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Metwally AM, Helmy MA, Salah El-Din EM, Saleh RM, Abdel Raouf ER, Abdallah AM, Khadr Z, Elsaied A, El-Saied MM, Bassiouni RI, Nagi DA, Shehata MA, El-Alameey IR, El-Hariri HM, Salama SI, Rabah TM, Abdel-Latif GA, El Etreby LA, Elmosalami DM, Sami SM, Eltahlawy E, Ibrahim NA, Elghareeb NA, Badawy HY, Dewdar EM, Ashaat EA. National screening for Egyptian children aged 1 year up to 12 years at high risk of Autism and its determinants: a step for determining what ASD surveillance needs. BMC Psychiatry 2023; 23:471. [PMID: 37381024 DOI: 10.1186/s12888-023-04977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
This study aimed to provide a national estimate of the prevalence of the high risk of autism spectrum disorder (ASD) and their determinants. A national screening survey was conducted for 41,640 Egyptian children aged 1 to 12 years in two phases. Tools used were Vineland's Adaptive Behavior Scales, Modified Checklist for Autism in Toddlers, Gilliam Autism Rating scale, and Denver II Developmental screening test. The overall prevalence of children at high risk of ASD was 3.3% (95% CI:3.1%-3.5%). Children living without mothers in homes, suffered from convulsions (AOR = 3.67; 95%CI:2.8-4.8), a history of cyanosis after birth (AOR = 1.87; 95% CI:1.35-2.59) or history of LBW babies (AOR = 1.53; 95% CI:1.23-1.89) carried higher odds of being at high risk of ASD.
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Affiliation(s)
- Ammal M Metwally
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt.
| | - Mona A Helmy
- Environmental and Occupational Medicine Department, Environmental and Climate Change Research Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Ebtissam M Salah El-Din
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Rehan M Saleh
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Ehab R Abdel Raouf
- Child With Special Needs Dept./ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Ali M Abdallah
- Quantitative Methods Department - Aswan University, Tingar, Egypt
| | - Zeinab Khadr
- Department of Statistics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt
- The Social Research Center of the American University in Cairo, Cairo, Egypt
| | - Amal Elsaied
- Child With Special Needs Dept./ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Mostafa M El-Saied
- Child With Special Needs Dept./ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Randa I Bassiouni
- Clinical Genetics Dept./ Human Genetics and Genome Research Institute, National Research Centre , Dokki, Cairo, 60014618, Egypt
| | - Dina A Nagi
- Clinical Genetics Dept./ Human Genetics and Genome Research Institute, National Research Centre , Dokki, Cairo, 60014618, Egypt
| | - Manal A Shehata
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Inas R El-Alameey
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Hazem M El-Hariri
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Somia I Salama
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Thanaa M Rabah
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Ghada A Abdel-Latif
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Lobna A El Etreby
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Dalia M Elmosalami
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Samia M Sami
- Child Health Department/ Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Eman Eltahlawy
- Environmental and Occupational Medicine Department, Environmental and Climate Change Research Institute, National Research Centre, Dokki, Cairo, 60014618, Egypt
| | - Nihad A Ibrahim
- Community Medicine Research Department/ Medical Research and Clinical Studies Institute, National Research Centre, Cairo, 60014618, Dokki, Egypt
| | - Nahed A Elghareeb
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Hala Y Badawy
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Eman M Dewdar
- Disability Prevention General Directorate, Ministry of Health and Population, Cairo, Egypt
| | - Engy A Ashaat
- Clinical Genetics Dept./ Human Genetics and Genome Research Institute, National Research Centre , Dokki, Cairo, 60014618, Egypt
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Metwally AM, Helmy MA, Salah El-Din EM, Saleh RM, Abdel Raouf ER, Abdallah AM, Khadr Z, Elsaied A, El-Saied MM, Bassiouni RI, Nagi DA, Shehata MA, El-Alameey IR, El-Hariri HM, Salama SI, Rabah TM, Abdel-Latif GA, El Etreby LA, Elmosalami DM, Sami SM, Eltahlawy E, Ibrahim NA, Elghareeb NA, Badawy HY, Dewdar EM, Ashaat EA. National screening for Egyptian children aged 1 year up to 12 years at high risk of Autism and its determinants: a step for determining what ASD surveillance needs. BMC Psychiatry 2023; 23:471. [DOI: https:/doi.org/10.1186/s12888-023-04977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/20/2023] [Indexed: 10/31/2023] Open
Abstract
AbstractThis study aimed to provide a national estimate of the prevalence of the high risk of autism spectrum disorder (ASD) and their determinants. A national screening survey was conducted for 41,640 Egyptian children aged 1 to 12 years in two phases. Tools used were Vineland's Adaptive Behavior Scales, Modified Checklist for Autism in Toddlers, Gilliam Autism Rating scale, and Denver II Developmental screening test. The overall prevalence of children at high risk of ASD was 3.3% (95% CI:3.1%–3.5%). Children living without mothers in homes, suffered from convulsions (AOR = 3.67; 95%CI:2.8–4.8), a history of cyanosis after birth (AOR = 1.87; 95% CI:1.35–2.59) or history of LBW babies (AOR = 1.53; 95% CI:1.23–1.89) carried higher odds of being at high risk of ASD.
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Pretzsch CM, Floris DL, Schäfer T, Bletsch A, Gurr C, Lombardo MV, Chatham CH, Tillmann J, Charman T, Arenella M, Jones E, Ambrosino S, Bourgeron T, Dumas G, Cliquet F, Leblond CS, Loth E, Oakley B, Buitelaar JK, Baron-Cohen S, Beckmann CF, Persico AM, Banaschewski T, Durston S, Freitag CM, Murphy DGM, Ecker C. Cross-sectional and longitudinal neuroanatomical profiles of distinct clinical (adaptive) outcomes in autism. Mol Psychiatry 2023; 28:2158-2169. [PMID: 36991132 PMCID: PMC10575772 DOI: 10.1038/s41380-023-02016-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/31/2023]
Abstract
Individuals with autism spectrum disorder (henceforth referred to as autism) display significant variation in clinical outcome. For instance, across age, some individuals' adaptive skills naturally improve or remain stable, while others' decrease. To pave the way for 'precision-medicine' approaches, it is crucial to identify the cross-sectional and, given the developmental nature of autism, longitudinal neurobiological (including neuroanatomical and linked genetic) correlates of this variation. We conducted a longitudinal follow-up study of 333 individuals (161 autistic and 172 neurotypical individuals, aged 6-30 years), with two assessment time points separated by ~12-24 months. We collected behavioural (Vineland Adaptive Behaviour Scale-II, VABS-II) and neuroanatomical (structural magnetic resonance imaging) data. Autistic participants were grouped into clinically meaningful "Increasers", "No-changers", and "Decreasers" in adaptive behaviour (based on VABS-II scores). We compared each clinical subgroup's neuroanatomy (surface area and cortical thickness at T1, ∆T (intra-individual change) and T2) to that of the neurotypicals. Next, we explored the neuroanatomical differences' potential genomic associates using the Allen Human Brain Atlas. Clinical subgroups had distinct neuroanatomical profiles in surface area and cortical thickness at baseline, neuroanatomical development, and follow-up. These profiles were enriched for genes previously associated with autism and for genes previously linked to neurobiological pathways implicated in autism (e.g. excitation-inhibition systems). Our findings suggest that distinct clinical outcomes (i.e. intra-individual change in clinical profiles) linked to autism core symptoms are associated with atypical cross-sectional and longitudinal, i.e. developmental, neurobiological profiles. If validated, our findings may advance the development of interventions, e.g. targeting mechanisms linked to relatively poorer outcomes.
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Affiliation(s)
- Charlotte M Pretzsch
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Dorothea L Floris
- Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Tim Schäfer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Anke Bletsch
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Caroline Gurr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michael V Lombardo
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - Chris H Chatham
- F. Hoffmann La Roche, Innovation Center Basel, Basel, Switzerland
| | - Julian Tillmann
- F. Hoffmann La Roche, Innovation Center Basel, Basel, Switzerland
| | - Tony Charman
- Clinical Child Psychology, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Martina Arenella
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Emily Jones
- Centre for Brain & Cognitive Development, University of London, London, UK
| | - Sara Ambrosino
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Guillaume Dumas
- CHU Sainte-Justine Research Center, Department of Psychiatry, University of Montreal, Montreal, QC, Canada
| | - Freddy Cliquet
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Claire S Leblond
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Christian F Beckmann
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - Antonio M Persico
- Child and Adolescent Neuropsychiatry, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sarah Durston
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Declan G M Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
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Parent Perceptions of the Effects of Early Intensive Behavioral Interventions for Children with Autism. Behav Sci (Basel) 2023; 13:bs13010045. [PMID: 36661617 PMCID: PMC9855042 DOI: 10.3390/bs13010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023] Open
Abstract
The current study aimed to understand parents' perceptions of the effects of early intensive behavioral intervention (EIBI) based on the principles of applied behavioral analysis (ABA) and the lasting outcomes for their children with Autism spectrum disorder (ASD). In particular, this study sought to examine parent perceptions of the relationship between the intensity of ABA interventions and current autism symptom severity, adaptive functioning, and school placement. The current study employed a convergent parallel mixed-methods design, which consisted of collecting, analyzing, interpreting, and combining both quantitative and qualitative data. Overall, results suggested that the intensity of previous ABA interventions was a unique predictor of current school placement. Additionally, results suggested that the intensity of previous ABA interventions was a unique predictor of adaptive skills, which was supported by parent interviews. However, the intensity of previous ABA interventions was not a unique predictor of current autism severity. Parent responses to interview questions revealed the imperative nature of the interventions and their effect on service delivery for their children with ASD. Overall, this study provided an increased understanding of parents' perceptions of the effectiveness of EIBI, which in turn may be central to understanding service utilization.
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Sato A, Tominaga K, Iwatani Y, Kato Y, Wataya-Kaneda M, Makita K, Nemoto K, Taniike M, Kagitani-Shimono K. Abnormal White Matter Microstructure in the Limbic System Is Associated With Tuberous Sclerosis Complex-Associated Neuropsychiatric Disorders. Front Neurol 2022; 13:782479. [PMID: 35359647 PMCID: PMC8963953 DOI: 10.3389/fneur.2022.782479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTuberous sclerosis complex (TSC) is a genetic disease that arises from TSC1 or TSC2 abnormalities and induces the overactivation of the mammalian/mechanistic target of rapamycin pathways. The neurological symptoms of TSC include epilepsy and tuberous sclerosis complex-associated neuropsychiatric disorders (TAND). Although TAND affects TSC patients' quality of life, the specific region in the brain associated with TAND remains unknown. We examined the association between white matter microstructural abnormalities and TAND, using diffusion tensor imaging (DTI).MethodsA total of 19 subjects with TSC and 24 age-matched control subjects were enrolled. Tract-based spatial statistics (TBSS) were performed to assess group differences in fractional anisotropy (FA) between the TSC and control groups. Atlas-based association analysis was performed to reveal TAND-related white matter in subjects with TSC. Multiple linear regression was performed to evaluate the association between TAND and the DTI parameters; FA and mean diffusivity in seven target regions and projection fibers.ResultsThe TBSS showed significantly reduced FA in the right hemisphere and particularly in the inferior frontal occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF), uncinate fasciculus (UF), and genu of corpus callosum (CC) in the TSC group relative to the control group. In the association analysis, intellectual disability was widely associated with all target regions. In contrast, behavioral problems and autistic features were associated with the limbic system white matter and anterior limb of the internal capsule (ALIC) and CC.ConclusionThe disruption of white matter integrity may induce underconnectivity between cortical and subcortical regions. These findings suggest that TANDs are not the result of an abnormality in a specific brain region, but rather caused by connectivity dysfunction as a network disorder. This study indicates that abnormal white matter connectivity including the limbic system is relevant to TAND. The analysis of brain and behavior relationship is a feasible approach to reveal TAND related white matter and neural networks. TAND should be carefully assessed and treated at an early stage.
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Affiliation(s)
- Akemi Sato
- United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Koji Tominaga
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiko Iwatani
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoko Kato
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mari Wataya-Kaneda
- Division of Health Science, Department of Neurocutaneous Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Kai Makita
- Research Center for Child Mental Development, University of Fukui, Fukui, Japan
| | - Kiyotaka Nemoto
- Division of Clinical Medicine, Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kuriko Kagitani-Shimono
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Molecular Research Center for Children's Mental Development, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
- *Correspondence: Kuriko Kagitani-Shimono
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Uljarević M, Spackman EK, Cai RY, Paszek KJ, Hardan AY, Frazier TW. Daily living skills scale: Development and preliminary validation of a new, open-source assessment of daily living skills. Front Psychiatry 2022; 13:1108471. [PMID: 36756637 PMCID: PMC9900738 DOI: 10.3389/fpsyt.2022.1108471] [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: 11/26/2022] [Accepted: 12/30/2022] [Indexed: 01/25/2023] Open
Abstract
Autistic individuals and individuals with a range of other neurodevelopmental conditions (NDD) often present with lower levels of daily living skills (DLS) when compared to their neurotypical peers. Importantly, lower levels of DLS have been linked to a range of negative outcomes, including lower rates of post-secondary education, lower employment rates, and higher daily support needs across autism and NDD. However, there are currently no open-source informant-reported instruments for capturing key aspects of DLS. This study describes the development, refinement, and initial psychometric evaluation of a new, relatively brief (53-item). Daily Living Skills Scale (DLSS) in a sample of 1,361 children aged 2-17 years, Confirmatory Factor Analysis demonstrated an excellent fit of unidimensional model to the data (CFI = 0.953, TLI = 0.951, RMSEA = 0.073 [95% CI: 0.071-0.074]). The single-factor CFA model showed evidence of measurement invariance of factor loadings, thresholds, and residual variance (strict invariance) across sex, age, race, and ethnicity. Model reliability and internal consistency were excellent (ω = 0.98; α = 0.97). Conditional reliability estimates indicated very good reliability (= 0.80) for the total DLS scale from very low (θ = -4.2) to high (θ = +2.4) scores. Conceptually derived self-care, homecare, and community participation subscales also showed strong reliability and internal consistency. With further replication, the EFS has excellent potential for wide adoption across research and clinical contexts.
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Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Emily K Spackman
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Ru Ying Cai
- Aspect Research Centre for Autism Practice, French's Forest, Sydney, NSW, Australia
| | - Katherine J Paszek
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights, OH, United States
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Rosello R, Martinez-Raga J, Mira A, Pastor JC, Solmi M, Cortese S. Cognitive, social, and behavioral manifestations of the co-occurrence of autism spectrum disorder and attention-deficit/hyperactivity disorder: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:743-760. [PMID: 34961363 DOI: 10.1177/13623613211065545] [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: 11/16/2022]
Abstract
LAY ABSTRACT This work aimed to review recent research on the characteristics of individuals who have both autism spectrum disorder and attention-deficit/hyperactivity disorder due to their high co-occurrence. Thirty-four studies were analyzed and main findings summarized in two content domains focusing on areas that could enhance our understanding of the cognitive and behavioral characteristics of individuals with autism spectrum disorder + attention-deficit/hyperactivity disorder (ASD+). Most of the results suggested that ASD+ is a co-occurring condition associated with more severe impairments in cognitive functioning, adaptive behavior, and increased likelihood to present more emotional/behavioral problems. These results will be helpful to provide improved care plans for individuals with both attention-deficit/hyperactivity disorder and autism spectrum disorder.
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Baker E, Stavropoulos KKM, Baker BL, Blacher J. Daily living skills in adolescents with autism spectrum disorder: Implications for intervention and independence. RESEARCH IN AUTISM SPECTRUM DISORDERS 2021; 83:101761. [PMID: 33796139 PMCID: PMC8009320 DOI: 10.1016/j.rasd.2021.101761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Challenges in adaptive behaviors are present in individuals with autism spectrum disorder (ASD), while variation in IQ, social skills, and comorbidities are possible influences on adaptive behaviors. However, adaptive behaviors do not consistently map onto cognitive abilities in ASD, as high IQ is not protective against challenges in adaptive behaviors. Additionally, individuals with both ASD and elevated levels of externalizing problem behaviors experience even worse adaptive behaviors. Identifying factors that contribute to the variance in adaptive behaviors, particularly daily living skills (DLS), may inform strategies to improve adaptive behaviors necessary for independence in adulthood. METHOD Adolescents with typical cognitive development (TD, n=84), intellectual disability (ID, n=30), or ASD (n=45) were included in this study to examine group differences in adaptive behaviors, identify relations between IQ and DLS, and determine factors that contribute to variance in DLS at youth age 13. The Vineland Adaptive Behavior Scales, 2nd Edition (VABS-II) was used to measure adaptive behaviors. RESULTS All domains of adaptive behavior were significantly higher in TD groups compared to ASD and ID youth. Significant positive correlations were observed between IQ and DLS in the ASD and ID groups. In the ASD youth group, higher externalizing behavior problems explained the most variance in DLS. CONCLUSIONS DLS are below age-expected levels in young adolescents with ASD, in part because of the higher externalizing behavior problems in this group. Incorporating adaptive skills training and behavior management strategies into current interventions may serve to prepare adolescents and families for the transition to adulthood.
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Affiliation(s)
- Elizabeth Baker
- University of California, Riverside. 900 University Ave,
Riverside, California, USA 92521
| | | | - Bruce L. Baker
- University of California, Los Angeles. Los Angeles,
California, USA 90095
| | - Jan Blacher
- University of California, Riverside. 900 University Ave,
Riverside, California, USA 92521
- University of California, Los Angeles. Los Angeles,
California, USA 90095
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Which Factors Influence Teacher Report of Adaptive Functioning in Autistic Children? J Autism Dev Disord 2021; 52:463-472. [PMID: 33710469 PMCID: PMC8732898 DOI: 10.1007/s10803-021-04930-z] [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] [Accepted: 01/09/2021] [Indexed: 11/16/2022]
Abstract
A wealth of parent-report research shows adaptive functioning difficulties in autistic children, with parent-report influenced by a number of child factors. Adaptive functioning in autistic children is known to vary across settings; however, no research has yet explored factors influencing education professional-report. This study investigated the rate and profile of impairment, and child factors influencing education professional-reported adaptive skills in 248 autistic children. Twelve children were < 3 years (min age for available normative data on the adaptive function measure), so were removed from the analyses. Results replicated parent-literature; adaptive skills were negatively associated with age and informant-reported autism severity, and positively associated with nonverbal ability and expressive language. Adaptive functioning is important for real-world outcomes, e.g. educational attainment, independence, and support needs. Improving our understanding of adaptive functioning in the education context may support opportunities for shared learning and enhance personalised support .
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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11
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Yu L, Zhu X, Shek DTL, Zou XB, Deng HZ, Au Yeung PWH. Validation of the Simplified Chinese Psychoeducational Profile Third Edition in Mainland China. J Autism Dev Disord 2019; 49:1599-1612. [PMID: 30542942 PMCID: PMC6450835 DOI: 10.1007/s10803-018-3827-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The Psychoeducational Profile 3rd Edition (PEP-3) is a comprehensive assessment tool designed for children with autism spectrum disorder (ASD). Although its original English version has been validated, few validation studies have been conducted on translated versions including Chinese ones. Based on 554 Chinese children with ASD and 311 typically developing Chinese children as the control group, this study investigated the psychometric properties of a simplified Chinese PEP-3 (sCPEP-3) in China mainland. Psychometric evaluation of the sCPEP-3 showed satisfactory internal consistency, test–retest reliability, inter-rater reliability, convergent validity, construct validity, and factorial validity. The findings have several implications such as utilizing the sCPEP-3 in mainland China for customized educational program planning, early identification, and evaluating the treatment effects for children with ASD.
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Affiliation(s)
- Lu Yu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China.
| | - Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Xiao-Bing Zou
- Behavioral Pediatrics Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Hong-Zhu Deng
- Behavioral Pediatrics Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
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12
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Protective Factors Against Distress for Caregivers of a Child with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:1092-1107. [PMID: 29313179 DOI: 10.1007/s10803-017-3372-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Caregivers of a child with autism spectrum disorder (ASD) often experience elevated distress. The current study examined potential protective factors against caregiver distress when child externalizing and internalizing behaviors are present: family resources, perceived social support, parenting efficacy, knowledge of ASD, and the agreement between actual and perceived knowledge of ASD. Caregivers of a child with ASD completed an online questionnaire. Results demonstrated main effects for externalizing behavior, family resources, and perceived social support. Significant interactions were found among parenting efficacy and internalizing behavior, and the agreement between actual and perceived knowledge with both externalizing and internalizing behaviors. Results indicate important factors that should be emphasized when working with families of a child with ASD.
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13
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Uljarević M, Hedley D, Nevill R, Evans DW, Cai RY, Butter E, Mulick JA. Brief report: Poor self-regulation as a predictor of individual differences in adaptive functioning in young children with autism spectrum disorder. Autism Res 2018; 11:1157-1165. [DOI: 10.1002/aur.1953] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 03/13/2018] [Accepted: 03/18/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Mirko Uljarević
- Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of Medicine; Stanford University; Stanford California
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne Victoria Australia
| | - Darren Hedley
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne Victoria Australia
- Nationwide Children's Hospital; Columbus Ohio
| | - Rose Nevill
- The Ohio State University; Columbus Ohio
- Kennedy Krieger Institute and John Hopkins School of Medicine; Baltimore Maryland
| | | | - Ru Ying Cai
- Olga Tennison Autism Research Centre; La Trobe University; Melbourne Victoria Australia
| | - Eric Butter
- Nationwide Children's Hospital; Columbus Ohio
- The Ohio State University; Columbus Ohio
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14
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The Application of Adaptive Behaviour Models: A Systematic Review. Behav Sci (Basel) 2018; 8:bs8010011. [PMID: 29342927 PMCID: PMC5791029 DOI: 10.3390/bs8010011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 11/17/2022] Open
Abstract
Adaptive behaviour has been viewed broadly as an individual’s ability to meet the standards of social responsibilities and independence; however, this definition has been a source of debate amongst researchers and clinicians. Based on the rich history and the importance of the construct of adaptive behaviour, the current study aimed to provide a comprehensive overview of the application of adaptive behaviour models to assessment tools, through a systematic review. A plethora of assessment measures for adaptive behaviour have been developed in order to adequately assess the construct; however, it appears that the only definition on which authors seem to agree is that adaptive behaviour is what adaptive behaviour scales measure. The importance of the construct for diagnosis, intervention and planning has been highlighted throughout the literature. It is recommended that researchers and clinicians critically review what measures of adaptive behaviour they are utilising and it is suggested that the definition and theory is revisited.
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15
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Golya N, McIntyre LL. Variability in adaptive behaviour in young children with autism spectrum disorder. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2018; 43:102-111. [PMID: 30581321 PMCID: PMC6300052 DOI: 10.3109/13668250.2017.1287886] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Understanding adaptive behaviour variability in children with autism spectrum disorder (ASD) may have important implications for early intervention. The purpose of this study was to explore whether autism symptom severity and caregiver depression affected adaptive behaviour in young children with ASD. METHOD Data were collected from 60 primary caregivers of children aged 2-6 years with ASD. A factorial multivariate analysis of covariance was conducted to investigate if different levels of autism symptom severity and caregiver depression affected communication, socialisation, and daily living skills, after controlling for child age. RESULTS Findings suggest that only autism symptom severity accounted for significant variance in adaptive behaviour, with socialisation being most impacted. Although more than half of the caregivers reported heightened depressive symptoms, caregiver depression was not related to adaptive behaviour. CONCLUSIONS Findings highlight the level of functional impairment that young children with ASD experience in relation to autism symptom severity.
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Affiliation(s)
- Nandita Golya
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Laura Lee McIntyre
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
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16
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Pathak M, Bennett A, Shui AM. Correlates of adaptive behavior profiles in a large cohort of children with autism: The autism speaks Autism Treatment Network registry data. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:87-99. [DOI: 10.1177/1362361317733113] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children with autism spectrum disorder have deficits in adaptive functioning. This study examines the adaptive behavior, its association with cognitive ability, gender, age, and symptom severity in children with autism spectrum disorder. Using data from Autism Treatment Network registry, the adaptive behavior profiles were examined in 2538 school-aged children (between 5 and 17 years, mean: 8.8 years, standard deviation: 3.0) who had an overall intelligence quotient and Vineland Adaptive Behavior Scale scores available. The children were grouped according to their intelligence quotient (low intelligence quotient < 70; borderline intelligence quotient = 70–85; average intelligence quotient > 85), age (5–10 and 11–17 years), and gender for the analyses. Significantly lower Vineland Adaptive Behavior Scale scores were found in borderline and average intelligence quotient groups when compared to mean intelligence quotient, while an opposite pattern was seen in the low intelligence quotient group, with better adaptive behavior scores than mean intelligence quotient. Vineland Adaptive Behavior Scale standard scores were positively correlated with intelligence quotient and poorly associated with autism spectrum disorder severity. Younger children had significantly higher Vineland Adaptive Behavior Scale scores. Adjusted comparisons by gender were not significant. Adaptive behavior profiles in the intelligence quotient categories are discussed. This study confirms a positive relationship between adaptive behavior and intellectual function in autism and indicates that children with higher intelligence quotient and older age are specifically impaired, with lower adaptive behavior, highlighting the need for assessment and targeted intervention in these groups. Future directions for research are discussed.
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Affiliation(s)
| | | | - Amy M Shui
- Massachusetts General Hospital Biostatistics Center, USA
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17
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Balboni G, Tasso A, Muratori F, Cubelli R. The Vineland-II in Preschool Children with Autism Spectrum Disorders: An Item Content Category Analysis. J Autism Dev Disord 2016. [PMID: 26210516 DOI: 10.1007/s10803-015-2533-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We investigated which item subsets of the Vineland-II can discriminate low-functioning preschoolers with ASD from matched peers with other neurodevelopmental disorders, using a regression analysis derived from a normative sample to account for cognitive and linguistic competencies. At variance with the typical profile, a pattern with Communication more impaired than Socialization was observed. The source of the frequently reported Socialization delay in ASD appears to be in Playing and Imitating skills only, not in other social adaptive behavior skills. The combination of item subsets Playing, Following instructions, Beginning to talk, and Speech skills provided the best discrimination between the two clinical groups. Evaluation of the Vineland-II score on item content categories is a useful procedure for a more efficient clinical description.
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Affiliation(s)
- Giulia Balboni
- Department of Surgery, Medical, Molecular and Critical Area Pathology, University of Pisa, Via Roma, 67, 56126, Pisa, Italy.
| | - Alessandra Tasso
- Department of Humanities, University of Ferrara, Via Paradiso, 12, 44121, Ferrara, Italy
| | - Filippo Muratori
- IRCCS Stella Maris Foundation, University of Pisa, Via dei Giacinti, 2, 56128, Calambrone, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Via dei Giacinti, 2, 56128, Calambrone, Pisa, Italy
| | - Roberto Cubelli
- Department of Psychology and Cognitive Sciences, University of Trento, Corso Bettini 31, 38068, Rovereto, Italy
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18
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Yang S, Paynter JM, Gilmore L. Vineland Adaptive Behavior Scales: II Profile of Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2016; 46:64-73. [PMID: 26231205 DOI: 10.1007/s10803-015-2543-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Adaptive behaviour is a crucial area of assessment for individuals with Autism Spectrum Disorder (ASD). This study examined the adaptive behaviour profile of 77 young children with ASD using the Vineland-II, and analysed factors associated with adaptive functioning. Consistent with previous research with the original Vineland a distinct autism profile of Vineland-II age equivalent scores, but not standard scores, was found. Highest scores were in motor skills and lowest scores were in socialisation. The addition of the Autism Diagnostic Observation Schedule calibrated severity score did not contribute significant variance to Vineland-II scores beyond that accounted for by age and nonverbal ability. Limitations, future directions, and implications are discussed.
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Affiliation(s)
- Sabrina Yang
- Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
| | - Jessica M Paynter
- AEIOU Foundation, PO Box 226, Nathan, QLD, 4111, Australia. .,Mater Research Institute - UQ, Level 3 Aubigny Place Raymond Terrace, South Brisbane, QLD, 4101, Australia.
| | - Linda Gilmore
- Queensland University of Technology, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia
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19
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Abstract
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and ASD + ADHD (n = 38). Results demonstrated lower socialisation and composite scores and greater discrepancy between cognitive and adaptive abilities in the ASD + ADHD group compared to the ADHD-only group. Significant associations were shown between reduced adaptive functioning and autism symptoms, but not ADHD symptoms. Children with ASD + ADHD present with exacerbated impairments in adaptive functioning relative to children with ADHD, associated with ASD symptoms. Disentangling variation in adaptive skills may aid the assessment of complex cases.
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20
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Abstract
Anxiety disorders are one of the most common psychiatric comorbidities among children and adolescents with autism spectrum disorders (ASD). There has been a recent proliferation of research examining the prevalence, phenomenology, assessment and treatment of anxiety disorders among youth with ASD. While there is currently very limited support for the use of pharmacological agents to treat anxiety among youth with ASD and comorbid anxiety, there has been overwhelming support across numerous modestly sized controlled studies for the efficacy of cognitive behavioral therapy. This review discusses advances in the treatment literature for anxiety in youth with ASD, and discusses the current evidence base for whether standard treatment needs to be adapted for this population.
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Affiliation(s)
- Carly Johnco
- Department of Pediatrics, University of South Florida
| | - Eric A. Storch
- Department of Pediatrics, University of South Florida
- Department of Psychology, University of South Florida
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida
- Department of Health Policy and Management, University of South Florida
- Rogers Behavioral Health – Tampa Bay
- All Children’s Hospital – Johns Hopkins Medicine
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21
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Mouga S, Almeida J, Café C, Duque F, Oliveira G. Adaptive profiles in autism and other neurodevelopmental disorders. J Autism Dev Disord 2015; 45:1001-12. [PMID: 25241010 DOI: 10.1007/s10803-014-2256-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We investigated the influence of specific autism spectrum disorder (ASD) deficits in learning adaptive behaviour, besides intelligence quotient (IQ). Participated 217 school-aged: ASD (N = 115), and other neurodevelopmental disorders (OND) groups (N = 102) matched by Full-Scale IQ. We compared standard scores of Vineland Adaptive Behaviour Scale (VABS) in communication, daily living skills, socialization and adaptive behaviour composite. Pearson-correlation analysis was performed between each domain of VABS and Full-Scale, Verbal and Performance IQ, and chronological age (CA). Results indicated that impairment in adaptive behaviour within the domain of socialization skills remains a distinctive factor of ASD versus OND, independently of intellectual disability (ID). Co-occurring ID result in further debilitating effects on overall functioning, especially in ASD. CA is negatively associated with VABS scores.
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Affiliation(s)
- Susana Mouga
- Faculty of Medicine, Institute for Biomedical Imaging and Life Sciences, University of Coimbra, Coimbra, Portugal,
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22
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Tyminski RF, Moore PJ. The Impact of Group Psychotherapy on Social Development in Children with Pervasive Developmental Disorders. Int J Group Psychother 2015; 58:363-79. [DOI: 10.1521/ijgp.2008.58.3.363] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Rivard M, Terroux A, Mercier C, Parent-Boursier C. Indicators of intellectual disabilities in young children with autism spectrum disorders. J Autism Dev Disord 2015; 45:127-37. [PMID: 25070470 DOI: 10.1007/s10803-014-2198-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
No agreement has been reached yet on the co-occurrence of Intellectual Disability (ID) and Autism Spectrum Disorders (ASD) in young children. This study describes the clinical profiles of 253 children with ASD between 30 and 65 months old, on IQ and adaptive behaviors, prior to their entry in an early behavioral intervention program. Results showed that 36.8% of the children met the criteria for ID, with 60.2% of these in the mild range (IQ 50-69) and 39.8% in the moderate range (IQ 35-49). ID profiles were similar for boys and girls. Intellectual and adaptive behavior profiles are described as well as their links to various socioeconomic factors.
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Affiliation(s)
- Mélina Rivard
- Département de psychologie de l', Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montréal, QC, H3C 3P8, Canada,
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24
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Weiss JA, Tint A, Paquette-Smith M, Lunsky Y. Perceived self-efficacy in parents of adolescents and adults with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:425-34. [PMID: 26019305 DOI: 10.1177/1362361315586292] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many parents of adolescents and adults with autism spectrum disorder experience difficulty accessing appropriate services for their children, and may report low levels of parent self-efficacy. In an effort to identify the factors that contribute to the difficulties these families face, this study examined the role of demographic, systemic, and clinical need variables as they relate to parents' experience of self-efficacy. Participants included 324 parents of individuals with autism spectrum disorder, 12-25 years of age. Results suggest that parent self-efficacy is related to a number of variables and not simply a child's clinical situation, including child age, parent immigrant status, barriers to service access, and caregiver burden. Given the crucial role that parents often play in the lives of individuals with autism spectrum disorder across the lifespan, it is important that service providers support the efforts of parents who provide and access care for their children.
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Affiliation(s)
| | | | | | - Yona Lunsky
- Centre for Addiction and Mental Health, Canada
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25
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Hong ER, Ganz JB, Ninci J, Neely L, Gilliland W, Boles M. An Evaluation of the Quality of Research on Evidence-Based Practices for Daily Living Skills for Individuals with Autism Spectrum Disorder. J Autism Dev Disord 2015; 45:2792-815. [DOI: 10.1007/s10803-015-2444-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Applied Behavior Analysis and the Autism Diagnostic Observation Schedule (ADOS): a Symbiotic Relationship for Advancements in Services for Individuals with Autism Spectrum Disorders (ASDs). Behav Anal Pract 2015; 8:62-65. [PMID: 27703883 DOI: 10.1007/s40617-014-0034-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The Autism Diagnostic Observation Schedule (ADOS) is a widely used diagnostic tool for the assessment of autism spectrum disorders. We compared interobserver reliability scores for observers using the existing guidelines for administration of the ADOS with those of the same observers using modified guidelines that included operational definitions for each area of observation. The results indicated increased mean interobserver reliability scores from 55.83 % using the existing guidelines to 84 % when using the modified guidelines and enhanced reliability scores for 3 of 3 clients with whom the ADOS was used. The guidelines are the following: integration of a highly effective diagnostic tool with ABA, the inclusion of a diagnostic tool may promote more comprehensive ABA services, more clearly define and identify areas of concern in autism, and impact implementation efficacy and reliability of assessments for individuals with autism.
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27
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Predictors and course of daily living skills development in toddlers with autism spectrum disorders. J Autism Dev Disord 2014; 44:256-63. [PMID: 21598046 DOI: 10.1007/s10803-011-1275-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Self-sufficiency is central to child and family well-being. This report focuses on predictors of adaptive daily living skills (DLS) development in young children with ASD and whether DLS gains predict decreases in parenting stress. Participants were 162 toddlers with ASD and their parents, assessed at 3 annual timepoints. Hierarchical Linear Models showed that age, DQ, and autism symptom severity uniquely predicted initial DLS and DLS growth. Child problem behaviors predicted initial DLS only. DLS was associated with change in parenting stress above and beyond DQ, autism symptom severity, and problem behaviors. Children with lower IQ and more severe symptoms showed slower DLS gains. Given its relation to parenting stress, DLS are an important intervention target in young children with ASD.
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28
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Abstract
The Vineland Adaptive Behavior Scale was administered to 54 children diagnosed with autism spectrum disorder (ASD) before age 2, and a matching group of 18 toddlers with developmental delay (DD). The group with ASD was more impaired on all scales of the Vineland than DD peers. When 18 ASD/DD pairs very closely matched on age, verbal and nonverbal development were selected, differences were found only on Vineland Receptive Communication and Daily Living. Correlation analyses to explore connection of these areas of difference with cognition and autistic symptoms suggested that Vineland Daily Living scores were significantly correlated with nonverbal ability and with ADOS total algorithm scores. Vineland Receptive Communication scores correlated significantly only with ADOS total algorithms. The clinical implications of these findings are discussed.
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29
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Lilienfeld SO. DSM‐5: Centripetal scientific and centrifugal antiscientific forces. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2014. [DOI: 10.1111/cpsp.12075] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Hedvall Å, Westerlund J, Fernell E, Holm A, Gillberg C, Billstedt E. Autism and developmental profiles in preschoolers: stability and change over time. Acta Paediatr 2014; 103:174-81. [PMID: 24237479 DOI: 10.1111/apa.12455] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/31/2013] [Accepted: 10/04/2013] [Indexed: 11/26/2022]
Abstract
AIM Increasing numbers of young children are now being diagnosed with autism spectrum disorder (ASD). This study aimed to analyse developmental trajectories in a representative group of preschool children with ASD. METHOD In a naturalistic study, 208 preschool children with different subtypes of ASD were followed over a 2-year period. Their trajectories, as regards persistence of ASD diagnoses, developmental/intellectual levels, adaptive functioning and expressive speech, were monitored. RESULTS Developmental profiles showed considerable change over time, especially in children with atypical autism and in those with developmental delay/borderline intellectual functioning at their first assessment. Approximately 50% of the children were found to have intellectual disability (ID) at follow-up and, of these, the majority had severe ID. This was in contrast to the first assessment by the referral team when ID had rarely been mentioned or discussed. CONCLUSION Changes in developmental profiles during preschool years are common in children with ASD. This implies that reassessments, covering different developmental areas, are needed. Such follow-up assessments prior to the start of school will yield a more valid estimation of the child's general cognitive level and a more accurate ASD diagnosis and thus form a better basis for realistic educational planning and intervention.
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Affiliation(s)
- Åsa Hedvall
- Gillberg Neuropsychiatry Centre; Sahlgrenska Academy; Gothenburg Sweden
- Department of Psychology; Karolinska University Hospital; Stockholm Sweden
| | | | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre; Sahlgrenska Academy; Gothenburg Sweden
- Research and Development Center; Skaraborg′s Hospital; Skövde Sweden
| | - Anette Holm
- Department of Psychology; Karolinska University Hospital; Stockholm Sweden
| | | | - Eva Billstedt
- Gillberg Neuropsychiatry Centre; Sahlgrenska Academy; Gothenburg Sweden
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31
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Duncan AW, Bishop SL. Understanding the gap between cognitive abilities and daily living skills in adolescents with autism spectrum disorders with average intelligence. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2013; 19:64-72. [PMID: 24275020 DOI: 10.1177/1362361313510068] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Daily living skills standard scores on the Vineland Adaptive Behavior Scales-2nd edition were examined in 417 adolescents from the Simons Simplex Collection. All participants had at least average intelligence and a diagnosis of autism spectrum disorder. Descriptive statistics and binary logistic regressions were used to examine the prevalence and predictors of a "daily living skills deficit," defined as below average daily living skills in the context of average intelligence quotient. Approximately half of the adolescents were identified as having a daily living skills deficit. Autism symptomatology, intelligence quotient, maternal education, age, and sex accounted for only 10% of the variance in predicting a daily living skills deficit. Identifying factors associated with better or worse daily living skills may help shed light on the variability in adult outcome in individuals with autism spectrum disorder with average intelligence.
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32
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Investigation of Quality of Life Determinants Among Mothers of Children with Pervasive Developmental Disorders in Iran. Hong Kong J Occup Ther 2013. [DOI: 10.1016/j.hkjot.2013.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective/Background The objective of the study was to examine the association between socio-economic status (SES), marital satisfaction, and subtypes of pervasive developmental disorders (PDDs) with quality of life (QOL) in mothers of children with PDDs. Methods The study was conducted using a convenience sample of 210 mothers of children with PDDs. Data were collected using the World Health Organization QOL-BREF, Index of Marital Satisfaction, and SES Questionnaires. Data analysis was done by analysis of variance and multivariate analysis of variance tests. Results The findings of the study showed that SES is associated strongly with the environmental domain (p < .001, r2 = .421), marital satisfaction with the social domain (p < .001, r2 = .394), and PDDs’ subtype with the psychological domain (p < .001, r2 = .283). Mothers of children with autistic disorder subtype reported lower QOL in all domains compared with other subtypes (p < .05). Conclusion The determinants such as SES, marital satisfaction, and subtypes of PDDs have an important influence on QOL of mothers of children with PDDs. Further investigation in this regard is warranted.
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Tonge B, Brereton A, Kiomall M, Mackinnon A, Rinehart NJ. A randomised group comparison controlled trial of 'preschoolers with autism': a parent education and skills training intervention for young children with autistic disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2012; 18:166-77. [PMID: 22987897 DOI: 10.1177/1362361312458186] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To determine the effect of parent education on adaptive behaviour, autism symptoms and cognitive/language skills of young children with autistic disorder. METHOD A randomised group comparison design involving a parent education and counselling intervention and a parent education and behaviour management intervention to control for parent skills training and a control sample. Two rural and two metropolitan regions were randomly allocated to intervention groups (n = 70) or control (n = 35). Parents from autism assessment services in the intervention regions were randomly allocated to parent education and behaviour management (n = 35) or parent education and counselling (n = 35). RESULTS Parent education and behaviour management resulted in significant improvement in adaptive behaviour and autism symptoms at 6 months follow-up for children with greater delays in adaptive behaviour. Parent education and behaviour management was superior to parent education and counselling. We conclude that a 20-week parent education programme including skills training for parents of young children with autistic disorder provides significant improvements in child adaptive behaviour and symptoms of autism for low-functioning children.
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Abstract
The prevalence of and risk factors for aggression were examined in 1,380 children and adolescents with autism spectrum disorders (ASD). Prevalence was high, with parents reporting that 68% had demonstrated aggression to a caregiver and 49% to non-caregivers. Overall, aggression was not associated with clinician observed severity of ASD symptoms, intellectual functioning, gender, marital status, parental educational level, or aspects of communication. Individuals who are younger, come from a higher income family, have more parent reported social/communication problems, or engage in repetitive behaviors were more likely to demonstrate aggression. Given the significant impact of aggression on individual and family outcomes, it is hoped that this knowledge will inform more targeted intervention efforts.
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Drahota A, Wood JJ, Sze KM, Van Dyke M. Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and concurrent anxiety disorders. J Autism Dev Disord 2011; 41:257-65. [PMID: 20508979 PMCID: PMC3040302 DOI: 10.1007/s10803-010-1037-4] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CBT is a promising treatment for children with autism spectrum disorders (ASD) and focuses, in part, on children’s independence and self-help skills. In a trial of CBT for anxiety in ASD (Wood et al. in J Child Psychol Psychiatry 50:224–234, 2009), children’s daily living skills and related parental intrusiveness were assessed. Forty children with ASD (7–11 years) and their primary caregiver were randomly assigned to an immediate treatment (IT; n = 17) or 3-month waitlist (WL; n = 23) condition. In comparison to WL, IT parents reported increases in children’s total and personal daily living skills, and reduced involvement in their children’s private daily routines. Reductions correlated with reduced anxiety severity. These results provide preliminary evidence that CBT may yield increased independence and daily living skills among children with ASD.
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Affiliation(s)
- Amy Drahota
- Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive (MC: 0603), La Jolla, CA 92093-0603, USA.
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Lee H, Marvin AR, Watson T, Piggot J, Law JK, Law PA, Constantino JN, Nelson SF. Accuracy of phenotyping of autistic children based on Internet implemented parent report. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1119-26. [PMID: 20552678 PMCID: PMC4311721 DOI: 10.1002/ajmg.b.31103] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
While strong familial evidence supports a substantial genetic contribution to the etiology of autism spectrum disorders (ASD), specific genetic abnormalities have been identified in only a small minority of all cases. In order to comprehensively delineate the genetic components of autism including the identification of rare and common variants, overall sample sizes an order of magnitude larger than those currently under study are critically needed. This will require rapid and scalable subject assessment paradigms that obviate clinic-based time-intensive behavioral phenotyping, which is a rate-limiting step. Here, we test the accuracy of a web-based approach to autism phenotyping implemented within the Interactive Autism Network (IAN). Families who were registered with the IAN and resided near one of the three study sites were eligible for the study. One hundred seven children ascertained from this pool who were verbal, age 4-17 years, and had Social Communication Questionnaire (SCQ) scores > or =12 (a profile that characterizes a majority of ASD-affected children in IAN) underwent a clinical confirmation battery. One hundred five of the 107 children were ASD positive (98%) by clinician's best estimate. One hundred four of these individuals (99%) were ASD positive by developmental history using the Autism Diagnostic Interview-Revised (ADI-R) and 97 (93%) were positive for ASD by developmental history and direct observational assessment (Autism Diagnostic Observational Schedule or expert clinician observation). These data support the reliability and feasibility of the IAN-implemented parent-report paradigms for the ascertainment of clinical ASD for large-scale genetic research.
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Affiliation(s)
- Hane Lee
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, California
| | - Alison R. Marvin
- Department of Medical Informatics, Kennedy Krieger Institute, Baltimore, Maryland
| | - Tamara Watson
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Judith Piggot
- Department of Child and Adolescent Psychiatry and Psychology, University of California-Los Angeles, Los Angeles, California
| | - J. Kiely Law
- Department of Medical Informatics, Kennedy Krieger Institute, Baltimore, Maryland
| | - Paul A. Law
- Department of Medical Informatics, Kennedy Krieger Institute, Baltimore, Maryland
| | - John N. Constantino
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Stanley F. Nelson
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, California
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Correspondence to: 695 Charles E. Young Dr. South, GONDA 5554, Los Angeles, CA 90095.
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Kenworthy L, Case L, Harms MB, Martin A, Wallace GL. Adaptive behavior ratings correlate with symptomatology and IQ among individuals with high-functioning autism spectrum disorders. J Autism Dev Disord 2010; 40:416-23. [PMID: 19949846 DOI: 10.1007/s10803-009-0911-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Caregiver report on the Adaptive Behavior Assessment System-II (ABAS) for 40 high-functioning individuals with Autism Spectrum Disorders (ASD) and 30 typically developing (TD) individuals matched for age, IQ, and sex ratio revealed global adaptive behavior deficits in ASD, with social skills impairments particularly prominent. Within the ASD group, adaptive communication skills were positively related to IQ while global adaptive functioning was negatively associated with autism symptomatology. Autistic behavior ratings related negatively to ABAS scores in the TD but not the ASD group. This investigation demonstrates: the utility of an adaptive functioning checklist for capturing impairments, even in high-functioning individuals with ASD; and that a relationship between social abilities and autism exists independently of intelligence.
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Affiliation(s)
- Lauren Kenworthy
- Laboratory of Brain & Cognition, National Institute of Mental Health, Bethesda, MD, USA.
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Benjak T, Vuletić Mavrinac G, Pavić Simetin I. Comparative study on self-perceived health of parents of children with autism spectrum disorders and parents of non-disabled children in Croatia. Croat Med J 2009; 50:403-9. [PMID: 19673041 DOI: 10.3325/cmj.2009.50.403] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM To assess self-perceived health of parents of children with autism spectrum disorders (ASD) in comparison with those of parents of non-disabled children. METHODS A total of 350 parents participated in the study: 178 parents of children with ASD (71% response rate) and 172 parents of non-disabled children matched by age, education, and place of living. Parents' self-perceived health was assessed using the Croatian version of the health status questionnaire SF-36, while socio-demographic information, chronic medical conditions, and needs were assessed by a general questionnaire. RESULTS For all dimensions of health, except physical health, parents of children with ASD had significantly poorer self-perceived health and reported significantly more deteriorated health in the last year than the control group (P<0.001). They also reported more psychological disorders (11% vs 4.3%), which was the largest difference in specified chronic medical conditions. Hundred twenty six (71%) parents of children with ASD thought that enhancing different policy measures (economic, social, educational) could advance their and their children's health and well-being. CONCLUSION Parents of children with ASD had poorer health than the control group in all components, except physical health. Because parents are the main providers of support for children with ASD, preserving parents' good health and well-being is a precondition for an optimal care for children. Therefore, current system for treating children with ASD in Croatia should also include permanent improvement of parents' health and well-being.
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Affiliation(s)
- Tomislav Benjak
- Croatian National Institute of Public Health, Rockefellerova 7, 10000, Zagreb, Croatia.
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Patterns of growth in adaptive social abilities among children with autism spectrum disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2009; 37:1019-34. [PMID: 19521762 DOI: 10.1007/s10802-009-9326-0] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Adaptive social skills were assessed longitudinally at approximately ages 2, 3, 5, 9, and 13 years in a sample of 192 children with a clinical diagnosis of autism (n = 93), PDD-NOS (n = 51), or nonspectrum developmental disabilities (n = 46) at age 2. Growth curve analyses with SAS proc mixed were used to analyze social trajectories over time. Both individual characteristics and environmental resources emerged as key predictors of adaptive social behavior outcome. The gap between children with autism and the other two diagnostic groups widened with time as the social skills of the latter groups improved at a higher rate. However, within diagnostic groups, improvement ranged from minimal to very dramatic. Children with autism most at risk for problems with social adaptive abilities later in life can be identified with considerable accuracy at a very young age so they can be targeted for appropriate early intervention services.
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Perry A, Flanagan HE, Dunn Geier J, Freeman NL. Brief report: the Vineland Adaptive Behavior Scales in young children with autism spectrum disorders at different cognitive levels. J Autism Dev Disord 2009; 39:1066-78. [PMID: 19234777 DOI: 10.1007/s10803-009-0704-9] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Accepted: 01/29/2009] [Indexed: 10/21/2022]
Abstract
Vineland Adaptive Behavior Scales (VABS) data were examined in a large sample of young children with ASD (n = 290) of varying cognitive levels. IQ was higher than VABS composite score among high functioning children only; the opposite pattern was found in lower IQ subgroups. Profile analysis of VABS domains across cognitive levels demonstrated different profiles in different subgroups. A characteristic "autism profile" was found for most subgroups for Age Equivalents but not Standard Scores. In a small set of matched pairs (n = 28) of children with autism versus MR, significantly different profiles were found, with Socialization and Communication lower in autism, but no differences were found between matched pairs of children with autism and PDD-NOS (n = 48). Correlations between age, cognitive level, and adaptive level were also reported, and regression analyses indicated that autism severity accounts for a modest amount of unique variance in Socialization and Daily Living Skills.
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Affiliation(s)
- Adrienne Perry
- TRE-ADD (Treatment, Research, and Education for Autism and Developmental Disorders), Thistletown Regional Centre, Toronto, ON, Canada.
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Reichow B, Salamack S, Paul R, Volkmar FR, Klin A. Pragmatic Assessment in Autism Spectrum Disorders: A Comparison of a Standard Measure With Parent Report. COMMUNICATION DISORDERS QUARTERLY 2008; 29:169-176. [PMID: 20948979 PMCID: PMC2952952 DOI: 10.1177/1525740108318697] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The purpose of this study was to investigate the concurrent validity of subtests on the Comprehensive Assessment of Spoken Language (CASL) by comparing them with the assessment of communication and social skills on the Vineland Adaptive Behavior Scales (Vineland). The participants were 35 children and adolescents with higher functioning autism spectrum disorders (ASD) who had received both the CASL and the Vineland. Results of the study suggest that the Pragmatic Judgment and Inferences subtests of the CASL appeared to document the difficulties that individuals with ASD had in adaptive use of language for communication.
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Tomanik SS, Pearson DA, Loveland KA, Lane DM, Bryant Shaw J. Improving the reliability of autism diagnoses: examining the utility of adaptive behavior. J Autism Dev Disord 2006; 37:921-8. [PMID: 17006778 DOI: 10.1007/s10803-006-0227-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The classification agreement of the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) was examined in 129 children and adolescents (aged 7-18 years) who were evaluated for autism. Participants received a diagnosis of autism or non-autism based on the ADI-R. Linear discriminant analysis revealed adequate concordance between the ADI-R and ADOS, with 75% of the participants being correctly classified using the ADOS. Classification accuracy significantly improved to 84% when a measure of adaptive functioning (i.e., the Vineland Adaptive Behavior Scales) was included in the analysis. The findings suggest that when clinicians obtain discrepant information on the ADI-R and ADOS, assessment of an individual's adaptive functioning may reduce diagnostic errors.
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Affiliation(s)
- Stacey S Tomanik
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical School at Houston, 1300 Moursund, Houston, TX 77030-3497, USA
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Williams SK, Scahill L, Vitiello B, Aman MG, Arnold LE, McDougle CJ, McCracken JT, Tierney E, Ritz L, Posey DJ, Swiezy NB, Hollway J, Cronin P, Ghuman J, Wheeler C, Cicchetti D, Sparrow S. Risperidone and adaptive behavior in children with autism. J Am Acad Child Adolesc Psychiatry 2006; 45:431-9. [PMID: 16601648 DOI: 10.1097/01.chi.0000196423.80717.32] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of risperidone on adaptive behavior in children with autistic disorder who have serious behavior problems and to examine different methods of scoring the Vineland Adaptive Behavior Scales to measure change. METHOD Forty-eight children (5 years to 16 years, 5 months) who showed behavioral improvement during acute treatment with risperidone were followed for 6 months and assessed with the Vineland Scales. RESULTS Raw scores, age-equivalents, and special norm percentile scores all showed significant increases in adaptive behavior in the areas of communication, daily living skills, and socialization (p <.01). During a period of 6 to 8 months, children gained an average of 7.8 age-equivalent months in the area of socialization, a > 6% improvement beyond what would be expected based on baseline growth rates. CONCLUSIONS Although limited by the absence of a control group, these results suggest that risperidone may improve adaptive skills in children with autistic disorder accompanied by serious behavioral problems. Vineland age-equivalent scores appear to be most useful in assessing change with treatment over time.
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Fine SE, Weissman A, Gerdes M, Pinto-Martin J, Zackai EH, McDonald-McGinn DM, Emanuel BS. Autism spectrum disorders and symptoms in children with molecularly confirmed 22q11.2 deletion syndrome. J Autism Dev Disord 2005; 35:461-70. [PMID: 16134031 PMCID: PMC2814423 DOI: 10.1007/s10803-005-5036-9] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study, we assessed the presence of autism spectrum disorders (ASD) among children with a confirmed 22q11.2 deletion (n = 98). The children's caregivers completed screening measures of ASD behaviors, and for those whose scores indicated significant levels of these behaviors, a standardized diagnostic interview (Autism Diagnostic Interview-Revised; ADI-R) was administered. Results demonstrated that over 20% of children (n = 22) were exhibiting significant levels of autism spectrum symptoms based on the screening measures. Based upon the ADI-R, 14 children qualified for a diagnosis of an ASD, and for 11 of those children a diagnosis of autism was most appropriate. These findings increase our knowledge of developmental disorders associated with the 22q11.2 deletion and point to avenues for future investigation.
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Affiliation(s)
- Sarah E Fine
- Department of Psychology, The Children's Hospital of Philadelphia, USA.
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Rajendran G, Mitchell P, Rickards H. How do Individuals with Asperger Syndrome Respond to Nonliteral Language and Inappropriate Requests in Computer-mediated Communication? J Autism Dev Disord 2005; 35:429-43. [PMID: 16134029 DOI: 10.1007/s10803-005-5033-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Computer-mediated communication in individuals with Asperger syndrome, Tourette syndrome and normal controls was explored with a program called Bubble Dialogue (Gray, Creighton, McMahon, and Cunninghamn (1991)) in which the users type text into speech bubbles. Two scenarios, based on Happé (1994) were adapted to investigate understanding of figure of speech and sarcasm, and a third, developed by ourselves, looked at responses to inappropriate requests (lending money and disclosing home address on a first meeting). Dialogue transcripts were assessed by 62 raters who were blind to the clinical diagnoses. Hierarchical linear modelling revealed that rated understanding of a figure of speech was predicted mainly by verbal ability and executive ability, as well as by clinical diagnosis, whereas handling inappropriate requests was predicted by age, verbal ability, executive ability and diagnosis. Notably, the Tourette comparison group showed better understanding than the Asperger group in interpreting a figure of speech and handling inappropriate requests, and differences between these groups were possibly attributable to individual differences in executive ability. In contrast, understanding sarcasm was predicted by age but not by either verbal ability, executive ability or clinical diagnosis. Evidently, there is a complicated relation between Asperger syndrome, verbal ability and executive abilities with respect to communicative performance.
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Affiliation(s)
- Gnanathusharan Rajendran
- School of Education, The University of Edinburgh, St John's Land Holyrood Road, EH8 8AQ Edinburgh, UK.
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Abstract
OBJECTIVES Autistic spectrum disorders (ASD) have variable developmental outcomes, for reasons that are not entirely clear. The objective of this study was to test the clinical observation that initial developmental parameters (degree of atypicality and level of intelligence) are a major predictor of outcome in children with ASD and to develop a statistical method for modeling outcome on the basis of these parameters. METHODS A retrospective chart review was conducted of a child development program at a tertiary center for the evaluation of children with developmental disabilities. All children who had ASD, were seen by J.C. between July 1997 and December 2002, met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for autism or pervasive developmental disorder (referred to hereafter as ASD), had undergone at least 1 administration of the Childhood Autism Rating Scale (CARS), and had at least 1 determination of developmental quotient (DQ) or IQ (N = 91) were studied. The sample was 92.3% male and 80.2% white. METHODS The DSM-IV was used to confirm that each patient met criteria for a diagnosis of autism or pervasive developmental disorder. The CARS was used to quantify the severity of expression of ASD. Age at evaluation, CARS score, and DQ or IQ at each visit were extracted from the medical record. The 2 independent sample t test or the Mann-Whitney test was used for comparing CARS and age between 2 groups: first recorded DQ or IQ <0.70 (n = 58) versus first recorded DQ or IQ >or=0.70 (n = 33). Associations among CARS score, IQ or DQ, and age were examined using Pearson or Spearman correlation. A mixed-effect model was used for expressing the multivariate model. Length of follow-up (period) was calculated by subtracting age in months at initial evaluation from age in months at each follow-up evaluation. Therefore, at first evaluation, period = 0. Period was considered as a random effect because collection of repeated information from patients was not uniform. The predictive relationships among CARS, age at first evaluation, period, and DQ or IQ group (<0.70 and >or=0.70) were examined using a mixed-effects model. Variables that were expressed as percentage change between first and last measurements were analyzed using the t test or the Mann-Whitney test. Socioeconomic status was assessed using Hollingshead criteria. RESULTS All patients met DSM-IV criteria for ASD. Mean age at initial evaluation was 46.2 months (SD: 23.7; range: 20.0-167.3 months). Mean CARS score at initial evaluation was 36.1 (SD: 6.3; range: 21.5-48). Mean DQ or IQ at initial evaluation was 0.65 (SD: 0.20; range: 0.16-1.10). There was no significant difference in socioeconomic status between DQ/IQ groups. CARS scores among children with an initial DQ or IQ <0.70 showed no significant decrement with time. In contrast, CARS scores among children with an initial DQ or IQ >or=0.70 showed a significant decrement with time, which could be modeled by the formula CARS = 37.93 - [(0.12 x age in months at first visit) + (0.23 x period)]. The predicted CARS scores generated by this model correlated with the observed values (r = 0.71) and explained 50% of the variability in the CARS scores for this group. CONCLUSIONS These data provide preliminary validation of a statistical model for clinical outcome of ASD on the basis of 3 parameters: age, degree of atypicality, and level of intelligence. This model, if replicated in a prospective, population-based sample that is controlled for treatment modalities, will enhance our ability to offer a prognosis for the child with ASD and will provide a benchmark against which to judge the putative benefits of various treatments for ASD. Our model may also be useful in etiologic and epidemiologic studies of ASD, because different causes of ASD are likely to follow different developmental trajectories along these 3 parameters.
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Affiliation(s)
- James Coplan
- University of Pennsylvania School of Medicine, Philadelphia, USA.
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de Bildt A, Serra M, Luteijn E, Kraijer D, Sytema S, Minderaa R. Social skills in children with intellectual disabilities with and without autism. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2005; 49:317-328. [PMID: 15817049 DOI: 10.1111/j.1365-2788.2005.00655.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Social skills were studied in 363 children with mild intellectual disabilities (ID) and 147 with moderate ID with and without autism (age 4 through 18). The objective was to investigate the value of the Children's Social Behaviour Questionnaire (CSBQ), as a measure of subtle social skills, added to a measure of basic social skills with the Vineland Adaptive Behaviour Scales (VABS), in identifying children with ID with or without autism. METHOD Children with mild and moderate ID, with and without autistic symptomatology were compared on basic social skills, measured with the Communication and Socialization domains of the VABS, and subtle social skills, measured with the CSBQ. RESULTS Measuring basic social skills is not sufficient in differentiating between levels of ID. Communicative skills and subtle social skills, that concern overlooking activities or situations and fear of changes in the existing situation, seem to play a far greater role. Additionally, with respect to identifying autistic symptomatology, basic social skills do not contribute, as opposed to communicative skills and the tendency to withdraw from others. CONCLUSIONS The results implicate that the CSBQ not only has specific value as a measure of subtle social skills to identify pervasive developmental disorders, but that the instrument also has a specific contribution to differentiating between the two levels of ID. Furthermore, our outcomes imply a slight difference between limitations in subtle social skills as mentioned by the AAMR (American Association on Mental Retardation 2002) and limitations in subtle social skills as seen in milder forms of pervasive developmental disorders. Clinical and theoretical implications will be discussed.
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Affiliation(s)
- A de Bildt
- Child and Adolescent Psychiatry, University of Groningen, The Netherlands.
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Kaufmann WE, Cortell R, Kau ASM, Bukelis I, Tierney E, Gray RM, Cox C, Capone GT, Stanard P. Autism spectrum disorder in fragile X syndrome: communication, social interaction, and specific behaviors. Am J Med Genet A 2005; 129A:225-34. [PMID: 15326621 DOI: 10.1002/ajmg.a.30229] [Citation(s) in RCA: 332] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The present study extends our previous work on social behavior impairment in young males with fragile X syndrome (FraX). Specifically, we evaluated whether the autistic phenomenon in FraX is expressed as a range of behavioral impairments as in idiopathic autism (Aut). We also examined whether there are behaviors, identified as items of the Autism Diagnostic Interview-Revised (ADI-R), that in FraX predispose to or differentiate subjects with autism spectrum disorder (ASD) diagnosis. Finally, regression models were utilized to test the relative contribution of reduced communication and socialization skills to ADI-R scores and diagnoses. A cohort of 56 boys (3-8 years) with FraX was examined in terms of scores on measures of cognition (IQ was a co-variate in most analyses.), autistic behavior, problem/aberrant behavior, adaptive behavior, and language development. We found that, indeed, in terms of problem behavior and adaptive skills, there is a range of severity from FraX + Aut to FraX + PDD (Pervasive Developmental Disorder) to FraX + none. ADI-R items representing "Play" types of interaction appear to be "susceptibility" factors since they were abnormal across the FraX cohort. Integrated regression models demonstrated that items reflecting complex social interaction differentiated the FraX + ASD (Aut + PDD) subgroup from the rest of the FraX cohort, while abnormalities in basic verbal and non-verbal communication distinguished the most severely affected boys with FraX + Aut from the milder FraX + PDD cohort. Models incorporating language, adaptive communication, and adaptive socialization skills revealed that socialization was not only the main influence on scores but also a predictor of ASD diagnosis. Altogether, our findings demonstrate that the diagnosis of ASD in FraX reflects, to a large extent, an impairment in social interaction that is expressed with variable severity in young males with FraX.
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Shek DTL, Tsang SKM, Lam LL, Tang FLY, Cheung PMP. Psychometric Properties of the Chinese Version of the Psycho-educational Profile-Revised (CPEP-R). J Autism Dev Disord 2005; 35:37-44. [PMID: 15796120 DOI: 10.1007/s10803-004-1029-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to examine the reliability and validity of the Chinese version of the Psycho-educational Profile-Revised (PEP-R). The Chinese PEP-R (CPEP-R) was administered to 63 preschool children with symptoms of autistic disorder recruited from special child-care centers in Hong Kong. Results showed that the scales of the CPEP-R were internally consistent, reliable across raters and temporally stable. Regarding the concurrent validity of the CPEP-R, the developmental score and developmental age assessed by the CPEP-R were significantly correlated with the Merrill-Palmer Scale of Mental Tests and the Hong Kong Based Adaptive Behavior Scale. The Behavioral Scale of the CPEP-R was also significantly related to the Childhood Autism Rating Scale. Besides replicating the findings in the Western context, the present study suggests that the psychometric properties of the PEP-R are stable across cultures and the related findings support the cross-cultural reliability of the tool.
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Affiliation(s)
- Daniel T L Shek
- Social Welfare Practice and Research Centre, Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong.
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