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Iao LS, Shen CW, Wu CC. A Longitudinal Study of Joint Attention, Motor Imitation and Language Development in Young Children with Autism Spectrum Disorder in Taiwan. J Autism Dev Disord 2024; 54:2651-2662. [PMID: 37142905 DOI: 10.1007/s10803-023-05950-7] [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: 02/25/2023] [Indexed: 05/06/2023]
Abstract
This longitudinal study examined early predictors of language development in 74 young children with Autism Spectrum Disorder (ASD) in Taiwan. Participants were assessed twice (initial age between 17 and 35 months) on responding to joint attention (RJA), initiating joint attention (IJA), motor imitation with objects (object imitation; OI) and without objects (manual imitation; MI), and receptive and expressive language. The two assessments were 18 months apart. Results showed that both RJA and MI concurrently and longitudinally predicted receptive and expressive language across the two assessments. These findings were not entirely consistent with the limited and mixed findings of Western longitudinal studies. However, they have implications for early interventions aiming to facilitate language development in children with ASD internationally.
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Affiliation(s)
- Lai-Sang Iao
- Department of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Ching-Wan Shen
- Department of Psychiatry, Zuoying Branch of Kaohsiung Armed Forces General Hospital, No.553, Junxiao Road, Kaohsiung, 81342, Taiwan
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, No.100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.
- Department of Medical Research, Kaohsiung Medical University Hospital, No.100, Tz-You 1st Rd, Kaohsiung, 80756, Taiwan.
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Hocking MC, Albee MV, Kim M, Berman JI, Fisher MJ, Roberts TP, Blaskey L. Social challenges, autism spectrum disorder, and attention deficit/hyperactivity disorder in youth with neurofibromatosis type I. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-9. [PMID: 38864448 PMCID: PMC11635006 DOI: 10.1080/21622965.2024.2365383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
OBJECTIVE Youth with neurofibromatosis type I (NF1) demonstrate high rates of Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD), which often have overlapping behaviors. Diagnostic clarity is important to guide services. This study evaluated ASD classification in NF1 using various methods and whether those with ADHD suspicion have more social challenges associated with ASD. METHOD 34 youth with NF1 (Mage = 10.5 ± 1.6 years), completed ASD assessments that combined direct observation and informant ratings to yield a Clinician Best Estimate (CBE) classification. Caregivers rated ASD-related social challenges using the Social Responsiveness Scale- 2nd Edition (SRS-2). RESULTS ASD classification varied depending on the method, ranging from 32% using low-threshold SRS-2 cut-scores (T ≥ 60) to under 6% when combining cut scores for diagnostic observational tools and stringent SRS-2 cut-scores (T ≥ 70). 14.7% had a CBE ASD classification. 44% were judged to have autism traits associated with a non-ASD diagnosis. The 52.9% with a suspicion of ADHD had higher SRS-2 scores than those without ADHD, F (7, 26) = 3.45, p < .05, Wilk's lambda = 0.518, partial eta squared = 0.482. CONCLUSIONS Findings highlight the importance of rigorous diagnostic methodology when evaluating ASD in NF1 to inform the selection of targeted interventions for socialization challenges in NF1.
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Affiliation(s)
- Matthew C. Hocking
- Children’s Hospital of Philadelphia
- Perelman School of Medicine at The University of Pennsylvania
| | | | - Mina Kim
- Children’s Hospital of Philadelphia
| | - Jeffrey I. Berman
- Children’s Hospital of Philadelphia
- Perelman School of Medicine at The University of Pennsylvania
| | - Michael J. Fisher
- Children’s Hospital of Philadelphia
- Perelman School of Medicine at The University of Pennsylvania
| | - Timothy P.L. Roberts
- Children’s Hospital of Philadelphia
- Perelman School of Medicine at The University of Pennsylvania
| | - Lisa Blaskey
- Children’s Hospital of Philadelphia
- Perelman School of Medicine at The University of Pennsylvania
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Sun K, Li Y, Zhai Z, Yin H, Liang S, Zhai F, Cui Y, Zhang G. Effects of transcutaneous auricular vagus nerve stimulation and exploration of brain network mechanisms in children with high-functioning autism spectrum disorder: study protocol for a randomized controlled trial. Front Psychiatry 2024; 15:1337101. [PMID: 38374975 PMCID: PMC10875019 DOI: 10.3389/fpsyt.2024.1337101] [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: 11/12/2023] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Background Autism Spectrum Disorders (ASD) are a collection of neurodevelopmental diseases characterized by poor social interaction and communication, a limited range of interests, and stereotyped behavior. High-functioning autism (HFA) indicates a subgroup of individuals with autism who possess cognitive and/or language skills that are within the average to above-normal range for their age. Transcutaneous auricular vagus nerve stimulation (taVNS) holds promise in children with HFA. However, few studies have used randomized controlled trials to validate the effectiveness of taVNS. Therefore, in this study, we intend to provide a study protocol to examine the therapeutic effects of taVNS in individuals diagnosed with HFA and to investigate the process of brain network remodeling in individuals with ASD using functional imaging techniques to observe alterations in large-scale neural networks. Methods and design We planned to employ a randomized, double-blind experimental design, including 40 children receiving sham stimulation and 40 children receiving real stimulation. We will assess clinical scales and perform functional imaging examinations before and after the stimulation. Additionally, we will include age- and gender-matched healthy children as controls and conduct functional imaging examinations. We plan first to observe the therapeutic effects of taVNS. Furthermore, we will observe the impact of taVNS stimulation on the brain network. Discussion taVNS was a low-risk, easy-to-administer, low-cost, and portable option to modulate the vagus system. taVNS may improve the social performance of HFA. Changes in the network properties of the large-scale brain network may be related to the efficacy of taVNS. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2300074035.
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Affiliation(s)
- Ke Sun
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Psychiatry, Beijing Children’s Hospital, Beijing, China
| | - Zhenhang Zhai
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Heqing Yin
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Shuli Liang
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Feng Zhai
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children’s Hospital, Beijing, China
| | - Guojun Zhang
- Functional Neurosurgery Department, National Center for Children’s Health, Beijing Children’s Hospital, Capital Medical University, Beijing, China
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"It Defines Who I Am" or "It's Something I Have": What Language Do [Autistic] Australian Adults [on the Autism Spectrum] Prefer? J Autism Dev Disord 2023; 53:677-687. [PMID: 32112234 DOI: 10.1007/s10803-020-04425-3] [Citation(s) in RCA: 181] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
There has been a recent shift from person-first to identity-first language to describe autism. In this study, Australian adults who reported having a diagnosis of autism (N = 198) rated and ranked autism-terms for preference and offensiveness, and explained their choice in free-text. 'Autistic', 'Person on the Autism Spectrum', and 'Autistic Person' were rated most preferred and least offensive overall. Ranked-means showed 'person on the autism spectrum' was the most preferred term overall. Six qualitative themes reflected (1) autism as core to, or (2) part of one's identity, (3) 'spectrum' reflecting diversity, (4) the rejection of stigmatising and (5) medicalised language, and (6) pragmatics. These findings highlight the importance of inclusive dialogue regarding individual language preference.
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Lovelace TS, Comis MP, Tabb JM, Oshokoya OE. Missing from the Narrative: A Seven-Decade Scoping Review of the Inclusion of Black Autistic Women and Girls in Autism Research. Behav Anal Pract 2022; 15:1093-1105. [PMID: 36605161 PMCID: PMC9745006 DOI: 10.1007/s40617-021-00654-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 01/09/2023] Open
Abstract
The intersectional experiences of Black autistic women and girls (BAWG) are missing from medical and educational research on autism spectrum disorder (ASD). Understanding the intersectional experiences of BAWG is important due to the rising prevalence of autism in Black children and girls (Centers for Disease Control and Prevention (CDC), 2020) and the concurrent lack of availability of culturally relevant autism-related interventions (Maenner et al., 2020; West et al., 2016). Intersectionality is the study of the overlapping discrimination produced by systems of oppression (Collins, 2019; Crenshaw, 1989, 1991) and allows the researcher to simultaneously address race and disability in special education (Artiles, 2013). In this scoping review, the authors used the PRISMA-ScR checklist (Tricco et al., 2018) and Arskey and O'Malley's (2005) framework to investigate the degree to which autism-related research (ARR) has included the intersectional experiences of BAWG. Utilizing narrative synthesis, strengths and gaps across the current body of literature are identified in order to set new directions for intersectional ARR. Overall, the authors found that across a 77-year period, three studies foregrounded BAWG and none addressed intersectionality as measured through criteria advanced by García and Ortiz (2013). These results reveal the scholarly neglect BAWG face in ARR, discourse, policy, and practice. A future agenda including research, practice, and policy priorities is identified and discussed.
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Affiliation(s)
- Temple S. Lovelace
- Department of Counseling, Psychology, and Special Education, 412B Canevin Hall, 600 Forbes Avenue, Pittsburgh, PA 15219 USA
| | - Mary P. Comis
- Department of Counseling, Psychology, and Special Education, 412B Canevin Hall, 600 Forbes Avenue, Pittsburgh, PA 15219 USA
| | - JoVonne M. Tabb
- Department of Counseling, Psychology, and Special Education, 412B Canevin Hall, 600 Forbes Avenue, Pittsburgh, PA 15219 USA
| | - Olajumoke E. Oshokoya
- Department of Counseling, Psychology, and Special Education, 412B Canevin Hall, 600 Forbes Avenue, Pittsburgh, PA 15219 USA
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Edelson SM. Evidence from Characteristics and Comorbidities Suggesting That Asperger Syndrome Is a Subtype of Autism Spectrum Disorder. Genes (Basel) 2022; 13:274. [PMID: 35205319 PMCID: PMC8871744 DOI: 10.3390/genes13020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022] Open
Abstract
The current version of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-V) does not consider Asperger syndrome a diagnostic category. This study was undertaken to see if there is evidence that this diagnosis should be reinstated. An online survey was conducted to examine symptoms and behaviors associated with the current diagnostic criteria of autism spectrum disorders (ASD) (DSM-V), and those associated with Asperger syndrome based on the previous version (DSM-IV-TR). The study also examined other characteristics historically associated with autism, as well as impairments often reported in infancy/young childhood and medical comorbidities frequently associated with autism. The sample included 251 individuals who had received a diagnosis of Asperger syndrome and 1888 who were diagnosed with autism or ASD. Numerous similarities and differences were found between the two groups. The findings are discussed in relation to reestablishing Asperger syndrome as a valid diagnostic category as well as a subtype of ASD.
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Blázquez Hinojosa A, Lázaro Garcia L, Puig Navarro O, Varela Bondelle E, Calvo Escalona R. Sensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2021; 14:202-211. [PMID: 34802987 DOI: 10.1016/j.rpsmen.2019.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 10/16/2019] [Indexed: 10/19/2022]
Abstract
BACKGROUND Controversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD). METHODS This study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. RESULTS DSM-5 sensitivity ranged from .69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the "low-functioning" category. DSM-5 specificity ranged from .64 to .73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD. CONCLUSIONS Further research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.
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Affiliation(s)
- Ana Blázquez Hinojosa
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain.
| | - Luisa Lázaro Garcia
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Departamento de Psiquiatría y Psicobiología Clínica, Universidad de Barcelona, Barcelona, Spain
| | - Olga Puig Navarro
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Eva Varela Bondelle
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain
| | - Rosa Calvo Escalona
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Amonkar N, Su WC, Bhat AN, Srinivasan SM. Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review. Front Psychiatry 2021; 12:722874. [PMID: 34867515 PMCID: PMC8637167 DOI: 10.3389/fpsyt.2021.722874] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.
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Affiliation(s)
- Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Sudha M. Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
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Angeletos Chrysaitis N, Jardri R, Denève S, Seriès P. No increased circular inference in adults with high levels of autistic traits or autism. PLoS Comput Biol 2021; 17:e1009006. [PMID: 34559803 PMCID: PMC8494311 DOI: 10.1371/journal.pcbi.1009006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 10/06/2021] [Accepted: 08/24/2021] [Indexed: 01/02/2023] Open
Abstract
Autism spectrum disorders have been proposed to arise from impairments in the probabilistic integration of prior knowledge with sensory inputs. Circular inference is one such possible impairment, in which excitation-to-inhibition imbalances in the cerebral cortex cause the reverberation and amplification of prior beliefs and sensory information. Recent empirical work has associated circular inference with the clinical dimensions of schizophrenia. Inhibition impairments have also been observed in autism, suggesting that signal reverberation might be present in that condition as well. In this study, we collected data from 21 participants with self-reported diagnoses of autism spectrum disorders and 155 participants with a broad range of autistic traits in an online probabilistic decision-making task (the fisher task). We used previously established Bayesian models to investigate possible associations between autistic traits or autism and circular inference. There was no correlation between prior or likelihood reverberation and autistic traits across the whole sample. Similarly, no differences in any of the circular inference model parameters were found between autistic participants and those with no diagnosis. Furthermore, participants incorporated information from both priors and likelihoods in their decisions, with no relationship between their weights and psychiatric traits, contrary to what common theories for both autism and schizophrenia would suggest. These findings suggest that there is no increased signal reverberation in autism, despite the known presence of excitation-to-inhibition imbalances. They can be used to further contrast and refine the Bayesian theories of schizophrenia and autism, revealing a divergence in the computational mechanisms underlying the two conditions.
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Affiliation(s)
- Nikitas Angeletos Chrysaitis
- Institute for Adaptive and Neural Computation, School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Renaud Jardri
- École Normale Supérieure, Institut de Sciences Cognitives, LNC (INSERM U960), Paris, France
- Université de Lille, INSERM U1172, Lille Neuroscience & Cognition Research Centre, Plasticity & SubjectivitY (PSY) team, CHU Lille, Lille, France
| | - Sophie Denève
- École Normale Supérieure, Institut de Sciences Cognitives, LNC (INSERM U960), Paris, France
| | - Peggy Seriès
- Institute for Adaptive and Neural Computation, School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
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Gender Differences in Misdiagnosis and Delayed Diagnosis among Adults with Autism Spectrum Disorder with No Language or Intellectual Disability. Brain Sci 2021; 11:brainsci11070912. [PMID: 34356146 PMCID: PMC8306851 DOI: 10.3390/brainsci11070912] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 12/28/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is often unrecognized, especially in mild forms and in women. Studies evaluating features associated with missed/misdiagnosis in men and women with ASD are warranted. 61 subjects (22 females, 39 males, age 28.5 ± 10.8 years) with ASD with no language/intellectual deficit were enrolled in the service for the treatment of psychiatric comorbidities in adults with ASD of the ASST Fatebenefratelli-Sacco in Milan (Italy). A detailed clinical history was gathered, and two self-report questionnaires (Autism Spectrum Quotient-AQ and Adult Autism Subthreshold Spectrum-AdAS Spectrum) were administered. 75.4% received their ASD diagnosis average eight years later than the first evaluation by mental health services. Compared to males, females showed a significantly greater delay in referral to mental health services and a significantly higher age at diagnosis of ASD. Among men, diagnostic delay inversely correlated with scores on the AdAS Spectrum total, Verbal communication, Empathy and Inflexibility and adherence to routine domains. Among women, diagnostic delay positively correlated with the Attention to detail score while the age at diagnosis of ASD positively correlated with the AdAS Spectrum Verbal communication and Restricted interests and rumination domain scores. Females were less likely to be correctly diagnosed and more likely to be misdiagnosed at first evaluation than men. Females reported significantly higher scores than men in the Hyper/Hyporeactivity to sensory input domain only among subjects who were misdiagnosed. Our findings provide gender-specific information about ASD patients seeking help for comorbid conditions and might be a primary ground for future research.
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Tang CH, Chi MH, Hsieh YT, Lee TI, Tai YC, Lien YJ, Yang YK, Chen PS. Sex differences in the diagnosis of autism spectrum disorder and effects of comorbid mental retardation and attention-deficit hyperactivity disorder. J Formos Med Assoc 2021; 121:210-217. [PMID: 33820714 DOI: 10.1016/j.jfma.2021.03.009] [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: 03/06/2020] [Revised: 09/08/2020] [Accepted: 03/08/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND/PURPOSE The association between sex and diagnostic behavior of autism spectrum disorder (ASD), and the effects of comorbid mental retardation (MR) and attention-deficit hyperactivity disorder (ADHD), were explored. METHODS Based on the Taiwan Longitudinal Health Insurance Database (LHID)-2000 and data from 1996 through 2008, the cumulative incidence of ASD over time was compared between the sexes (both cohorts n = 38,117) using the log-rank test. The effects of comorbid MR and ADHD on the incidence of ASD were evaluated using Cox proportional hazard regression analysis. The age at first diagnosis of ASD in the two sexes was compared using the independent-sample t-test. RESULTS The incidence was higher in males than in females (0.0007 vs. 0.0002) across ages. Comorbid MR or ADHD increased the incidence of ASD in both sexes; comorbid MR or ADHD also decreased the male to female hazard ratio of ASD, with no significant differences in the incidence density of ASD between sexes. ADHD delayed diagnosis in both sexes (males: 6.61 vs 5.10, p < 0.0001; females: 6.83 vs 4.69, p = 0.0037). CONCLUSIONS The general concept of a higher incidence of ASD among males was noted in this study of a Taiwanese population, but disappeared in those with comorbid MR or ADHD, indicating unique vulnerabilities to MR/ADHD or under-identification of high-functioning females with ASD in childhood. Increasing the diagnostic sensitivity of ASD in those with comorbid ADHD is important due to a delayed diagnostic age in this group.
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Affiliation(s)
- Chia Hung Tang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi Ting Hsieh
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tzu I Lee
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ying Chun Tai
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yueh-Ju Lien
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po See Chen
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
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Gupta M, Chaudhary R. Diagnostic Challenges of High-Functioning Autism Spectrum Disorder in Females. Cureus 2021; 13:e13006. [PMID: 33659137 PMCID: PMC7919612 DOI: 10.7759/cureus.13006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In the last decade, research about distinct female phenotypes in autism spectrum disorders has gained momentum. These patients are often undiagnosed since they do not meet the diagnostic criterion. And since the current standardized instruments are based on the same criterion, these assessments may often lead to false negative results. In clinical settings these patients have a distinct presentation, challenges, and impairments. These findings are useful in understanding, early identification, and effectively treating these individuals. We present a case series to highlight these issues and summarize the recent advances in research.
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Affiliation(s)
- Mayank Gupta
- Psychiatry, Lake Erie College of Osteopathic Medicine, Erie, USA.,Psychiatry and Behavioral Sciences, Clarion Psychiatric Center, Clarion, USA
| | - Ridhima Chaudhary
- Psychiatry and Behavioral Sciences, Santokba Durlabhji Hospital, Jaipur, IND
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Redmond SM. Clinical Intersections Among Idiopathic Language Disorder, Social (Pragmatic) Communication Disorder, and Attention-Deficit/Hyperactivity Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:3263-3276. [PMID: 33064599 PMCID: PMC8363244 DOI: 10.1044/2020_jslhr-20-00050] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 05/04/2023]
Abstract
Purpose Estimates of the expected co-occurrence rates of idiopathic language disorder and attention-deficit/hyperactivity disorder (ADHD) provide a confusing and inconsistent picture. Potential sources for discrepancies considered so far include measurement and ascertainment biases (Redmond, 2016a, 2016b). In this research symposium forum article, the potential impact of applying different criteria to the observed co-occurrence rate is examined through an appraisal of the literature and an empirical demonstration. Method Eighty-five cases were selected from the Redmond, Ash, et al. (2019) study sample. Standard scores from clinical measures collected on K-3rd grade students were used to assign language impairment status, nonverbal impairment status, social (pragmatic) communication disorder status, and ADHD status. Criteria extrapolated from the specific language impairment (Stark & Tallal, 1981), developmental language disorder (Bishop et al., 2017), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder (American Psychiatric Association, 2013) designations were applied. Results The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder designation and its separation of language disorder from the social (pragmatic) communication disorder designation provided the clearest segregation of idiopathic language deficits from elevated ADHD symptoms, showing only a 2% co-occurrence rate. In contrast, applying the broader developmental language disorder designation raised the observed co-occurrence rate to 22.3%. The specific language impairment designation yielded an intermediate value of 16.9%. Conclusions Co-occurrence rates varied as a function of designation adopted. The presence of pragmatic symptoms exerted a stronger influence on observed co-occurrence rates than low nonverbal abilities. Impacts on clinical management and research priorities are discussed. Presentation Video https://doi.org/10.23641/asha.13063751.
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Affiliation(s)
- Sean M. Redmond
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
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Kulage KM, Goldberg J, Usseglio J, Romero D, Bain JM, Smaldone AM. How has DSM-5 Affected Autism Diagnosis? A 5-Year Follow-Up Systematic Literature Review and Meta-analysis. J Autism Dev Disord 2020; 50:2102-2127. [PMID: 30852784 DOI: 10.1007/s10803-019-03967-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We conducted a 5-year follow-up systematic review and meta-analysis to determine change in frequency of autism spectrum disorder (ASD) diagnosis since diagnostic and statistical manual 5 (DSM-5) publication and explore the impact of Social Communication Disorder (SCD). For 33 included studies, use of DSM-5 criteria suggests decreases in diagnosis for ASD [20.8% (16.0-26.7), p < 0.001], DSM-IV-TR Autistic Disorder [10.1% (6.2-16.0), p < 0.001], and Asperger's [23.3% (12.9-38.5), p = 0.001]; pervasive developmental disorder-not otherwise specified decrease was not significant [46.1% (34.6-58.0), p = 0.52]. Less than one-third [28.8% (13.9-50.5), p = 0.06] of individuals diagnosed with DSM-IV-TR but not DSM-5 ASD would qualify for SCD. Findings suggest smaller decreases in ASD diagnoses compared to earlier reviews. Future research is needed as concerns remain for impaired individuals without a diagnosis.
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Affiliation(s)
- Kristine M Kulage
- Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA.
| | - Johanna Goldberg
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, 701 West 168th Street, New York, NY, 10032, USA
| | - Danielle Romero
- Lucile Packard Children's Hospital at Stanford, 770 Welch Road, Palo Alto, CA, 94304, USA
| | - Jennifer M Bain
- Department of Neurology, Division of Child Neurology, Columbia University Vagelos College of Physicians and Surgeons, 180 Fort Washington Avenue, 5th Floor, New York, NY, 10032, USA
| | - Arlene M Smaldone
- Columbia University School of Nursing, 630 West 168th Street, Box 6, New York, NY, 10032, USA
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15
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Peters WJ, Matson JL. Comparing Rates of Diagnosis Using DSM-IV-TR Versus DSM-5 Criteria for Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:1898-1906. [PMID: 30815773 DOI: 10.1007/s10803-019-03941-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
With the publication of DSM-5, many changes were introduced regarding how Autism Spectrum Disorder (ASD) would be diagnosed. Changes from DSM-IV-TR were controversial, with many arguing that individuals would lose their diagnosis with the new criteria. The purpose of this study was to examine differences in the application of diagnostic criteria across both recent versions in a sample of infants and toddlers. Fewer individuals met criteria according to DSM-5; however, a larger proportion of individuals met criteria for both. Additionally, individuals with higher levels of symptoms were more likely to meet criteria for both versions as compared to either alone. Overall, results suggest that there are meaningful differences in how DSM criteria may apply to individuals with an ASD.
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Affiliation(s)
- W Jason Peters
- Department of Psychology, Louisiana State University, Baton Rouge, LA, 70803, USA.
| | - Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA, 70803, USA
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Huang Y, Arnold SR, Foley KR, Trollor JN. Diagnosis of autism in adulthood: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1311-1327. [PMID: 32106698 DOI: 10.1177/1362361320903128] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2025]
Abstract
LAY ABSTRACT More adults are getting assessed for possible autism. Here, we give an overview on what is already known about autism diagnosis in adulthood and find areas that need more research. We divided results from the studies we found into six topics of (1) rates of autism in different groups; (2) the process of getting an autism diagnosis in adulthood; (3) gender; (4) personality traits, abilities and behaviours of diagnosed adults; (5) mental and physical health conditions that occur together with autism; and (6) how adults think and feel about being assessed and diagnosed. We found that adults often have strong emotions after being diagnosed, the process of getting a diagnosis can be unclear and different for everyone, and not many support services are available for adults. More research on diagnosing adults with intellectual disability, differences between early and late-diagnosed adults, and support after diagnosis would be useful.
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Affiliation(s)
- Yunhe Huang
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Samuel Rc Arnold
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Kitty-Rose Foley
- University of New South Wales, Australia
- Southern Cross University, Australia
| | - Julian N Trollor
- University of New South Wales, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Fernandes CS, Tomazelli J, Girianelli VR. Diagnóstico de autismo no século XXI: evolução dos domínios nas categorizações nosológicas. PSICOLOGIA USP 2020. [DOI: 10.1590/0103-6564e200027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Resumo Os critérios que subsidiaram o diagnóstico do autismo passaram por diversas mudanças ao longo dos anos, acompanhando os pressupostos conceituais hegemônicos no período. O objetivo deste estudo é analisar a evolução do diagnóstico do autismo no século XXI, a partir dos domínios e subdomínios em que se baseiam as categorizações nosológicas. Adicionalmente, são sinalizados instrumentos auxiliares utilizados e algumas tecnologias diagnósticas em desenvolvimento, além de modelos conceituais que tratam do perfil neuropsicológico. Trata-se de pesquisa documental, tendo como referência os manuais diagnósticos existentes no período. Os domínios de interação social, comunicação e padrão restrito e repetitivo de comportamento foram mantidos nos diferentes manuais diagnósticos abordados. Os subdomínios de interação social e comunicação foram reduzidos, enquanto o padrão restrito e repetitivo teve consolidação no DSM-5. Compreender a evolução dos critérios diagnósticos tende a promover o desenvolvimento da clínica, potencializando a antecipação do diagnóstico e as intervenções necessárias para um melhor prognóstico.
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Affiliation(s)
| | - Jeane Tomazelli
- Instituto Nacional de Câncer José Alencar Gomes da Silva, Brasil
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18
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Blázquez Hinojosa A, Lázaro Garcia L, Puig Navarro O, Varela Bondelle E, Calvo Escalona R. Sensitivity and specificity of DSM-5 diagnostic criteria for autism spectrum disorder in a child and adolescent sample. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2019; 14:S1888-9891(19)30099-0. [PMID: 31864965 DOI: 10.1016/j.rpsm.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Controversy exists regarding the DSM-5 criteria for autism spectrum disorders (ASD). Given the mixed results that have been reported, our main aim was to determine DSM-5 sensitivity and specificity in a child and adolescent Spanish sample. As secondary goals, we assessed the diagnostic stability of DSM-IV-TR in DSM-5, and clinical differences between children diagnosed with an ASD or a social (pragmatic) communication disorder (SPCD). METHODS This study was carried out in 2017, reviewing the medical records of patients evaluated in our service. Items from a parent report measure of ASD symptoms (Autism Diagnostic Interview-Revised) were matched to DSM-5 criteria and used to assess the sensitivity and specificity of the DSM-5 criteria and current DSM-IV criteria when compared with clinical diagnoses. RESULTS DSM-5 sensitivity ranged from 0.69 to 1.00, and was higher in females. By age, the DSM-5 and DSM-IV-TR criteria showed similar sensitivity. In the case of intellectual quotient, DSM-5 criteria sensitivity was lower for those in the "low-functioning" category. DSM-5 specificity ranged from 0.64 to 0.73, while DSM-5 specificity was similar for all phenotypic subgroups. With respect to stability, 83.3% of autism disorder cases retained a diagnosis of ASD using the DSM-5 criteria. With regard to differences between ASD and SPCD, we found that patients diagnosed with ASD received more pharmacological treatment than those diagnosed with SPCD. CONCLUSIONS Further research is required to confirm our results. Studies focusing on the SPCD phenotype will be necessary to determine outcome differences with ASD and the most effective diagnostic and therapeutic tools.
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Affiliation(s)
- Ana Blázquez Hinojosa
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España.
| | - Luisa Lázaro Garcia
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España; Departamento de Psiquiatría y Psicobiología Clínica, Universidad de Barcelona, Barcelona, España
| | - Olga Puig Navarro
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
| | - Eva Varela Bondelle
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España
| | - Rosa Calvo Escalona
- Servicio de Psiquiatría y Psicología Infantil y Juvenil, Instituto de Neurociencias, Hospital Clínico Universitario, Barcelona, España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, España
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de Giambattista C, Ventura P, Trerotoli P, Margari M, Palumbi R, Margari L. Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome. J Autism Dev Disord 2019; 49:138-150. [PMID: 30043350 PMCID: PMC6331497 DOI: 10.1007/s10803-018-3689-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Since Hans Asperger's first description (Arch Psych Nervenkrankh 117:76-136, 1944), through Lorna Wing's translation and definition (Psychol Med 11:115-129, 1981), to its introduction in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, 1994), Asperger Syndrome has always aroused huge interest and debate, until vanishing in the DSM fifth edition (2013). The debate regarded its diagnostic validity and its differentiation from high functioning autism (HFA). The present study aimed to examine whether AS differed from HFA in clinical profiles and to analyze the impact of DSM-5's innovation. Differences in cognitive, language, school functioning and comorbidities, were revealed when 80 AS and 70 HFA patients (3-18 years) were compared. Results suggested that an AS empirical distinction within autism spectrum disorder should be clinically useful.
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Affiliation(s)
- Concetta de Giambattista
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Patrizia Ventura
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Paolo Trerotoli
- Medical Statistic, Department of Biomedical Science and Human Oncology, University of “Aldo Moro” Bari, Bari, Italy
| | - Mariella Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Roberto Palumbi
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
| | - Lucia Margari
- Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, Hospital Polyclinic of Bari, University of “Aldo Moro” Bari, Piazza Giulio Cesare 1, 70100 Bari, Italy
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20
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A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder. J Autism Dev Disord 2018. [PMID: 28620892 DOI: 10.1007/s10803-017-3200-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.
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21
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Hou YM, Stewart L, Iao LS, Wu CC. Parenting stress and depressive symptoms in Taiwanese mothers of young children with autism spectrum disorder: Association with children's behavioural problems. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:1113-1121. [PMID: 29790634 DOI: 10.1111/jar.12471] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 04/03/2018] [Accepted: 04/17/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study examined the severity of parenting stress and depressive symptoms in Taiwanese mothers of young children with autism spectrum disorder (ASD) compared to mothers of young children with developmental delay (DD). The associations between parenting stress, depressive symptoms, and children's behavioural problems were also tested. METHODS The study sample included 51 young children with ASD (mean age = 31 months), 51 young children with DD (mean age = 30 months) and their mothers. RESULTS The results confirmed that mothers of young children with ASD experienced higher levels of parenting stress and depressive symptoms than mothers of young children with DD. In addition, children's behavioural problems were robust predictors of parenting stress and depressive symptoms in mothers of young children with ASD, but not in mothers of young children with DD. CONCLUSION The findings indicated that one of the critical goals in early intervention for young children with ASD and their families is to reduce children's behavioural problems.
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Affiliation(s)
- Yuh-Ming Hou
- Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chai-Yi, Taiwan
| | - Lydia Stewart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
| | - Lai-Sang Iao
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Chin-Chin Wu
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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22
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Sung M, Goh TJ, Tan BLJ, Chan JS, Liew HSA. Comparison of DSM-IV-TR and DSM-5 Criteria in Diagnosing Autism Spectrum Disorders in Singapore. J Autism Dev Disord 2018; 48:3273-3281. [DOI: 10.1007/s10803-018-3594-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sim A, Vaz S, Cordier R, Joosten A, Parsons D, Smith C, Falkmer T. Factors associated with stress in families of children with autism spectrum disorder. Dev Neurorehabil 2018; 21:155-165. [PMID: 28598245 DOI: 10.1080/17518423.2017.1326185] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The purpose of this study was to identify key factors associated with severe stress in families raising a child with autism spectrum disorder (ASD). METHODS Questionnaires were mailed to families with one or more children with a diagnosis of ASD. Data from 543 surveys were analyzed using univariate and multivariate logistic regression. RESULTS Forty-four percent (n = 241) of the caregivers reported severe family stress related to raising a child with ASD. Severe family stress was associated with (1) reduced ability to socialize; (2) not having accessed individual therapy; (3) negative co-parent relationships; and (4) high out of pockets costs due to the child's ASD. The specific ASD diagnosis, comorbid conditions, socio-demographic variables, and social support were not associated with severe family stress. CONCLUSION The findings of the current study highlight the importance of a systemic approach to family stress, whereby individual, family, and ecological factors are investigated.
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Affiliation(s)
- Angela Sim
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia
| | - Sharmila Vaz
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia
| | - Reinie Cordier
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia
| | - Annette Joosten
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia
| | - Dave Parsons
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia
| | - Cally Smith
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia
| | - Torbjörn Falkmer
- a School of Occupational Therapy and Social Work , Curtin University , Perth , Western Australia , Australia.,b School of Occupational Therapy , La Trobe University , Melbourne , Vic , Australia.,c Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH) , Faculty of Health Sciences, Linköping University & Pain and Rehabilitation Centre, UHL, County Council , Linköping , Sweden.,d Cooperative Research Centre for Living with Autism Spectrum Disorders (Autism CRC), Long Pocket , Brisbane , Queensland , Australia
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24
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Yaylaci F, Miral S. A Comparison of DSM-IV-TR and DSM-5 Diagnostic Classifications in the Clinical Diagnosis of Autistic Spectrum Disorder. J Autism Dev Disord 2017; 47:101-109. [PMID: 27747464 DOI: 10.1007/s10803-016-2937-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Aim of this study was to compare children diagnosed with Pervasive Developmental Disorder (PDD) according to DSM-IV-TR and DSM-5 diagnostic systems. One hundred fifty children aged between 3 and 15 years diagnosed with PDD by DSM-IV-TR were included. PDD symptoms were reviewed through psychiatric assessment based on DSM-IV-TR and DSM-5 criteria. Clinical severity was determined using Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC). A statistically significant decrease (19.3 %) was detected in the diagnostic ratio with DSM-5. Age and symptom severity differed significantly between those who were and were not diagnosed with PDD using DSM-5. B4 criteria in DSM-5 was most common criterion. Results indicate that individuals diagnosed with PDD by DSM-IV-TR criteria may not be diagnosed using DSM-5 criteria.
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Affiliation(s)
- Ferhat Yaylaci
- Karaman State Hospital, Child and Adolescent Psychiatry Unit, Universite Mah., 1984 Sk., No: 1, Karaman, Turkey.
| | - Suha Miral
- Dokuz Eylul University Hospital, Child and Adolescent Psychiatry Unit, Izmir, Turkey
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25
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Burns CO, Matson JL. An evaluation of the clinical application of the DSM-5 for the diagnosis of autism spectrum disorder. Expert Rev Neurother 2017; 17:909-917. [PMID: 28678629 DOI: 10.1080/14737175.2017.1351301] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The changes to the diagnostic criteria for autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were met with much controversy by researchers, clinicians, and families of individuals with ASD. The goal of this paper is to review the literature on the impact of these changes. Areas covered: This paper reviews the major changes to diagnostic criteria from DSM-IV-TR to DSM-5. It emphasizes how these changes are hypothesized to impact prevalence rates, as well as trends in characteristics of individuals who would have met previous criteria for ASD but no longer qualify for a diagnosis under DSM-5. Policy issues such as access to services and research considerations are also briefly reviewed. Expert commentary: Researchers have found that the DSM-5 diagnostic criteria for ASD may significantly impact which children receive diagnoses, which in turn affects access to services that address impairments characteristic of this disorder. Despite the fact that the DSM-5 has now been in use for four years, fewer recent studies were identified than was expected. Future research should continue to focus on the impact of changes in criteria, as well as on translational scientific advances across disciplines.
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Affiliation(s)
- Claire O Burns
- a Louisiana State University , Department of Psychology, Clinical Psychology , Baton Rouge , LA , USA
| | - Johnny L Matson
- a Louisiana State University , Department of Psychology, Clinical Psychology , Baton Rouge , LA , USA
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Zauche LH, Darcy Mahoney AE, Higgins MK. Predictors of Co-occurring Neurodevelopmental Disabilities in Children With Autism Spectrum Disorders. J Pediatr Nurs 2017; 35:113-119. [PMID: 28728761 DOI: 10.1016/j.pedn.2017.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/30/2017] [Accepted: 04/05/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Co-occurring neurodevelopmental disabilities (including cognitive and language delays and attention deficit hyperactivity disorder) affect over half of children with ASD and may affect later behavioral, language, and cognitive outcomes beyond the ASD diagnosis. However, no studies have examined predictors of co-occurring neurodevelopmental disabilities in children with ASD. This study investigated whether maternal sociodemographic, perinatal and neonatal factors are associated with co-occurring disabilities. DESIGN AND METHODS This study involved a retrospective analysis of medical records for children diagnosed with ASD between 2009 and 2010 at an Autism Center in the southeast United States. Logistic regression was used to identify predictors of co-occurring neurodevelopmental disabilities. RESULTS Of the 385 children in the sample, 61% had a co-occurring neurodevelopmental disability. Children whose mothers had less education (OR: 0.905), had never been married (OR: 1.803), or had bleeding during pregnancy (OR: 2.233) were more likely to have a co-occurring neurodevelopmental disability. Both preterm birth and African American race were associated with bleeding during pregnancy. CONCLUSIONS Several maternal and perinatal risk factors for ASD were found to put children at risk for further diagnoses of co-occurring neurodevelopmental disabilities. While prematurity, a well-established risk factor for ASD, as well as maternal ethnicity was not found to increase the risk of a co-occurring disability, this study suggests that bleeding during pregnancy may moderate these relationships. PRACTICE IMPLICATIONS Understanding maternal, perinatal, and neonatal risk factors may inform healthcare provider screening for ASD and co-occurring neurodevelopmental disabilities by helping providers recognize infants who present with multiple risk factors.
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Affiliation(s)
- Lauren Head Zauche
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Ashley E Darcy Mahoney
- George Washington University, Autism and Neurodevelopmental Disorders Institute, 2121 Eye Street NW, Washington, D.C. 20052, United States
| | - Melinda K Higgins
- Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322, United States
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Williams ME, Wheeler BY, Linder L, Jacobs RA. Evolving Definitions of Autism and Impact on Eligibility for Developmental Disability Services: California Case Example. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 55:192-209. [PMID: 28608770 DOI: 10.1352/1934-9556-55.3.192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
When establishing eligibility for developmental disability (DD) services, definitions of specific diagnostic conditions, such as autism, impact policy. Under the Medicaid home and community-based waiver program, states have discretion in determining specific program or service eligibility criteria, the nature of supports to be provided, and the number of individuals to be served. Individuals with DD, their families, and advocates have pushed to expand eligibility and improve the quality of services and supports received. This article uses a California legal case to explore the impact on individuals seeking eligibility for DD services when states rely on evolving diagnostic criteria for autism spectrum disorder. Recommendations are made for a more equitable and consistent approach to disability eligibility determination.
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Affiliation(s)
- Marian E Williams
- Marian E. Williams, Barbara Y. Wheeler, Lisa Linder, and Robert A. Jacobs, Children's Hospital Los Angeles, USC University Center for Excellence in Developmental Disabilities. Lisa Linder is now at Department of Family and Child Development, San Diego State University
| | - Barbara Y Wheeler
- Marian E. Williams, Barbara Y. Wheeler, Lisa Linder, and Robert A. Jacobs, Children's Hospital Los Angeles, USC University Center for Excellence in Developmental Disabilities. Lisa Linder is now at Department of Family and Child Development, San Diego State University
| | - Lisa Linder
- Marian E. Williams, Barbara Y. Wheeler, Lisa Linder, and Robert A. Jacobs, Children's Hospital Los Angeles, USC University Center for Excellence in Developmental Disabilities. Lisa Linder is now at Department of Family and Child Development, San Diego State University
| | - Robert A Jacobs
- Marian E. Williams, Barbara Y. Wheeler, Lisa Linder, and Robert A. Jacobs, Children's Hospital Los Angeles, USC University Center for Excellence in Developmental Disabilities. Lisa Linder is now at Department of Family and Child Development, San Diego State University
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28
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Darcy-Mahoney A, Minter B, Higgins M, Guo Y, Zauche LH, Hirst J. Maternal and Neonatal Birth Factors Affecting the Age of ASD Diagnosis. NEWBORN AND INFANT NURSING REVIEWS : NAINR 2016; 16:340-347. [PMID: 28989330 PMCID: PMC5630129 DOI: 10.1053/j.nainr.2016.09.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Early diagnosis of autism spectrum disorders (ASD) enables early intervention that improves long term functioning of children with ASD but is often delayed until age of school entry. Few studies have identified factors that affect timely diagnosis. This study addressed how maternal education, race, age, marital status as well as neonatal birth factors affect the age at which a child is diagnosed with ASD. This study involved a retrospective analysis of 664 records of children treated at one of the largest autism treatment centers in the United States from March 1, 2009 to December 30, 2010. Logistic regression and Cox proportional hazards regression were used to identify maternal and neonatal factors associated with age of diagnosis. Infant gender, maternal race, marital status, and maternal age were identified as significant factors for predicting the age of ASD diagnosis. In the Cox proportional hazards regression model, only maternal race and marital status were included. Median survival age till diagnosis of children born to married mothers was 53.4 months compared to 57.8 months and 63.7 months of children born to single and divorced or widowed mothers respectively. Median survival age till diagnosis for children of African American mothers was 53.8 months compared to 57.2 months for children of Caucasian mothers. No statistically significant difference of timing of ASD diagnosis was found for children of varying gestational age. Children born to older or married mothers and mothers of minority races were more likely to have an earlier ASD diagnosis. No statistically significant differences in timing of ASD diagnosis were found for children born at varying gestational ages. Identification of these factors has the potential to inform public health outreach aimed at promoting timely ASD diagnosis. This work could enhance clinical practice for timelier diagnoses of ASD by supporting parents and clinicians around the world in identifying risk factors beyond gender and SES and developing strategies to recognize earlier signs of ASD and contribute to improved development outcomes in children with ASD.
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Affiliation(s)
| | - Bonnie Minter
- Children's Healthcare of Atlanta, Marcus Autism Center, Atlanta, GA 30329
| | - Melinda Higgins
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA 30322
| | - Ying Guo
- Emory University Nell Hodgson Woodruff School of Nursing, Emory University Rollins School of Public Health, Atlanta, GA 30322
| | - Lauren Head Zauche
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA 30322
| | - Jessica Hirst
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA 30322
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29
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Change in Autism Diagnoses Prior to and Following the Introduction of DSM-5. J Autism Dev Disord 2016; 47:163-171. [DOI: 10.1007/s10803-016-2942-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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30
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Lobar SL. DSM-V Changes for Autism Spectrum Disorder (ASD): Implications for Diagnosis, Management, and Care Coordination for Children With ASDs. J Pediatr Health Care 2016; 30:359-65. [PMID: 26602109 DOI: 10.1016/j.pedhc.2015.09.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 08/31/2015] [Accepted: 09/17/2015] [Indexed: 10/22/2022]
Abstract
The purpose of this article is to highlight issues about diagnosis and management of autism spectrum disorders (ASDs) in all settings, along with care coordination for all children with ASDs. The article outlines differences between the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised (DSM-IV-TR) and the newer version (DSM-V) for ASDs. These changes may limit the eligibility of some children for services in school, leading to poorer social/academic outcomes, lower rates of employment, and decreased assistance in eventual independent living. Primary care providers identified a lack of knowledge regarding ASDs before the DSM-V was published, describing difficulty in making ASD diagnoses, recognizing early symptoms of developmental concern, and managing care. Care coordination is part of the role of the advanced practice nurse, and lack of understanding of ASD changes in the DSM-V may diminish the ability of advanced practice nurses to screen for ASDs and make the appropriate referrals.
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31
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Judgments of Nonverbal Behaviour by Children with High-Functioning Autism Spectrum Disorder: Can they Detect Signs of Winning and Losing from Brief Video Clips? J Autism Dev Disord 2016; 46:2916-23. [PMID: 27306454 DOI: 10.1007/s10803-016-2839-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Typically developing children are able to judge who is winning or losing from very short clips of video footage of behaviour between active match play across a number of sports. Inferences from "thin slices" (short video clips) allow participants to make complex judgments about the meaning of posture, gesture and body language. This study extends the use of the thin slice research paradigm to children with high-functioning autism spectrum disorder (ASD). We tested 38 children with ASD, in two age groups: 15 participants aged 5-8 years and 23 participants aged 9-13 years. We found that the children with ASD had a rate of accuracy similar to that of typically developing peers tested in a previous study.
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32
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Hartley-McAndrew M, Mertz J, Hoffman M, Crawford D. Rates of Autism Spectrum Disorder Diagnosis Under the DSM-5 Criteria Compared to DSM-IV-TR Criteria in a Hospital-Based Clinic. Pediatr Neurol 2016; 57:34-8. [PMID: 26869267 DOI: 10.1016/j.pediatrneurol.2016.01.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/08/2016] [Accepted: 01/09/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND We aimed to determine whether there was a decrease in the number of children diagnosed on the autism spectrum after the implementation of the new diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition published in May 2013. METHOD We reviewed 1552 charts of children evaluated at the Women and Children's Hospital of Buffalo, Autism Spectrum Disorders Clinic. A comparison was made of children diagnosed with autism spectrum disorder (autism, Asperger disorder, pervasive developmental disorder-not otherwise specified) from 2010 to May 2013 using the Diagnostic and Statistical Manual of Mental Health Disorders Fourth Edition, Text Revision criteria with children diagnosed from June 2013 through June 2015 under the Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition. RESULTS Using χ(2) analysis, the 2013-2015 rate of autism spectrum disorder diagnosis (39%) was significantly lower (P < 0.01) than the 2010 to May 2013 sample years rate (50%). CONCLUSION The rate of autism spectrum disorder diagnosis was significantly lower under the recently implemented Diagnostic and Statistical Manual of Mental Health Disorders Fifth Edition criteria.
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Affiliation(s)
- Michelle Hartley-McAndrew
- Department of Pediatrics Children's Guild Foundation Autism Spectrum Disorder Center Women and Children's Hospital of Buffalo Buffalo, New York; Department of Neurology Children's Guild Foundation Autism Spectrum Disorder Center Women and Children's Hospital of Buffalo Buffalo, New York.
| | - Jana Mertz
- Department of Pediatrics Children's Guild Foundation Autism Spectrum Disorder Center Women and Children's Hospital of Buffalo Buffalo, New York; Department of Neurology Children's Guild Foundation Autism Spectrum Disorder Center Women and Children's Hospital of Buffalo Buffalo, New York
| | - Martin Hoffman
- Division of Behavioral Pediatrics and Rehabilitation, Department of Pediatrics, Robert Warner Center for Children with Special Needs, Women and Children's Hospital of Buffalo, Buffalo, New York
| | - Donald Crawford
- Department of Child Psychiatry, Women and Children's Hospital of Buffalo, Buffalo, New York
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33
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Smith IC, Reichow B, Volkmar FR. The Effects of DSM-5 Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorder: A Systematic Review. J Autism Dev Disord 2016; 45:2541-52. [PMID: 25796195 DOI: 10.1007/s10803-015-2423-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A growing body of research has raised concerns about the number of individuals diagnosed with autism spectrum disorder (ASD) according to DSM-IV-TR who may no longer qualify for diagnoses under the new DSM-5 criteria, published in May 2013. The current study systematically reviews 25 articles evaluating samples according to both DSM-IV-TR and DSM-5 ASD criteria. Consistent with previous reviews, the majority of included studies indicated between 50 and 75% of individuals will maintain diagnoses. We conducted visual analyses of subgroups using harvest plots and found the greatest decreases among high-functioning populations with IQs over 70 and/or previous diagnoses of PDD-NOS or Asperger's disorder. We discuss the potential research and clinical implications of reduced numbers of individuals diagnosed with ASD.
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Affiliation(s)
- Isaac C Smith
- Yale Child Study Center, 230 South Frontage Rd., New Haven, CT, 06520, USA,
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34
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A Meta-analysis of DSM-5 Autism Diagnoses in Relation to DSM-IV and DSM-IV-TR. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-016-0070-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Harstad EB, Fogler J, Sideridis G, Weas S, Mauras C, Barbaresi WJ. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using DSM-IV-TR and DSM-5 Criteria. J Autism Dev Disord 2015; 45:1437-50. [PMID: 25384720 DOI: 10.1007/s10803-014-2306-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Controversy exists regarding the DSM-5 criteria for ASD. This study tested the psychometric properties of the DSM-5 model and determined how well it performed across different gender, IQ, and DSM-IV-TR sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70). DSM-5 was psychometrically superior to the DSM-IV-TR model (Comparative Fit Index of 0.970 vs 0.879, respectively). Measurement invariance revealed good model fit across gender and IQ. Younger children tended to meet fewer diagnostic criteria. Those with autistic disorder were more likely to meet social communication and repetitive behaviors criteria (p < .001) than those with PDD-NOS. DSM-5 is a robust model but will identify a different, albeit overlapping population of individuals compared to DSM-IV-TR.
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Affiliation(s)
- Elizabeth B Harstad
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA,
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36
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The Effects of DSM5 Autism Diagnostic Criteria on Number of Individuals Diagnosed with Autism Spectrum Disorders: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2014. [DOI: 10.1007/s40489-014-0016-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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37
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Abstract
PURPOSE OF REVIEW In the lead up to and following the recent publication of the DSM-5, the diagnostic construct of autism has received intense scrutiny. RECENT FINDINGS This article briefly reviews the history of the diagnosis of autism, the changes that have occurred in the diagnosis over time, and the rationale for change. The most significant changes being introduced with the DSM-5 are highlighted, as well as some of the concerns that will be a focus of attention with respect to the potential impacts going forward. SUMMARY The categorical divisions that characterized the pervasive developmental disorders are now collapsed into a single entity, autism spectrum disorder. The final DSM-5 criteria have yet to be formally compared prospectively against prior criteria, but early indications suggest that the boundaries around the pervasive developmental disorders have not been substantially altered.
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Affiliation(s)
- Bryan H. King
- Seattle Children’s Hospital, Seattle, USA
- University of Washington Psychiatry & Behavioral Sciences, Washington, USA
| | - Noa Navot
- University of Washington Psychiatry & Behavioral Sciences, Washington, USA
| | - Raphael Bernier
- Seattle Children’s Hospital, Seattle, USA
- University of Washington Psychiatry & Behavioral Sciences, Washington, USA
| | - Sara Jane Webb
- Seattle Children’s Hospital, Seattle, USA
- University of Washington Psychiatry & Behavioral Sciences, Washington, USA
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