1
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Hamsho N, Collier-Meek M, McAvoy H, Blacher J, Eisenhower A. Relationships of paraeducators and teachers with their autistic students. J Sch Psychol 2024; 105:101321. [PMID: 38876552 DOI: 10.1016/j.jsp.2024.101321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/21/2023] [Accepted: 04/26/2024] [Indexed: 06/16/2024]
Abstract
Paraeducators play an important role in the classroom experiences of many autistic students. Although previous research has indicated that autistic students typically have strained relationships with their teachers, little is known about their relationships with paraeducators. We examined relationship quality reported by teachers (N = 171) and paraeducators (N = 28) with their elementary-age autistic students (IQ ≥ 50, ages 4-8 years, Grades PreK-3). Paraeducators reported strained relationships with their autistic students relative to normative means. This was especially apparent when compared with teacher report as paraeducators reported significantly lower overall relationship quality with their autistic students marked by higher conflict and dependency, yet similar reports of closeness. Indirect effect analysis indicated that higher conflict between paraeducators and their autistic students was accounted for by their fewer years of classroom experience compared to teachers. These findings should encourage school psychologists to consider the systemic factors likely contributing to paraeducators' fewer years of experiences and, as members of special education teams, use a consultative framework to provide supports needed to foster positive relationships between paraeducators and their autistic students.
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Affiliation(s)
- Narmene Hamsho
- School of Psychology and Counseling, Fairleigh Dickinson University, 1000 River Road, T-WH1-01, Teaneck, NJ 07666, USA.
| | - Melissa Collier-Meek
- Department of Health and Behavior Studies, Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027, USA.
| | - Hayley McAvoy
- Graduate School of Education, University of California Riverside, 1207 Sproul Hall, Riverside, CA 92521, USA.
| | - Jan Blacher
- Graduate School of Education, University of California Riverside, 1207 Sproul Hall, Riverside, CA 92521, USA.
| | - Abbey Eisenhower
- Department of Psychology, University of Massachusetts Boston, 100 William T. Morrissey Blvd., Boston, MA 02125.
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2
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Birkeneder SL, Bullen J, McIntyre N, Zajic MC, Lerro L, Solomon M, Sparapani N, Mundy P. The Construct Validity of the Childhood Joint Attention Rating Scale (C-JARS) in School-Aged Autistic Children. J Autism Dev Disord 2023:10.1007/s10803-023-06051-1. [PMID: 37480436 DOI: 10.1007/s10803-023-06051-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 07/24/2023]
Abstract
Preliminary evidence from the Childhood Joint Attention Rating Scale (C-JARS; Mundy et al., 2017) suggests symptoms related to diminished joint attention and the spontaneous sharing of experience with others can be assessed with a parent-report measure in children and adolescents with autism. This study was designed to expand on the previous study by examining the validity of both a Social Symptom (SS) and a Prosocial (PS) scale of the C-JARS in a study of school-aged autistic children (n = 89) with and without co-occurring intellectual disability (ID), as well as an age matched neurotypical sample (n = 62). Results indicated that both C-JARS scales were sensitive and specific with respect to identifying the diagnostic status of the children. In addition, the PS scale was sensitive to differences in cognitive abilities (IQ) and sex differences in the autism group. These results are consistent with the hypothesis that joint attention and spontaneous sharing of experience symptoms are not only characteristic of preschool children with autism but may also constitute a developmentally continuous dimension of the social phenotype of autism that can be measured in school-aged children.
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Affiliation(s)
- Sandy L Birkeneder
- School of Education and the MIND Institute, University of California, Davis, One Shields Ave., Davis, CA, 95616, USA.
| | - Jennifer Bullen
- MIND Institute and Department of Psychiatry and Behavioral Science, University of California, Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Nancy McIntyre
- Communication Sciences and Disorder, University of Central Florida, 12805 Pegasus Drive, Orlando, FL, USA
| | - Matthew C Zajic
- Teachers College, Health and Behavior Studies, Columbia University, 525 W. 120th Street, Box 223, New York, NY, 10027, USA
| | - Lindsay Lerro
- The Swain Center, Santa Rosa, 795 Farmers Lane, Suite 23, Santa Rosa, CA, 95405, USA
| | - Marjorie Solomon
- MIND Institute and Department of Psychiatry and Behavioral Science, University of California, Davis, 2825 50th Street, Sacramento, CA, 95817, USA
| | - Nicole Sparapani
- School of Education and the MIND Institute, University of California, Davis, One Shields Ave., Davis, CA, 95616, USA
| | - Peter Mundy
- School of Education and the MIND Institute, University of California, Davis, One Shields Ave., Davis, CA, 95616, USA
- MIND Institute and Department of Psychiatry and Behavioral Science, University of California, Davis, 2825 50th Street, Sacramento, CA, 95817, USA
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3
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Miniarikova E, Audras-Torrent L, Berard M, Peries M, Picot MC, Munir K, Baghdadli A. Adaptive behaviors and related factors in children and adolescents with autism spectrum disorder: Report from ELENA cohort. J Psychiatr Res 2023; 163:43-54. [PMID: 37201237 DOI: 10.1016/j.jpsychires.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/02/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
There are strong individual differences in adaptive behaviors (AB) in autism spectrum disorder (ASD) with conflicting results in literature about specific patterns and related factors. The present study aims to describe AB and identify related factors in terms of clinical and socio-familial characteristics in 875 children and adolescents with ASD in the multiregional ELENA cohort in France. Results showed that AB in children and adolescents with ASD were lower than in typically developing subjects, regardless of age group. AB were associated with clinical (gender, age at diagnosis, IQ, ASD severity, psychiatric comorbidities, motor and language skills, challenging behaviors), interventional (school attendance, special interventions) and familial characteristics (age, educational and socio-economic status of parents, household status, number of siblings). There is a need of interventions focusing on improvement of AB, tailored to children's characteristics.
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Affiliation(s)
- Ela Miniarikova
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France.
| | - Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France.
| | - Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France.
| | - Marie-Christine Picot
- Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, France.
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France; Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Faculté de Médecine, Université de Montpellier, France.
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4
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Araujo MO, Tamplain P, Duarte NAC, Comodo ACM, Ferreira GOA, Queiróga A, Oliveira CS, Collange-Grecco LA. Transcranial direct current stimulation to facilitate neurofunctional rehabilitation in children with autism spectrum disorder: a protocol for a randomized, sham-controlled, double-blind clinical trial. Front Neurol 2023; 14:1196585. [PMID: 37396775 PMCID: PMC10310925 DOI: 10.3389/fneur.2023.1196585] [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: 03/30/2023] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Background Anodal transcranial direct current stimulation (tDCS) over the primary motor cortex and cerebellum is gaining prominence in the literature due to its potential to favor learning and motor performance. If administered during motor training, tDCS is capable of increasing the effect of training. Considering the motor impairment presented by children with Autism Spectrum Disorders (ASD), atDCS applied during motor training may contribute to the rehabilitation of these children. However, it is necessary to examine and compare the effects of atDCS over the motor cortex and the cerebellum on the motor skills of children with ASD. This information may benefit future clinical indications of tDCS for rehabilitation of children with ASD. The aim of the proposed study is to determine whether anodal tDCS over the primary motor cortex and cerebellum can enhance the effects of gait training and postural control on motor skills, mobility, functional balance, cortical excitability, cognitive aspects and behavioral aspects in children with ASD. Our hypothesis is the active tDCS combined with motor training will enhance the performance of the participants in comparison to sham tDCS. Methods and design A randomized, sham-controlled, double-blind clinical trial will be conducted involving 30 children with ASD that will be recruited to receive ten sessions of sham or ten sessions of active anodal tDCS (1 mA, 20 min) over the primary motor cortex or cerebellun combined with motor training. The participants will be assessed before as well as one, four and eight weeks after the interventions. The primary outcome will be gross and fine motor skills. The secondary outcomes will be mobility, functional balance, motor cortical excitability, cognitive aspects and behavioral aspects. Discussion Although abnormalities in gait and balance are not primary characteristics of ASD, such abnormalities compromise independence and global functioning during the execution of routine activities of childhood. If demonstrated that anodal tDCS administered over areas of the brain involved in motor control, such as the primary motor cortex and cerebellum, can enhance the effects of gait and balance training in only ten sessions in two consecutive weeks, the clinical applicability of this stimulation modality will be expanded as well as more scientifically founded.Clinical trial registration February 16, 2023 (https://ensaiosclinicos.gov.br/rg/RBR-3bskhwf).
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Affiliation(s)
- Marcela O. Araujo
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
- Children's Rehabilitation Department, Follow Kids Child Neurorehabilitation Clinic, Rio de Janeiro, Brazil
| | - Priscila Tamplain
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, United States
| | - Natália A. C. Duarte
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
| | - Andréa C. M. Comodo
- Children's Rehabilitation Department, Follow Kids Child Neurorehabilitation Clinic, Rio de Janeiro, Brazil
| | - Giselle O. A. Ferreira
- Children's Rehabilitation Department, Follow Kids Child Neurorehabilitation Clinic, Rio de Janeiro, Brazil
| | - Amanda Queiróga
- Department of Child Neurofunctional Physiotherapy, Center of Pediatric Neurostimulation, São Paulo, Brazil
| | - Claudia S. Oliveira
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
| | - Luanda A. Collange-Grecco
- Human Movement and Rehabilitation, Post Graduate Program, Evangelic University of Goias, Anápolis, Brazil
- Department of Child Neurofunctional Physiotherapy, Center of Pediatric Neurostimulation, São Paulo, Brazil
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5
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Berkovits L, Blacher J, Eisenhower A, Daniel S. The Emotion Regulation Checklist with Young Autistic Children: Data Set for Comparative Use in Intervention Studies. J Autism Dev Disord 2023:10.1007/s10803-023-05991-y. [PMID: 37129696 DOI: 10.1007/s10803-023-05991-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Comparative data of autism-sensitive standardized measures of emotion regulation and lability, describing percentage change over time for populations of young autistic children, are currently publicly unavailable. We propose publication of such data as a support for future therapeutic intervention studies. METHODS We generate and present data of the Emotion Regulation Checklist (and subscales) for a comparative array of percentage change over time (10 months) for autistic children not receiving psychological or behavioral therapies (N = 98, ages 4-8). RESULTS Comparative data summaries are presented here, and the full data set is presented as Online Resource 1. CONCLUSION We propose that this autism-sensitive measure, now with autism-specific comparative data to provide a comparison group in studies of therapeutic intervention, is well placed to assess co-occurring affective, regulatory, and behavioral factors of personal development for autistic children.
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Affiliation(s)
- Lauren Berkovits
- University of Colorado, School of Medicine and Children's Hospital Colorado, Aurora, CO, USA.
| | - Jan Blacher
- University of California, Riverside, CA, USA
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6
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Mundy P. Research on social attention in autism and the challenges of the research domain criteria (RDoC) framework. Autism Res 2023; 16:697-712. [PMID: 36932883 DOI: 10.1002/aur.2910] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
The fuzzy nature of categories of psychopathology, such as autism, leads to significant research challenges. Alternatively, focusing research on the study of a common set of important and well-defined psychological constructs across psychiatric conditions may make the fundamental etiological processes of psychopathology easier to discern and treat (Cuthbert, 2022). The development of the research domain criteria (RDoC) framework is designed to guide this new research approach (Insel et al., 2010). However, progress in research may be expected to continually refine and reorganize the understanding of the specifics of these mental processes (Cuthbert & Insel, 2013). Moreover, knowledge gleaned from the study of both normative and atypical development can be mutually informative in the evolution of our understanding of these fundamental processes. A case in point is the study of social attention. This Autism 101 commentary provides an educational summary of research over the last few decades indicates that social attention is major construct in the study of human social-cognitive development, autism and other forms of psychopathology. The commentary also describes how this research can inform the Social Process dimension of the RDoC framework.
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Affiliation(s)
- Peter Mundy
- School of Education, Department of Psychiatry and the MIND Institute, University of California at Davis, Davis, California, USA
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7
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Joseph RM, Lai ER, Bishop S, Yi J, Bauman ML, Frazier JA, Santos HP, Douglas LM, Kuban KK, Fry RC, O’Shea MT. Comparing autism phenotypes in children born extremely preterm and born at term. Autism Res 2023; 16:653-666. [PMID: 36595641 PMCID: PMC10551822 DOI: 10.1002/aur.2885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
Children born preterm are at increased risk for autism spectrum disorder (ASD). There is limited knowledge about whether ASD phenotypes in children born preterm differ from children born at term. The objective of this study was to compare ASD core symptoms and associated characteristics among extremely preterm (EP) and term-born children with ASD. EP participants (n = 59) from the Extremely Low Gestational Age Newborn Study who met diagnostic criteria for ASD at approximately 10 years of age were matched with term-born participants from the Simons Simplex Collection on age, sex, spoken language level, and nonverbal IQ. Core ASD symptomatology was evaluated with the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS). Developmental milestones, anthropometrics, seizure disorder, and psychiatric symptoms were also investigated. The EP group had lower parent-reported symptom scores on ADI-R verbal communication, specifically stereotyped language, and restricted, repetitive behaviors. There were no between-group differences on ADI-R nonverbal communication and ADI-R reciprocal social interaction or with direct observation on the ADOS-2. The EP group was more likely to have delayed speech milestones and lower physical growth parameters. Results from female-only analyses were similar to those from whole-group analyses. In sum, behavioral presentation was similar between EP and IQ- and sex-matched term-born children assessed at age 10 years, with the exception of less severe retrospectively reported stereotyped behaviors, lower physical growth parameters, and increased delays in language milestones among EP-born children with ASD.
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Affiliation(s)
- Robert M. Joseph
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Emily R. Lai
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Somer Bishop
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Joe Yi
- Department of Allied Health Sciences, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Margaret L. Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Jean A. Frazier
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Hudson P. Santos
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | | | - Karl K.C. Kuban
- Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michael T. O’Shea
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
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8
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Stahmer AC, Suhrheinrich J, Rieth SR, Roesch S, Vejnoska S, Chan J, Nahmias A, Wang T. A Waitlist Randomized Implementation Trial of Classroom Pivotal Response Teaching for Students With Autism. FOCUS ON AUTISM AND OTHER DEVELOPMENTAL DISABILITIES 2023; 38:32-44. [PMID: 38605730 PMCID: PMC11008494 DOI: 10.1177/10883576221133486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Classroom Pivotal Response Teaching (CPRT) is a community-partnered adaptation of a naturalistic developmental behavioral intervention identified as an evidence-based practice for autistic children. The current study evaluated student outcomes in a randomized, wait-list controlled implementation trial across classrooms. Participants included teachers (n = 126) and students with autism (n = 308). Teachers participated in 12 hours of didactic, interactive training and additional in-classroom coaching. Generalized Estimating Equations accounted for clustering. Adjusted models evaluated the relative effects of training group, CPRT fidelity, and classroom quality on student outcomes. Results indicate higher CPRT fidelity was associated with greater increases in student learning. Having received CPRT training predicted increased student engagement and greater decreases in reported approach/withdrawal problems. These differences may be linked to the theoretical foundations of CPRT of increasing student motivation and engagement and collaborative adaptation to increase feasibility in schools. Overall, results suggest CPRT may be a beneficial approach for supporting autistic students.
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Affiliation(s)
- Aubyn C. Stahmer
- UC Davis MIND Institute, Sacramento, CA, USA
- Child and Adolescent Services Research Center, CA, USA
| | - Jessica Suhrheinrich
- Child and Adolescent Services Research Center, CA, USA
- San Diego State University, CA, USA
| | - Sarah R. Rieth
- Child and Adolescent Services Research Center, CA, USA
- San Diego State University, CA, USA
| | - Scott Roesch
- Child and Adolescent Services Research Center, CA, USA
- San Diego State University, CA, USA
| | - Sarah Vejnoska
- UC Davis MIND Institute, Sacramento, CA, USA
- Child and Adolescent Services Research Center, CA, USA
| | - Janice Chan
- Child and Adolescent Services Research Center, CA, USA
- San Diego State University, CA, USA
| | | | - Tiffany Wang
- Child and Adolescent Services Research Center, CA, USA
- University of California, San Diego, USA
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9
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Waizbard-Bartov E, Miller M. Does the severity of autism symptoms change over time? A review of the evidence, impacts, and gaps in current knowledge. Clin Psychol Rev 2023; 99:102230. [PMID: 36469976 PMCID: PMC10357465 DOI: 10.1016/j.cpr.2022.102230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/10/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022]
Abstract
Studies evaluating change in autism symptom severity across the lifespan have yielded inconsistent results, making it difficult to assess the prevalence of meaningful change in autism symptom severity, and what characterizes it. Better understanding the ways in which autism symptoms change over time is crucial, with important implications for intervention. Synthesizing information across past studies, autism symptom severity change (especially decreases) appears common, though stability of symptoms is also frequent. Symptom severity change is characterized by variability in patterns of change between different individuals (between-person), variability in change within a person's trajectory across time (within-person), and variability in change patterns across symptom domains (i.e., social-communication, restricted/repetitive behaviors). Variability in severity change is likely impacted by differences in person-level characteristics (e.g., sex, IQ, sociodemographic factors) as well as developmental processes across time. Numerous methodological issues may impact our ability to understand how common change in symptom severity is, including varying measurement tools, analytic approaches, and change patterns between symptom domains across time. Potential implications of better understanding and characterizing symptom severity change include incorporation of severity change patterns and predictors of change into research on biomarkers, and consideration of such predictors as moderators or mediators of change in clinical practice.
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Affiliation(s)
- Einat Waizbard-Bartov
- Department of Psychology, University of California Davis, Davis, CA, USA; MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA.
| | - Meghan Miller
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA
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10
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Breastfeeding is not a risk factor for clinical severity in Autism spectrum disorder in children from the ELENA cohort. Sci Rep 2023; 13:816. [PMID: 36646708 PMCID: PMC9842713 DOI: 10.1038/s41598-022-27040-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that results from a complex interaction between genes and environment. Breastfeeding (BF) is thought to promote healthy cognitive development, and a body of research has suggested that it may also protect against ASD. Our objectives were to identify the relationship between the initiation and duration of BF and the severity of clinical presentation in ASD. Data were collected from 243 children with a confirmed diagnosis of ASD followed in the ELENA cohort. Clinical severity was measured according to multiple dimensions using standardised tools. The frequency of the initiation of BF was comparable to that of the general population and the rate of children still being breastfed at six months of age was higher. Our results did not indicate a contribution of initiation or duration of BF to the prevention of clinical severity of ASD. We discuss our results in the light of possible methodological limitations of previous reports of an association between BF and ASD.Clinical Trial Registration: NCT02625116.
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11
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Dong L, Wang Y, Wang X, Luo T, Zhou Q, Zhao G, Li B, Xia L, Xia K, Li J. Interactions of genetic risks for autism and the broad autism phenotypes. Front Psychiatry 2023; 14:1110080. [PMID: 37102084 PMCID: PMC10123509 DOI: 10.3389/fpsyt.2023.1110080] [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: 11/30/2022] [Accepted: 03/07/2023] [Indexed: 04/28/2023] Open
Abstract
Background Common polygenic risk and de novo variants (DNVs) capture a small proportion of autism spectrum disorder (ASD) liability, and ASD phenotypic heterogeneity remains difficult to explain. Integrating multiple genetic factors contribute to clarifying the risk and clinical presentation of ASD. Methods In our study, we investigated the individual and combined effects of polygenic risk, damaging DNVs (including those in ASD risk genes), and sex among 2,591 ASD simplex families in the Simons Simplex Collection. We also explored the interactions among these factors, along with the broad autism phenotypes of ASD probands and their unaffected siblings. Finally, we combined the effects of polygenic risk, damaging DNVs in ASD risk genes, and sex to explain the total liability of ASD phenotypic spectrum. Results Our findings revealed that both polygenic risk and damaging DNVs contribute to an increased risk for ASD, with females exhibiting higher genetic burdens than males. ASD probands that carry damaging DNVs in ASD risk genes showed reduced polygenic risk. The effects of polygenic risk and damaging DNVs on autism broad phenotypes were inconsistent; probands with higher polygenic risk exhibited improvement in some behaviors, such as adaptive/cognitive behaviors, while those with damaging DNVs exhibited more severe phenotypes. Siblings with higher polygenic risk and damaging DNVs tended to have higher scores on broader autism phenotypes. Females exhibited more severe cognitive and behavioral problems compared to males among both ASD probands and siblings. The combination of polygenic risk, damaging DNVs in ASD risk genes, and sex explained 1-4% of the total liability of adaptive/cognitive behavior measurements. Conclusion Our study revealed that the risk for ASD and the autism broad phenotypes likely arises from a combination of common polygenic risk, damaging DNVs (including those in ASD risk genes), and sex.
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Affiliation(s)
- Lijie Dong
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Yijing Wang
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Xiaomeng Wang
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Tengfei Luo
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
| | - Qiao Zhou
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guihu Zhao
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bin Li
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lu Xia
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
- *Correspondence: Lu Xia,
| | - Kun Xia
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Kun Xia,
| | - Jinchen Li
- Bioinformatics Center and National Clinical Research Centre for Geriatric Disorders, Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Centre for Medical Genetics and Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, Hunan, China
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Jinchen Li,
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12
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Denisova K, Lin Z. The importance of low IQ to early diagnosis of autism. Autism Res 2023; 16:122-142. [PMID: 36373182 PMCID: PMC9839551 DOI: 10.1002/aur.2842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 10/19/2022] [Indexed: 11/15/2022]
Abstract
Some individuals can flexibly adapt to life's changing demands while others, in particular those with Autism Spectrum Disorder (ASD), find it challenging. The origin of early individual differences in cognitive abilities, the putative tools with which to navigate novel information in life, including in infants later diagnosed with ASD remains unexplored. Moreover, the role of intelligence quotient (IQ) vis-à-vis core features of autism remains debated. We systematically investigate the contribution of early IQ in future autism outcomes in an extremely large, population-based study of 8000 newborns, infants, and toddlers from the US between 2 and 68 months with over 15,000 cross-sectional and longitudinal assessments, and for whom autism outcomes are ascertained or ruled out by about 2-4 years. This population is representative of subjects involved in the National Institutes of Health (NIH)-funded research, mainly on atypical development, in the US. Analyses using predetermined age bins showed that IQ scores are consistently lower in ASD relative to typically developing (TD) children at all ages (p < 0.001), and IQ significantly correlates with social, non-social, and total Calibrated Severity Scores (CSS) on the Autism Diagnostic Observation Schedule (ADOS) (p<0.01). Lower IQ is associated with greater autistic impairments. Note, verbal IQ (VIQ) is no better than the full-scale IQ to predict ASD cases. These findings raise new, compelling questions about potential atypical brain circuitry affecting performance in both verbal and nonverbal abilities and preceding an ASD diagnosis. This study is the first to establish prospectively that low early IQ is a major feature of ASD in early childhood. LAY SUMMARY: The role of IQ scores in autism remains debated. We systematically investigate the contribution of early IQ in an extremely large study of 8,000 children between 2 and 68 months with autism outcomes by about 2-4 years. We show that IQ scores are consistently lower in ASD relative to TD children. This study is the first to establish prospectively that low early IQ is a predictor for ASD diagnosis in early childhood.
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Affiliation(s)
- Kristina Denisova
- Laboratory of Autism Origins and Mind and Brain Development, Division of Math and Natural Sciences, Department of Psychology, Queens College and Graduate Center City University of New York New York New York USA
| | - Zhichun Lin
- Laboratory of Autism Origins and Mind and Brain Development, Division of Math and Natural Sciences, Department of Psychology, Queens College and Graduate Center City University of New York New York New York USA
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13
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Hong JS, Singh V, Kalb L, Reetzke R, Ludwig NN, Pfeiffer D, Holingue C, Menon D, Lu Q, Ashkar A, Landa R. Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder. Autism Res 2022; 15:2181-2191. [PMID: 36054678 PMCID: PMC10246880 DOI: 10.1002/aur.2801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 08/15/2022] [Indexed: 02/06/2023]
Abstract
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians.
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Affiliation(s)
- Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute
| | - Luke Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Natasha N. Ludwig
- Department of Neuropsychology, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Danika Pfeiffer
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health
| | - Deepa Menon
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Neurology, Johns Hopkins University School of Medicine
| | - Qing Lu
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Johns Hopkins University School of Arts and Sciences
| | - Ahlam Ashkar
- Center for Autism and Related Disorders, Kennedy Krieger Institute
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
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14
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Costanzo V, Narzisi A, Cerullo S, Crifaci G, Boncoddo M, Turi M, Apicella F, Tancredi R, Muratori F, Calderoni S, Billeci L. High-Risk Siblings without Autism: Insights from a Clinical and Eye-Tracking Study. J Pers Med 2022; 12:jpm12111789. [PMID: 36573785 PMCID: PMC9699372 DOI: 10.3390/jpm12111789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022] Open
Abstract
Joint attention (JA)-the human ability to coordinate our attention with that of other people-is impaired in the early stage of Autism Spectrum Disorder (ASD). However, little is known about the JA skills in the younger siblings of children with ASD who do not develop ASD at 36 months of age [high-risk (HR)-noASD]. In order to advance our understanding of this topic, a prospective multicenter observational study was conducted with three groups of toddlers (age range: 18-33 months): 17 with ASD, 19 with HR-noASD and 16 with typical development (TD). All subjects underwent a comprehensive clinical assessment and an eye-tracking experiment with pre-recorded stimuli in which the visual patterns during two tasks eliciting initiating joint attention (IJA) were measured. Specifically, fixations, transitions and alternating gaze were analyzed. Clinical evaluation revealed that HR-noASD subjects had lower non-verbal cognitive skills than TD children, while similar levels of restricted and repetitive behaviors and better social communication skills were detected in comparison with ASD children. Eye-tracking paradigms indicated that HR-noASD toddlers had visual patterns resembling TD in terms of target-object-to-face gaze alternations, while their looking behaviors were similar to ASD toddlers regarding not-target-object-to-face gaze alternations. This study indicated that high-risk, unaffected siblings displayed a shared profile of IJA-eye-tracking measures with both ASD patients and TD controls, providing new insights into the characterization of social attention in this group of toddlers.
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Affiliation(s)
- Valeria Costanzo
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Antonio Narzisi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Sonia Cerullo
- Child Psychopathology Unit, Scientific Institute IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini, 22040 Lecco, Italy
| | - Giulia Crifaci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), 56124 Pisa, Italy
| | - Maria Boncoddo
- Interdepartmental Program “Autism 0-90”, “G. Martino” University Hospital of Messina, 98100 Messina, Italy
| | - Marco Turi
- Stella Maris Mediterraneo Foundation, 85032 Chiaromonte, Italy
| | - Fabio Apicella
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Raffaella Tancredi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
- Correspondence: ; Tel./Fax: +39-050-886200
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), 56124 Pisa, Italy
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15
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Burrows CA, Grzadzinski RL, Donovan K, Stallworthy IC, Rutsohn J, St John T, Marrus N, Parish-Morris J, MacIntyre L, Hampton J, Pandey J, Shen MD, Botteron KN, Estes AM, Dager SR, Hazlett HC, Pruett JR, Schultz RT, Zwaigenbaum L, Truong KN, Piven J, Elison JT. A Data-Driven Approach in an Unbiased Sample Reveals Equivalent Sex Ratio of Autism Spectrum Disorder-Associated Impairment in Early Childhood. Biol Psychiatry 2022; 92:654-662. [PMID: 35965107 PMCID: PMC10062179 DOI: 10.1016/j.biopsych.2022.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/12/2022] [Accepted: 05/30/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Sex differences in the prevalence of neurodevelopmental disorders are particularly evident in autism spectrum disorder (ASD). Heterogeneous symptom presentation and the potential of measurement bias hinder early ASD detection in females and may contribute to discrepant prevalence estimates. We examined trajectories of social communication (SC) and restricted and repetitive behaviors (RRBs) in a sample of infant siblings of children with ASD, adjusting for age- and sex-based measurement bias. We hypothesized that leveraging a prospective elevated familial likelihood sample, deriving data-driven behavioral constructs, and accounting for measurement bias would reveal less discrepant sex ratios than are typically seen in ASD. METHODS We conducted direct assessments of ASD symptoms at 6 to 9, 12 to 15, 24, and 36 to 60 months of age (total nobservations = 1254) with infant siblings of children with ASD (n = 377) and a lower ASD-familial-likelihood comparison group (n = 168; nobservations = 527). We established measurement invariance across age and sex for separate models of SC and RRB. We then conducted latent class growth mixture modeling with the longitudinal data and evaluated for sex differences in trajectory membership. RESULTS We identified 2 latent classes in the SC and RRB models with equal sex ratios in the high-concern cluster for both SC and RRB. Sex differences were also observed in the SC high-concern cluster, indicating that girls classified as having elevated social concerns demonstrated milder symptoms than boys in this group. CONCLUSIONS This novel approach for characterizing ASD symptom progression highlights the utility of assessing and adjusting for sex-related measurement bias and identifying sex-specific patterns of symptom emergence.
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Affiliation(s)
- Catherine A Burrows
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota.
| | - Rebecca L Grzadzinski
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kevin Donovan
- Department of Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Isabella C Stallworthy
- Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
| | - Joshua Rutsohn
- Department of Biostatistics, Gillings School of Global PubLic Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tanya St John
- UW Autism Center, Center on Human Development & Disability, University of Washington, Seattle, Washington
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Julia Parish-Morris
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Leigh MacIntyre
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec, Canada
| | - Jacqueline Hampton
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Juhi Pandey
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Mark D Shen
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; UNC Neuroscience Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelly N Botteron
- Department of Radiology, University of Washington Medical Center, Seattle, Washington; Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Annette M Estes
- UW Autism Center, Center on Human Development & Disability, University of Washington, Seattle, Washington; Department of Speech & Hearing Sciences, University of Washington, Seattle, Washington
| | - Stephen R Dager
- Department of Radiology, University of Washington Medical Center, Seattle, Washington
| | - Heather C Hazlett
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John R Pruett
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Robert T Schultz
- Center for Autism Research, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Alberta, Canada
| | - Kinh N Truong
- Department of Biostatistics, Gillings School of Global PubLic Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jed T Elison
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota; Institute of Child Development, College of Education and Human Development, University of Minnesota, Minneapolis, Minnesota
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16
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Zheng S, Kaat A, Farmer C, Thurm A, Burrows CA, Kanne S, Georgiades S, Esler A, Lord C, Takahashi N, Nowell KP, Will E, Roberts J, Bishop SL. Bias in measurement of autism symptoms by spoken language level and non-verbal mental age in minimally verbal children with neurodevelopmental disorders. Front Psychol 2022; 13:927847. [PMID: 35967726 PMCID: PMC9372407 DOI: 10.3389/fpsyg.2022.927847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Increasing numbers of children with known genetic conditions and/or intellectual disability are referred for evaluation of autism spectrum disorder (ASD), highlighting the need to refine autism symptom measures to facilitate differential diagnoses in children with cognitive and language impairments. Previous studies have reported decreased specificity of ASD screening and diagnostic measures in children with intellectual disability. However, little is known about how cognitive and language abilities impact the measurement of specific ASD symptoms in this group. We aggregated a large sample of young children (N = 1196; aged 31-119 months) to examine measurement invariance of ASD symptoms among minimally verbal children within the context of the Autism Diagnostic Observation Schedule (ADOS) Module 1. Using confirmatory factor analysis (CFA) and moderated non-linear factor analysis (MNLFA), we examined how discrete behaviors were differentially associated with the latent symptom domains of social communication impairments (SCI) and restricted and repetitive behaviors (RRB) across spoken language levels and non-verbal mental age groupings. While the two-factor structure of SCI and RRB held consistently across language and cognitive levels, only partial invariance was observed for both ASD symptom domains of SCI and RRB. Specifically, four out of the 15 SCI items and one out of the three RRB items examined showed differential item functioning between children with "Few to No Words" and those with "Some Words"; and one SCI item and one RRB item showed differential item functioning across non-verbal mental age groups. Moreover, even after adjusting for the differential item functioning to reduce measurement bias across groups, there were still differences in ASD symptom domain scores across spoken language levels. These findings further underscore the influence of spoken language level on measurement of ASD symptoms and the importance of measuring ASD symptoms within refined spoken language levels, even among those with minimal verbal abilities.
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Affiliation(s)
- Shuting Zheng
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Aaron Kaat
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, United States
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, United States
| | - Catherine A. Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Stephen Kanne
- Center for Autism and the Developing Brain, Weill Cornell Medical College, White Plains, NY, United States
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - Amy Esler
- Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, United States
| | - Catherine Lord
- UCLA Semel Institute for Neuroscience & Human Behavior, Center for Autism Research and Treatment, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicole Takahashi
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO, United States
| | - Kerri P. Nowell
- Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri, Columbia, MO, United States
- Department of Health Psychology, University of Missouri, Columbia, MO, United States
| | - Elizabeth Will
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Jane Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, United States
| | - Somer L. Bishop
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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17
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Feldman M, Hamsho N, Blacher J, Carter AS, Eisenhower A. Predicting peer acceptance and peer rejection for autistic children. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Melanie Feldman
- TEACCH Autism Program School of Medicine, University of North Carolina Chapel Hill North Carolina USA
| | - Narmene Hamsho
- Department of Psychology University of Massachusetts Boston Massachusetts USA
| | - Jan Blacher
- Graduate School of Education University of California Riverside California USA
| | - Alice S. Carter
- Department of Psychology University of Massachusetts Boston Massachusetts USA
| | - Abbey Eisenhower
- Department of Psychology University of Massachusetts Boston Massachusetts USA
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18
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Li G, Chen MH, Li G, Wu D, Lian C, Sun Q, Rushmore RJ, Wang L. Volumetric Analysis of Amygdala and Hippocampal Subfields for Infants with Autism. J Autism Dev Disord 2022; 53:2475-2489. [PMID: 35389185 DOI: 10.1007/s10803-022-05535-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
Previous studies have demonstrated abnormal brain overgrowth in children with autism spectrum disorder (ASD), but the development of specific brain regions, such as the amygdala and hippocampal subfields in infants, is incompletely documented. To address this issue, we performed the first MRI study of amygdala and hippocampal subfields in infants from 6 to 24 months of age using a longitudinal dataset. A novel deep learning approach, Dilated-Dense U-Net, was proposed to address the challenge of low tissue contrast and small structural size of these subfields. We performed a volume-based analysis on the segmentation results. Our results show that infants who were later diagnosed with ASD had larger left and right volumes of amygdala and hippocampal subfields than typically developing controls.
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Affiliation(s)
- Guannan Li
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China.,Department of Radiology and Biomedical Research Imaging Center, Bioinformatics Building, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Gang Li
- Department of Radiology and Biomedical Research Imaging Center, Bioinformatics Building, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA
| | - Di Wu
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Chunfeng Lian
- Department of Radiology and Biomedical Research Imaging Center, Bioinformatics Building, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA
| | - Quansen Sun
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China
| | - R Jarrett Rushmore
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Center for Morphometric Analysis, Massachusetts General Hospital, 149 Thirteenth Street, Charlestown, MA, 02129, USA
| | - Li Wang
- Department of Radiology and Biomedical Research Imaging Center, Bioinformatics Building, University of North Carolina at Chapel Hill, 130 Mason Farm Rd, Chapel Hill, NC, 27599, USA.
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19
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Kalb LG, Singh V, Hong JS, Holingue C, Ludwig NN, Pfeiffer D, Reetzke R, Gross AL, Landa R. Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2). JAMA Netw Open 2022; 5:e229498. [PMID: 35471566 PMCID: PMC9044110 DOI: 10.1001/jamanetworkopen.2022.9498] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE There are long-standing disparities in the prevalence of autism spectrum disorder (ASD) across race and sex. Surprisingly, few studies have examined whether these disparities arise partially out of systematic biases in the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the reference standard measure of ASD. OBJECTIVE To examine differential item functioning (DIF) of ADOS-2 items across sex and race. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional study of children who were evaluated for ASD between 2014 and 2020 at a specialty outpatient clinic located in the Mid-Atlantic region of the US. Data were analyzed from July 2021 to February 2022. EXPOSURES Child race (Black/African American vs White) and sex (female vs male). MAIN OUTCOMES AND MEASURES Item-level biases across ADOS-2 harmonized algorithm items, including social affect (SA; 10 items) and repetitive/restricted behaviors (RRBs; 4 items), were evaluated across 3 modules. Measurement bias was identified by examining DIF and differential test functioning (DTF), within a graded response, item response theory framework. Statistical significance was determined by a likelihood ratio χ2 test, and a series of metrics was used to examine the magnitude of DIF and DTF. RESULTS A total of 6269 children (mean [SD] age, 6.77 [3.27] years; 1619 Black/African American [25.9%], 3151 White [50.3%], and 4970 male [79.4%]), were included in this study. Overall, 16 of 140 ADOS-2 diagnostic items (11%) had a significant DIF. For race, 8 items had a significant DIF, 6 of which involved SA. No single item showed DIF consistently across all modules. Most items with DIF had greater difficulty and poorer discrimination in Black/African American children compared with White children. For sex, 5 items showed significant DIF. DIF was split across SA and RRB. However, hand mannerisms evidenced DIF across all 5 algorithms, with generally greater difficulty. The magnitude of DIF was only moderate to large for 2 items: hand mannerisms (among female children) and repetitive interests (among Black/African American children). The overall estimated effect of DIF on total DTF was not large. CONCLUSIONS AND RELEVANCE These findings suggest that the ADOS-2 does not have widespread systematic measurement bias across race or sex. However, the findings raise some concerns around underdetection that warrant further research.
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Affiliation(s)
- Luther G. Kalb
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
| | - Vini Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
| | - Ji Su Hong
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Calliope Holingue
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
| | - Natasha N. Ludwig
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Danika Pfeiffer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rachel Reetzke
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alden L. Gross
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rebecca Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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20
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Bakare MO, Frazier TW, Karpur A, Abubakar A, Nyongesa MK, Mwangi PM, Dixon P, Khaliq I, Gase NK, Sandstrom J, Okidegbe N, Rosanoff M, Munir KM, Shih A. Brief report: Validity and reliability of the Nigerian Autism Screening Questionnaire. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1581-1590. [PMID: 35261274 PMCID: PMC7613535 DOI: 10.1177/13623613221080250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Informant-report measures for screening symptoms of autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs) are needed for low-resource settings if early identification is to be prioritized because early developmental concerns are likely to be expressed by parents and other caregivers. This paper describes the initial psychometric evaluation of the Nigeria Autism Screening Questionnaire (NASQ). Parents and other caregivers completed the NASQ on 12,311 children ages 1 to 18 in a Nigerian population sample as part of the World Bank National General Household Survey conducted in the country in 2016. Factor analyses indicated a parsimonious three-factor structure with social communication/interaction, repetitive sensory motor, and insistence on sameness dimensions. Measurement invariance was excellent across age and sex. Reliability of the subscales and total scale was good, and item response theory analyses indicated good measurement precision in the range from below average to high scores, crucial for screening, and tracking ASD symptoms. Studies with gold standard ASD diagnostic instruments and clinical confirmation are needed to evaluate screening and diagnostic accuracy. The NASQ appears to be a reliable instrument with a clear factor structure and potential for use in screening and tracking ASD symptoms in future Nigerian samples.
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Affiliation(s)
- Muideen O Bakare
- Federal Neuro Psychiatric Hospital, Nigeria.,Childhood Neuropsychiatric Disorders Initiatives (CNDI), Nigeria.,Ike Foundation for Autism (IFA), Nigeria.,World Psychiatric Association (WPA), Switzerland
| | | | | | - Amina Abubakar
- Aga Khan University, Kenya.,KEMRI-Wellcome Trust Research Programme, Kenya
| | | | | | | | | | | | | | | | | | - Kerim M Munir
- World Psychiatric Association (WPA), Switzerland.,Harvard Medical School, USA
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21
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Wolff N, Eberlein M, Stroth S, Poustka L, Roepke S, Kamp-Becker I, Roessner V. Abilities and Disabilities-Applying Machine Learning to Disentangle the Role of Intelligence in Diagnosing Autism Spectrum Disorders. Front Psychiatry 2022; 13:826043. [PMID: 35308891 PMCID: PMC8927055 DOI: 10.3389/fpsyt.2022.826043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/10/2022] [Indexed: 12/25/2022] Open
Abstract
Objective Although autism spectrum disorder (ASD) is a relatively common, well-known but heterogeneous neuropsychiatric disorder, specific knowledge about characteristics of this heterogeneity is scarce. There is consensus that IQ contributes to this heterogeneity as well as complicates diagnostics and treatment planning. In this study, we assessed the accuracy of the Autism Diagnostic Observation Schedule (ADOS/2) in the whole and IQ-defined subsamples, and analyzed if the ADOS/2 accuracy may be increased by the application of machine learning (ML) algorithms that processed additional information including the IQ level. Methods The study included 1,084 individuals: 440 individuals with ASD (with a mean IQ level of 3.3 ± 1.5) and 644 individuals without ASD (with a mean IQ level of 3.2 ± 1.2). We applied and analyzed Random Forest (RF) and Decision Tree (DT) to the ADOS/2 data, compared their accuracy to ADOS/2 cutoff algorithms, and examined most relevant items to distinguish between ASD and Non-ASD. In sum, we included 49 individual features, independently of the applied ADOS module. Results In DT analyses, we observed that for the decision ASD/Non-ASD, solely one to four items are sufficient to differentiate between groups with high accuracy. In addition, in sub-cohorts of individuals with (a) below (IQ level ≥4)/ID and (b) above average intelligence (IQ level ≤ 2), the ADOS/2 cutoff showed reduced accuracy. This reduced accuracy results in (a) a three times higher risk of false-positive diagnoses or (b) a 1.7 higher risk for false-negative diagnoses; both errors could be significantly decreased by the application of the alternative ML algorithms. Conclusions Using ML algorithms showed that a small set of ADOS/2 items could help clinicians to more accurately detect ASD in clinical practice across all IQ levels and to increase diagnostic accuracy especially in individuals with below and above average IQ level.
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Affiliation(s)
- Nicole Wolff
- Department of Child and Adolescent Psychiatry and Psychotherapy, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Matthias Eberlein
- Institute of Circuits and Systems, Faculty of Electrical and Computer Engineering, Technische Universität Dresden, Dresden, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Stefan Roepke
- Department of Psychiatry, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University, Marburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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22
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Larkin F, Hollaway L, Garlington M, Hobson J. Guided Participation and Parental Tutoring in Preschool Children with Autism: A Pilot Study of Relationship Development Intervention (RDI). PSYCHOANALYTIC INQUIRY 2022. [DOI: 10.1080/07351690.2021.2022402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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23
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Berard M, Peries M, Loubersac J, Picot MC, Bernard JY, Munir K, Baghdadli A. Screen time and associated risks in children and adolescents with autism spectrum disorders during a discrete COVID-19 lockdown period. Front Psychiatry 2022; 13:1026191. [PMID: 36532191 PMCID: PMC9751585 DOI: 10.3389/fpsyt.2022.1026191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic may affect the screen time of children and adolescents with Autism Spectrum Disorders (ASD). This study aimed to examine the screen time of children and adolescents with ASD during a discrete lockdown period in France and identify risk factors for excessive screen time. METHODS The study sample consisted of 249 ASD subjects, 3-17 years of age, enrolled in the ELENA cohort. Information about the screen time was collected using the COVID-19 questionnaire specially created for this study. The clinical, socio-demographic and familial characteristics were collected from the last ELENA follow-up visit. RESULTS More than one third of subjects exceeded recommended levels of screen time and almost half of parents reported that their child spent more time using screen since COVID-19 pandemic beginning. Excessive screen time was significantly related to age with higher screen time in adolescents. Risk factors for excessive screen time were high withdrawn behaviors and low socioeconomic status for children, and older age and male gender for adolescents. CONCLUSION These results imply to adapt the recommendations already formulated in general population concerning the good use of screens in youth with ASD. Specific recommendations and suitable guidance are needed to help children and adolescents with ASD and their parents implement the more optimal use of screen time activities for educational, therapeutic and social goals. TRIAL REGISTRATION NUMBER NCT02625116.
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Affiliation(s)
- Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Julie Loubersac
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Marie-Christine Picot
- Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Clinical Research and Epidemiology Unit, Department of Medical Information, University Hospital, CHU Montpellier, Montpellier, France
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre de Recherche en Épidémiologie et Statistiques, Paris, France.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, CHU Montpellier, Montpellier, France.,Centre d'Excellence sur l'Autisme et les Troubles Neuro-développementaux, CHU Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
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24
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Luongo-Zink C, Ammons C, Al-Ramadhani R, Logan R, Ono K, Bhalla S, Kheder A, Marcus D, Drane D, Bearden D. Longitudinal neurodevelopmental profile of a pediatric patient with de novo SPTAN1, epilepsy, and left hippocampal sclerosis. Epilepsy Behav Rep 2022; 19:100550. [PMID: 35620303 PMCID: PMC9126767 DOI: 10.1016/j.ebr.2022.100550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/23/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
Abstract
We present the first longitudinal study of neuropsychological functioning in a pediatric patient with SPTAN1. To our knowledge we report the first case of SPTAN1 heterozygosity in a patient with MTLE due to HS. This case is the first to show that lisdexamfetamine dimesylate improved attention, behavior, and school performance in a patient with heterozygous SPTAN1 variant.
Pathogenic variants in SPTAN1 result in abnormal neurodevelopment but limited information is available on the spectrum of neurodevelopmental profiles associated with variations in this gene. We present novel data collected at two time points over a three-year period in a nine-year-old patient with heterozygous de novo SPTAN1 variant, drug-resistant epilepsy, and left hippocampal sclerosis. Across evaluations, our patient’s performance was highly variable, ranging from below age expectation to within age-expected range. The patient exhibited relative cognitive strengths at both time points on verbal-expressive tasks. Weaknesses were seen in her attention, executive function, psychomotor processing speed, fine motor, visual-motor integration, and social skills. Memory findings were consistent those associated with left hippocampal sclerosis. Evaluations resulted in diagnoses including attention deficit hyperactivity disorder and autism spectrum disorder.
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Affiliation(s)
- C. Luongo-Zink
- William James College, Newton, MA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - C. Ammons
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - R. Al-Ramadhani
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - R. Logan
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - K.E. Ono
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - S. Bhalla
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - A. Kheder
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - D.J. Marcus
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - D.L. Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - D.J. Bearden
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Corresponding author at: Center for Advanced Pediatrics, Children’s Healthcare of Atlanta, 1400 Tullie Rd. NE, Ste. 430, Atlanta, GA 30329, USA.
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25
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Muhammad AA, ElFiky YH, Shoeib RM, Rifaie NAEA, Saleh MM. Construction of a tool for assessment of joint attention in Egyptian Cairene children. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2021. [DOI: 10.1186/s43088-021-00181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Joint attention (JA) is a basic social communicative skill important for language development. JA deficits appear prior to language acquisition. Because autism is often not diagnosed until a child is three or four years of age, it is important to look for indicators prior to language acquisition such as JA to provide appropriate treatment at a younger age. Therefore, the aim of this study is to construct an objective tool for assessment of joint attention skills in young Egyptian children to detect the presence of autistic behaviour in high-risk children in order to conduct plans for early intervention. The questionnaire was constructed to assess the five main components of JA and was termed Egyptian Joint Attention Questionnaire. The questions were formulated in the colloquial Egyptian Arabic language and in an ‘easy-to understand’ design that would be comprehensible by mothers. No question was directly translated from another questionnaire. Ten typically developing (TD) children, with an age range of 18–54 months, were included in the pilot study of the test design. It was applied to 90 TD children and 30 autistic children (contrast group) within the same age range. Participant's responses were statistically analysed to assess the validity and reliability of the questionnaire and to compare the responses related to TD children and autistic children.
Results
There was high internal consistency and reliability of the questionnaire (Cronbach’s α = 0.9, Intra-class correlation = .776), with a statistically significant difference between TD and autistic children (P < 0.001).
Conclusions
The questionnaire is a valid and reliable assessment tool that could be used in early detection of autistic Egyptian children.
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26
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Dow D, Holbrook A, Toolan C, McDonald N, Sterrett K, Rosen N, Kim SH, Lord C. The Brief Observation of Symptoms of Autism (BOSA): Development of a New Adapted Assessment Measure for Remote Telehealth Administration Through COVID-19 and Beyond. J Autism Dev Disord 2021; 52:5383-5394. [PMID: 34914016 PMCID: PMC8674519 DOI: 10.1007/s10803-021-05395-w] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/28/2022]
Abstract
Interest in telehealth assessment for autism has increased due to COVID-19 and subsequent expansion of remote psychological services, though options that are easy for clinicians to adopt and available through the lifespan are limited. The Brief Observation of Symptoms of Autism (BOSA) provides a social context with standardized materials and activities that can be coded by clinicians trained in the Autism Diagnostic Observation Schedule. The current project examined psychometric properties to determine optimal use for each BOSA version. Three hundred and seven participants with 453 BOSAs were included to determine best performing items for algorithms, validity, sensitivity, specificity, recommended cut-offs, and proposed ranges of concern. While preliminary, the BOSA provides a promising new option for telehealth-administered assessment for autism.
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Affiliation(s)
- Deanna Dow
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 760 Westwood Plaza, RM 68-265, Los Angeles, CA, 90024, USA
| | - Alison Holbrook
- Simons Foundation Autism Research Initiative, 160 5th Ave, New York, NY, 10010, USA
| | - Christina Toolan
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 760 Westwood Plaza, RM 68-265, Los Angeles, CA, 90024, USA
| | - Nicole McDonald
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 760 Westwood Plaza, RM 68-265, Los Angeles, CA, 90024, USA
| | - Kyle Sterrett
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 760 Westwood Plaza, RM 68-265, Los Angeles, CA, 90024, USA
| | - Nicole Rosen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 760 Westwood Plaza, RM 68-265, Los Angeles, CA, 90024, USA
| | - So Hyun Kim
- Department of Psychiatry, Weill Cornell Medical College, New York-Presbyterian Hospital, 21 Bloomingdale Road, Rogers Building, White Plains, NY, 10605, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), 760 Westwood Plaza, RM 68-265, Los Angeles, CA, 90024, USA.
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27
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Dimachkie Nunnally A, Nguyen V, Anglo C, Sterling A, Edgin J, Sherman S, Berry-Kravis E, del Hoyo Soriano L, Abbeduto L, Thurman AJ. Symptoms of Autism Spectrum Disorder in Individuals with Down Syndrome. Brain Sci 2021; 11:1278. [PMID: 34679343 PMCID: PMC8533848 DOI: 10.3390/brainsci11101278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
There is a growing body of evidence to suggest that individuals with Down syndrome (DS) are diagnosed with autism spectrum disorders (ASD) at a higher rate than individuals in the general population. Nonetheless, little is known regarding the unique presentation of ASD symptoms in DS. The current study aims to explore the prevalence and profiles of ASD symptoms in a sample of individuals with DS (n = 83), aged between 6 and 23 years. Analysis of this sample (MAge = 15.13) revealed that approximately 37% of the sample met the classification cut-off for ASD using the Autism Diagnostic Observation Schedule 2 (ADOS-2) Calibrated Severity Score (CSS), an indicator of the participants' severity of ASD-related symptoms. Item-level analyses revealed that multiple items on Module 2 and Module 3 of the ADOS-2, mostly in the Social Affect (SA) subdomain, differentiated the children with DS who did not meet ASD classification (DS-only) from those who did (DS + ASD). Lastly, comparisons of individuals with DS-only and those with DS + ASD differed significantly on the syntactic complexity of their expressive language. These findings shed light on the unique presentation of ASD symptoms in a sample of individuals with DS and suggest that expressive language abilities may play a pivotal role in the presentation of ASD symptoms in DS.
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Affiliation(s)
- Amanda Dimachkie Nunnally
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Vivian Nguyen
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Claudine Anglo
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Audra Sterling
- Waisman Center and Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Jamie Edgin
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA;
| | - Stephanie Sherman
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA 30322, USA;
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences and Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Laura del Hoyo Soriano
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Leonard Abbeduto
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA 95817, USA
| | - Angela John Thurman
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA 95817, USA
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28
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Preliminary Efficacy of Occupational Therapy in an Equine Environment for Youth with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:4114-4128. [PMID: 34557985 DOI: 10.1007/s10803-021-05278-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to identify appropriate outcome measures and assess preliminary efficacy of occupational therapy in an equine environment (OTee HORSPLAY) for youth with autism spectrum disorder (ASD). Twenty-four youth with ASD aged 6-13 were randomized to 10 weeks of OTee HORSPLAY or to a waitlist control condition, occupational therapy in a garden. Youth demonstrated significantly improved goal attainment and social motivation, and decreased irritability after OTee HORSPLAY. When compared to the subset of participants who completed the waitlist control condition, the OTee HORSPLAY group still demonstrated significant improvements in goal attainment. This study provides preliminary evidence that horses can be integrated into occupational therapy for youth with ASD to improve social and behavioral goals.
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29
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Sano M, Yoshimura Y, Hirosawa T, Hasegawa C, An KM, Tanaka S, Naitou N, Kikuchi M. Joint attention and intelligence in children with autism spectrum disorder without severe intellectual disability. Autism Res 2021; 14:2603-2612. [PMID: 34427050 PMCID: PMC9291323 DOI: 10.1002/aur.2600] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/27/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
In children with autism spectrum disorder (ASD), joint attention is regarded as a predictor of language function, social skills, communication, adaptive function, and intelligence. However, existing information about the association between joint attention and intelligence is limited. Most such studies have examined children with low intelligence. For this study, we investigated whether joint attention is related to intelligence in young children with autism spectrum disorder (ASD) without severe intellectual disability. We analyzed 113 children with ASD aged 40–98 months. Their Kaufman Assessment Battery (K‐ABC) Mental Processing Index (MPI) scores are 60 and more (mean 93.4). We evaluated their intelligence using K‐ABC and evaluated their joint attention using ADOS‐2. After we performed simple regression analyses using K‐ABC MPI and its nine subscales as dependent variables, using joint attention as the independent variable, we identified joint attention as a positive predictor of the MPI and its two subscales. From this result, we conclude that joint attention is related to intelligence in young children with ASD without severe intellectual disability. This result suggests a beneficial effect of early intervention targeting joint attention for children with ASD.
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Affiliation(s)
- Masuhiko Sano
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Yuko Yoshimura
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan.,Faculty of Education, Institute of Human and Social Sciences, Kanazawa University, Kanazawa, Japan
| | - Tetsu Hirosawa
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.,Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Chiaki Hasegawa
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Kyung-Min An
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Sanae Tanaka
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
| | - Nobushige Naitou
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.,Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan
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30
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Holzinger D, Weber C, Bölte S, Fellinger J, Hofer J. Assessment of Autism Spectrum Disorder in Deaf Adults with Intellectual Disability: Feasibility and Psychometric Properties of an Adapted Version of the Autism Diagnostic Observation Schedule (ADOS-2). J Autism Dev Disord 2021; 52:3214-3227. [PMID: 34322824 PMCID: PMC9213306 DOI: 10.1007/s10803-021-05203-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 01/13/2023]
Abstract
This study describes the adaptation of the autism diagnostic observation schedule (ADOS-2) to assess autism spectrum disorder (ASD) in adults with intellectual disability (ID) and hearing loss who communicate primarily visually. This adapted ADOS-2 was applied to residents of specialized therapeutic living communities (n = 56). The internal consistency of the adapted ADOS-2 was excellent for the Social Affect of modules 2 and 3 and acceptable for Restricted and Repetitive Behaviors subscale of module 2, but poor for module 3. Interrater reliability was comparable to standard ADOS-2 modules 1–3. Results suggest that autism symptoms of deaf adults with ID can be reliably identified by an adapted ADOS-2, provided adequate expertise in deafness, ID, ASD and proficiency in signed language by the administrator.
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Affiliation(s)
- D Holzinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria.,Institut für Sprachwissenschaft, Karl-Franzens-Universität Graz, Graz, Austria
| | - C Weber
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Inklusive Pädagogik, Pädagogische Hochschule OÖ, Linz, Austria
| | - S Bölte
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - J Fellinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.,Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria.,Abteilung für Sozialpsychiatrie der Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Vienna, Austria
| | - J Hofer
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria. .,Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria. .,Abteilung für Pädiatrie I, Medizinische Universität Innsbruck, Innsbruck, Austria.
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Berard M, Rattaz C, Peries M, Loubersac J, Munir K, Baghdadli A. Impact of containment and mitigation measures on children and youth with ASD during the COVID-19 pandemic: Report from the ELENA cohort. J Psychiatr Res 2021; 137:73-80. [PMID: 33662654 PMCID: PMC7898988 DOI: 10.1016/j.jpsychires.2021.02.041] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/04/2021] [Accepted: 02/17/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Containment, involving separation and restriction of movement of people due to the COVID-19 pandemic, and mitigation, also referred to as lockdown, involving closure of schools, universities and public venues, has had a profound impact on people's lives globally. The study focuses on the effects of containment and mitigation measures, on the behavior of children and youth (CaY) with Autism Spectrum Disorders (ASD). The study primary aim was to examine the impact of these urgent measures on the behaviors, communication, sleep, and nutritional status of the CaY. A secondary aim was to explore risk and protective factors on behavior change including sociodemographic variables, living conditions, ASD symptom severity and continuity of interventions. METHODS The study sample consisted of 239 ASD subjects, 2-21 years of age, enrolled in the ELENA cohort in France at Stage 3 confinement and mitigation measures announced on March 16, 2020. A parent informant completed the COVID-19 questionnaire. RESULTS Of the domains examined, challenging behaviors, communicative skills and sleep had the greatest impact; in terms of risk and protective factors, subject age, ASD severity, single parenthood, daily living skills, and intervention continuity were most likely to impact behaviors; living conditions were not linked to behavior change. CONCLUSIONS The findings highlight the topography of behavioral change in CaY with ASD following institution of containment and mitigation measures during the COVID-19 pandemic and help identify risk and protective factors to help better address needs and tailor interventions in the future.
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Affiliation(s)
- Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Cécile Rattaz
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Marianne Peries
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Julie Loubersac
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
| | - Kerim Munir
- Developmental Medicine Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France; Faculté de Médecine, Université de Montpellier, France.
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32
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Winston M, Nayar K, Landau E, Maltman N, Sideris J, Zhou L, Sharp K, Berry-Kravis E, Losh M. A Unique Visual Attention Profile Associated With the FMR1 Premutation. Front Genet 2021; 12:591211. [PMID: 33633778 PMCID: PMC7901883 DOI: 10.3389/fgene.2021.591211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/11/2021] [Indexed: 12/13/2022] Open
Abstract
Atypical visual attention patterns have been observed among carriers of the fragile X mental retardation gene (FMR1) premutation (PM), with some similarities to visual attention patterns observed in autism spectrum disorder (ASD) and among clinically unaffected relatives of individuals with ASD. Patterns of visual attention could constitute biomarkers that can help to inform the neurocognitive profile of the PM, and that potentially span diagnostic boundaries. This study examined patterns of eye movement across an array of fixation measurements from three distinct eye-tracking tasks in order to investigate potentially overlapping profiles of visual attention among PM carriers, ASD parents, and parent controls. Logistic regression analyses were conducted to examine whether variables constituting a PM-specific looking profile were able to effectively predict group membership. Participants included 65PM female carriers, 188 ASD parents, and 84 parent controls. Analyses of fixations across the eye-tracking tasks, and their corresponding areas of interest, revealed a distinct visual attention pattern in carriers of the FMR1 PM, characterized by increased fixations on the mouth when viewing faces, more intense focus on bodies in socially complex scenes, and decreased fixations on salient characters and faces while narrating a wordless picture book. This set of variables was able to successfully differentiate individuals with the PM from controls (Sensitivity = 0.76, Specificity = 0.85, Accuracy = 0.77) as well as from ASD parents (Sensitivity = 0.70, Specificity = 0.80, Accuracy = 0.72), but did not show a strong distinction between ASD parents and controls (Accuracy = 0.62), indicating that this set of variables comprises a profile that is unique to PM carriers. Regarding predictive power, fixations toward the mouth when viewing faces was able to differentiate PM carriers from both ASD parents and controls, whereas fixations toward other social stimuli did not differentiate PM carriers from ASD parents, highlighting some overlap in visual attention patterns that could point toward shared neurobiological mechanisms. Results demonstrate a profile of visual attention that appears strongly associated with the FMR1 PM in women, and may constitute a meaningful biomarker.
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Affiliation(s)
- Molly Winston
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Kritika Nayar
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Emily Landau
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Nell Maltman
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - John Sideris
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States
| | - Lili Zhou
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | - Kevin Sharp
- Department of Pediatrics, Rush University Medical Center, Chicago, IL, United States
| | | | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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33
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Caplan B, Blacher J, Eisenhower A, Baker BL, Lee SS. Gene x responsive parenting interactions in social development: Characterizing heterogeneity in autism spectrum disorder. Dev Psychobiol 2021; 63:1082-1097. [PMID: 33511631 DOI: 10.1002/dev.22095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/05/2022]
Abstract
Emerging research suggests that caregiving environments and genetic variants independently contribute to social functioning in children with typical development or autism spectrum disorder (ASD). However, biologically plausible interactive models and complimentary assessment of mechanisms are needed to: (a) explain considerable social heterogeneity, (b) resolve inconsistencies in the literature, and (c) develop and select optimal treatments based on individual differences. This study examined the role of child genotypes and responsive parenting in the social development of 104 children with ASD (ages 4-7 years). We utilized a longitudinal, multi-informant design and structural equation models to evaluate: (a) the additive and interactive effects of biologically plausible candidate genes (5-HTTLPR, OXTR, DRD4) and responsive parenting in predicting prospective social development in ASD across three time points spanning 1.5 years, and (b) whether child emotion regulation mediated observed gene x environment interactions (GxEs). Responsive parenting positively predicted prospective change in child social skills; these associations were moderated by 5-HTTLPR and DRD4 in teacher-report models, and DRD4 in parent-report models. No GxE effects were found for OXTR. Emotion regulation did not significantly mediate the GxEs involving 5-HTTLPR and DRD4. Acknowledging the complexities of GxE research, implications for future research, and targeted intervention efforts are discussed.
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Affiliation(s)
- Barbara Caplan
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jan Blacher
- Department of Education, University of California, Riverside, Riverside, CA, USA
| | - Abbey Eisenhower
- Department of Psychology, University of Massachusetts, Boston, Boston, MA, USA
| | - Bruce L Baker
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Steve S Lee
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Lebersfeld JB, Swanson M, Clesi CD, O'Kelley SE. Systematic Review and Meta-Analysis of the Clinical Utility of the ADOS-2 and the ADI-R in Diagnosing Autism Spectrum Disorders in Children. J Autism Dev Disord 2021; 51:4101-4114. [PMID: 33475930 DOI: 10.1007/s10803-020-04839-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/28/2022]
Abstract
The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) and the Autism Diagnostic Interview, Revised (ADI-R) have high accuracy as diagnostic instruments in research settings, while evidence of accuracy in clinical settings is less robust. This meta-analysis focused on efficacy of these measures in research versus clinical settings. Articles (n = 22) were analyzed using a hierarchical summary receiver operating characteristics (HSROC) model. ADOS-2 performance was stronger than the ADI-R. ADOS-2 sensitivity and specificity ranged from .89-.92 and .81-.85, respectively. ADOS-2 accuracy in research compared with clinical settings was mixed. ADI-R sensitivity and specificity were .75 and .82, respectively, with higher specificity in research samples (Research = .85, Clinical = .72). A small number of clinical studies were identified, indicating ongoing need for investigation outside research settings.
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Affiliation(s)
- Jenna B Lebersfeld
- University of Alabama at Birmingham, 1720 7th Ave S, Birmingham, AL, 35233, USA.
| | - Marissa Swanson
- University of Alabama at Birmingham, 1720 7th Ave S, Birmingham, AL, 35233, USA
| | - Christian D Clesi
- University of Alabama at Birmingham, 1720 7th Ave S, Birmingham, AL, 35233, USA
| | - Sarah E O'Kelley
- University of Alabama at Birmingham, 1720 7th Ave S, Birmingham, AL, 35233, USA
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35
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Del Giudice T, Dose C, Görtz-Dorten A, Steiner J, Bruning N, Bell H, Roland P, Walter D, Junghänel M, Döpfner M. Dimensions of Autistic Traits Rated by Parents of Children and Adolescents with Suspected Autism Spectrum Disorders. J Autism Dev Disord 2021; 51:3989-4002. [PMID: 33420648 PMCID: PMC8510981 DOI: 10.1007/s10803-020-04850-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/24/2022]
Abstract
To examine the factor structure of autism spectrum disorder (ASD) and the psychometric properties of the German Symptom Checklist for Autism Spectrum Disorders (SCL-ASD). Data were collected from 312 clinical referrals with suspected ASD (2–18 years). Confirmatory factor analyses and analyses of reliability, convergent and divergent validity were performed. A bifactor model with one general ASD factor and two specific factors (interaction-communication; restricted, repetitive behaviors) provided an adequate data fit. Internal consistencies of the SCL-ASD subscales and the total scale were > .70. Correlations with measures of ASD traits were higher than correlations with measures of externalizing and internalizing symptoms. The results support a factor structure consistent with DSM-5/ICD-11 criteria. The SCL-ASD has sound psychometric properties.
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Affiliation(s)
- Teresa Del Giudice
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Christina Dose
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Anja Görtz-Dorten
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Jennifer Steiner
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Nicole Bruning
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Hannah Bell
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Pamela Roland
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Daniel Walter
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Michaela Junghänel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany
| | - Manfred Döpfner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. .,School of Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Pohligstraße 9, 50969, Cologne, Germany.
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36
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Evers K, Maljaars J, Carrington SJ, Carter AS, Happé F, Steyaert J, Leekam SR, Noens I. How well are DSM-5 diagnostic criteria for ASD represented in standardized diagnostic instruments? Eur Child Adolesc Psychiatry 2021; 30:75-87. [PMID: 32076870 DOI: 10.1007/s00787-020-01481-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 01/23/2020] [Indexed: 01/19/2023]
Abstract
Five years after the publication of DSM-5 in 2013, three widely used diagnostic instruments have published algorithms designed to represent its (sub-)criteria for Autism Spectrum Disorder (ASD) in children and adolescents. This study aimed to: (1) establish the content validity of these three DSM-5-adapted algorithms, and (2) identify problems with the operationalization of DSM-5 diagnostic criteria in measurable and observable behaviors. Algorithm items of the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), Developmental, Dimensional and Diagnostic Interview (3di) and Diagnostic Interview for Social and Communication Disorders-11th edition (DISCO-11) were mapped onto DSM-5 sub-criteria. The development and decision-making rules integrated in their algorithms were then compared with DSM-5. Results demonstrated significant variability in the number and nature of sub-criteria covered by the ADOS-2, 3di and DISCO-11. In addition to differences in the development of algorithms and cut-off scores, instruments also differed in the extent to which they follow DSM-5 decision-making rules for diagnostic classification. We conclude that such differences in interpretation of DSM-5 criteria provide a challenge for symptom operationalization which will be most effectively overcome by consensus, testing and reformulation.
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Affiliation(s)
- Kris Evers
- Parenting and Special Education Research Unit, KU Leuven, Leopold Vanderkelenstraat 32, P.O. Box 3765, 3000, Leuven, Belgium. .,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium. .,Child and Adolescent Psychiatry, Z.org UPC KU Leuven, Leuven, Belgium.
| | - Jarymke Maljaars
- Parenting and Special Education Research Unit, KU Leuven, Leopold Vanderkelenstraat 32, P.O. Box 3765, 3000, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, Z.org UPC KU Leuven, Leuven, Belgium
| | - Sarah J Carrington
- School of Life and Health Sciences, Department of Psychology, Aston University, Birmingham, UK
| | | | - Francesca Happé
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jean Steyaert
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Child and Adolescent Psychiatry, Z.org UPC KU Leuven, Leuven, Belgium.,Center for Developmental Psychiatry, KU Leuven, Leuven, Belgium
| | - Susan R Leekam
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, UK
| | - Ilse Noens
- Parenting and Special Education Research Unit, KU Leuven, Leopold Vanderkelenstraat 32, P.O. Box 3765, 3000, Leuven, Belgium.,Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium
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37
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Carruthers S, Charman T, El Hawi N, Kim YA, Randle R, Lord C, Pickles A. Utility of the Autism Diagnostic Observation Schedule and the Brief Observation of Social and Communication Change for Measuring Outcomes for a Parent-Mediated Early Autism Intervention. Autism Res 2020; 14:411-425. [PMID: 33274842 PMCID: PMC7898818 DOI: 10.1002/aur.2449] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/03/2020] [Accepted: 11/21/2020] [Indexed: 12/14/2022]
Abstract
Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item-level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS-2) algorithm, and ADOS-2 Calibrated Severity Scores (CSS) with autistic children aged 2-5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS-BOSCC). Among the 117 children using single or no words (Module 1), the ADOS-BOSCC, ADOS algorithm, and ADOS CSS each detected small non-significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with "few to no words" at baseline, while children with "some words" showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item-level intervention effects reached significance, with largest changes observed for Gesture (ADOS-BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item-level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS-BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item-level intervention effect plots have the potential to indicate intervention "signatures of change," a concept that may be useful in future trials and systematic reviews. LAY SUMMARY: This study compares two outcome measures in a parent-mediated therapy. Neither was clearly better or worse than the other; however, the Autism Diagnostic Observation Schedule produced somewhat clearer evidence than the Brief Observation of Social Communication Change of improvement among children who had use of "few to no" words at the start. We explore which particular behaviors are associated with greater improvement. These findings can inform researchers when they consider how best to explore the impact of their intervention.
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Affiliation(s)
- Sophie Carruthers
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.,National & Specialist Services, Child & Adolescent Mental Health Services Directorate, South London and Maudsley NHS Foundation Trust, London, UK
| | - Nicole El Hawi
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Young Ah Kim
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Rachel Randle
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Catherine Lord
- Department of Psychiatry, University of California, Los Angeles, California, USA
| | - Andrew Pickles
- Department of Biostatistics and Health Informatics, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
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38
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Shulman C, Rice CE, Morrier MJ, Esler A. The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:605-628. [PMID: 33126998 DOI: 10.1016/j.psc.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.
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Affiliation(s)
- Cory Shulman
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel.
| | - Catherine E Rice
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Michael J Morrier
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Amy Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota 2540 Riverside Ave S., RPB 550, Minneapolis, MN 55454, USA
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39
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Parent-Mediated Music Interventions with Children with ASD: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2020. [DOI: 10.1007/s40489-020-00219-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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40
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Adaptation of One-Session Treatment for Specific Phobias for Children with Autism Spectrum Disorder Using a Non-concurrent Multiple Baseline Design: A Preliminary Investigation. J Autism Dev Disord 2020; 51:1015-1027. [PMID: 32613485 DOI: 10.1007/s10803-020-04582-5] [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: 10/23/2022]
Abstract
Anxiety disorders are among the most common co-occurring disorders for individuals with ASD. Several adaptations to cognitive behavioral approaches have been proposed for this population (Moree & Davis, 2010). The current study examined feasibility and preliminary efficacy of an ASD-specific adaptation of one-session treatment (OST) for specific phobia (SP). Standard OST consists of one 3-h session followed by four weekly phone calls. Modifications for ASD included increased parental involvement, use of visual aids, and inclusion of four 1-h booster sessions in place of the four weekly phone calls. Visual inspection and Friedman tests revealed significant reductions in fear ratings and phobia severity from pre- to post-treatment and follow-up assessments. Modest changes were observed in behavioral avoidance. These findings provide initial evidence that this treatment merits further study.
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41
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Bal VH, Maye M, Salzman E, Huerta M, Pepa L, Risi S, Lord C. The Adapted ADOS: A New Module Set for the Assessment of Minimally Verbal Adolescents and Adults. J Autism Dev Disord 2020; 50:719-729. [PMID: 31736004 DOI: 10.1007/s10803-019-04302-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Few measures are appropriate to assess autism symptoms in minimally verbal adolescents and adults. The Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2, Lord et al., in Autism diagnostic observation schedule-2nd edition (ADOS-2). Western Psychological Services, Los Angeles, 2012) Modules 1 and 2 were designed and validated with children whose spoken language ranges from few- to- no words to phrase speech. This study describes the development and initial validation of the Adapted-ADOS (A-ADOS), which includes tasks, materials and behavioral codes modified to be suitable for assessing older minimally verbal individuals. A-ADOS algorithms exhibit comparable sensitivity and improved specificity relative to ADOS-2 Modules 1 and 2. Although further validation is needed, the A-ADOS will facilitate research to further understanding of minimally verbal adults and symptom trajectories across the lifespan.
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Affiliation(s)
- Vanessa H Bal
- Graduate School of Applied & Professional Psychology, Rutgers University-New Brunswick, 607 Allison Road, Smithers Hall, Piscataway, NJ, 08854-8001, USA.
| | - Melissa Maye
- Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Emma Salzman
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Marisela Huerta
- Weill Cornell Medicine, New York, NY, USA.,Felicity House, New York, NY, USA
| | | | - Susan Risi
- Washtenaw Intermediate School District, Early On, Ann Arbor, MI, USA
| | - Catherine Lord
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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42
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A Developmental Study of Mathematics in Children with Autism Spectrum Disorder, Symptoms of Attention Deficit Hyperactivity Disorder, or Typical Development. J Autism Dev Disord 2020; 50:4463-4476. [PMID: 32306219 DOI: 10.1007/s10803-020-04500-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study examined mathematics achievement in school-aged children with autism spectrum disorder (ASD), symptoms of attention-deficit/hyperactivity disorder (ADHD), or typical development (TD) over a 30-month period and the associations between cognitive and reading abilities with mathematics achievement in children with ASD. Seventy-seven children with ASD without intellectual disability (ASD-WoID), 39 children with ADHD, and 43 children with TD participated in this study. The results revealed that the ASD-WoID and ADHD samples displayed significant and comparable delays in problem solving and calculation abilities. Lower VIQ was related to lower math achievement across all subgroups. The ASD-WoID sample differed from comparison samples in terms of their pattern of mathematical achievement and the role of cognitive abilities in the development of mathematics competence.
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The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan. Child Adolesc Psychiatr Clin N Am 2020; 29:275-299. [PMID: 32169263 DOI: 10.1016/j.chc.2020.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.
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Al-Dewik N, Al-Jurf R, Styles M, Tahtamouni S, Alsharshani D, Alsharshani M, Ahmad AI, Khattab A, Al Rifai H, Walid Qoronfleh M. Overview and Introduction to Autism Spectrum Disorder (ASD). ADVANCES IN NEUROBIOLOGY 2020; 24:3-42. [PMID: 32006355 DOI: 10.1007/978-3-030-30402-7_1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder generally manifesting in the first few years of life and tending to persist into adolescence and adulthood. It is characterized by deficits in communication and social interaction and restricted, repetitive patterns of behavior, interests, and activities. It is a disorder with multifactorial etiology. In this chapter, we will focus on the most important and common epidemiological studies, pathogenesis, screening, and diagnostic tools along with an explication of genetic testing in ASD.
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Affiliation(s)
- Nader Al-Dewik
- Clinical and Metabolic Genetics Section, Pediatrics Department, Hamad General Hospital (HGH), Women's Wellness and Research Center (WWRC) and Interim Translational Research Institute (iTRI), Hamad Medical Corporation (HMC), Doha, Qatar. .,College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar. .,Faculty of Health and Social Care Sciences, Kingston University, St. George's University of London, London, UK.
| | - Rana Al-Jurf
- Department of Biomedical Science, College of Health Science, Qatar University, Doha, Qatar
| | - Meghan Styles
- Health Profession Awareness Program, Health Facilities Development, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Sona Tahtamouni
- Child Development Center, Hamad Medical Corporation, Doha, Qatar
| | - Dalal Alsharshani
- College of Health and Life Sciences, Hamad Bin Khalifa University (HBKU), Doha, Qatar
| | - Mohammed Alsharshani
- Diagnostic Genetics Division (DGD), Department of Laboratory Medicine and Pathology (DLMP), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Amal I Ahmad
- Qatar Rehabilitation Institute (QRI), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Azhar Khattab
- Qatar Rehabilitation Institute (QRI), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Hilal Al Rifai
- Department of Pediatrics and Neonatology, Newborn Screening Unit, Hamad Medical Corporation, Doha, Qatar
| | - M Walid Qoronfleh
- Research and Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
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Haebig E, Sterling A, Barton-Hulsey A, Friedman L. Rates and Predictors of Co-occurring Autism Spectrum Disorder in Boys with Fragile X Syndrome. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2020; 5:2396941520905328. [PMID: 35847766 PMCID: PMC9281610 DOI: 10.1177/2396941520905328] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background and aims Males with fragile X syndrome display many behavioral features of autism spectrum disorder. Despite this overlap, our understanding of autism spectrum disorder symptoms and severity in fragile X syndrome is limited due to variation in assessment methods in the literature. Furthermore, the relationship between autism spectrum disorder symptoms and child characteristics, like age, language, and cognitive abilities, are not well understood in individuals with fragile X syndrome. Therefore, the first research aim was to compare the rates of autism spectrum disorder classifications from three commonly reported autism spectrum disorder assessments in the literature. Our second research aim was to examine the relationship between autism spectrum disorder characteristics and other child characteristics. Methods The present study compared autism spectrum disorder classifications and symptoms using the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview, Revised, and Childhood Autism Rating Scale, second edition in a sample of 33 school-age and adolescent boys with fragile X syndrome. In addition, the participants completed nonverbal IQ testing, expressive vocabulary and grammar tests, and a conversation language sample. Results The majority of the participants met criteria for autism spectrum disorder on the Autism Diagnostic Observation Schedule (96.97%) and Autism Diagnostic Interview, Revised (90.91%), while only half met criteria for autism spectrum disorder on the Childhood Autism Rating Scale, second edition. Sixteen boys (48.48%) met criteria for autism spectrum disorder on all three measures, and all participants met criteria for autism spectrum disorder on at least one measure. Expressive vocabulary accounted for a unique amount of variance in Childhood Autism Rating Scale, second edition and Autism Diagnostic Observation Schedule scores. Additionally, grammatical complexity accounted for a unique amount of variance in Childhood Autism Rating Scale, second edition scores. None of the child variables accounted for the variance found in Autism Diagnostic Interview, Revised scores. Although nonverbal IQ scores did not account for a significant amount of variance on the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview, Revised, and Childhood Autism Rating Scale, Second Edition, boys who met criteria for autism spectrum disorder on all three measures had lower nonverbal IQ compared to the boys who did not. Additionally, mean length of utterance and expressive vocabulary scores were lower in the boys who met criteria for autism spectrum disorder on all three measures than those who did not. Conclusions Our findings identify areas of overlap and difference in the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview, Revised, and Childhood Autism Rating Scale, second edition when used with males with fragile X syndrome. Variation in assessments may differentially identify the phenotypic behaviors of boys with fragile X syndrome that lead to a co-diagnosis of autism spectrum disorder, which contributes to the variation in reported co-morbidity of fragile X syndrome and autism spectrum disorder. Also, expressive language abilities, especially expressive vocabulary, are associated with autism spectrum disorder symptomatology. Implications: When interpreting comorbid fragile X syndrome and autism spectrum disorder rates in the literature, it is important to consider the assessment tool that was used. Although the assessments that we used in the present study yielded scores that were highly correlated (i.e. Autism Diagnostic Observation Schedule and Childhood Autism Rating Scale, second edition), their categorical classifications did not align perfectly. Our findings also highlight the importance of considering language skills when assessing autism spectrum disorder severity in fragile X syndrome.
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Affiliation(s)
- Eileen Haebig
- Department of Communication Sciences and Disorders, Louisiana State
University, USA
| | - Audra Sterling
- Department of Communication Sciences and Disorders, University of
Wisconsin-Madison, USA; Waisman Center, University of Wisconsin-Madison,
USA
| | - Andrea Barton-Hulsey
- Waisman Center, University of Wisconsin-Madison, USA; School of
Communication Sciences and Disorders, Florida State University, USA
| | - Laura Friedman
- Department of Communication Sciences and Disorders, University of
Wisconsin-Madison, USA; Waisman Center, University of Wisconsin-Madison,
USA
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Muratori F, Billeci L, Calderoni S, Boncoddo M, Lattarulo C, Costanzo V, Turi M, Colombi C, Narzisi A. How Attention to Faces and Objects Changes Over Time in Toddlers with Autism Spectrum Disorders: Preliminary Evidence from An Eye Tracking Study. Brain Sci 2019; 9:E344. [PMID: 31783561 PMCID: PMC6955945 DOI: 10.3390/brainsci9120344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022] Open
Abstract
Further understanding of the longitudinal changes in visual pattern of toddlers with autism spectrum disorders (ASDs) is needed. We examined twelve 19 to 33-month-old toddlers at their first diagnosis (mean age: 25.1 months) and after six months (mean age: 31.7 months) during two initiating joint attention (IJA) tasks using eye tracking. Results were compared with the performance of age-matched typically developing (TD) toddlers evaluated at a single time-point. Autistic toddlers showed longitudinal changes in the visual sensory processing of the IJA tasks, approaching TD performance with an improvement in the ability to disengage and to explore the global space. Findings suggest the use of eye tracking technology as an objective, non-intrusive, adjunctive tool to measure outcomes in toddlers with ASD.
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Affiliation(s)
- Filippo Muratori
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56128 Calambrone, PI, Italy
| | - Lucia Billeci
- Institute of Clinical Physiology, National Research Council of Italy (CNR), 56128 Calambrone, PI, Italy;
| | - Sara Calderoni
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56128 Calambrone, PI, Italy
| | - Maria Boncoddo
- Programma Interdipartimentale “Autismo 0–90”, A.O.U. Policlinico G. Martino, 98124 Messina, ME, Italy;
| | - Caterina Lattarulo
- Stella Maris Mediterraneo Foundation, 85032 Chiaromonte, PZ, Italy; (C.L.); (M.T.)
| | - Valeria Costanzo
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
| | - Marco Turi
- Stella Maris Mediterraneo Foundation, 85032 Chiaromonte, PZ, Italy; (C.L.); (M.T.)
| | - Costanza Colombi
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA;
| | - Antonio Narzisi
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, PI, Italy; (F.M.); (V.C.); (A.N.)
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Clabaugh C, Mahajan K, Jain S, Pakkar R, Becerra D, Shi Z, Deng E, Lee R, Ragusa G, Matarić M. Long-Term Personalization of an In-Home Socially Assistive Robot for Children With Autism Spectrum Disorders. Front Robot AI 2019; 6:110. [PMID: 33501125 PMCID: PMC7805891 DOI: 10.3389/frobt.2019.00110] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/15/2019] [Indexed: 11/25/2022] Open
Abstract
Socially assistive robots (SAR) have shown great potential to augment the social and educational development of children with autism spectrum disorders (ASD). As SAR continues to substantiate itself as an effective enhancement to human intervention, researchers have sought to study its longitudinal impacts in real-world environments, including the home. Computational personalization stands out as a central computational challenge as it is necessary to enable SAR systems to adapt to each child's unique and changing needs. Toward that end, we formalized personalization as a hierarchical human robot learning framework (hHRL) consisting of five controllers (disclosure, promise, instruction, feedback, and inquiry) mediated by a meta-controller that utilized reinforcement learning to personalize instruction challenge levels and robot feedback based on each user's unique learning patterns. We instantiated and evaluated the approach in a study with 17 children with ASD, aged 3–7 years old, over month-long interventions in their homes. Our findings demonstrate that the fully autonomous SAR system was able to personalize its instruction and feedback over time to each child's proficiency. As a result, every child participant showed improvements in targeted skills and long-term retention of intervention content. Moreover, all child users were engaged for a majority of the intervention, and their families reported the SAR system to be useful and adaptable. In summary, our results show that autonomous, personalized SAR interventions are both feasible and effective in providing long-term in-home developmental support for children with diverse learning needs.
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Affiliation(s)
- Caitlyn Clabaugh
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Kartik Mahajan
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Shomik Jain
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Roxanna Pakkar
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - David Becerra
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Zhonghao Shi
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Eric Deng
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Rhianna Lee
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Gisele Ragusa
- STEM Education Research Group, Division of Engineering Education, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
| | - Maja Matarić
- Interaction Lab, Department of Computer Science, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
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Evans SC, Boan AD, Bradley C, Carpenter LA. Sex/Gender Differences in Screening for Autism Spectrum Disorder: Implications for Evidence-Based Assessment. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2019; 48:840-854. [PMID: 29601216 PMCID: PMC6274603 DOI: 10.1080/15374416.2018.1437734] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Autism spectrum disorder (ASD) is diagnosed more often in boys than in girls; however, little is known about the nature of this sex/gender discrepancy or how it relates to diagnostic assessment practices. This study examined the performance of the Social Communication Questionnaire (SCQ) in screening for ASD among boys and girls. Data were drawn from the South Carolina Children's Educational Surveillance Study, a population-based study of ASD prevalence among children 8-10 years of age. Analyses were conducted using SCQ data from 3,520 children, with direct assessment data from 272 with elevated SCQ scores. A bifactor model based on the Diagnostic and Statistical Manual of Mental Disorders's (5th ed.) two ASD symptom domains fit the data well and performed slightly better for girls. In the general population sample, girls exhibited fewer social communication/interaction and restricted-repetitive behavior symptoms than boys. In the direct assessment sample, however, girls with ASD showed greater impairment in social communication/interaction than boys with ASD. Items pertaining to social communication/interaction problems at ages 4-5 were among the most diagnostically efficient overall and particularly for girls. Similarly, receiver operating characteristic analyses suggested that the SCQ performs adequately among boys and well among girls. Results support the use of the SCQ in screening for ASD but do not indicate sex/gender-specific cutoffs. Girls with ASD may exhibit pronounced intraindividual deficits in social communication/interaction compared to male peers with ASD and female peers without ASD. Although more research is needed, careful attention to social communication/interaction deficits around 4-5 years of age may be especially useful for assessing ASD in girls.
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Affiliation(s)
| | - Andrea D. Boan
- Department of Pediatrics Medical University of South
Carolina, Charleston, SC, USA
| | - Catherine Bradley
- Department of Pediatrics Medical University of South
Carolina, Charleston, SC, USA
| | - Laura A. Carpenter
- Department of Pediatrics Medical University of South
Carolina, Charleston, SC, USA
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Zhang Y, Song W, Tan Z, Zhu H, Wang Y, Lam CM, Weng Y, Hoi SP, Lu H, Man Chan BS, Chen J, Yi L. Could social robots facilitate children with autism spectrum disorders in learning distrust and deception? COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Autism Spectrum Symptomatology in Children with Williams Syndrome Who Have Phrase Speech or Fluent Language. J Autism Dev Disord 2019; 48:3037-3050. [PMID: 29671106 DOI: 10.1007/s10803-018-3555-4] [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: 12/24/2022]
Abstract
To characterize autism spectrum-related symptomatology in children with Williams syndrome (WS) with phrase speech or fluent language, the Autism Diagnostic Observation Schedule Module 2 or 3 was administered. The cutoff for autism spectrum was met by 35% (14/40) who completed Module 2 and 30% (18/60) who completed Module 3. Similarities and differences in socio-communicative strengths and weaknesses as a function of language ability were identified. Symptom severity was negatively associated with IQ for participants with phrase speech but not for those with fluent language. The findings suggest an elevated risk of ASD for individuals with WS relative to the general population and contribute to a more nuanced sense of the socio-communicative functioning of children with WS.
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