Early Screening of the Autism Spectrum Disorders: Validity Properties and Cross-Cultural Generalizability of the First Year Inventory in Italy

Tools for early screening of autism spectrum disorders in primary health care – a scoping review

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests itself in early childhood. Early diagnosis of these disorders allows for the initiation of early therapy, which is crucial for the child's further functioning in society.

Objectives

This review aims to gather and present the existing ASD screening tools that can be used in primary care and adapted to different countries conditions linguistically and culturally.

Eligibility criteria

We searched for English-language publications on ASD screening tools for children aged 0–3 years suitable for use in primary care (i.e. free, requiring no additional training or qualifications).

Sources of evidence

Four databases were explored to find English studies on ASD screening tools intended for the rapid assessment of children aged 0–3.

Charting methods

The information sought (specific features of the questionnaires relevant to primary health care workers, psychometric and diagnostic values of a given cultural adaptation of screening tools, and the linguistic and cultural changes made) were extracted and collected to create profiles of these tools.

Results

We found 81 studies which met inclusion criteria and underwent full data extraction. Three additional data sources were included. These allowed to create 75 profiles of adaptations for 26 different screening tools and collect data on their psychometric values and characteristic features.

Conclusions

The results of our study indicate the availability of several diagnostic tools for early ASD screening in primary care setting concordant culturally and linguistically with a given population. They could be an effective method of accelerating the diagnostic process and starting personalized therapy faster. However, most tools have significant limitations – some are only available for research purposes, while others do not have scientific evidence to prove their effectiveness.

Role of Parental Attachment Styles in Moderating Interaction Between Parenting Stress and Perceived Infant Characteristics

By employing the transactional model of development and focusing on the multifactorial nature of parenting, this study aimed to (1) examine whether important risk factors, particularly mothers' insecure attachment styles and parenting stress contribute to the perception of their infants' characteristics and (2) explore whether maternal attachment styles moderate the relationship between parenting stress and perceived infants' characteristics. We recruited 357 mothers (age: 34.23; ± 5.38) who had 1-year-old infants (161 males and 196 females; age: 12.70; ± 1.60 months). All the mothers completed three self-report instruments: Parenting Stress Index-Short Form (PSI-SF), Attachment Style Questionnaire (ASQ), and 1st-Year Inventory (FYI). Although the latter was originally developed to determine the risk for autism in 1-year-olds, it was employed in this study to measure infant's characteristics within two domains: social communication and sensory regulatory functions. Multiple regression analyses revealed that one of the PSI-SF dimensions - specifically the Parent-Child Dysfunctional Interaction - contributed to mothers' perceptions of their children's social communication abilities, whereas the attachment style did not. Other multiple regression analyses showed that all the dimensions of parenting stress - that is, Parenting Distress (PD), Parent-Child Dysfunctional Interaction (PCDI), and Difficult Child (DC) - contributed to mothers' perceptions of their sensory regulatory abilities. The attachment styles, particularly anxious attachment, contributed significantly to a biased perception of these abilities controlled for parenting stress. Mothers reporting high levels of avoidance and high levels of PD viewed their children as less able in the social communicative domain (SC Dom) than if they had low levels of PD. By contrast, when levels of avoidance were low, mothers with high PD perceived their children as less difficult in the SC Dom than those with low levels of PD. Moreover, high avoidance levels influenced how mothers who considered the interaction with their children as difficult perceived them as having greater difficulties in relation to sensory regulatory domain (SR Dom). By contrast, mothers with high levels of anxiety high levels of PD view their children as less able in the SC Dom than if they had low levels of PD. When mothers' levels of anxiety were very low, those with high PD viewed their children as less difficult in the SC Dom in comparison to those with low levels of PD.

The Challenging Heterogeneity of Autism: Editorial for Brain Sciences Special Issue "Advances in Autism Research"

My personal experience as Guest Editor of the Special Issue (SI) entitled "Advances in Autism Research" began with a nice correspondence with Andrew Meltzoff, from the University of Washington, Seattle (WA, USA), which, in hindsight, I consider as a good omen for the success of this Special Issue: "Dear Antonio… [...].

The Criterion Validity of the First Year Inventory and the Quantitative-CHecklist for Autism in Toddlers: A Longitudinal Study

Pediatric surveillance through screening procedures is needed to detect warning signs of risk for Autism Spectrum Disorder under 24 months of age and to promote early diagnosis and treatment. The main purpose of this study is to extend the literature regarding the psychometric properties of two screening tools, the First Year Inventory (FYI) and the Quantitative-CHecklist for Autism in Toddler (Q-CHAT), testing their criterion validity. They were administered during a three-wave approach involving the general population. At T1, 657 children were tested with the FYI and 36 of them were found to be at risk. At T2, 545 were tested with the Q-CHAT and 29 of them were found to be at risk. At T3, 12 out of the 36 children with a high score on the FYI and 11 out of the 29 children with a high score on the Q-CHAT were compared to 15 typically developing children. The criterion validity was tested considering the severity of the autistic symptoms, emotional/behavioral problems, and limited global functioning as criteria. Accuracy parameters were also calculated. Furthermore, we investigated which dimension of each questionnaire better predicted the aforementioned criterion. The results corroborated the hypotheses and confirmed the criterion validity of FYI and Q-CHAT.