. The implications of this have to do with the possibility of establishing a remote assessment system for children at risk of autism on a population scale.
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Affiliation(s)
- Gabriel Gatica-Bahamonde
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Sección de Psiquiatría del Niño y del Adolescente, División de Neurociencias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Mental Health, Policy and Economics Group, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Tremün Lab, Corporación Tremün, Villarrica, Chile
| | - Alejandra Mendez-Fadol
- Tremün Lab, Corporación Tremün, Villarrica, Chile
- Departamento de Pediatría, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | | | | | - Robin van Kessel
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Mental Health, Policy and Economics Group, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Andres Roman-Urrestarazu
- Mental Health, Policy and Economics Group, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Tremün Lab, Corporación Tremün, Villarrica, Chile
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
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6
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Shuffrey LC, Rennie B, Li X, Galai N, Pini N, Akbaryan A, Alshawabkeh A, Aschner J, Vargas JC, Costello L, D'Sa V, Deoni S, Dunlop A, Elliott AJ, Fifer WP, Hash J, Koinis-Mitchell D, Lai JS, Leventhal BL, Lewis J, Lucchini M, McArthur KL, Morales S, Nozadi SS, O'Connor TG, O'Shea TM, Page GP, Propper C, Sania A, Shuster C, Zimmerman E, Margolis AE. Combining developmental and sleep health measures for autism spectrum disorder screening: an ECHO study. Pediatr Res 2024:10.1038/s41390-024-03306-0. [PMID: 38867029 DOI: 10.1038/s41390-024-03306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses. METHODS Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included. We performed logistic LASSO regression models with 10-fold cross-validation to identify whether a combination of items derived from the M-CHAT-R and BISQ are superior to the standard M-CHAT-R in predicting ASD diagnoses. RESULTS The final sample comprised 1552 children. The standard M-CHAT-R had a sensitivity of 44% (95% CI: 34, 55), specificity of 92% (95% CI: 91, 94), and AUROC of 0.726 (95% CI: 0.663, 0.790). A higher proportion of children with ASD had difficulty falling asleep or resisted bedtime during infancy/toddlerhood. However, LASSO models revealed parental reports of sleep problems did not improve the accuracy of the M-CHAT-R in predicting ASD diagnosis. CONCLUSION While children with ASD had higher rates of sleep problems during infancy/toddlerhood, there was no improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. IMPACT Parental-reported sleep problems are common in autism spectrum disorder (ASD). We investigated whether the inclusion of parental-reports of infant/toddler sleep patterns enhanced the effectiveness of developmental screening for autism. We reported higher rates of difficulty falling asleep and resisting bedtime during infancy and toddlerhood among children later diagnosed with ASD; however, we did not find an improvement in ASD developmental screening through the incorporation of parent-report sleep metrics. In our sample, the standard M-CHAT-R had a sensitivity of 39% among children of mothers with government insurance compared with a sensitivity of 53% among children of mothers with employer-based insurance.
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Affiliation(s)
- Lauren C Shuffrey
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA.
| | - Brandon Rennie
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Noya Galai
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Statistics, University of Haifa, Mt Carmel, Israel
| | - Nicolò Pini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Anahid Akbaryan
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | | | - Judy Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Julianna Collazo Vargas
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Lauren Costello
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Viren D'Sa
- Department of Pediatrics, Brown University, Providence, RI, USA
| | - Sean Deoni
- Maternal Newborn and Child Health: Discovery & Tools, The Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Anne Dunlop
- Department of Gynecology & Obstetrics, Emory University, Atlanta, Georgia
| | - Amy J Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, USA
| | - William P Fifer
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- Division of Developmental Neuroscience, New York State Psychiatric Institute, New York, NY, USA
| | - Jonica Hash
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - Daphne Koinis-Mitchell
- Departments of Pediatrics and Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bennett L Leventhal
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA
| | - Johnnye Lewis
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | - Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Kristen L McArthur
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Santiago Morales
- Departments of Psychology and Pediatrics, Developmental and Brain and Cognitive Science Areas, University of Southern California, Los Angeles, CA, USA
| | - Sara S Nozadi
- Community Environmental Health Program, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Thomas G O'Connor
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - T Michael O'Shea
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Grier P Page
- Analytics Program, RTI International, Research Triangle Park, NC, USA
| | - Cathi Propper
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Ayesha Sania
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Coral Shuster
- The Brown Center for the Study of Children at Risk, Woman & Infants Hospital of Rhode Island, Providence, RI, USA
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Chicago, IL, USA
| | - Amy E Margolis
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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7
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Adelson RP, Ciobanu M, Garikipati A, Castell NJ, Barnes G, Tawara K, Singh NP, Rumph J, Mao Q, Vaish A, Das R. Family-Centric Applied Behavior Analysis Promotes Sustained Treatment Utilization and Attainment of Patient Goals. Cureus 2024; 16:e62377. [PMID: 39011193 PMCID: PMC11247253 DOI: 10.7759/cureus.62377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND/OBJECTIVES Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication difficulties and restricted repetitive behaviors or interests. Applied behavior analysis (ABA) has been shown to significantly improve outcomes for individuals on the autism spectrum. However, challenges regarding access, cost, and provider shortages remain obstacles to treatment delivery. To this end, parents were trained as parent behavior technicians (pBTs), improving access to ABA, and empowering parents to provide ABA treatment in their own homes. We hypothesized that patients diagnosed with severe ASD would achieve the largest gains in overall success rates toward skill acquisition in comparison to patients diagnosed with mild or moderate ASD. Our secondary hypothesis was that patients with comprehensive treatment plans (>25-40 hours/week) would show greater gains in skill acquisition than those with focused treatment plans (less than or equal to 25 hours/week). Methods: This longitudinal, retrospective chart review evaluated data from 243 patients aged two to 18 years who received at least three months of ABA within our pBT treatment delivery model. Patients were stratified by utilization of prescribed ABA treatment, age, ASD severity (per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), and treatment plan type (comprehensive vs. focused). Patient outcomes were assessed by examining success rates in acquiring skills, both overall and in specific focus areas (communication, emotional regulation, executive functioning, and social skills). RESULTS Patients receiving treatment within the pBT model demonstrated significant progress in skill acquisition both overall and within specific focus areas, regardless of cohort stratification. Patients with severe ASD showed greater overall skill acquisition gains than those with mild or moderate ASD. In addition, patients with comprehensive treatment plans showed significantly greater gains than those with focused treatment plans. CONCLUSION The pBT model achieved both sustained levels of high treatment utilization and progress toward patient goals. Patients showed significant gains in success rates of skill acquisition both overall and in specific focus areas, regardless of their level of treatment utilization. This study reveals that our pBT model of ABA treatment delivery leads to consistent improvements in communication, emotional regulation, executive functioning, and social skills across patients on the autism spectrum, particularly for those with more severe symptoms and those following comprehensive treatment plans.
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Affiliation(s)
- Robert P Adelson
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Madalina Ciobanu
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Anurag Garikipati
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Natalie J Castell
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Gina Barnes
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Ken Tawara
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Navan P Singh
- Engineering, Montera, Inc. DBA Forta, San Francisco, USA
| | - Jodi Rumph
- Clinical Team, Montera, Inc. DBA Forta, San Francisco, USA
| | - Qingqing Mao
- Research and Development, Montera, Inc. DBA Forta, San Francisco, USA
| | - Anshu Vaish
- Clinical Team, Montera, Inc. DBA Forta, San Francisco, USA
| | - Ritankar Das
- Executive Leadership, Montera, Inc. DBA Forta, San Francisco, USA
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8
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Silver BB, Brooks A, Gerrish K, Tokar EJ. Isolation and Characterization of Cell-Free DNA from Cerebral Organoids. Int J Mol Sci 2024; 25:5522. [PMID: 38791569 PMCID: PMC11121789 DOI: 10.3390/ijms25105522] [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: 04/23/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Early detection of neurological conditions is critical for timely diagnosis and treatment. Identifying cellular-level changes is essential for implementing therapeutic interventions prior to symptomatic disease onset. However, monitoring brain tissue directly through biopsies is invasive and poses a high risk. Bodily fluids such as blood or cerebrospinal fluid contain information in many forms, including proteins and nucleic acids. In particular, cell-free DNA (cfDNA) has potential as a versatile neurological biomarker. Yet, our knowledge of cfDNA released by brain tissue and how cfDNA changes in response to deleterious events within the brain is incomplete. Mapping changes in cfDNA to specific cellular events is difficult in vivo, wherein many tissues contribute to circulating cfDNA. Organoids are tractable systems for examining specific changes consistently in a human background. However, few studies have investigated cfDNA released from organoids. Here, we examined cfDNA isolated from cerebral organoids. We found that cerebral organoids release quantities of cfDNA sufficient for downstream analysis with droplet-digital PCR and whole-genome sequencing. Further, gene ontology analysis of genes aligning with sequenced cfDNA fragments revealed associations with terms related to neurodevelopment and autism spectrum disorder. We conclude that cerebral organoids hold promise as tools for the discovery of cfDNA biomarkers related to neurodevelopmental and neurological disorders.
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Affiliation(s)
- Brian B. Silver
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC 27709, USA
- Molecular Genomics Core, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC 27709, USA;
| | - Ashley Brooks
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC 27709, USA;
| | - Kevin Gerrish
- Molecular Genomics Core, Division of Intramural Research, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC 27709, USA;
| | - Erik J. Tokar
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC 27709, USA
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9
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Braddock B, Turner K, Kumarason K, Bock L, Stumpe K, Wallace M, Heithaus J, Goretzke S, Portnoy S. Improving Access to Autism Evaluation: A Coordinated Developmental-Behavioral Pediatrics and Pediatric Neurology Diagnostic Pathway. MISSOURI MEDICINE 2024; 121:225-230. [PMID: 38854594 PMCID: PMC11160370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
A shortage of board-certified developmental-behavioral pediatricians generates a bottleneck for children and families who seek autism diagnostic services. Wait time for autism evaluation commonly exceeds a year. To improve access, clinicians developed a coordinated Developmental-Behavioral Pediatrics and Pediatric Neurology autism diagnostic pathway. For a subset of children referred to neurology clinic, pediatric neurologists completed the medical part of an autism evaluation and Knights of Columbus Developmental Center psychologists or speech-language pathologists completed developmental assessments. Forty-four autism diagnostic evaluations completed through this coordinated pathway over the course of six months had shortened wait time [mean=50.89 days; range 3 to 184 days; median= 48.50 day]. Parents reported satisfaction with the autism evaluation and resources navigation process. Sustainability and scalability efforts are discussed.
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Affiliation(s)
- Barbara Braddock
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Katharyn Turner
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Krithika Kumarason
- Division of Neurology (Pediatric Neurology Group), Department of Neurology, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Lynn Bock
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Kaitlyn Stumpe
- Division of Neurology (Pediatric Neurology Group), Department of Neurology, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Maxwell Wallace
- Division of Neurology (Pediatric Neurology Group), Department of Neurology, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Jennifer Heithaus
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Sean Goretzke
- Division of Neurology (Pediatric Neurology Group), Department of Neurology, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Shulamit Portnoy
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, Saint Louis University School of Medicine, St. Louis, Missouri
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10
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Miletic K, Servais M, Cardy JO, Denusik L. Do Caregiver Perceptions of the Virtual More Than Words® Program Differ Based on Autistic Children's Attributes? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1127-1141. [PMID: 38381120 DOI: 10.1044/2024_ajslp-23-00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
PURPOSE More Than Words® (MTW) is a caregiver-mediated intervention program led by a speech-language pathologist (SLP) who teaches caregivers strategies to support their autistic child's early social communication and play development. The program includes group sessions composed of multiple families with children of varying profiles. We explored whether caregiver experiences and perceived outcomes of the virtual MTW program differed depending on the child's age and social communication stage. METHOD As part of a program evaluation of virtual MTW delivered to over 2,000 families in Ontario, Canada, between 2020 and 2021, we randomly selected 31 families across four social communication stages and two age groups using stratified sampling (n = 4, in all but one subgroup). The Final Reflection and Evaluation form was analyzed both qualitatively and quantitatively, and a modified RE-AIM framework guided our analyses, including theme development. RESULTS Child attributes did not appear to impact caregivers' experiences, but perceived child skill improvements varied by children's social communication stage. The majority of caregivers reported changes in how they interact with their child. Four themes emerged: (a) perceived child skill improvements differed by social communication stage, (b) caregivers gained new knowledge and strategies regardless of child attributes, (c) SLPs effectively managed families' individual needs, and (d) program components were appropriate for a variety of families. CONCLUSIONS Findings suggest that the content taught in the MTW program was relevant for a variety of children, including those beyond the program's intended age of 5 years and under. Grouping families of children with varying profiles does not appear to negatively influence caregivers' experiences or perceived outcomes. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25237009.
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Affiliation(s)
| | - Michelle Servais
- University of Western Ontario, London, Canada
- Thames Valley Children's Centre, London, Ontario, Canada
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11
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Delehanty A, Lorio CM, Romano M, Brown JA, Woods JJ, Wetherby AM. Social Communication and Parent Verbal Responsiveness Across Interaction Contexts in Toddlers on the Autism Spectrum. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1266-1282. [PMID: 38407116 PMCID: PMC11081527 DOI: 10.1044/2024_ajslp-23-00319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/24/2023] [Accepted: 01/02/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE Interactions with caregivers during the ordinary activities that occur as families go about their everyday lives are critical to supporting children's acquisition of social communication and language skills. The purpose of this study was to examine child communication and parent verbal responsiveness across interaction contexts in 211 children (Mage = 20 months) on the autism spectrum (n = 121), with developmental delay (n = 46), or with typical development (n = 44). METHOD Families participated in up to eight activities during an hour-long, video-recorded home observation. We tested differences in the strength of associations between diagnostic group and interaction context using linear mixed-effects models, with child rate per minute of communication and proportions of parent follow-in comments and directives as outcome variables. Child communicative functions expressed across contexts were also examined. RESULTS Children across groups communicated at significantly higher rates per minute during book sharing and play with people compared to other interaction contexts. Most child communication was for the function of joint attention during book sharing, for social interaction during play with people, and for behavior regulation during necessary activities such as family chores and meals. On average, parents of children responded using proportionally more follow-in comments during book sharing and play compared to necessary activities, during which parents used more follow-in directives. CONCLUSION Results provide a glimpse into the dyadic communication that may occur within everyday activities at home, which supports the need for future intervention research and may aid clinicians seeking to identify activities that serve as important contexts for intervention.
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Affiliation(s)
- Abigail Delehanty
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Ciera M. Lorio
- Communication Sciences and Disorders, Illinois State University, Normal
| | - Mollie Romano
- School of Communication Science and Disorders, Florida State University, Tallahassee
| | - Jennifer A. Brown
- Mary Frances Early College of Education, University of Georgia, Athens
| | - Juliann J. Woods
- Emeritus Professor, School of Communication Science and Disorders, Florida State University, Tallahassee
| | - Amy M. Wetherby
- Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee
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12
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Pillay S, Duncan M, de Vries PJ. 'We wait and we wait'-caregiver perspectives on autism spectrum disorder services in the Western Cape Province of South Africa. Child Adolesc Ment Health 2024; 29:145-153. [PMID: 38533770 DOI: 10.1111/camh.12704] [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] [Accepted: 02/19/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION Caregivers of children with autism face significant challenges in navigating health, education and other systems of care to ensure appropriate services for their children. In South Africa, for example, many children with autism are reported to be out of schools and waiting long periods for specialist school placements thus adding to the burden of care for caregivers and raising many questions about equity, diversity and inclusion. METHODS Here we performed a qualitative study using focus groups to collect data on the perspectives of caregivers of children with autism waiting for school placement in the Western Cape Province of South Africa. We asked families about their experiences of current autism services and for suggestions to improve service delivery. RESULTS The main theme that emerged was 'We wait and we wait'. Caregivers expressed high levels of frustration with existing autism educational and other services. Perspectives about services were captured under three categories. The first category, 'The costs of waiting' describes the socioemotional, financial and time costs associated with having a child with autism wait for educational services. The second category 'Barriers while waiting' describes the attitudinal, structural, process and communication barriers experienced by caregivers while seeking services for their children. The final category 'Expecting action' describes attitudinal, service and policy expectations that caregivers felt could improve service delivery. Caregivers provided 10 recommendations for autism service improvements. CONCLUSION Caregivers of children with autism waiting for educational services in the Western Cape Province of South Africa expressed dissatisfaction with existing services. Efforts to find solutions to providing services and support to children with autism waiting for educational services and their caregivers should be prioritized.
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Affiliation(s)
- Sarosha Pillay
- Department of Health and Rehabilitation Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Madeleine Duncan
- Department of Health and Rehabilitation Sciences, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
| | - Petrus J de Vries
- Centre for Autism Research in Africa, Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
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Ben-Sasson A, Guedalia J, Nativ L, Ilan K, Shaham M, Gabis LV. A Prediction Model of Autism Spectrum Diagnosis from Well-Baby Electronic Data Using Machine Learning. CHILDREN (BASEL, SWITZERLAND) 2024; 11:429. [PMID: 38671647 PMCID: PMC11049145 DOI: 10.3390/children11040429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Early detection of autism spectrum disorder (ASD) is crucial for timely intervention, yet diagnosis typically occurs after age three. This study aimed to develop a machine learning model to predict ASD diagnosis using infants' electronic health records obtained through a national screening program and evaluate its accuracy. A retrospective cohort study analyzed health records of 780,610 children, including 1163 with ASD diagnoses. Data encompassed birth parameters, growth metrics, developmental milestones, and familial and post-natal variables from routine wellness visits within the first two years. Using a gradient boosting model with 3-fold cross-validation, 100 parameters predicted ASD diagnosis with an average area under the ROC curve of 0.86 (SD < 0.002). Feature importance was quantified using the Shapley Additive explanation tool. The model identified a high-risk group with a 4.3-fold higher ASD incidence (0.006) compared to the cohort (0.001). Key predictors included failing six milestones in language, social, and fine motor domains during the second year, male gender, parental developmental concerns, non-nursing, older maternal age, lower gestational age, and atypical growth percentiles. Machine learning algorithms capitalizing on preventative care electronic health records can facilitate ASD screening considering complex relations between familial and birth factors, post-natal growth, developmental parameters, and parent concern.
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Affiliation(s)
- Ayelet Ben-Sasson
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Joshua Guedalia
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Liat Nativ
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Keren Ilan
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Meirav Shaham
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel (L.N.)
| | - Lidia V. Gabis
- Maccabi Healthcare Services, Tel-Aviv 6812509, Israel;
- Pediatrics, Faculty of Medicine and Health Sciences, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Keshet Autism Center Maccabi Wolfson, Holon 5822007, Israel
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Anixt JS, Ehrhardt J, Duncan A. Evidence-Based Interventions in Autism. Pediatr Clin North Am 2024; 71:199-221. [PMID: 38423716 DOI: 10.1016/j.pcl.2024.01.001] [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
Pediatricians have a critically important role in the care of children with autism, including conducting developmental screening to support early diagnosis and intervention, advising families about evidence-based treatments for autism spectrum disorder, and supporting families' emotional health as they care for a child with a developmental disability. The purpose of this article is to provide pediatricians with information about evidence-based autism treatments and how to determine which interventions are appropriate for children across the autism spectrum at different ages and developmental stages.
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Affiliation(s)
- Julia S Anixt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA.
| | - Jennifer Ehrhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
| | - Amie Duncan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
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Aishworiya R, Valica T, Hagerman R, Restrepo B. An Update on Psychopharmacological Treatment of Autism Spectrum Disorder. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2024; 22:198-211. [PMID: 38680976 PMCID: PMC11046717 DOI: 10.1176/appi.focus.24022006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
While behavioral interventions remain the mainstay of treatment of autism spectrum disorder (ASD), several potential targeted treatments addressing the underlying neurophysiology of ASD have emerged in the last few years. These are promising for the potential to, in future, become part of the mainstay treatment in addressing the core symptoms of ASD. Although it is likely that the development of future targeted treatments will be influenced by the underlying heterogeneity in etiology, associated genetic mechanisms influencing ASD are likely to be the first targets of treatments and even gene therapy in the future for ASD. In this article, we provide a review of current psychopharmacological treatment in ASD including those used to address common comorbidities of the condition and upcoming new targeted approaches in autism management. Medications including metformin, arbaclofen, cannabidiol, oxytocin, bumetanide, lovastatin, trofinetide, and dietary supplements including sulforophane and N-acetylcysteine are discussed. Commonly used medications to address the comorbidities associated with ASD including atypical antipsychotics, serotoninergic agents, alpha-2 agonists, and stimulant medications are also reviewed. Targeted treatments in Fragile X syndrome (FXS), the most common genetic disorder leading to ASD, provide a model for new treatments that may be helpful for other forms of ASD. Appeared originally in Neurotherapeutics 2022; 19:248-262.
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Affiliation(s)
- Ramkumar Aishworiya
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA (Aishworiya, Valica, Hagerman, Restrepo); Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore (Aishworiya); Association for Children With Autism, Chisinau, Moldova (Valica); Department of Pediatrics, University of California Davis School of Medicine, 4610 X St, Sacramento, CA 95817, USA (Hagerman, Restrepo)
| | - Tatiana Valica
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA (Aishworiya, Valica, Hagerman, Restrepo); Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore (Aishworiya); Association for Children With Autism, Chisinau, Moldova (Valica); Department of Pediatrics, University of California Davis School of Medicine, 4610 X St, Sacramento, CA 95817, USA (Hagerman, Restrepo)
| | - Randi Hagerman
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA (Aishworiya, Valica, Hagerman, Restrepo); Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore (Aishworiya); Association for Children With Autism, Chisinau, Moldova (Valica); Department of Pediatrics, University of California Davis School of Medicine, 4610 X St, Sacramento, CA 95817, USA (Hagerman, Restrepo)
| | - Bibiana Restrepo
- Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California Davis, 2825 50th Street, Sacramento, CA 95817, USA (Aishworiya, Valica, Hagerman, Restrepo); Khoo Teck Puat-National University Children's Medical Institute, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 119228, Singapore (Aishworiya); Association for Children With Autism, Chisinau, Moldova (Valica); Department of Pediatrics, University of California Davis School of Medicine, 4610 X St, Sacramento, CA 95817, USA (Hagerman, Restrepo)
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16
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Cappe E, Despax J, Pedoux A, Zylberberg P, Chaste P, De Gaulmyn A, Doyen C, Pommepuy N. Parental involvement and adjustment during the diagnostic evaluation of autism spectrum disorder at two diagnostic centers. L'ENCEPHALE 2024:S0013-7006(24)00046-0. [PMID: 38523027 DOI: 10.1016/j.encep.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVES The primary objective of this study was to determine the effects of permanent, mediated parental presence during all autism spectrum disorder diagnostic evaluations on parental adjustment (perceived parental stress and sense of parental competence) compared with procedures that traditionally only involve parents in pivotal periods of the diagnosis. The level of satisfaction with the diagnostic procedure and parents' needs were also evaluated to complete this first objective. The secondary objective was to assess the effects of psychosocial, individual, and contextual variables on perceived parental stress and sense of parental competence. METHODS The total sample of 49 parents was divided (using simple randomization) into two subgroups, each for a different procedure. Participants were met with once before the first consultation and once after. They completed self-reported questionnaires on parental stress, sense of parental competence, satisfaction with the procedure, social support, locus of control, and appraisal of life events. Statistical analysis was conducted using SPAD and SPSS software. RESULTS There was no difference between the two groups in the variables assessed. Satisfaction with the diagnostic procedure was high in both groups, but parents highlighted that they had important needs following the diagnosis. The child's level of autonomy, the presence of disruptive behaviors, and satisfaction with social support were found to be important for determining parental adjustment. CONCLUSIONS Several hypotheses may explain the lack of differences between the two groups, including that parents may not yet have been in a position to benefit from the procedure aimed at integrating them. Our suggestion is that professional interventions should focus on improving the child's autonomy and helping the parent to develop a satisfactory support network. Finally, parents' needs for the post-diagnosis phase should be given greater consideration, particularly in future research.
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Affiliation(s)
- Emilie Cappe
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, 92100 Boulogne-Billancourt, France; Institut universitaire de France (IUF), Paris, France.
| | - Johanna Despax
- Université Paris Cité, Laboratoire de Psychopathologie et Processus de Santé, 92100 Boulogne-Billancourt, France
| | - Amandine Pedoux
- Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, AP-HP, Paris University, Paris, France
| | - Pascale Zylberberg
- Unité de psychiatrie pédiatrique, Assistance publique-Hôpitaux de Paris (AP-HP), hôpital Necker-Enfants Malades, 75015 Paris, France
| | - Pauline Chaste
- Service de psychiatrie de l'enfant et de l'adolescent, AP-HP, hôpital universitaire Necker-Enfants Malades, 75015 Paris, France
| | - Aude De Gaulmyn
- CREDAT, centre de recherche de d'évaluation des troubles du neurodéveloppement, GHU Paris psychiatrie et neurosciences, 75014 Paris, France
| | - Catherine Doyen
- CREDAT, centre de recherche de d'évaluation des troubles du neurodéveloppement, GHU Paris psychiatrie et neurosciences, 75014 Paris, France
| | - Noël Pommepuy
- Pôle de psychiatrie de l'enfant et de l'adolescent 93I05, EPS Ville-Evrard, 93330 Neuilly-sur-Marne, France
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Smith JV, Menezes M, Brunt S, Pappagianopoulos J, Sadikova E, O Mazurek M. Understanding autism diagnosis in primary care: Rates of diagnosis from 2004 to 2019 and child age at diagnosis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241236112. [PMID: 38456360 DOI: 10.1177/13623613241236112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
LAY ABSTRACT The current demand for autism diagnostic services exceeds the ability of the workforce to assess and diagnose children in a timely manner. One solution may be to equip primary care providers (PCPs) with the tools and expertise needed to diagnose autism within their practice. PCPs are often trusted professionals who have many touchpoints with children during early development, in which they can identify early signs of autism. Recent initiatives have focused on bolstering PCPs' diagnostic capabilities; however, no studies have examined how the rates of autism diagnosis in primary care have changed over time. We aimed to evaluate whether autism diagnosis in primary care has changed over time and how diagnosis in primary care relates to a child's age at the time of diagnosis. We found that the likelihood of a child being diagnosed by a PCP decreased by about 2% with every passing year from 2004 to 2019 when accounting for demographic characteristics. In our sample, PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychologists and psychiatrists). Further research is needed to understand why the proportion of children diagnosed by PCPs decreases over time. However, this decrease suggests more work is needed to get capacity-building initiatives into community primary care practice. Though we must continue to find effective ways to build community PCPs' ability to diagnose autism, the present findings support the crucial role PCPs can play in early autism diagnosis.
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Affiliation(s)
- Jessica V Smith
- Department of Human Services, School of Education and Human Development, University of Virginia, USA
| | - Michelle Menezes
- Department of Human Services, School of Education and Human Development, University of Virginia, USA
| | - Sophie Brunt
- Department of Human Services, School of Education and Human Development, University of Virginia, USA
| | - Jessica Pappagianopoulos
- Department of Human Services, School of Education and Human Development, University of Virginia, USA
| | - Eleonora Sadikova
- Department of Human Services, School of Education and Human Development, University of Virginia, USA
| | - Micah O Mazurek
- Department of Human Services, School of Education and Human Development, University of Virginia, USA
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18
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Williams TI, Loucas T, Sin J, Jeremic M, Meyer S, Boseley S, Fincham-Majumdar S, Aslett G, Renshaw R, Liu F. Using music to assist language learning in autistic children with minimal verbal language: The MAP feasibility RCT. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613241233804. [PMID: 38433533 DOI: 10.1177/13623613241233804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
LAY ABSTRACT Research has shown that autistic individuals often have unusually good musical skills and that combining words and music helps autistic individuals to focus on spoken words. This study tests the idea that music will help with early language learning of preschool autistic children. The results show that when caregivers sing words to autistic children, the children pay more attention to the caregiver than when the words are spoken and that they learn word combinations more easily.
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Haine-Schlagel R, Corsello C, Caplan B, Gould H, Brookman-Frazee L. Setting Families Up for Success: A Pilot Study of a Toolkit to Enhance the Autism Spectrum Disorder Diagnostic Evaluation Process. J Autism Dev Disord 2024; 54:1221-1230. [PMID: 35665870 DOI: 10.1007/s10803-022-05601-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2022] [Indexed: 11/25/2022]
Abstract
Families of children with autism spectrum disorder (ASD) face challenges engaging in services following diagnosis. This study: (1) developed and implemented a toolkit to tailor ASD evaluation feedback to families' needs, and (2) evaluated caregiver and provider perceptions of the toolkit. Focus groups with providers (N = 11) informed toolkit development. Seven providers participated in pilot training and implementation. Provider and caregiver toolkit perceptions were assessed using interviews, surveys, and a fidelity checklist. Toolkit strategies reflect focus group themes. Provider and caregiver ratings suggest the initial feasibility, acceptability, and utility of the toolkit. This toolkit may be feasible to implement in community settings and may increase caregiver satisfaction, though further refinements are needed to support service connection.
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Affiliation(s)
- Rachel Haine-Schlagel
- Department of Child and Family Development, San Diego State University, San Diego, USA.
- Child and Adolescent Services Research Center (CASRC), San Diego, USA.
| | - Christina Corsello
- UNC Department of Psychiatry, The TEACCH Program, UNC-Chapel Hill, Chapel Hill, USA
| | - Barbara Caplan
- Child and Adolescent Services Research Center (CASRC), San Diego, USA
- Department of Psychiatry, UC San Diego, San Diego, USA
| | - Hilary Gould
- Department of Psychiatry, UC San Diego, San Diego, USA
| | - Lauren Brookman-Frazee
- Child and Adolescent Services Research Center (CASRC), San Diego, USA
- Department of Psychiatry, UC San Diego, San Diego, USA
- Rady Children's Hospital-San Diego Autism Discovery Institute, San Diego, USA
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20
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Li J, Kong X, Sun L, Chen X, Ouyang G, Li X, Chen S. Identification of autism spectrum disorder based on electroencephalography: A systematic review. Comput Biol Med 2024; 170:108075. [PMID: 38301514 DOI: 10.1016/j.compbiomed.2024.108075] [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: 09/30/2023] [Revised: 12/22/2023] [Accepted: 01/27/2024] [Indexed: 02/03/2024]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social communication and repetitive and stereotyped behaviors. According to the World Health Organization, about 1 in 100 children worldwide has autism. With the global prevalence of ASD, timely and accurate diagnosis has been essential in enhancing the intervention effectiveness for ASD children. Traditional ASD diagnostic methods rely on clinical observations and behavioral assessment, with the disadvantages of time-consuming and lack of objective biological indicators. Therefore, automated diagnostic methods based on machine learning and deep learning technologies have emerged and become significant since they can achieve more objective, efficient, and accurate ASD diagnosis. Electroencephalography (EEG) is an electrophysiological monitoring method that records changes in brain spontaneous potential activity, which is of great significance for identifying ASD children. By analyzing EEG data, it is possible to detect abnormal synchronous neuronal activity of ASD children. This paper gives a comprehensive review of the EEG-based ASD identification using traditional machine learning methods and deep learning approaches, including their merits and potential pitfalls. Additionally, it highlights the challenges and the opportunities ahead in search of more effective and efficient methods to automatically diagnose autism based on EEG signals, which aims to facilitate automated ASD identification.
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Affiliation(s)
- Jing Li
- School of Computer Science and Engineering, Tianjin University of Technology, Tianjin, 300384, China
| | - Xiaoli Kong
- School of Computer Science and Engineering, Tianjin University of Technology, Tianjin, 300384, China
| | - Linlin Sun
- Neuroscience Research Institute, Peking University, Beijing, 100191, China; Key Laboratory for Neuroscience, Ministry of Education/National Health Commission of China, Beijing, 100191, China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Beijing, 100120, China; The Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100032, China
| | - Gaoxiang Ouyang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
| | - Shengyong Chen
- School of Computer Science and Engineering, Tianjin University of Technology, Tianjin, 300384, China
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Alshaban FA, Ghazal I, Al-Harahsheh ST, Lotfy M, Al-Shammari H, Al-Faraj F, Thompson IR, Ratto AB, Nasir A, Tolefat M. Effects of COVID-19 on Autism Spectrum Disorder in Qatar. Front Psychiatry 2024; 15:1322011. [PMID: 38445086 PMCID: PMC10913057 DOI: 10.3389/fpsyt.2024.1322011] [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: 10/15/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction The unprecedented impact of the coronavirus pandemic (COVID-19) has had profound implications on the ASD community, including disrupting daily life, increasing stress and emotional dysregulation in autistic children, and worsening individual and family well-being. Methods This study used quantitative and qualitative survey data from parents in Qatar (n=271), to understand the impact of the COVID-19 pandemic on autistic children and their families in Qatar. The questionnaire was a combination of open-ended (qualitative) and closed-ended (quantitative) questions to explore patterns in the experiences of the different families, as well as to contrive themes. The survey was created in a way to evaluate the psychological, academic/intervention, economic, and other impacts of the pandemic related measures on a sample of multicultural families residing in the State of Qatar during the peak period of confinement and physical distancing in 2020. Data acquisition involved the utilization of Google Forms. Subsequent quantitative analysis employed the SPSS software and chi-square analysis for numerical examination, enabling the characterization of the studied population and exploration of associations between parental stress levels and variables such as employment status, therapy accessibility, presence of hired assistance, and alterations in their childs skills. Concurrently, qualitative data from written responses underwent thorough categorization, encompassing themes such as emotional isolation, mental or financial challenges, and difficulties in obtaining support. Results Parents expressed distress and disturbance in their daily lives, including profound disruptions to their childrens access to treatment, education, and activities. Most parents reported deteriorations in their childrens sleep (69.4%), behavioral regulation (52.8%), and acquired skills across multiple domains (54.2%). Parents also reported decreased access to family and social support networks, as well as decreased quality of clinical and community support. Qualitative analysis of parental responses revealed that child developmental regression was an important source of parental stress. Discussion and conclusion The greater impact of the pandemic on autistic children and their families emphasizes the need for accessible and affordable health, education, and family services to manage their special needs.
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Affiliation(s)
- Fouad A. Alshaban
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Iman Ghazal
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | | | - Mustafa Lotfy
- Community Outreach, Qatar Autism Family Association, Doha, Qatar
| | - Hawraa Al-Shammari
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - Fatema Al-Faraj
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - I. Richard Thompson
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - Allison B. Ratto
- Center for Autism Spectrum Disorders, Childrens National Health System, Rockville, MD, United States
| | - Assal Nasir
- Department of Biological Sciences, Drexel University, Philadelphia, PA, United States
| | - Mohamed Tolefat
- Autism Department, Shafallah Center for Children with Disabilities, Doha, Qatar
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Ou J, Dong H, Dai S, Hou Y, Wang Y, Lu X, Xun G, Xia K, Zhao J, Shen Y. Development and validation of a risk score model for predicting autism based on pre- and perinatal factors. Front Psychiatry 2024; 15:1291356. [PMID: 38435974 PMCID: PMC10904522 DOI: 10.3389/fpsyt.2024.1291356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
Background The use of pre- and perinatal risk factors as predictive factors may lower the age limit for reliable autism prediction. The objective of this study was to develop a clinical model based on these risk factors to predict autism. Methods A stepwise logistic regression analysis was conducted to explore the relationships between 28 candidate risk factors and autism risk among 615 Han Chinese children with autism and 615 unrelated typically developing children. The significant factors were subsequently used to create a clinical risk score model. A chi-square automatic interaction detector (CHAID) decision tree was used to validate the selected predictors included in the model. The predictive performance of the model was evaluated by an independent cohort. Results Five factors (pregnancy influenza-like illness, pregnancy stressors, maternal allergic/autoimmune disease, cesarean section, and hypoxia) were found to be significantly associated with autism risk. A receiver operating characteristic (ROC) curve indicated that the risk score model had good discrimination ability for autism, with an area under the curve (AUC) of 0.711 (95% CI=0.679-0.744); in the external validation cohort, the model showed slightly worse but overall similar predictive performance. Further subgroup analysis indicated that a higher risk score was associated with more behavioral problems. The risk score also exhibited robustness in a subgroup analysis of patients with mild autism. Conclusion This risk score model could lower the age limit for autism prediction with good discrimination performance, and it has unique advantages in clinical application.
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Affiliation(s)
- Jianjun Ou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Huixi Dong
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Si Dai
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yanting Hou
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ying Wang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiaozi Lu
- Qingdao Mental Health Center, Qingdao, Shandong, China
| | - Guanglei Xun
- Shandong Mental Health Center, Jinan, Shandong, China
| | - Kun Xia
- Center for Medical Genetics and School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Jingping Zhao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yidong Shen
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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23
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Rouhandeh AA, Honsberger C, Shanok NA, Lozott EB, Levy T, Kolevzon A, Buxbaum JD, Sotelo M, Foss-Feig J, Siper PM. Brief Report: Assessment of a Caregiver-Implemented Intervention for Improving Social Communication Skills in Toddlers and Young Children with Autism. J Autism Dev Disord 2024; 54:794-802. [PMID: 35616818 PMCID: PMC9134715 DOI: 10.1007/s10803-022-05587-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 10/25/2022]
Abstract
As early identification of autism improves, there is a critical need for interventions to support the development of social communication skills in toddlers. Caregiver coaching and parental involvement is crucial for improving outcomes and providing children with adequate hours of planned active engagement. This pilot study assessed a 4-week intervention for individual caregiver-child dyads. Eight toddlers 21- to 45-months of age participated. Standardized assessments were collected at four study visits to assess autism symptomatology, language development, and both caregiver knowledge and engagement. Results demonstrated the feasibility of the intervention. Social communication, receptive and expressive language all improved as measured by direct assessment. Caregiver knowledge and caregivers' subjective feelings of engagement with their toddlers also improved.
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Affiliation(s)
- Audrey A Rouhandeh
- Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | | | | | | | - Tess Levy
- Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | | | - Jennifer Foss-Feig
- Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Paige M Siper
- Seaver Autism Center for Research and Treatment at Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA.
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24
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Klaiman C, White S, Richardson S, McQueen E, Walum H, Aoki C, Smith C, Minjarez M, Bernier R, Pedapati E, Bishop S, Ence W, Wainer A, Moriuchi J, Tay SW, Deng Y, Jones W, Gillespie S, Klin A. Expert Clinician Certainty in Diagnosing Autism Spectrum Disorder in 16-30-Month-Olds: A Multi-site Trial Secondary Analysis. J Autism Dev Disord 2024; 54:393-408. [PMID: 36396807 PMCID: PMC9672659 DOI: 10.1007/s10803-022-05812-8] [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: 10/30/2022] [Indexed: 11/18/2022]
Abstract
Differential diagnosis of young children with suspected autism spectrum disorder (ASD) is challenging, and clinician uncertainty about a child's diagnosis may contribute to misdiagnosis and subsequent delays in access to early treatment. The current study was designed to replicate and expand a recent report in this Journal (McDonnell et al. in J Autism Dev Disord 49:1391-1401, https://doi.org/10.1080/15374416.2020.1823850 , 2019), in which only 60% of diagnoses were made with complete certainty by clinicians evaluating 478 toddlers and preschool children referred for possible ASD to specialized clinics. In this study, secondary analyses were performed on diagnostic, demographic and clinical data for 496 16-30-month-old children who were consecutive referrals to a 6-site clinical trial executed by specialized centers with experienced clinicians following best-practice procedures for the diagnosis of ASD. Overall, 70.2% of diagnoses were made with complete certainty. The most important factor associated with clinician uncertainty was mid-level autism-related symptomatology. Mid-level verbal age equivalents were also associated with clinician uncertainty, but measures of symptomatology were stronger predictors. None of the socio-demographic variables, including sex of the child, was significantly associated with clinician certainty. Close to one third of early diagnoses of ASD are made with a degree of uncertainty. The delineation of specific ranges on the ADOS-2 most likely to result in clinician uncertainty identified in this study may provide an opportunity to reduce random subjectivity in diagnostic decision-making via calibration of young-child diagnostic thresholds based on later-age longitudinal diagnostic outcome data, and via standardization of decision-making in regard to clinical scenarios frequently encountered by clinicians.
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Affiliation(s)
- Cheryl Klaiman
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Stormi White
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Shana Richardson
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Emma McQueen
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Hasse Walum
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Christa Aoki
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | - Mendy Minjarez
- Seattle Children's Hospital & Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Raphael Bernier
- Seattle Children's Hospital & Department of Psychiatry, University of Washington, Seattle, WA, USA
| | - Ernest Pedapati
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Somer Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - Whitney Ence
- University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | - Warren Jones
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Center for Translational Social Neuroscience, Emory University, 954 Gatewood Road, Atlanta, GA, USA
| | - Scott Gillespie
- Pediatric Biostatistics Core, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Ami Klin
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
- Division of Autism & Related Disorders, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
- Center for Translational Social Neuroscience, Emory University, 954 Gatewood Road, Atlanta, GA, USA.
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25
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So WC, Wong E, Ng W, Fuego J, Lay S, So MT, Lee YY, Chan WY, Chua LY, Lam HL, Lam WT, Li HM, Leung WT, Ng YH, Wong WT. Seeing through a robot's eyes: A cross-sectional exploratory study in developing a robotic screening technology for autism. Autism Res 2024; 17:366-380. [PMID: 38183409 DOI: 10.1002/aur.3087] [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: 04/27/2023] [Accepted: 12/09/2023] [Indexed: 01/08/2024]
Abstract
The present exploratory cross-sectional case-control study sought to develop a reliable and scalable screening tool for autism using a social robot. The robot HUMANE, installed with computer vision and linked with recognition technology, detected the direction of eye gaze of children. Children aged 3-8 (M = 5.52; N = 199) participated, 87 of whom had been confirmed with autism, 55 of whom were suspected to have autism, and 57 of whom were not considered to cause any concern for having autism. Before a session, a human experimenter instructed HUMANE to narrate a story to a child. HUMANE prompted the child to return his/her eye gaze to the robot if the child looked away, and praised the child when it re-established its eye gaze quickly after a prompt. The reliability of eye gaze detection was checked across all pairs of human raters and HUMANE and reached 0.90, indicating excellent interrater agreement. Using the pre-specified reference standard (Autism Spectrum Quotient), the sensitivity and specificity of the index tests (i.e., the number of robot prompts and duration of inattentiveness) reached 0.88 or above and the Diagnostic Odds Ratios were beyond 190. These results show that social robots may detect atypical eye patterns, suggesting a potential future for screening autism using social robots.
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Affiliation(s)
- Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Elsa Wong
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - Wingo Ng
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - John Fuego
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - Sally Lay
- NEC Hong Kong Limited, Hung Hom, Hong Kong
| | - Ming-Ting So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yuen-Yung Lee
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wai-Yan Chan
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lok-Ying Chua
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hiu-Lok Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-Tung Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hin-Miu Li
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-To Leung
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yu-Hei Ng
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wing-Ting Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
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26
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Dinstein I, Solomon S, Zats M, Shusel R, Lottner R, Gershon BB, Meiri G, Menashe I, Shmueli D. Large increase in ASD prevalence in Israel between 2017 and 2021. Autism Res 2024; 17:410-418. [PMID: 38193609 DOI: 10.1002/aur.3085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/09/2023] [Indexed: 01/10/2024]
Abstract
Accurate estimation of annual changes in autism spectrum disorders (ASD) prevalence is critical for planning the expansion of diagnostic, education, and intervention services at an adequate rate. Previous studies from Israel have reported that ASD prevalence among 8-year-old children has increased from estimates of 0.3% in 2008 to 0.65% in 2015 and 1.3% in 2018. Here, we analyzed data acquired from the National Insurance Institute of Israeli (NII), a governmental organization that approves and monitors all ASD children who receive welfare services in Israel, and Clalit Health Services (CHS), the largest Health Maintenance Organization in Israel that provides health services to ~52% of the population. Data from both sources included annual data files from 2017 to 2021 containing the number of ASD cases per year of birth for 1-17-year-old children. This allowed us to estimate annual ASD prevalence among 3.5 million children born between 2000 and 2020 in Israel. Both data sources revealed a nearly two-fold increase in ASD prevalence among 1-17-year-old children from 2017 to 2021. Estimated prevalence rates differed across age groups with 2-3-year-old (day-care) children increasing from 0.27% to 1.19% (>4 fold change), 4-6-year-old (pre-school) children increasing from 0.8% to 1.83%, and 8-year-old children increasing from 0.82% to 1.56% in NII data. These results demonstrate that autism prevalence continues to increase in Israel with a shift towards diagnosis at earlier ages. These findings highlight the challenge facing health and education service providers in meeting the needs of a rapidly growing autism population.
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Affiliation(s)
- Ilan Dinstein
- Psychology Department, Ben Gurion University of the Negev, Beer Sheva, Israel
- Cognitive and Brain Sciences Department, Ben Gurion University of the Negev, Beer Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Shirley Solomon
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Zats
- ALUT, The National Society for Children and Adults with Autism, Tel Aviv, Israel
| | - Ronit Shusel
- ALUT, The National Society for Children and Adults with Autism, Tel Aviv, Israel
| | | | | | - Gal Meiri
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Child and Adolescent Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Idan Menashe
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Dorit Shmueli
- Child Development Services, Clalit Healthcare, Tel Aviv, Israel
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27
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Hai Y, Kou W, Gu Z, Zhang C, Zou Q, Wang F, Yao H, Wei P. Obstructive sleep apnea affects the psychological and behavioural development of children-a case-control study. J Sleep Res 2024; 33:e13924. [PMID: 37194421 DOI: 10.1111/jsr.13924] [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: 12/07/2022] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 05/18/2023]
Abstract
This study aims to investigate the effects of obstructive sleep apnea on paediatric psychological and behavioural abnormalities. A total of 1086 paediatric patients with obstructive sleep apnea and 728 sample snoring controls were enrolled in the study. Patients with obstructive sleep apnea underwent bilateral tonsillectomy plus adenoidectomy or adenoidectomy alone. Repeated Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory were performed to assess the autism symptoms, anxiety level and depressive symptoms before and after surgery. The score of Autism Behaviour Checklist in preschool children with obstructive sleep apnea was higher than that in control. In school children with obstructive sleep apnea, the score of Spence Children's Anxiety Scale was also higher. School children with obstructive sleep apnea with depressive symptoms were significantly higher than that in control. The scores of Autism Behaviour Checklist, Spence Children's Anxiety Scale, and Children's Depression Inventory in the obstructive sleep apnea group after surgery were significantly lower than that before surgery. Our study showed that the score of Spence Children's Anxiety Scale and Children's Depression Inventory had a close correlation with the illness course and hypoxia duration. The Spence Children's Anxiety Scale and Children's Depression Inventory scores are also closely associated with the Autism Behaviour Checklist score. These results suggest that obstructive sleep apnea may have a significant impact on autism symptoms, anxiety levels and depressive symptoms in children. We found that the longer the duration of the obstructive sleep apnea course and hypoxia, the greater the impact on anxiety level and depressive symptoms. The suspected autism symptoms, anxiety level and depressive symptoms in children with obstructive sleep apnea were also significantly correlated. Thus, early detection and timely treatment may often reverse the psychological and behavioural abnormalities caused by obstructive sleep apnea.
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Affiliation(s)
- Yang Hai
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
- Department of Otolaryngology, Chongqing Youyou Baobei Women and Children's Hospital, Chongqing, China
| | - Wei Kou
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Zheng Gu
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Cheng Zhang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Qiyuan Zou
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Fan Wang
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
| | - Ping Wei
- Department of Otolaryngology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing, China
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28
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SEZEROL MA, DAVUN S. Autism spectrum disorder: evaluation of community-based screening program. Turk J Med Sci 2024; 54:555-562. [PMID: 39049996 PMCID: PMC11265902 DOI: 10.55730/1300-0144.5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 06/12/2024] [Accepted: 01/24/2024] [Indexed: 07/27/2024] Open
Abstract
Background/aim This study was conducted to evaluate the results of autism spectrum disorder (ASD) screenings conducted in a region of İstanbul between 2018 and 2023. Materials and methods This descriptive study was conducted between April 2018 and February 2023 among 25,839 children aged between 18-36 months who had been screened for autism spectrum disorder in Sultanbeyli, İstanbul. Children between 18-36 months are examined and a form consisting of 5 questions and typical symptoms of ASD is filled. Each question is answered as yes or no. Answering yes to at least one of the questions is sufficient to direct them to child psychiatry. Results Between 2018 and 2023, a total of 25,839 children were screened for autism spectrum disorders, 1449 children were found to be at risk, and 88 were diagnosed with autism spectrum disorder. According to the sex distribution of the children, the male:female ratio is 3.6:1. The 5-year prevalence was found to be 0.9%. With the effect of the pandemic between 2020 and 2021, screening rates have decreased and the number of diagnoses has decreased. The most common symptom among those diagnosed is delay in speaking, and the second is inability to make eye contact. Conclusion Autism spectrum disorder is a developmental disorder whose prevalence is increasing globally and for which early diagnosis is important. To recognize this disease, it is necessary to increase screening and raise awareness among families. This study will also shed light on future studies on this subject.
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Affiliation(s)
- Mehmet Akif SEZEROL
- Epidemiology Program, Institute of Health Sciences, İstanbul Medipol University, İstanbul,
Turkiye
- Department of Public Health, School of Medicine, İstanbul Medipol University, İstanbul,
Turkiye
- Sultanbeyli District Health Directorate, İstanbul,
Turkiye
| | - Selin DAVUN
- Sultanbeyli District Health Directorate, İstanbul,
Turkiye
- Department of Public Health, School of Pharmacy, İstanbul Medipol University, İstanbul,
Turkiye
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29
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Al Awaji NN, Al-Taleb SM, Albagawi TO, Alshammari MT, Sharar FA, Mortada EM. Evaluating Parents' Concerns, Needs, and Levels of Satisfaction with the Services Provided for ASD Children in Saudi Arabia. J Multidiscip Healthc 2024; 17:123-146. [PMID: 38222477 PMCID: PMC10785689 DOI: 10.2147/jmdh.s447151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024] Open
Abstract
Background Supporting children with autism spectrum disorder (ASD) and their parents is vital in improving their children's abilities and their parents' ability to care for them. Thus, parents' perceptions of and levels of satisfaction with the services provided for their children must be assessed. Aim This study aimed to understand parents' perceptions of and satisfaction with the speech-language services (SLS) provided for ASD children in different health facilities in Saudi Arabia. Methods This cross-sectional study included 109 parents of ASD children. The survey included five sections dealing with (1) general information about the child; (2) assessment of the child's ASD characteristics (including their age when diagnosed, when they first noticed symptoms, and their speech, language, and communication abilities); (3) the reasons for enrollment in SLS sessions; (4) questions about SLS; and (5) parents' perceptions of SLS, satisfaction with the service, descriptions of their children's progress, and the respect and support they received. Results Parents' satisfaction levels were significantly higher when they had easy access to SLS, sufficient information and support, proper training in applying therapy exercises at home, and perceived respect and support from speech and language pathologists (SLPs). The reasons for discontinuing SLS included high session costs, the need for initial behavioral sessions, the lack of qualified SLPs, the end of the sessions, the lack of improvement, the nonavailability of specialized centers, and parents' dependence on home training only. They also sought opportunities for work and education, continuous and intensive SLS sessions, reduced costs, centers for adults with ASD, and accessible schools. Parents' main concerns were their children's poor speech and language skills, independence, and social acceptance. Conclusion and Implications The study highlighted the importance of understanding parents' experiences with SLS, identifying the factors that enhance SLS use by ASD children, and improving parents' satisfaction with such services.
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Affiliation(s)
- Nisreen Naser Al Awaji
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Sumaih Mohammed Al-Taleb
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Teef Olayan Albagawi
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Maram Taleb Alshammari
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Fay Abdullah Sharar
- Department of Health Communication Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
| | - Eman M Mortada
- Health Sciences department, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia
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Song J, Reilly M, Reichow B. Overview of Meta-Analyses on Naturalistic Developmental Behavioral Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord 2024:10.1007/s10803-023-06198-x. [PMID: 38170431 DOI: 10.1007/s10803-023-06198-x] [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: 11/17/2023] [Indexed: 01/05/2024]
Abstract
We conducted an overview of reviews to determine the effects of naturalistic developmental behavioral interventions (NDBIs; Schreibman et al. (2015) J Autism Dev Disorders 45:2411-2428) on children with autism spectrum disorder under 8 years old. We conducted an electronic database search of Academic Search Premier, CINHAL, ERIC, Medline, and APA PsycINFO in October 2022 and August 2023 and utilized snowball methods to locate relevant reviews of NDBI. We included reviews meeting the following inclusion criteria: (1) review included a meta-analytic synthesis for at least one child outcome; (2) primary studies examined a NDBI; (3) primary studies included children with ASD with a mean pre-treatment age under eight years; (4) primary studies were conducted using a two-group comparison design; and (5) review was published in English. We extracted data on characteristics of the review, participant characteristics from the primary studies, intervention characteristics, and assessed the risk of bias of the included reviews. We conducted a narrative synthesis across outcomes reported in the included reviews. We included five reviews from six reports in this overview. Two reviews included studies that examined the Early Start Denver Model, two reviews included studies that examined the Pivotal Response Treatment, and one review included studies examining NDBIs collectively. We found positive effects of NDBIs on child's communication/language, cognition, and adaptive behavior. We found mixed effects for NDBIs on autism symptomatology and restricted and repetitive behaviors. Examination of moderator analyses reported in the included reviews suggested variables influencing the effects of NDBIs included proximity of outcome to intervention, boundedness of outcome to intervention, and study location. As shown in this overview, positive effects of NDBI for young children with ASD are supported by meta-analytic evidence. While the overall findings for NDBI across reviews are positive, the findings on specific outcomes and influential variables moderating the effects of NDBI are inconsistent. Additional evidence from randomized controlled trials and future meta-analyses are needed to strengthen our knowledge of the effects of NDBI for young children with ASD.Protocol Registration: PROSPERO CRD42022353045.
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Affiliation(s)
- Jinwei Song
- A. J. Pappanikou Center for Excellence in Developmental Disabilities, UConn Health, Farmington, CT, USA
- Neag School of Education, University of Connecticut, Storrs, CT, USA
| | - Molly Reilly
- A. J. Pappanikou Center for Excellence in Developmental Disabilities, UConn Health, Farmington, CT, USA
- Neag School of Education, University of Connecticut, Storrs, CT, USA
| | - Brian Reichow
- A. J. Pappanikou Center for Excellence in Developmental Disabilities, UConn Health, Farmington, CT, USA.
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31
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González León N, González-Olguín A. [Motor intervention strategies on postural control in children and youth with autism spectrum disorder: A systematic review]. Rehabilitacion (Madr) 2024; 58:100820. [PMID: 37913716 DOI: 10.1016/j.rh.2023.100820] [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: 09/15/2022] [Revised: 12/17/2022] [Accepted: 01/16/2023] [Indexed: 11/03/2023]
Abstract
Autism spectrum disorder (ASD) has varied characteristics with an impact at the social, communicative and sensorimotor (SM) level. An SM feature is postural control (PC) problems. There are various motor intervention strategies (MIS), but the benefit over LC is something that has been analyzed less extensively. The objective was to describe the MIS and its results on the PC of children and adolescents with ASD. A search of PubMed, Scopus, Web of Science and Cochrane was performed. A total of eight articles met the eligibility criteria. All MIS showed beneficial results on the improvement of PC. The MIS were of a varied nature (dance practice, personalized physical activity, video games, Tai Chi Chuan, Taekwondo and virtual reality). It is necessary to improve the designs and consider the risks of bias, since they limit the scope of the results.
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Affiliation(s)
- N González León
- Facultad de Ciencias de la Rehabilitación, Universidad Andrés Bello, Santiago, Chile
| | - A González-Olguín
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile; Escuela de Kinesiología, Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Santiago, Chile; Centro de Estudios del Movimiento Humano, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile.
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32
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Denusik L, Glista D, Servais M, Friesen J, Oram J, Cunningham BJ. "We were the best people to do the job": Caregivers' reported outcomes of a virtual caregiver-delivered program for autistic preschoolers. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415241244767. [PMID: 38694817 PMCID: PMC11062079 DOI: 10.1177/23969415241244767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Background and aims Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them. This study explored caregivers' perceived outcomes following one virtual caregiver-delivered program, The Hanen Centre's More Than Words® (MTW) program. Methods This study was a secondary analysis of data from individual interviews conducted with 21 caregivers who had recently participated in a virtual MTW program. A hybrid codebook thematic analysis approach was taken to analyze the interview data. Program outcomes were coded and analyzed within the International Classification Functioning, Disability, and Health (ICF) framework. Additionally, caregivers completed an online survey and rated Likert Scale items about perceived program outcomes, which were analyzed descriptively. Results Five themes were identified: (1) caregivers learned new strategies to facilitate their child's development, (2) caregivers developed a new mindset, (3) children gained functional communication skills, (4) caregiver-child relationships improved, and (5) caregivers gained a social and professional support network. These themes fell within four of five ICF framework components (activities, participation, personal factors, and environmental factors). No themes were identified under Body Structures and Functions. Survey results indicated most caregivers reported learning new communication strategies (n = 20, 95%), and identifying new teaching opportunities with their child (n = 21, 100%). Conclusions Some reported outcomes, related to Activities and Participation, were consistent with previous reports in the literature on the MTW program. In line with previous research, caregivers learned strategies to support their child's communication development. Contrary to previous quantitative studies, caregivers in this study rarely commented on gains in vocabulary and instead focused on gains in skills that positively impacted their child's ability to engage in meaningful social interaction. Novel outcomes were identified within the Participation, Personal Factors, and Environmental Factors components of the ICF framework. Implications Caregivers in this study identified important outcomes for themselves and their child that have not been the focus of prior research, suggesting it is important to integrate their perspectives in the development and evaluation of caregiver-delivered programs. Clinicians should include goals that address outcomes identified as important by caregivers, including those that address children's Participation, and those that target caregivers' Personal and Environmental Factors. Developers of caregiver-delivered programs could integrate identified goals to ensure they are meeting families' needs.
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Affiliation(s)
- Lauren Denusik
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Danielle Glista
- University of Western Ontario, London, ON, Canada
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | | | - Jodi Friesen
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Janis Oram
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
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Chung KM, Chung E, Lee H. Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis. Soa Chongsonyon Chongsin Uihak 2024; 35:29-38. [PMID: 38204739 PMCID: PMC10774556 DOI: 10.5765/jkacap.230019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/21/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.
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Affiliation(s)
- Kyong-Mee Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Eunsun Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Hoomyung Lee
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
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Buffle P, Armijos C, Naranjo A, Gentaz E. Feasibility of an observational procedure to enhance early identification of autism spectrum disorder in paediatric settings: A mixed-methods study on an Ecuadorian sample. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:84-94. [PMID: 37313623 PMCID: PMC10771021 DOI: 10.1177/13623613231175587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
LAY ABSTRACT In Ecuador, the low official estimate of the number of persons with autism spectrum disorder suggest that many children are not identified and are not receiving support. Screening tools are short parent-addressed questionnaires used to identify children that may be developing with autism. Their use is recommended, but their application can be perceived as challenging in paediatric routines. Some professionals prefer looking for autism-related behaviours in a child rather than using screening questionnaires. Although a short observation does not replace the use of validated screening questionnaires, tasks to guide the observation of autistic early signs can help professionals decide to screen or refer the family for assessment and early intervention. In this study, we tested observational tasks that could be adapted to the Ecuadorian paediatric contexts.
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Affiliation(s)
- Paulina Buffle
- University of Geneva, Switzerland
- Pontificia Universidad Católica del Ecuador, Ecuador
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35
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Nitzan T, Koller J, Ilan M, Faroy M, Michaelovski A, Menashe I, Meiri G, Dinstein I. The Importance of Language Delays as an Early Indicator of Subsequent ASD Diagnosis in Public Healthcare Settings. J Autism Dev Disord 2023; 53:4535-4544. [PMID: 36222994 DOI: 10.1007/s10803-022-05757-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 10/17/2022]
Abstract
Previous studies have reported that ASD children with more severe symptoms are diagnosed earlier. However, previous studies in community settings have mostly relied on retrospective parental reports without the use of quantitative standardized test scores. Here, we evaluated the association of language, cognitive, and ASD severity standardized scores with the age of diagnosis in 1-6-year-old children diagnosed in a public healthcare setting. The results revealed that language scores were the strongest variable associated with the age of diagnosis, explaining ~ 30% of the variability across children. Indeed, all children diagnosed before 30-months of age exhibited moderate-to-severe language delays. These results further substantiate the prominence of language delay as a highly visible symptom associated with earlier ASD diagnosis in community clinical settings.
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Affiliation(s)
- Tanya Nitzan
- Psychology Department, Ben Gurion University, Beer Sheva, Israel.
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Judah Koller
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Ilan
- Psychology Department, Ben Gurion University, Beer Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Michal Faroy
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Analya Michaelovski
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Zusman Child Development Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Idan Menashe
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Public Health Department, Ben Gurion University, Beer Sheva, Israel
| | - Gal Meiri
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pre-School Psychiatry Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Ilan Dinstein
- Psychology Department, Ben Gurion University, Beer Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Beer Sheva, Israel
- Cognitive and Brain Sciences Department, Ben Gurion University, Beer Sheva, Israel
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Saban-Bezalel R, Avni E, Ben-Itzchak E, Zachor DA. Relationship between Parental Concerns about Social-Emotional Reciprocity Deficits and Their Children's Final ASD Diagnosis. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1786. [PMID: 38002877 PMCID: PMC10670729 DOI: 10.3390/children10111786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023]
Abstract
Concerns raised by parents regarding their child's development are compatible with the child's final diagnosis of autism spectrum disorder. A better understanding of the relationship between parental concerns and a final diagnosis of autism spectrum disorder is therefore critical. In the current study, we compared the frequencies of parental concerns related to DSM-5 criteria for autism spectrum disorder between pair-matched groups with and without a final diagnosis of autism spectrum disorder and determined which parental concerns predicted a final diagnosis of autism spectrum disorder. The cohort included 80 participants (48-154 months of age, IQ > 70) assessed for a possible autism spectrum disorder diagnosis. Parental concerns were retrieved from the free-description portion of the introductory questions of the Autism Diagnostic Interview-Revised and analyzed to assess whether they corresponded to any of the seven DSM-5 criteria for ASD. The two groups only differed in the frequency of parental concerns relating to deficits in social-emotional reciprocity. Parents of children diagnosed with autism spectrum disorder were four times as likely to report deficits in social-emotional reciprocity. This finding highlights the significance of parental concerns regarding deficits in social-emotional reciprocity in predicting a final diagnosis of autism spectrum disorder.
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Affiliation(s)
- Ronit Saban-Bezalel
- Bruckner Center for Autism Research, Department of Communication Disorders, Ariel University, Ariel 40700, Israel;
| | - Einat Avni
- The Autism Center/ALUT, Department of Pediatrics, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel; (E.A.); (D.A.Z.)
| | - Esther Ben-Itzchak
- Bruckner Center for Autism Research, Department of Communication Disorders, Ariel University, Ariel 40700, Israel;
| | - Ditza A. Zachor
- The Autism Center/ALUT, Department of Pediatrics, Shamir (Assaf Harofeh) Medical Center, Zerifin 70300, Israel; (E.A.); (D.A.Z.)
- The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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Harstad E, Hanson E, Brewster SJ, DePillis R, Milliken AL, Aberbach G, Sideridis G, Barbaresi WJ. Persistence of Autism Spectrum Disorder From Early Childhood Through School Age. JAMA Pediatr 2023; 177:1197-1205. [PMID: 37782510 PMCID: PMC10546296 DOI: 10.1001/jamapediatrics.2023.4003] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 10/03/2023]
Abstract
Importance While the prevalence of autism spectrum disorder (ASD) continues to increase and early diagnosis is emphasized, there is limited information on outcomes for children diagnosed with ASD in early childhood using contemporary diagnostic criteria. Objectives To determine the frequency with which children who are clinically diagnosed with ASD at 12 to 36 months of age continue to meet diagnostic criteria for ASD at 5 to 7 years of age and to evaluate whether baseline child-specific and demographic characteristics and receipt of interventions are associated with ASD persistence. Design, Setting, and Participants In this natural history cohort study, children who received a clinical ASD diagnosis at 12 to 36 months of age underwent a research diagnostic assessment at 5 to 7 years of age. Research assessments occurred from August 14, 2018, to January 8, 2022. Intervention Children received community-based interventions, and parents provided details about interventions received. Main Outcomes and Measures The main outcome was persistence of ASD diagnosis based on current functioning. An experienced research psychologist assigned an ASD diagnosis (present or absent) according to criteria from the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) after the research assessment. The research assessment included administration of the Autism Diagnostic Observation Schedule-2, Autism Diagnostic Interview-Research, and a cognitive measure. Results Of the 213 participants diagnosed with ASD at initial clinical assessment (mean [SD] age, 24.6 [3.9] months; 177 boys [83.1%]), 79 (37.1%) did not continue to meet diagnostic criteria for ASD (nonpersistent ASD) at research assessment (mean [SD] age, 74.3 [7.1] months). All children with nonpersistent ASD had IQ of at least 70, while there was a bimodal distribution of IQ for those with persistent ASD (46 with IQ <70 and 88 with IQ ≥70). All children received some interventions, and 201 (94.4%) received ASD-specific intervention, mostly applied behavioral analysis. In a multilevel logistic regression model, the only variables associated with increased odds of being in the nonpersistent ASD group at 6 years of age were higher baseline adaptive skills (b coefficient = -0.287 [SE, 0.108]) and female sex (b = 0.239 [SE, 0.064]). Conclusions and Relevance The findings of this cohort study suggest that among toddlers diagnosed with ASD, baseline adaptive function and sex may be associated with persistence of ASD.
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Affiliation(s)
- Elizabeth Harstad
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Ellen Hanson
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Stephanie J. Brewster
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
- Rosamund Stone Zander Translational Neuroscience Center, Boston Children’s Hospital, Boston, Massachusetts
| | - Rafael DePillis
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Anna L. Milliken
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Gabriella Aberbach
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - Georgios Sideridis
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | - William J. Barbaresi
- Division of Developmental Medicine, Boston Children’s Hospital, Boston, Massachusetts
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Horiuchi S, Nomura O, Curry L, Kushima M, Arnold L, Yamagata Z. 'Caregivers' awareness matters': Call for a child-centred approach to early detection of autism spectrum disorder through well-child visits in Japan. Child Care Health Dev 2023; 49:985-994. [PMID: 36807909 DOI: 10.1111/cch.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Early detection of autism spectrum disorder (ASD) is essential to provide children with timely treatment and support. Evidence-based screening measures make it possible to identify children with suspected ASD at an early stage. Although Japan has a universal healthcare system that covers well-child visits, detection rates of developmental disorders, including ASD, at 18 months vary widely between municipalities (0.2%-48.0%). The reasons for this high level of variation are poorly understood. The present study aims to describe the barriers and facilitators of incorporating ASD identification during well-child visits in Japan. METHODS This is a qualitative study that conducts semi-structured in-depth interviews in two municipalities of Yamanashi Prefecture. We recruited all public health nurses (n = 17) and paediatricians (n = 11) involved in the well-child visit in each municipality and caregivers of children who also participated in the visits during the study period (n = 21). RESULTS We identified four themes characterizing the process of ASD identification in the target municipalities: (1) Identification of children with ASD is driven by caregivers' sense of concern, acceptance and awareness. (2) Multidisciplinary cooperation and shared decision-making is limited. (3) Skills and training for developmental disabilities screening are underdeveloped. (4) Caregivers' expectations shape the interaction in important ways. CONCLUSIONS Non-standardization of screening methods, limited knowledge and skills on screening and child development among healthcare providers and poor coordination among healthcare providers and caregivers are the main barriers to effective early detection of ASD through well-child visits. The findings suggest the importance of promoting a child-centred care approach through the application of evidence-based screening measures and effective information sharing.
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Affiliation(s)
- Sayaka Horiuchi
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, Yamanashi, Japan
| | - Osamu Nomura
- Department of Health Sciences Education, Hirosaki University, Aomori, Japan
- Centre for Community-based Health Professions Education, Hirosaki University, Aomori, Japan
| | - Leslie Curry
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, Connecticut, USA
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
| | - Linda Arnold
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, Connecticut, USA
- International Pediatric Association (IPA), IPA-LEAD program, Marengo, Illinois, USA
| | - Zentaro Yamagata
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, Yamanashi, Japan
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
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Dai Y, Deng T, Chen M, Huang B, Ji Y, Feng Y, Liu S, Zhong D, Zhang T, Zhang L. Improving early detection, diagnosis and intervention for children with autism spectrum disorder: A cross-sectional survey in China. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 142:104616. [PMID: 37820392 DOI: 10.1016/j.ridd.2023.104616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 08/01/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Detection and diagnosis of autism spectrum disorder (ASD) are prerequisites for early interventions. However, few studies focused on this topic. AIM This study aims to characterize the timing from symptom detection to intervention in children with ASD and identify predictors of age at ASD diagnosis, presence of intervention, and the time lag between detection and diagnosis. METHODS AND PROCEDURES A cross-sectional survey was conducted with 303 parents (111 fathers and 192 mothers, 21-54 years) of children with ASD in Guangzhou, China. OUTCOMES AND RESULTS The median time from symptom observation to the first doctor visit was 3 months, while the time to ASD diagnosis averaged 6 months. Most children (76.24 %) were diagnosed within one year after detection, and 25.58 % had no intervention after diagnosis. Predictors of earlier ASD diagnosis included ASD-related symptoms identified at an older age, less serious symptoms, and initial symptoms with atypical motor development and sensory anomalies. ASD-related symptoms observed at an older age, initial symptoms with social deficits, sensory anomalies, and without language impairment, primary caregivers other than parents, families with lower income, and less social support utilization increased the odds of a time lag between detection and diagnosis. Children with fathers having lower education were less likely to receive interventions. CONCLUSIONS AND IMPLICATIONS Earlier ASD identification and intervention might be facilitated by health education on typical symptoms of ASD for parents with young children and incorporating ASD screening during routine health examinations for children. For children whose primary caregivers are not their parents and from lower-income families, additional support may be required for timely diagnosis after reporting ASD-related symptoms. Moreover, more intervention supports are expected for children whose fathers have lower education levels. Helping families take full advantage of support is also important for early diagnosis and intervention.
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Affiliation(s)
- Yushen Dai
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Tao Deng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Miaoying Chen
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Baoqin Huang
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Yan Ji
- Child Development and Behavior Center, The Third Affiliated Hospital of Sun Yat-Sen University Lingnan Hospital, Guangzhou, China
| | - Yongshen Feng
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Shaofei Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Dongmei Zhong
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Tao Zhang
- Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macao, China
| | - Lifeng Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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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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Eldeeb SY, Ludwig NN, Wieckowski AT, Dieckhaus MFS, Algur Y, Ryan V, Dufek S, Stahmer A, Robins DL. Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F). AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2112-2123. [PMID: 36786236 PMCID: PMC10423742 DOI: 10.1177/13623613231154728] [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: 02/15/2023]
Abstract
LAY ABSTRACT This study examined a widely used autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up to identify differences in screening for autism between toddler males and females. Examining sex differences in screening for autism in toddlerhood is important as it determines who will be referred for evaluations and receive diagnoses, which is critical for access to autism-specific early intervention. This study found that females were less likely to screen positive and be invited for evaluations compared with males. Females at high likelihood for autism were less likely to be diagnosed with autism, which decreases confidence in the screener's results. Importantly, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identified both males and females with autism. Future research should examine ways to improve accuracy in screening results for females.
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Affiliation(s)
| | - Natasha N. Ludwig
- Kennedy Krieger Institute, John Hopkins School of Medicine, Baltimore, MD
| | | | | | - Yasemin Algur
- Department of Epidemiology & Biostatistics, Drexel University, Philadelphia, PA
| | - Victoria Ryan
- Department of Epidemiology & Biostatistics, Drexel University, Philadelphia, PA
| | - Sarah Dufek
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Sacramento, CA
| | - Aubyn Stahmer
- Department of Psychiatry and Behavioral Sciences, University of California, Davis MIND Institute, Sacramento, CA
| | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA
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Jeong HI, Kim SG, Youn H, Lee J, Lee SI. A Pilot Study on the Validity and Reliability of Korean School Readiness Inventory on Children With Autism Spectrum Disorder. Psychiatry Investig 2023; 20:940-945. [PMID: 37899217 PMCID: PMC10620335 DOI: 10.30773/pi.2023.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/06/2023] [Accepted: 08/02/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE Successful transition to school is of great importance to children with autism spectrum disorder (ASD). The purpose of this study was to develop a school readiness inventory for Korean children with ASD, and demonstrate its content validity and reliability. METHODS The Korean School Readiness Inventory (K-SRI) was developed to assess current levels of some fundamental skills needed for attending school for children with ASD. The K-SRI was comprised of four subscales and 16 test items: Self-help skills, Social and emotional development, School behavior, and Literacy and numeracy skills. For content validity, six experts rated the validity of the test items. Lawshe's Content Validity Ratio (CVR) was calculated. For reliability, parents of 22 children with ASD entering school completed the KSRI twice. Cronbach's alpha coefficient was calculated for internal consistency. The test-retest reliability was assessed using the intraclass correlation coefficient (ICC). RESULTS All the items except two items in the literacy and numeracy skills did not show a CVR of 1. The two items were deleted resulting in a 14-item inventory. The Cronbach's alpha coefficient of the K-SRI was 0.93, showing good internal consistency reliability. The test- retest reliability results showed ICC value of 0.93 (p<0.001), which indicates good stability. CONCLUSION A parent-rated, 14-item school readiness inventory for Korean children with ASD were developed and preliminary evidence of its content validity and reliability were demonstrated in this study. The present study provides a basis for future studies that would further help evaluate and promote school readiness of the children with ASD.
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Affiliation(s)
- Hye In Jeong
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Shin-Gyeom Kim
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - HyunChul Youn
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Jeewon Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea
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Li Y, Zhu M, Chen WX, Luo J, Li X, Cao Y, Zheng M, Ma S, Xiao Z, Zhang Y, Jiang L, Wang X, Tan T, Li X, Gong Q, Xiong X, Wang J, Tang M, Li M, Tang YP. A novel mutation in intron 1 of Wnt1 causes developmental loss of dopaminergic neurons in midbrain and ASD-like behaviors in rats. Mol Psychiatry 2023; 28:3795-3805. [PMID: 37658228 PMCID: PMC10730402 DOI: 10.1038/s41380-023-02223-8] [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: 02/01/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 09/03/2023]
Abstract
Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders with a strong genetic liability. Despite extensive studies, however, the underlying pathogenic mechanism still remains elusive. In the present study, we identified a homozygous mutation in the intron 1 of Wnt1 via large-scale screening of ASD risk/causative genes and verified that this mutation created a new splicing donor site in the intron 1, and consequently, a decrease of WNT1 expression. Interestingly, humanized rat models harboring this mutation exhibited robust ASD-like behaviors including impaired ultrasonic vocalization (USV), decreased social interactions, and restricted and repetitive behaviors. Moreover, in the substantia nigra compacta (SNpc) and the ventral tegmental area (VTA) of mutant rats, dopaminergic (DAergic) neurons were dramatically lost, together with a comparable decrease in striatal DAergic fibers. Furthermore, using single-cell RNA sequencing, we demonstrated that the decreased DAergic neurons in these midbrain areas might attribute to a shift of the boundary of the local pool of progenitor cells from the hypothalamic floor plate to the midbrain floor plate during the early embryonic stage. Moreover, treatments of mutant rats with levodopa could attenuate the impaired USV and social interactions almost completely, but not the restricted and repetitive behaviors. Our results for the first time documented that the developmental loss of DAergic neurons in the midbrain underlies the pathogenesis of ASD, and that the abnormal progenitor cell patterning is a cellular underpinning for this developmental DAergic neuronal loss. Importantly, the effective dopamine therapy suggests a translational significance in the treatment of ASD.
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Affiliation(s)
- Yongyi Li
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
- Department of Pharmacology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Mingwei Zhu
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Wen-Xiong Chen
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jing Luo
- School of Basic Medicine, Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Xin Li
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- School of Basic Medicine, Southwest Medical University, Luzhou, Sichuan, 646000, China
- Department of Pathology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China
| | - Yangyang Cao
- Department of Child Health, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Meng Zheng
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Shanshan Ma
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
- Department of Pharmacology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhilan Xiao
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yani Zhang
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Linyan Jiang
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Xiumin Wang
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Ting Tan
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Xia Li
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Qian Gong
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Xiaoli Xiong
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jun Wang
- Department of Child Health, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Mingxi Tang
- Department of Pathology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, China.
| | - Mingtao Li
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
- Department of Pharmacology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Ya-Ping Tang
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Department of Child Health, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
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Chen YH, Drye M, Chen Q, Fecher M, Liu G, Guthrie W. Delay from Screening to Diagnosis in Autism Spectrum Disorder: Results from a Large National Health Research Network. J Pediatr 2023; 260:113514. [PMID: 37244580 PMCID: PMC10805541 DOI: 10.1016/j.jpeds.2023.113514] [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: 12/21/2022] [Revised: 03/22/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
To examine delay from developmental screening to autism diagnosis, we used real-world health care data from a national research network to estimate the time between these events. We found an average delay of longer than 2 years from first screening to diagnosis, with no significant differences observed by sex, race, or ethnicity.
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Affiliation(s)
- Yu-Hsin Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA
| | - Madison Drye
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA.
| | - Madison Fecher
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Guodong Liu
- Department of Public Health Sciences, The Pennsylvania State University, Hershey, PA; Department of Psychiatry and Behavioral Health, The Pennsylvania State University, Hershey, PA
| | - Whitney Guthrie
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA; Clinical Futures, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Psychiatry and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
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Shehzad I, Raju M, Jackson I, Beeram M, Govande V, Chiruvolu A, Vora N. Evaluation of Autism Spectrum Disorder Risk in Infants With Intraventricular Hemorrhage. Cureus 2023; 15:e45541. [PMID: 37868372 PMCID: PMC10586226 DOI: 10.7759/cureus.45541] [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: 07/25/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Background This study evaluates the long-term risk of autism spectrum disorder (ASD) in infants with intraventricular hemorrhage (IVH) using the Modified Checklist for Autism in Toddlers-Revised with Follow-Up (M-CHAT-R/F) screening tool. Methods This retrospective cohort study compared IVH (exposed) infants across all gestational age groups with no-IVH (non-exposed) infants admitted to level IV neonatal intensive care unit (NICU). The M-CHAT-R/F screening tool was used to assess the ASD risk at 16-30 months of age. Discharge cranial ultrasound (CUS) findings also determined the ASD risk. Descriptive statistics comprised median and interquartile range for skewed continuous data and frequencies and percentages for categorical variables. Comparisons for non-ordinal categorical measures in bivariate analysis were carried out using the χ2 test or Fisher exact test. Results Of the 334 infants, 167 had IVH, and 167 had no IVH. High ASD risk (43% vs. 20%, p = 0.044) and cerebral palsy (19% vs. 5%, p = 0.004) were significantly associated with severe IVH. Infants with CUS findings of periventricular leukomalacia had 3.24 odds of developing high ASD risk (odds ratios/OR: 3.24, 95% confidence interval/CI: 0.73-14.34), and those with hydrocephalus needing ventriculoperitoneal (VP) shunt had 4.75 odds of developing high ASD risk (OR: 4.75, 95% CI: 0.73-30.69). Conclusion Severe IVH, but not mild IVH, increased the risk of ASD and cerebral palsy. This study demonstrates the need for timely screening for ASD in high-risk infants. Prompt detection leads to earlier treatment and better outcomes.
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Affiliation(s)
- Irfan Shehzad
- Neonatology, Baylor Scott & White Health, Temple, USA
| | - Muppala Raju
- Neonatology, Baylor Scott & White Health, Temple, USA
| | | | | | | | | | - Niraj Vora
- Neonatology, Baylor Scott & White Health, Temple, USA
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Hussain A, John JR, Dissanayake C, Frost G, Girdler S, Karlov L, Masi A, Alach T, Eapen V. Sociocultural factors associated with detection of autism among culturally and linguistically diverse communities in Australia. BMC Pediatr 2023; 23:415. [PMID: 37612588 PMCID: PMC10463473 DOI: 10.1186/s12887-023-04236-2] [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: 10/06/2022] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The age at which parents or caregivers first develop concerns about their child's development has significant implications on formal diagnosis and intervention. This study aims to determine the sociocultural factors that are associated with the age and type of first concern reported by parents of autistic children among culturally and linguistically diverse (CALD) communities in Australia. We also assessed whether sociocultural factors predict autism traits measured in terms of social affect (SA), restricted and repetitive behaviours (RRB), and calibrated severity scores (CSS). METHODS This study is a secondary data analysis of the data collected from six Autism Specific Early Learning and Care Centres (ASELCCs) as part of the Autism Co-operative Research Centre (CRC) program between 2015 and 2019. Data analysed in this study included a family history questionnaire with sociodemographic and sociocultural information, parent-reported age and type of first concern, and clinician/researcher administered Autism Diagnostic Observation Schedule - Second Edition (ADOS-2) which includes standardised domain-wise scores of social affect (SA) and restricted and repetitive behaviours (RRB) as well as calibrated severity scores (CSS), a measure of severity of autism. Primary analysis included multivariable linear regression models to examine the predictive influence of sociodemographic and sociocultural factors on the dependant variables of age of concern (AOC) and the autism traits (SA, RRB, and CSS). RESULTS The mean AOC in the sample was 18.18 months and the most common concerns were speech/language delay, limited social interaction, and hyperactivity/behavioural changes. The multivariable linear regression models showed factors such as increase in age of child, those from a CALD background, annual family income, sibling's autism diagnosis, and developmental concerns to be significantly associated with parental AOC. Additionally, we also found that increase in child's age and CALD status to be significant predictors of autism trait (RRB) and severity measured in terms of the CSS score. Further, females (compared to males) were associated with higher difficulties with social communication and interaction skills. CONCLUSION Understanding key factors that contribute to early identification of autism can help tailor awareness programs for parents and caregivers, whilst also informing the development of services focused on serving all CALD communities.
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Affiliation(s)
- Aniqa Hussain
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - James Rufus John
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Cheryl Dissanayake
- School of Psychology and Public Health, Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Grace Frost
- Autism Specific Early Learning and Care Centre, Prospect, South Australia, Australia
| | - Sonya Girdler
- School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- Cooperative Research Centre for Living with Autism, Brisbane, Australia
| | - Lisa Karlov
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Anne Masi
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Tasha Alach
- Director of Therapy and Clinical Services, Autism Association of Western Australia Inc, Subiaco, WA, Australia
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
- Academic Unit of Child Psychiatry, South Western Sydney Local Health District, Liverpool Hospital, Sydney, NSW, Australia.
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Cui M, Ni Q, Wang Q. Review of intervention methods for language and communication disorders in children with autism spectrum disorders. PeerJ 2023; 11:e15735. [PMID: 37576502 PMCID: PMC10422951 DOI: 10.7717/peerj.15735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/20/2023] [Indexed: 08/15/2023] Open
Abstract
In recent years, the number of patients-particularly children-with autism spectrum disorder (ASD) has been continually increasing. ASD affects a child's language communication and social interaction to a certain extent and has an impact on behavior, intelligence level, and other aspects of the child. Data indicates that 40% to 70% of children with ASD experience language developmental delays, which are mainly manifested as lack of language or language developmental delay, self-talk, use of stereotyped language, parroting, et cetera. A language communication disorder is a major symptom of ASD and is the most common reason for patients to visit a doctor. Therefore, language intervention training and communication skills have been made a cornerstone of autism intervention. However, a literature search has revealed that most studies only examine certain intervention methods or a combination of two or three intervention methods, which cannot be used by therapists or rehabilitation teachers. Therefore, this article summarizes relevant literature on language communication training for ASD children at home and abroad and briefly introduces the characteristics and training methods of language disorders in children with ASD in order to provide some ideas and references for relevant researchers and practitioners.
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Affiliation(s)
- Mengmeng Cui
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong, China
| | - Qingbin Ni
- The Affiliated Taian City Central Hospital of Qingdao University, Taian, Shandong, China
| | - Qian Wang
- The Affiliated Taian City Central Hospital of Qingdao University, Taian, Shandong, China
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Termine C, Galli V, Dui LG, Berlusconi V, Lipari R, Lunardini F, Ferrante S. Autism in Preschool-Aged Children: The Effects of COVID-19 Lockdown. J Autism Dev Disord 2023:10.1007/s10803-023-06078-4. [PMID: 37540405 DOI: 10.1007/s10803-023-06078-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 08/05/2023]
Abstract
The COVID-19 lockdown affected children, especially those with autism spectrum disorder, due to the disruption in rehabilitation and educational activities. We conducted a cross-sectional study of 315 preschool-aged children, 35 of which had autism, to investigate this impact. A questionnaire was administered to explore socio-demographic status, familiar/home environment, and COVID-19 exposure. The clinical features of autistic subjects were also examined. Seven variables were considered to describe the effect of pandemic: Remote learning, Behavior changes, Home activities, Sleep habits, Night awakenings, Physical activity, Information about the virus. The lockdown had a significant impact on Remote learning, Behavior changes, and Information about the virus in participants with autism. Moreover, we found a worsening in repetitive movements, echolalia, restricted interests, and aggressive behaviors.
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Affiliation(s)
- Cristiano Termine
- Child Neuropsychiatry Unit, Department of Medicine and Surgery, University of Insubria, Piazza Biroldi 19, 21100, Varese, Italy
- Department of Maternal and Child Health, Del Ponte Hospital, Varese, Italy
| | - Vera Galli
- Child Neuropsychiatry Unit, Department of Medicine and Surgery, University of Insubria, Piazza Biroldi 19, 21100, Varese, Italy.
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
| | - Linda Greta Dui
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy
| | - Valentina Berlusconi
- Child Neuropsychiatry Unit, Department of Medicine and Surgery, University of Insubria, Piazza Biroldi 19, 21100, Varese, Italy
| | - Rossella Lipari
- Child Neuropsychiatry Unit, Department of Medicine and Surgery, University of Insubria, Piazza Biroldi 19, 21100, Varese, Italy
| | - Francesca Lunardini
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy
| | - Simona Ferrante
- Department of Electronics, Information and Bioengineering, Politecnico Di Milano, Milan, Italy
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Vismara LA, Nyugen L, McCormick CEB. Abbreviating the Early Start Denver Model for community-based family-centered care. Front Psychol 2023; 14:1167885. [PMID: 37546470 PMCID: PMC10399628 DOI: 10.3389/fpsyg.2023.1167885] [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: 02/16/2023] [Accepted: 05/22/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Parent-mediated approaches for young children with or with a higher likelihood of autism have gained traction, with mounting evidence of efficacy, but a research-to-gap practice exists, and community effectiveness remains to be firmly established. Methods Using a community-participatory framework, a total of 10 parent-child dyads received a five-day workshop and six follow-up sessions of ESDM parent coaching. Intervention was implemented across two phases with in-person and telehealth delivery. Results From pre to post intervention across both phases, parents improved in their fidelity of intervention implementation and children maid gains on proximal measures of social communication. Discussion Community delivery of an evidence-based parent-mediated interventions for toddlers on the autism spectrum is feasible and promising. Giving resource efficiencies associated with parent-mediated approaches, particularly when delivered through government-funded programs, findings bolster current efforts to promote earlier and more widespread community access to necessary interventions. Facilitators and barriers to supporting parent learning and behavior change via interactive strategies are discussed.
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Affiliation(s)
| | - Lucy Nyugen
- Thrive Autism Collaborative, Denver, CO, United States
| | - Carolyn E. B. McCormick
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, United States
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Zukerman G, Yahav G, Ben-Itzchak E. After one year in university; a robust decrease in autistic traits reporting among autistic students. Front Psychiatry 2023; 14:1146819. [PMID: 37469360 PMCID: PMC10352486 DOI: 10.3389/fpsyt.2023.1146819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/12/2023] [Indexed: 07/21/2023] Open
Abstract
Background Previous research on autistic students enrolled in university support programs has reported moderate improvement in anxiety/depression or adaptive behavior. However, alterations in autistic traits have not been examined. Methods This longitudinal study evaluated changes in university students' autistic trait and state/trait anxiety levels. Participants were 24 neurotypically developed (ND) students with high levels of social anxiety symptoms (High SA), 30 ND students with low levels of SA symptoms (Low SA), and 41 autistic students (the primary focus of this study) residing with an ND peer student mentor as part of participating in the university's integration support program. Autism spectrum quotient [AQ and State Trait Anxiety Inventory STAI] data were collected during the first semester of two consecutive academic years (T1, T2), as well as baseline (T1) levels of social anxiety, depression, and obsessive-compulsive symptoms. Results Significant interaction between group and time was observed, denoting a sharp decrease (2.9 SD) from T1 to T2 in the overall autistic trait level among the autistic group (AQ "attention switching" subscale demonstrating the most robust decrease), and a moderate decrease (0.5 SD) among the high SA group. Only for the autistic students were more compulsive symptoms at T1 associated with a lesser decrease in AQ scores (T1-T2), which in turn was negatively correlated with their T1 year-end grade point average. Conclusion The findings suggest that attending post-secondary education (while partaking in a support/transition program) is followed by a profound change of the individual's subjective experience of autism, characterized by a sharp decline in the level of autistic traits, particularly attention switching. This change is independent of alterations in well-being indices, such as anxiety, that are known to characterize students attending university.
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Affiliation(s)
- Gil Zukerman
- Department of Communication Disorders, Ariel University, Ariel, Israel
| | - Gili Yahav
- Department of Communication Disorders, Ariel University, Ariel, Israel
| | - Ester Ben-Itzchak
- Department of Communication Disorders, Ariel University, Ariel, Israel
- Bruckner Center for Autism Research, Ariel University, Ariel, Israel
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