1
|
Schiltz HK, Clarke E, Rosen N, De La Rosa SG, Masjedi N, Christopher K, Lord C. A Longitudinal Mixed-Methods Characterization of Family Support from Adolescence to Young Adulthood in Autism and Other Developmental Disabilities. J Autism Dev Disord 2024; 54:3225-3241. [PMID: 37668851 PMCID: PMC11362242 DOI: 10.1007/s10803-023-06070-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 09/06/2023]
Abstract
Although caregiving responsibilities and need for support persist and evolve across the life course in families with autistic youth or youth with other developmental disabilities (DDs), little is known about support during their child's adulthood years. Therefore, the present study used a mixed-methods approach to examine change and stability in formal and informal family support across the transition to adulthood. Caregivers of 126 individuals with autism or DDs completed a modified version of the Family Support Scale, including open-ended questions, at five time points from adolescence (age 16) into young adulthood (age 22). Caregivers reported that informal support from family members was the most frequently used, helpful, and valued source of support with relative stability across time. In contrast, the reported helpfulness, use, and value of formal support (e.g., professionals, schools) for caregivers declined over time. Qualitative content analyses revealed characteristics of highly valued support included support type (e.g., instrumental or emotional) and features of the support source (e.g., their understanding). There was a shift to valuing emotional support more than instrumental support over time, especially for caregivers of less able adults. Partnership and dependability emerged as highly valued features of the support source. These findings fit within a social convoy perspective and likely reflect the "service cliff" experienced by autistic individuals or people with DDs and their families. As social networks shrink over time and formal services are less readily available in adulthood, remaining sources of support, particularly from family members, become increasingly important.
Collapse
Affiliation(s)
- Hillary K Schiltz
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
| | - Elaine Clarke
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Nicole Rosen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Sofi Gomez De La Rosa
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Nina Masjedi
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Kourtney Christopher
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA
| |
Collapse
|
2
|
Chen H, Ge S, Yao P, Yang T, Cao X, Sun D. Evaluation of the Quality of Management Guidelines for Children and Adolescents With Autism Spectrum Disorder. Psychol Rep 2024:332941241269510. [PMID: 39102695 DOI: 10.1177/00332941241269510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVE To systematically assess the quality of management guidelines for children and adolescents with autism spectrum disorder, analyze key management recommendation differences and causes among guidelines, and provide better guideline assessments for clinical workers. METHODS Clinical guidelines for managing children and adolescents with autism were systematically retrieved from a database. Four reviewers independently evaluated the guidelines using the assessment guideline tool, Appraisal of Guidelines for Research and Evaluation II (AGREE II), and the intra-group correlation coefficient (ICC) was used to measure the consistency of the assessment guidelines among the four reviewers and the differences and reasons for the recommendations and supporting evidence were compared and analyzed. RESULTS A total of ten management guidelines for children and adolescents with autism spectrum disorder published from 2014 to 2022 were included in this study, with high overall agreement between raters (range of intra-group correlation coefficients: 53.3% ∼ 85.0%), and areas with better median scores and ranges in Protocol II were as follows: domain 1 (scope and purpose, median = 86.1%, 59.7%-98.6%), Domain 4 (clarity of statements, median = 88.2%, 38.9%-100.0%) and domain 6 (independence of editors, median = 71.9%, 0.0%-100.0%). Among the ten guidelines the guidelines published by the Scott Intercollegiate Guidelines Network in 2016 and by the National Institute for health and care excellence in 2021 scored high and were recommended for adoption, 88.7%, 84.9%, respectively. CONCLUSION There is considerable variation between the quality of guidelines for the management of children and adolescents with autism spectrum disorders.
Collapse
Affiliation(s)
- Huiling Chen
- The Key Laboratory of the 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shiliang Ge
- Department of Burn Surgery, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Penghao Yao
- The Key Laboratory of the 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ting Yang
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xia Cao
- The Key Laboratory of the 2nd Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Dali Sun
- Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, Kunming, China
| |
Collapse
|
3
|
Alasmari M, Alduais A, Qasem F. A thematic review of autism spectrum disorder research in Saudi Arabia: Insights into diagnosis, assessment, and language considerations. APPLIED NEUROPSYCHOLOGY. CHILD 2023:1-15. [PMID: 37983315 DOI: 10.1080/21622965.2023.2283718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
This study reviews the crucial role of language in Autism Spectrum Disorder (ASD) diagnosis and assessment in Saudi Arabia. Using tailored search strings, 206 relevant documents were retrieved from the Web of Science and Scopus databases. An increasing trend in ASD research in Saudi Arabia was observed through temporal analysis. Keyword analysis identified key themes including "autism," "language," "assessment," "diagnosis," "Saudi Arabia," and "children." The focus of research has shifted over the years, from pure clinical and diagnostic aspects to a more comprehensive approach that includes language and cultural factors in ASD evaluation. The findings underscore the need for culturally and linguistically sensitive assessment tools, acknowledging the impact of bilingualism on language development, and the importance of language difficulties in diagnostic decision-making. The study highlights the necessity for further research, especially longitudinal studies examining the influence of language and cultural factors on ASD outcomes. The findings are significant for clinical practice, emphasizing the need for linguistically sensitive approaches in ASD diagnosis and assessment. This research serves as a guide for future studies by identifying the gaps in existing literature and areas of focus. The study identifies crucial gaps in existing literature, particularly the need for longitudinal studies examining the influence of language and cultural factors on ASD outcomes. The findings underscore the importance of culturally and linguistically sensitive approaches in ASD diagnosis and assessment, providing a novel insight for future research and clinical practice in Saudi Arabia.
Collapse
Affiliation(s)
- Mohamed Alasmari
- Department of English Language and Literature, College of Letters and Arts, University of Bisha, Bisha, Saudi Arabia
| | - Ahmed Alduais
- Department of Human Sciences (Psychology), University of Verona, Verona, Italy
- Department of English and Communication, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Fawaz Qasem
- Fawaz Ali Ahmed Qasem, College of Arts, University of Bisha, Bisha, Saudi Arabia
| |
Collapse
|
4
|
Bolognesi E, Guerini FR, Sotgiu S, Chiappedi M, Carta A, Mensi MM, Agliardi C, Zanzottera M, Clerici M. GC1f Vitamin D Binding Protein Isoform as a Marker of Severity in Autism Spectrum Disorders. Nutrients 2022; 14:nu14235153. [PMID: 36501185 PMCID: PMC9740250 DOI: 10.3390/nu14235153] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/25/2022] [Accepted: 11/30/2022] [Indexed: 12/09/2022] Open
Abstract
Autism spectrum disorders (ASD) are characterized by a wide spectrum of clinical, behavioral, and cognitive manifestations. It is, therefore, crucial to investigate possible biomarkers associated with specific ASD phenotypes. Ample literature suggests a possible role for vitamin D (VD) in influencing ASD clinical phenotypes. We analyzed three vitamin D binding protein gene (DBP) functional polymorphisms (rs2282679, rs7041, and rs4588), which are involved in the modulation of vitamin D serum concentration in 309 ASD children and 831 healthy controls. Frequency comparisons of single nucleotide polymorphisms (SNPs) alleles, genotypes, and GC isoforms (GC1f, G1s, and GC2)—generated by the combination of rs7041 and rs4588 alleles—were correlated with ASD diagnostic, behavioral, and functioning scales. The GC1f isoform was significantly more frequent in ASD compared with controls (18.6% vs. 14.5% pc = 0.02). Significantly higher scores for item 15 of the Childhood Autism Rating Scale (CARS) and lower ones for the Children’s Global Assessment Scale (CGAS) functioning scales were seen in ASD carrying the GC1f isoform. In GC phenotype analysis, a gradient of severity for overall CARS scores and CARS item 15 was observed, with scores decreasing according to the presence of GC1f-GC1f > GC1f-GC1s > GC1s-GC1s > GC1f-GC2 > GC2-GC2 isoforms. Similarly, lower CGAS scores were seen in carriers of the GC1f-GC1f isoform, whereas higher scores were present in those carrying GC2-GC2 (p = 0.028). This is the first study to evaluate possible relationships between GC variants and the different aspects of ASD in Italian ASD children. Results, although needing to be validated in ampler cohorts, suggest that the GC1f isoform could be a marker of severity in ASD that may be useful in establishing the intensity of therapeutic and rehabilitative protocols.
Collapse
Affiliation(s)
| | - Franca Rosa Guerini
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
- Correspondence: ; Tel.: +39-02-4030-8342; Fax: +39-02-4030-8438
| | - Stefano Sotgiu
- Unit of Child Neuropsychiatry, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Matteo Chiappedi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy
| | - Alessandra Carta
- Unit of Child Neuropsychiatry, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | | | | | | | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| |
Collapse
|
5
|
Lopes LT, Rodrigues JM, Baccarin C, Oliveira K, Abreu M, Ribeiro V, Anastácio ZC, Machado JP. Autism Spectrum as an Etiologic Systemic Disorder: A Protocol for an Umbrella Review. Healthcare (Basel) 2022; 10:healthcare10112200. [PMID: 36360541 PMCID: PMC9690003 DOI: 10.3390/healthcare10112200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/29/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder with a huge prevalence increasing every year (1/44 children). Still diagnosed as a mental disorder, the last 10 years of research found possible causes, risks, genetics, environmental triggers, epigenetics, metabolic, immunological, and neurophysiological unbalances as relevant aetiology. Umbrella methodology is the highest level of scientific evidence, designed to support clinical and political decisions. A literature search for autism aetiology, pathophysiology, or causes, conducted in the last 10 years, at PubMed, Embase, Cochrane, Scopus, and the Web of Science, resulted in six umbrella reviews. Nevertheless, only one quantitative analysis reported risk factors and biomarkers but excluded genetics, experiments on animal models, and post-mortem studies. We grouped ASD’s multi-factorial causes and risks into five etiological categories: genetic, epigenetic, organic, psychogenic, and environmental. Findings suggest that autism might be evaluated as a systemic disorder instead of only through the lens of mental and behavioural. The overview implications of included studies will be qualitatively analysed under ROBIS and GRADE tools. This umbrella review can provide a rational basis for a new urgent health policy to develop better and adequate integrated care services for ASD. The methodological protocol has the register CRD42022348586 at PROSPERO.
Collapse
Affiliation(s)
- Lara Teixeira Lopes
- Institute of Biomedical Sciences, University of Porto, 4099-030 Porto, Portugal
- Center of BioSciences in Integrative Health, 4200-355 Porto, Portugal
- Correspondence:
| | | | - Celeste Baccarin
- Center of BioSciences in Integrative Health, 4200-355 Porto, Portugal
| | - Kevin Oliveira
- Center of BioSciences in Integrative Health, 4200-355 Porto, Portugal
| | - Manuela Abreu
- Center of BioSciences in Integrative Health, 4200-355 Porto, Portugal
| | - Victor Ribeiro
- Center of BioSciences in Integrative Health, 4200-355 Porto, Portugal
| | - Zélia Caçador Anastácio
- Research Center on Child Studies, Institute of Education, University of Minho, 4804-533 Braga, Portugal
| | - Jorge Pereira Machado
- Institute of Biomedical Sciences, University of Porto, 4099-030 Porto, Portugal
- Center of BioSciences in Integrative Health, 4200-355 Porto, Portugal
| |
Collapse
|
6
|
Alenezi S, Alyahya AS, AlKhalifah SM, Bakhsh HR, Alismail EH, Aldhalaan H, Alwazna T, Alzrayer N, AlSuwailem SS, Alnemary F, AlAnsari AMS, Alqulaq EI, Alyamani A, Amer YS, Albawardi IM, Albalawi WM, Alhassan MA, Algazlan MS, Alramady M, Ad-Dab’bagh Y. Saudi Expert Consensus-Based Autism Spectrum Disorder Statement: From Screening to Management. CHILDREN 2022; 9:children9091269. [PMID: 36138578 PMCID: PMC9496905 DOI: 10.3390/children9091269] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
Background: There is a large gap between the needs of individuals diagnosed with autism spectrum disorder (ASD) and the currently available services in Saudi Arabia. Services are often difficult to access, inconsistent in quality, incomplete, unsatisfactory, and costly. As such, there is a national need for expert consensus on the appropriate standards for the assessment and management of children on the autism spectrum. Methodology: A guideline development group (GDC) was formed by professionals representing all related specialties and institutions involved in the management of individuals on the autism spectrum in Saudi Arabia. They met on a regular basis over 21 months. The guideline development process consisted of five steps starting from reviewing existing guidelines and ending with discussing and writing this manuscript. A formal voting process was utilized and recommendations were discussed until a consensus was reached. Results: There was consensus on the following: A specialized diagnostic assessment needs to be carried out by an experienced multidisciplinary team for children referred to assess for ASD. They should be assessed for medical etiology, their behavioral history carefully reviewed, and symptoms directly observed. Longitudinal assessments are encouraged to reflect the effects of symptoms on the individual’s ability to function while with their family, among peers, and in school settings. An additional formal assessment of language, cognitive, and adaptive abilities as well as sensory status is essential to complete the diagnostic process. Interventions should be individualized, developmentally appropriate, and intensive, with performance data relevant to intervention goals to evaluate and adjust interventions. Target symptoms must be identified to address and develop monitoring systems to track change. Conclusion: ASD is a complex condition with widely varying clinical manifestations, thus requiring evaluation and intervention by a range of professionals working in coordination. Behavioral and environmental interventions are the key to optimal outcomes, in conjunction with medications when indicated for specific symptoms. Parental involvement in interventions is vital to sustaining therapeutic gains.
Collapse
Affiliation(s)
- Shuliweeh Alenezi
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ahmad S. Alyahya
- Department of Psychiatry, Eradah Complex for Mental Health, Riyadh 12571, Saudi Arabia
- Correspondence:
| | - Shahad M. AlKhalifah
- Center for Autism Research, King Faisal Specialist Hospital & Research Center, Riyadh 11564, Saudi Arabia
| | - Hadeel R. Bakhsh
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Eiman H. Alismail
- Center for Autism Research, King Faisal Specialist Hospital & Research Center, Riyadh 11564, Saudi Arabia
| | - Hesham Aldhalaan
- Department of Neuroscience, King Faisal Specialist Hospital & Research Center, Riyadh 11564, Saudi Arabia
| | - Talat Alwazna
- Department of Neurology, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Nouf Alzrayer
- Department of Special Education, College of Education, King Saud University, Riyadh 11451, Saudi Arabia
| | | | | | - Ahmed M. S. AlAnsari
- Department of Psychiatry, College of Medecine and Medical Sciences, Arabian Gulf University, Manama 293, Bahrain
| | - Enas I. Alqulaq
- Prince Mohammed Bin Salman Center for Autism and Neurodevelopment, Riyadh 12426, Saudi Arabia
- Health Services of Ministry of Defense, Riyadh 12426, Saudi Arabia
| | - Amal Alyamani
- Prince Mohammed Bin Salman Center for Autism and Neurodevelopment, Riyadh 12426, Saudi Arabia
- Department of Psychiatry, King Fahad Armed Forces Hospital, Jeddah 23311, Saudi Arabia
| | - Yasser S. Amer
- Pediatrics Department, King Khalid University Hospital, Riyadh 12372, Saudi Arabia
- Quality Management Department, King Saud University Medical City, Riyadh 12746, Saudi Arabia
- Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh 11451, Saudi Arabia
- Alexandria Center for Evidence-Based Clinical Practice Guidelines, Alexandria University, Alexandria 5424041, Egypt
- Adaptation Working Group, Guidelines International Network (GIN), Perth PH16 5BU, UK
| | - Ibrahim M. Albawardi
- Department of Psychiatry, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia
| | | | - Mohammed A. Alhassan
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | - Maha S. Algazlan
- Department of Psychiatry, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia
| | | | - Yasser Ad-Dab’bagh
- Mental Health Department, Neuroscience Center, King Fahad Specialist Hospital-Dammam (KFSH-D), Dammam 32253, Saudi Arabia
| |
Collapse
|