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Mata-Iturralde S, Alonso-Esteban Y, Alcantud-Marín F, Young R. Autism Detection in Early Childhood (ADEC) in a Low-Income Spanish-Speaking Population in Guayaquil (Ecuador). J Autism Dev Disord 2024:10.1007/s10803-024-06413-3. [PMID: 38819703 DOI: 10.1007/s10803-024-06413-3] [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: 05/17/2024] [Indexed: 06/01/2024]
Abstract
Autism Spectrum Disorder (ASD) must be present early in development, but may not fully manifest until social demands exceed capacities. In the absence of adequate biological or brain imaging markers to detect and diagnose autism, diagnosis relies on clinical judgment based on observation of symptoms. Many tools have been developed in English-speaking countries (questionnaires for parents, symptom checklists for professionals, observation systems, etc.). Screening in countries with other languages requires cultural and linguistic adaptation of these instruments. This paper presents the adaptation of the ADEC (Autism Detection in Early Childhood). METHODS The original version of the ADEC was translated and culturally and linguistically adapted to the characteristics of the population of Guayaquil (Ecuador). PARTICIPANTS A pilot study was conducted with a sample of 613 children aged 18-48 months. RESULTS Cronbach's alpha values (0.89) indicate high internal consistency. The correlation between the MCHAT-R/F follow-up interview and the ADEC (mean r = 0.93) indicates high construct validity. In terms of predictive validity, using the original cut-off points of the ADEC, they show excellent diagnostic ability. The sensitivity and specificity results (sensitivity 1.00; specificity 0.92; positive predictive value 0.83; negative predictive value 0.99) are even better than those obtained in a similar study in the Mexican population. CONCLUSIONS Considering that the MCHAT R/F is a parent-reported instrument, the Guayaquil Spanish version of the ADEC (ADEC-GU) seems to be a suitable instrument to be used in a complementary way as a second-level screening instrument for autism, before resorting to a full diagnostic process.
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Dahl E, Moody EJ, Barger B, Rosenberg S, DiGuiseppi C, Fallin MD, Lee LC, Wiggins L. Differential Performance of Social Communication Questionnaire Items in African American/Black vs. White Children. J Autism Dev Disord 2024; 54:1820-1833. [PMID: 36897518 PMCID: PMC10913152 DOI: 10.1007/s10803-023-05931-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2023] [Indexed: 03/11/2023]
Abstract
Screening for autism spectrum disorder (ASD) is an essential early step in the identification process and inaccurate screening may lead to significant delays in the onset of treatment. Past research has highlighted discrepancies in the performance of ASD screening tools such as the Social Communication Questionnaire (SCQ) among certain racial and ethnic groups. The current study explored the functioning of the SCQ among African American/Black and White respondents based on item level performance on the measure. Differential Item Functioning (DIF) analyses showed that 16 (41%) items of the SCQ functioned differently for African American/Black respondents when compared to White respondents. Implications, such as the potential for delayed diagnosis and treatment, and the influence on downstream outcomes, are discussed.
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Affiliation(s)
- Ethan Dahl
- Department of Education, Health, & Behavior Studies, College of Education & Human Development, University of North Dakota, 231 Centennial Dr Stop 7189, Grand Forks, ND, 58202-7189, USA.
| | - Eric J Moody
- Wyoming Institute for Disabilities, University of Wyoming, Laramie, WY, USA
| | - Brian Barger
- Center for Leadership in Disabilities, Georgia State University, Atlanta, Georgia
| | - Steven Rosenberg
- Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Daniele Fallin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lisa Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Cepanec M, Šimleša S. Item-Based Analysis of Some ADOS-2 Items with Typically Developing Participants Might help Improve Cross-Cultural Validity of ADOS-2. J Autism Dev Disord 2024; 54:109-120. [PMID: 36323993 DOI: 10.1007/s10803-022-05791-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Most internationally recognized instruments for the screening and diagnosis of autism spectrum disorder have been developed in the USA, which calls into question the degree of their cultural adaptation to diverse populations. The aim of this study is to examine the characteristics of social communication in typically developing Croatian-speaking participants (N = 220) using ADOS-2-defined item-level normative values. Croatian subjects showed the expected ("typical") results in the domain of verbal communication, slightly atpical results in nonverbal communication (primarily gesture use), and more significant deviations in pragmatics (offering and asking for information), relative to the expectations of the ADOS-2. As ADOS-2 has become an important component of thorough ASD diagnostic evaluations worldwide, identifying methods for increasing the cross-cultural validity is essential.
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Affiliation(s)
- Maja Cepanec
- Child Communication Research Laboratory, Department of Speech and Language Pathology, Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia.
| | - Sanja Šimleša
- Child Communication Research Laboratory, Department of Speech and Language Pathology, Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia
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Buffle P, Armijos C, Naranjo A, Gentaz E. Feasibility of an observational procedure to enhance early identification of autism spectrum disorder in paediatric settings: A mixed-methods study on an Ecuadorian sample. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:84-94. [PMID: 37313623 PMCID: PMC10771021 DOI: 10.1177/13623613231175587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
LAY ABSTRACT In Ecuador, the low official estimate of the number of persons with autism spectrum disorder suggest that many children are not identified and are not receiving support. Screening tools are short parent-addressed questionnaires used to identify children that may be developing with autism. Their use is recommended, but their application can be perceived as challenging in paediatric routines. Some professionals prefer looking for autism-related behaviours in a child rather than using screening questionnaires. Although a short observation does not replace the use of validated screening questionnaires, tasks to guide the observation of autistic early signs can help professionals decide to screen or refer the family for assessment and early intervention. In this study, we tested observational tasks that could be adapted to the Ecuadorian paediatric contexts.
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Affiliation(s)
- Paulina Buffle
- University of Geneva, Switzerland
- Pontificia Universidad Católica del Ecuador, Ecuador
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5
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Segre G, Cargnelutti C, Bersani C, Njogu W, Roberti E, Campi R, De Vita MV, Morino G, Canevini MP, Bonati M. Early detection of neurodevelopmental disorders in African children living in informal settlements in Nairobi. BMJ Paediatr Open 2023; 7:e002117. [PMID: 37890890 PMCID: PMC10619007 DOI: 10.1136/bmjpo-2023-002117] [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: 06/06/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Children in low-income and middle-income countries (LMICs) are at a substantially increased risk of delayed physical, emotional and sociocognitive outcomes, with consequential neurodevelopmental disorders. Evidence based, cost-effective and culturally appropriate screening tools are recommended for early identification of developmental disorders. METHODS The present study aims to assess the feasibility of early screening for neurodevelopmental disorders in children living in informal settlements in Nairobi, Kenya (Korogocho). The selected tools (ie, the CDC checklist and the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)), widely used in high-income countries, are applied in two different populations: one from Kenya (LMIC) and one from Italy, to compare the different scores. RESULTS Of 509 children screened, 8.6% were classified at-risk based on the results of the screening tools. Significant risk factors are history of low birth weight and Apgar score, presence of neurological disorders, malnutrition and/or rickets, younger age of the child and older age of the mother. Caesarean section delivery, first pregnancy and mothers' older age were common risk factors among the Kenyan and the Italian samples. The Italian sample had a significantly greater rate of missed milestones. CONCLUSIONS Our data demonstrate the feasibility of using the CDC and M-CHAT-R tools in informal settlement dwellers. Further studies are needed to explore the opportunity for early diagnosis of developmental disorders in LMICs.
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Affiliation(s)
- Giulia Segre
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Cecilia Cargnelutti
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | - Carlotta Bersani
- Department of Health Sciences, Università degli Studi di Milano, Milano, Italy
| | | | - Elisa Roberti
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Rita Campi
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | | | | | - Maurizio Bonati
- Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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Sobieski M, Sobieska A, Sekułowicz M, Bujnowska-Fedak MM. Tools for early screening of autism spectrum disorders in primary health care – a scoping review. BMC PRIMARY CARE 2022; 23:46. [PMID: 35291950 PMCID: PMC8925080 DOI: 10.1186/s12875-022-01645-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/21/2022] [Indexed: 12/30/2022]
Abstract
Abstract
Background
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests itself in early childhood. Early diagnosis of these disorders allows for the initiation of early therapy, which is crucial for the child's further functioning in society.
Objectives
This review aims to gather and present the existing ASD screening tools that can be used in primary care and adapted to different countries conditions linguistically and culturally.
Eligibility criteria
We searched for English-language publications on ASD screening tools for children aged 0–3 years suitable for use in primary care (i.e. free, requiring no additional training or qualifications).
Sources of evidence
Four databases were explored to find English studies on ASD screening tools intended for the rapid assessment of children aged 0–3.
Charting methods
The information sought (specific features of the questionnaires relevant to primary health care workers, psychometric and diagnostic values of a given cultural adaptation of screening tools, and the linguistic and cultural changes made) were extracted and collected to create profiles of these tools.
Results
We found 81 studies which met inclusion criteria and underwent full data extraction. Three additional data sources were included. These allowed to create 75 profiles of adaptations for 26 different screening tools and collect data on their psychometric values and characteristic features.
Conclusions
The results of our study indicate the availability of several diagnostic tools for early ASD screening in primary care setting concordant culturally and linguistically with a given population. They could be an effective method of accelerating the diagnostic process and starting personalized therapy faster. However, most tools have significant limitations – some are only available for research purposes, while others do not have scientific evidence to prove their effectiveness.
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Buffle P, Gentaz E, Vivanti G. Perception, Beliefs, and Causal Attribution of Autism Early Signs in Ecuadorian General Population. Front Psychol 2022; 13:915817. [PMID: 35814115 PMCID: PMC9260421 DOI: 10.3389/fpsyg.2022.915817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
The identification and diagnosis of children with autism currently rely on behavioral presentation and developmental history. Cultural norms and other socio-demographic factors can influence what is expected or non-expected behaviors in a developing child. Perceptions, beliefs, and causal attribution of early signs can influence families’ help-search behaviors. Lack of recognition of autism’s first manifestations can critically delay the age of diagnosis, the provision of informed guidance to families, and the implementation of adapted interventions during the critical period of early development. Furthermore, a lack of understanding of early signs as the manifestations of a developmental condition may increase stigma and non-conventional explanations. Still, cultural and socio-demographic factors are largely understudied, particularly in low-and middle-income settings. Based on the hypothesis that non-specialists such as family members and friends are one of the first sources of referral in Latin American contexts, we aimed to study the general population’s perceptions and the explanatory causes of autism’s early signs. One-hundred-and-eighty-three Ecuadorian adults responded to a questionnaire developed for this study, describing sixteen ASD-related behaviors. Results indicated that, with the exemption of language impairment and self-injurious behaviors, a substantial proportion of participants did not endorse many behaviors as “concerning and requiring professional attention.” Also, language impairment was the only behavior identified as related to a developmental disorder. Additionally, most participants attributed the majority of behaviors listed in the questionnaire to causes unrelated to ASD, such as child personality. We discuss the impact of those findings in clinical practice and on awareness programs.
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Affiliation(s)
- Paulina Buffle
- Department of Psychology and Education, Université de Genève, Geneva, Switzerland
- *Correspondence: Paulina Buffle,
| | - Edouard Gentaz
- Department of Psychology and Education, Université de Genève, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | - Giacomo Vivanti
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
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Abstract
The rural areas have been at the receiving end amidst mental health disparity across the USA. There is a serious and concerning divide among ones with autism spectrum disorders (ASDs) living in underserved areas as compared to urban residents. With the higher than ever prevalence of ASD as per the recent reports of the Centers for Disease Control and Prevention; there is a need for a closer look at the prevailing issues. The trends are reflecting marked underdiagnosis, late diagnosis, lack of evidence-based diagnostic measures and interventions. These factors interplay in worsening the mental health crisis and there is an urgent need for corrective measures to address these highly modifiable problems.
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Flores-Rodríguez Y, Roldán Ceballos O, Albores-Gallo L. Assessing autism with DSM-IV and DSM-5 criteria using the Childhood Autism Rating Scale (CARS). SALUD MENTAL 2022. [DOI: 10.17711/sm.0185-3325.2022.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction. The Childhood Autism Rating Scale (CARS) is an observational instrument for assessing autism. It is the most widely used instrument for the diagnosis of autism in Mexico. Objective. To study the psychometric properties in the Mexican population using DSM-IV and DSM-5 criteria. Method. This is an observational, cross-sectional study. Participants (N = 137) were 78.8% male, with an age range between 2 and 18 years, mean 8.5. Parents completed the M-CHAT, the ABC, the ADI-R, and semi-structured clinical interviews with DSM-IV. We inferred DSM-5 criteria by selecting atypical sensory items from the ABC. Results. The internal consistency for the total CARS items was α = .88. The concurrent validity of the CARS and the DSM-IV criteria showed a Spearman coefficient of correlation of rs = .62. The convergent validity with the ADI-R showed moderate correlations, rs = .32 to .61, with the DSM-IV k = .33 and DSM-5 k = .36. The concordance with the DSM-IV and DSM-5 was 71% and 84.5%, sensitivity was 58.1% and 46-7%, and specificity 76.6% and 90.5%, respectively. The discriminant analysis showed that the CARS correctly classified 97% of children with autism, 70% with pervasive developmental disorders not otherwise specified (PDD-NOS), and 12.5% with Asperger’s syndrome. Discussion and conclusion. The Mexican version of the CARS is a valid and reliable instrument for diagnosing autism in Mexican children and adolescents.
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Golson ME, Ficklin E, Haverkamp CR, McClain MB, Harris B. Cultural differences in social communication and interaction: A gap in autism research. Autism Res 2021; 15:208-214. [PMID: 34936220 DOI: 10.1002/aur.2657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/07/2022]
Abstract
Social communication and interaction deficits are a diagnostic criteria of autism and integral to practitioner and researcher conceptualization. Culture is an influential factor in expectations for, and demonstration of, social communication and interaction skills, but there is limited research published in autism journals on this topic. This paucity of autism research examining cultural factors related to social communication and interaction may contribute to known identification disparities for racial and ethnic populations minoritized by systemic factors and research bias. We call for increased commitment from researchers to recruit racially and ethnically minoritized participants, prioritize investigating cultural expectations and perceptions of social communication and interaction, and evaluate measures related to social communication for cultural and linguistic responsivity. LAY SUMMARY: A diagnosis of autism requires the presence of deficits in social communication and interaction. Examples of these behaviors and skills include holding a back-and-forth conversation, the use of nonverbal communicative behaviors (e.g., gestures), and developing and maintaining social relationships. Culture influences the expectations for, and presentation of, these behaviors. However, research on this topic is lacking. Conducting more research related to culture and social communication could help reduce the disparities in autism identification across racially and ethnically minoritized populations.
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Affiliation(s)
- Megan E Golson
- Department of Psychology, Utah State University, Logan, Utah, USA
| | - Erica Ficklin
- Department of Psychology, Utah State University, Logan, Utah, USA
| | | | | | - Bryn Harris
- University of Colorado Denver, Denver, Colorado, USA
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DuBay M, Watson LR, Baranek GT, Lee H, Rojevic C, Brinson W, Smith D, Sideris J. Rigorous Translation and Cultural Adaptation of an Autism Screening Tool: First Years Inventory as a Case Study. J Autism Dev Disord 2021; 51:3917-3928. [PMID: 33394249 PMCID: PMC8254827 DOI: 10.1007/s10803-020-04837-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2020] [Indexed: 01/02/2023]
Abstract
Screening tools for autism spectrum disorders serve a vital role in early identification of all children who may need evaluation and support. Recent studies suggest that traditional methods used in this field to translate such tools may be insufficient for maintaining linguistic, construct, or technical equivalence, resulting in screening tools that do not meet high psychometric standards in the new population. This study implemented a rigorous translation and cultural adaptation process by translating the First Years Inventory v3.1 (Baranek et al. First year inventory (FYI) 3.1. University of North Carolina at Chapel Hill Chapel Hill, NC, 2003) for a US-based Spanish-speaking population. A description of this process is provided with results from data collected during each phase. The unique challenges that were identified and addressed are detailed for future translation teams.
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Affiliation(s)
- Michaela DuBay
- Department of Human Services, School of Education and Human Development, University of Virginia, 405 Emmet St. S, Charlottesville, VA, 22904, USA.
- The PEARLS Network, Chapel Hill, NC, 27516, USA.
| | - Linda R Watson
- Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC, 27516, USA
- The PEARLS Network, Chapel Hill, NC, 27516, USA
| | - Grace T Baranek
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St., Los Angeles, CA, 90089, USA
- The PEARLS Network, Chapel Hill, NC, 27516, USA
| | - Helen Lee
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St., Los Angeles, CA, 90089, USA
- The PEARLS Network, Chapel Hill, NC, 27516, USA
| | - Carolina Rojevic
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St., Los Angeles, CA, 90089, USA
- University of California at San Francisco Benioff Children's Hospital, 747 52nd St., Oakland, CA, 94609, USA
| | - William Brinson
- Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC, 27516, USA
| | - Danna Smith
- Speech and Hearing Sciences, Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S Columbia St., Chapel Hill, NC, 27516, USA
| | - John Sideris
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, 1540 Alcazar St., Los Angeles, CA, 90089, USA
- The PEARLS Network, Chapel Hill, NC, 27516, USA
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12
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Children and adolescents with neurodevelopmental disorders show cognitive heterogeneity and require a person-centered approach. Sci Rep 2021; 11:18463. [PMID: 34531454 PMCID: PMC8445997 DOI: 10.1038/s41598-021-97551-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/09/2021] [Indexed: 11/15/2022] Open
Abstract
We aimed to identify patterns of cognitive differences and characterize subgroups of Mexican children and adolescents with three neurodevelopmental disorders (NDD): intellectual disability (ID), autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD). The sample included 74 children and adolescents 6–15 years; 34% had ID, ASD or ADHD, 47% had ID in comorbidity with ASD, ADHD or both, 11% had ASD + ADHD, 8% were children without NDD. We applied WISC-IV, Autism Diagnostic Interview-Revised, Mini-International Neuropsychiatric Structured Interview, Child Behavior Checklist, and UNICEF Child Functioning Module. We evaluated the normality of the WISC-IV sub-scales using the Shapiro-Francia test, then conducted a latent class analysis and assessed inter-class differences in terms of household, parent and child characteristics. The following four-class solution best fit the data: “Lower Cognitive Profile” (LCP), “Lower Working Memory” (LWM), “Higher Working Memory” (HWM), “Higher Cognitive Profile” (HCP). LCP included most of the children with ID, who had a low Working Memory (WM) index score. LWM included mainly children with ASD or ID + ADHD; their Perceptual Reasoning (PR) and Processing Speed (PS) index scores were much higher than those for Verbal Comprehension (VC) and WM. HWM included children with ASD or ADHD; their scores for PR, PS and VC were high with lower WM (although higher than for LWM). HCP included children without NDD and with ASD or ADHD or both and had the highest scores on all indices. Children with NDD show cognitive heterogeneity and thus require individualized treatment plans.
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Barger B, Benevides T, Riszk S, Rice C, Heiman H, Salmon A, Sanchez-Alvarez S. Race/ethnic inequities in conjoint monitoring and screening for U.S. children 3 and under: Disparities in Monitoring and Screening. Disabil Health J 2021; 15:101179. [PMID: 34412986 DOI: 10.1016/j.dhjo.2021.101179] [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: 11/13/2020] [Revised: 07/10/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Non-White children with developmental disabilities are frequently identified later than White children and therefore miss out on opportunities for early intervention (EI). Recent research indicates that conjoint monitoring and screening is more strongly associated with EI receipt than monitoring or screening alone. OBJECTIVE To determine if there are racial/ethnic inequities in the conjoint receipt of monitoring and screening. METHOD A series of survey weighted and stratified logistic regression analyses were conducted on National Surveys of Children's Health (2016-2018) data with conjoint monitoring and screening, screening alone, monitoring alone, and non-receipt as outcomes for children aged 9-23 months of age. The primary predictor was child race/ethnicity (Black, Hispanic, Other, and White). Additional co-variates included child (e.g., Age), caretaker/family (e.g., poverty level), healthcare (e.g., usual source of healthcare), state EI policies, and city metropolitan status. RESULTS Bivariate analyses indicated significant variation in conjoint monitoring and screening across racial/ethnic groups and covariates. Bivariate analyses showed that Black and Hispanic children had significantly lower odds of conjoint monitoring and screening receipt than White children. Multivariate analyses showed that this relationship was better accounted by co-variates. The health service variable, usual source of healthcare, had the strongest relationship with receipt of conjoint monitoring and screening. CONCLUSIONS Black and Hispanic children are less likely to receive conjoint monitoring and screening than White children. Analyses investigating the role of usual source of healthcare seem particularly promising for understanding the sources of inequities in monitoring and screening receipt.
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Affiliation(s)
- Brian Barger
- Center for Leadership in Disability, School of Public Health, Georgia State University, United States; Population Health Sciences, School of Public Health, Georgia State University, United States.
| | - Teal Benevides
- Department of Occupational Therapy, Augusta State University, United States
| | - Sabrin Riszk
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, United States
| | | | - Harry Heiman
- Center for Leadership in Disability, School of Public Health, Georgia State University, United States; Department of Health Management and Policy, School of Public Health, Georgia State University, United States
| | - Ashley Salmon
- Center for Leadership in Disability, School of Public Health, Georgia State University, United States
| | - Sonia Sanchez-Alvarez
- Center for Leadership in Disability, School of Public Health, Georgia State University, United States
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Shrestha R, Dissanayake C, Barbaro J. Implementing and evaluating Social Attention and Communication Surveillance (SACS) to prospectively identify autism in very young children in Nepal. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 115:104013. [PMID: 34144316 DOI: 10.1016/j.ridd.2021.104013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/31/2021] [Accepted: 06/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although Autism Spectrum Disorder (ASD) can be identified as early as 12 months and diagnosed by 24 months, the mean age of diagnosis of ASD in Nepal is ∼58 months, with children missing the opportunity for early intervention. AIMS This study implemented and evaluated a Nepali version of the Social Attention and Communication Surveillance (SACS-N) tool, to identify children between 11-30 months who are at "high likelihood" of ASD in a local community in Nepal. METHODS Sixty Female Community Health Volunteers (FCHVs) were trained to monitor and identify the early signs of ASD using SACS-N. RESULTS Overall, 1926 children were monitored with the SACS-N, with 11 children (0.57 %) referred for further assessments at 11-15 months (n = 4), 16-21 months (n = 4), and 22-30 months (n = 3). Of these children, 10 children had a developmental disorder, including ASD and Global Developmental Delay; no information was available on one child who migrated. Hence, the positive predictive value (PPV) of SACS-N for all developmental disorders was 100 %. Of seven children attending a gold standard diagnostic/ developmental assessment, three had ASD (43 % PPV for ASD). The estimated prevalence of ASD ranged between 0.16 % to 0.26 %. CONCLUSION Community-based developmental monitoring of ASD and other developmental delays by FCHVs is a feasible, cost-effective and sustainable approach to promoting early identification of ASD in Nepal. Further training and awareness of autism is needed for more accurate and increased referral rates using the SACS-N, including regular supervision of FCHVs.
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Affiliation(s)
- Rena Shrestha
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia.
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Doehring P. Does the Arc of Science Bend Towards Impact? Four Decades of Empirical Research Published in JADD Since the DSM-III. J Autism Dev Disord 2021; 51:4411-4421. [PMID: 33974159 PMCID: PMC8531089 DOI: 10.1007/s10803-021-05052-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2021] [Indexed: 11/17/2022]
Abstract
The present study explored the shift from understanding to intervention to population impact in the empirical research published in this journal at five points of time over 40 years since the release of DSM-III. Two-thirds of the more than 600 original studies identified involved basic research, a pattern that is consistent with previous analyses of research funding allocations and that did not change over time. One of every eight studies involved intervention research, which occurred in community-based programs only about one-quarter of the time. These gaps in intervention research and community impact did not improve over time. The findings underscore the need to broaden the training and experience of researchers, and to re-consider priorities for research funding and publication.
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Affiliation(s)
- Peter Doehring
- ASD Roadmap, 5 Nine Gates Road, Chadds Ford, PA, 19317, USA.
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16
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Buffle P, Cavadini T, Posada A, Gentaz E. A study on visual preference for social stimuli in typical Ecuadorian preschoolers as a contribution to the identification of autism risk factors. Sci Rep 2021; 11:8461. [PMID: 33875728 PMCID: PMC8055895 DOI: 10.1038/s41598-021-87888-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
The goal of this study was to examine the visual preference towards socially salient stimuli, using a low-cost eye-tracking device in a group of typically developing (TD) Ecuadorian preschoolers aged 11 to 60 months, from rural and urban areas, and from families with low to high socioeconomic status (SES). Series of original stimuli inspired by those used in Western experiments on the early detection of Autism Spectrum Disorder (ASD) were proposed in two eye-tracking tasks. Two types of movements (human vs. object) were presented in task 1, and dynamic speaking faces in task 2. Parental perceptions of the adaptability of the low-cost eye-tracking device used here were also investigated through a questionnaire. The analyses of mean fixation times showed a visual preference for human movements compared to moving objects whatever age, residency location or SES. In task 2, visual preference for the mouth's area compared to the eyes' area was observed in specific conditions, modulated by residency location and SES but not by age. The analyses of the parental perception indicated that the eye-tracking technique is well accepted. The findings suggest that these stimuli, along with the experimental procedure and low-cost eye-tracking device used in the present study may be a relevant tool that can be used in clinical settings as a contribution to the early identification of at-risk factors of ASD in low- and middle-income contexts.
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Affiliation(s)
- Paulina Buffle
- Faculty of Psychology and Educational Sciences, Department of Psychology, University of Geneva, 40 boulevard du Pont-d'Arve, 1211, Geneva 4, Switzerland.
| | - Thalia Cavadini
- Faculty of Psychology and Educational Sciences, Department of Psychology, University of Geneva, 40 boulevard du Pont-d'Arve, 1211, Geneva 4, Switzerland
| | - Andres Posada
- Faculty of Psychology and Educational Sciences, Department of Psychology, University of Geneva, 40 boulevard du Pont-d'Arve, 1211, Geneva 4, Switzerland
| | - Edouard Gentaz
- Faculty of Psychology and Educational Sciences, Department of Psychology, University of Geneva, 40 boulevard du Pont-d'Arve, 1211, Geneva 4, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- CNRS, Grenoble, France
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17
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Shrestha R, Barbaro J, Dissanayake C. Changes in Knowledge on the Signs of Autism in Young Children (11-30 Months) among Female Community Health Volunteers in Nepal. J Autism Dev Disord 2021; 52:219-239. [PMID: 33709379 DOI: 10.1007/s10803-021-04944-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 10/21/2022]
Abstract
Nepalese Female Community Health Volunteers' (FCHVs) knowledge on social attention and communication development and the early signs of autism was evaluated before, immediately after, and 12-months following training on typical and atypical social-communicative development in infants/toddlers, early signs of autism, and monitoring of key "markers" of autism using Social Attention and Communication Surveillance. FCHVs (N = 60) significantly improved their knowledge about autism and reported increased perceived confidence in monitoring and referring young children at high likelihood of autism following training, which was sustained one year later. FCHVs also reported a positive impact of training on their work. These findings indicate the effectiveness of training in improving FCHVs' knowledge and perceived confidence to monitor and refer young children at high likelihood of autism.
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Affiliation(s)
- Rena Shrestha
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia
| | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia.
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18
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Are Developmental Monitoring and Screening Better Together for Early Autism Identification Across Race and Ethnic Groups? J Autism Dev Disord 2021; 52:203-218. [PMID: 33666797 DOI: 10.1007/s10803-021-04943-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
National Surveys of Children's Health (NSCH, 2016-2018) data were analyzed to determine if conjoint monitoring and screening showed stronger associations with children under 5 identified with ASD compared to monitoring alone, screening alone or no monitoring or screening; and investigate relationships between monitoring and screening across racial/ethnic subgroups. 86 of 332 children with ASD received their diagnosis in a timeframe suggesting potential monitoring and screening for identification purposes. Analyses showed that conjoint monitoring and screening and monitoring alone, but not screening alone, was associated with early identified ASD cases across race groups. Caution is warranted as interpreting NSCH monitoring and screening items solely for identification purposes is inaccurate in many cases. More research on monitoring with screening is needed.
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19
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Prevalence of Decreased Sound Tolerance (Hyperacusis) in Individuals With Autism Spectrum Disorder: A Meta-Analysis. Ear Hear 2021; 42:1137-1150. [PMID: 33577214 DOI: 10.1097/aud.0000000000001005] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Hyperacusis, defined as decreased tolerance to sound at levels that would not trouble most individuals, is frequently observed in individuals with autism spectrum disorder (ASD). Despite the functional impairment attributable to hyperacusis, little is known about its prevalence or natural history in the ASD population. The objective of this study was to conduct a systematic review and meta-analysis estimating the current and lifetime prevalence of hyperacusis in children, adolescents, and adults with ASD. By precisely estimating the burden of hyperacusis in the ASD population, the present study aims to enhance recognition of this particular symptom of ASD and highlight the need for additional research into the causes, prevention, and treatment of hyperacusis in persons on the spectrum. DESIGN We searched PubMed and ProQuest to identify peer-reviewed articles published in English after January 1993. We additionally performed targeted searches of Google Scholar and the gray literature, including studies published through May 2020. Eligible studies included at least 20 individuals with diagnosed ASD of any age and reported data from which the proportion of ASD individuals with current and/or lifetime hyperacusis could be derived. To account for multiple prevalence estimates derived from the same samples, we utilized three-level Bayesian random-effects meta-analyses to estimate the current and lifetime prevalence of hyperacusis. Bayesian meta-regression was used to assess potential moderators of current hyperacusis prevalence. To reduce heterogeneity due to varying definitions of hyperacusis, we performed a sensitivity analysis on the subset of studies that ascertained hyperacusis status using the Autism Diagnostic Interview-Revised (ADI-R), a structured parent interview. RESULTS A total of 7783 nonduplicate articles were screened, of which 67 were included in the review and synthesis. Hyperacusis status was ascertained in multiple ways across studies, with 60 articles employing interviews or questionnaires and seven using behavioral observations or objective measures. The mean (range) age of samples in the included studies was 7.88 years (1.00 to 34.89 years). The meta-analysis of interview/questionnaire measures (k(3) = 103, nASD = 13,093) estimated the current and lifetime prevalence of hyperacusis in ASD to be 41.42% (95% CrI, 37.23 to 45.84%) and 60.58% (50.37 to 69.76%), respectively. A sensitivity analysis restricted to prevalence estimates derived from the ADI-R (k(3) = 25, nASD = 5028) produced similar values. The estimate of current hyperacusis prevalence using objective/observational measures (k(3) = 8, nASD = 488) was 27.30% (14.92 to 46.31%). Heterogeneity in the full sample of interview/questionnaire measures was substantial but not significantly explained by any tested moderator. However, prevalence increased sharply with increasing age in studies using the ADI-R (BF10 = 93.10, R2Het = 0.692). CONCLUSIONS In this meta-analysis, we found a high prevalence of current and lifetime hyperacusis in individuals with ASD, with a majority of individuals on the autism spectrum experiencing hyperacusis at some point in their lives. The high prevalence of hyperacusis in individuals with ASD across the lifespan highlights the need for further research on sound tolerance in this population and the development of services and/or interventions to reduce the burden of this common symptom.
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20
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Long KA, Gordillo M, Orsmond GI. Improving the Validity and Generalizability of Adult Autism Research Through Incorporating Family and Cultural Contexts. AUTISM IN ADULTHOOD 2020; 2:177-184. [PMID: 32959029 DOI: 10.1089/aut.2019.0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The relatively nascent empirical knowledge base regarding autism in adulthood provides an opportunity to adopt a contextual approach that conceptualizes autism features, outcomes, and supportive services as interactions between the characteristics of the condition and contextual factors across the life course. Although a contextual approach encompasses many aspects of a person's identity and social ecology, we focus here on the closely interrelated family and cultural contexts, which have been poorly integrated into adult autism research. We argue that designing studies with a priori attention to context (e.g., family and culture) will improve the relevance and comprehensiveness of findings, which in turn will improve construct validity and provide a more accurate understanding of autism-related outcomes in adulthood. Similarly, designing and/or selecting measures that have been validated with culturally and linguistically diverse samples will improve the utility of findings and reduce spurious or null effects. More contextually informed methodologies will lead to improved generalizability and practical applications of findings. We offer concrete guidance regarding how to increase the social ecological perspective within adult autism research as it relates to study conceptualization, methodology, and measurement.
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Affiliation(s)
- Kristin A Long
- Department of Psychological & Brain Sciences and Boston University, Boston, Massachusetts, USA
| | - Monica Gordillo
- Department of Psychological & Brain Sciences and Boston University, Boston, Massachusetts, USA
| | - Gael I Orsmond
- Department of Occupational Therapy, Boston University, Boston, Massachusetts, USA
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21
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Petrocchi S, Levante A, Lecciso F. Systematic Review of Level 1 and Level 2 Screening Tools for Autism Spectrum Disorders in Toddlers. Brain Sci 2020; 10:brainsci10030180. [PMID: 32204563 PMCID: PMC7139816 DOI: 10.3390/brainsci10030180] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 02/06/2023] Open
Abstract
The present study provides a systematic review of level 1 and level 2 screening tools for the early detection of autism under 24 months of age and an evaluation of the psychometric and measurement properties of their studies. Methods: Seven databases (e.g., Scopus, EBSCOhost Research Database) were screened and experts in the autism spectrum disorders (ASD) field were questioned; Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines and Consensus-based Standard for the selection of health Measurement INstruments (COSMIN) checklist were applied. Results: the study included 52 papers and 16 measures; most of them were questionnaires, and the Modified-CHecklist for Autism in Toddler (M-CHAT) was the most extensively tested. The measures' strengths (analytical evaluation of methodological quality according to COSMIN) and limitations (in term of Negative Predictive Value, Positive Predictive Value, sensitivity, and specificity) were described; the quality of the studies, assessed with the application of the COSMIN checklist, highlighted the necessity of further validation studies for all the measures. According to COSMIN results, the M-CHAT, First Years Inventory (FYI), and Quantitative-CHecklist for Autism in Toddler (Q-CHAT) seem to be promising measures that may be applied systematically by health professionals in the future.
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Affiliation(s)
- Serena Petrocchi
- Institute of Communication and Health, Università della Svizzera Italiana, Via Buffi 13, 6900 Lugano, Switzerland
- Lab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy; (A.L.); (F.L.)
- Applied Research Division for Cognitive and Psychological Science, IRCCS European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy
- Correspondence:
| | - Annalisa Levante
- Lab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy; (A.L.); (F.L.)
- Department of History, Society and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy
| | - Flavia Lecciso
- Lab of Applied Psychology and Intervention, Department of History, Society and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy; (A.L.); (F.L.)
- Department of History, Society and Human Studies, University of Salento, Via di Valesio, 73100 Lecce, Italy
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22
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Early Screening of the Autism Spectrum Disorders: Validity Properties and Cross-Cultural Generalizability of the First Year Inventory in Italy. Brain Sci 2020; 10:brainsci10020108. [PMID: 32085413 PMCID: PMC7071436 DOI: 10.3390/brainsci10020108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 01/06/2023] Open
Abstract
This study examined the cross-cultural generalisability of the First Year Inventory (FYI) on an Italian sample, testing its construct validity, consistency, and structural validity. Six hundred ninety-eight parents of children aged 11–13 months completed the questionnaire. Similarities between analyses of Italian and American/Israeli samples were found, as were demonstrations of the instrument’s construct validity and internal consistency with both groups. The original factorial structure was not demonstrated; thus, a new factorial structure was tested, and a short version of the FYI was demonstrated via confirmatory factor analysis. The findings supported the generalisability of the Italian version of the FYI and its validity. The FYI may aid in medical decision-making on further steps for referral of the child to an early diagnostic assessment.
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23
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Rescorla LA, Given C, Glynn S, Ivanova MY, Achenbach TM. International comparisons of autism spectrum disorder behaviors in preschoolers rated by parents and caregivers/teachers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 23:2043-2054. [PMID: 30995081 DOI: 10.1177/1362361319839151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
This study tested international similarities and differences in scores on a scale comprising 12 items identified by international mental health experts as being very consistent with the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) category of autism spectrum disorder. Participants were 19,850 preschoolers in 24 societies rated by parents on the Child Behavior Checklist for Ages 1½-5; 10,521 preschoolers from 15 societies rated by caregivers/teachers on the Caregiver-Teacher Report Form, and 7380 children from 13 societies rated by both types of informant. Rank ordering of the items with respect to base rates and mean ratings was more similar across societies for parent ratings than caregiver/teacher ratings, especially with respect to the items tapping restricted interests and repetitive behaviors. Items 80. Strange behavior; 63. Repeatedly rocks head or body; 67. Seems unresponsive to affection; and 98. Withdrawn, doesn't get involved with others had low base rates in these population samples across societies and types of informants, suggesting that they may be particularly discriminating for identifying autism spectrum disorder in young children. Cross-informant agreement was stronger for the items tapping social communication and interaction problems than restricted interests and repetitive behaviors. The findings support the feasibility of international use of the scale for autism spectrum disorder screening in population samples.
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24
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Guo C, Luo M, Wang X, Huang S, Meng Z, Shao J, Zhang X, Shao Z, Wu J, Robins DL, Jing J. Reliability and Validity of the Chinese Version of Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F). J Autism Dev Disord 2019; 49:185-196. [PMID: 30047095 DOI: 10.1007/s10803-018-3682-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although early detection of autism facilitates intervention, early detection strategies are not yet widespread in China. To improve the situation, the Chinese version of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) was validated. The sample included 7928 toddlers, aged 16 to 30 months, screened during their routine care in six provinces of China. When the cut-off value was 3, the sensitivity and specificity of M-CHAT-R were 0.963 and 0.865. The inter-rater reliability and the test-retest reliability were also adequate (intraclass correlation coefficients were 0.853 and 0.759, both ps < .01). The Chinese version of M-CHAT-R/F is an effective tool for early detection of ASD and is applicable to early screening in China.
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Affiliation(s)
- Cuihua Guo
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China
| | - Meifang Luo
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China
| | - Xuxiang Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China
| | - Saijun Huang
- Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan, No. 11 Renmin West Road, Chancheng, Foshan, People's Republic of China
| | - Zhaoxue Meng
- Tongzhou Maternal&Child Health Hospital of Beijing, No. 124 Yuqiao Middle Road, Tongzhou, Beijing, 101100, People's Republic of China
| | - Jie Shao
- The Children's Hospital, Zhejiang University School of Medicine, No. 57 Zhuganxiang, Hangzhou, 310003, Zhejiang, People's Republic of China
| | - Xuan Zhang
- Department of Child Health Care, Hubei Maternal and Child Health Hospital, No 745, Wuluo Road, Hongshan, Wuhan, Hubei, People's Republic of China
| | - Zhi Shao
- The Ninth People's Hospital of Chongqing, No. 1 Yueya village, Beibei, Chongqing, People's Republic of China
| | - Jieling Wu
- Guangdong Women and Children Hospital, No. 13 Guangyuan West Road, Guangzhou, People's Republic of China
| | - Diana L Robins
- AJ Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan 2nd Road, Yuexiu, 510080, Guangzhou, People's Republic of China.
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25
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Marlow M, Servili C, Tomlinson M. A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries. Autism Res 2019; 12:176-199. [DOI: 10.1002/aur.2033] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 06/08/2018] [Accepted: 06/27/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Marguerite Marlow
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
| | - Chiara Servili
- Department of Mental Health and Substance Abuse; World Health Organization; Geneva Switzerland
| | - Mark Tomlinson
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
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26
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Tsai JM, Lu L, Jeng SF, Cheong PL, Gau SSF, Huang YH, Wu YT. Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:205-216. [PMID: 30579261 DOI: 10.1016/j.ridd.2018.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 11/17/2018] [Accepted: 11/24/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) is a two-stage screening scale for determining the risk of autism spectrum disorder (ASD) in toddlers. However, the validity of the M-CHAT-R/F for Asian populations has not yet been established. AIMS This study investigated the psychometric properties of the M-CHAT-R/F, Taiwan version (M-CHAT-R/F-T), among low- and high-risk Taiwanese toddlers aged 16-30 months. The associations among M-CHAT-R/F-T scores, developmental performance at 24 and 30 months, and ASD diagnosis prediction at 36 months were examined. METHODS AND PROCEDURES A two-stage screening of the M-CHAT-R/F-T was applied to a study sample comprising 25 toddlers with ASD and 71 atypically developing (ATD) and 221 typically developing (TD) toddlers. OUTCOMES AND RESULTS The M-CHAT-R/F-T exhibited acceptable internal consistency and test-retest reliability. The M-CHAT-R/F-T scores were significantly correlated with several syndrome scores of the Child Behavior Checklist for Ages 1.5-5 and were significantly higher among toddlers with ASD than among ATD or TD toddlers. Furthermore, M-CHAT-R/F-T scores were negatively correlated with developmental scores in the Mullen Scales of Early Learning at 24 and 30 months. Moreover, the screening exhibited acceptable predictive validity (sensitivity = 0.86; specificity = 0.96) for ASD diagnosis at 36 months. CONCLUSIONS AND IMPLICATIONS The findings indicate that the M-CHAT-R/F-T is a valid and reliable tool for the developmental screening of low- and high-risk Taiwanese toddlers in community and clinical settings.
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Affiliation(s)
- Jung-Mei Tsai
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Lu Lu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Suh-Fang Jeng
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pou-Leng Cheong
- Department of Pediatrics, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yen-Hsun Huang
- Department of Child and Adolescent Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
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27
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Carruthers S, Kinnaird E, Rudra A, Smith P, Allison C, Auyeung B, Chakrabarti B, Wakabayashi A, Baron-Cohen S, Bakolis I, Hoekstra RA. A cross-cultural study of autistic traits across India, Japan and the UK. Mol Autism 2018; 9:52. [PMID: 30410715 PMCID: PMC6217788 DOI: 10.1186/s13229-018-0235-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/21/2018] [Indexed: 11/10/2022] Open
Abstract
Background There is a global need for brief screening instruments that can identify key indicators for autism to support frontline professionals in their referral decision-making. Although a universal set of conditions, there may be subtle differences in expression, identification and reporting of autistic traits across cultures. In order to assess the potential for any measure for cross-cultural screening use, it is important to understand the relative performance of such measures in different cultures. Our study aimed to identify the items on the Autism Spectrum Quotient (AQ)-Child that are most predictive of an autism diagnosis among children aged 4-9 years across samples from India, Japan and the UK. Methods We analysed parent-reported AQ-Child data from India (73 children with an autism diagnosis and 81 neurotypical children), Japan (116 children with autism and 190 neurotypical children) and the UK (488 children with autism and 532 neurotypical children). None of the children had a reported existing diagnosis of intellectual disability. Discrimination indices (DI) and positive predictive values (PPV) were used to identify the most predictive items in each country. Results Sixteen items in the Indian sample, 15 items in the Japanese sample and 28 items in the UK sample demonstrated excellent discriminatory power (DI ≥ 0.5 and PPV ≥ 0.7), suggesting these items represent the strongest indicators for predicting an autism diagnosis within these countries. Across cultures, good performing items were largely overlapping, with five key indicator items appearing across all three countries (can easily keep track of several different people's conversations, enjoys social chit-chat, knows how to tell if someone listening to him/her is getting bored, good at social chit-chat, finds it difficult to work out people's intentions). Four items indicated potential cultural differences. One item was highly discriminative in Japan but poorly discriminative (DI < 0.3) in the UK and India, and a further item had excellent discrimination properties in the UK but poorly discriminated in the Indian and Japanese samples. Two additional items were highly discriminative in two cultures but poor in the third. Conclusions Cross-cultural overlap in the items most predictive of an autism diagnosis supports the general notion of universality in autistic traits whilst also highlighting that there can be cultural differences associated with certain autistic traits. These findings have the potential to inform the development of a brief global screening tool for autism. Further development and evaluation work is needed.
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Affiliation(s)
- Sophie Carruthers
- 1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emma Kinnaird
- 1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alokananda Rudra
- 2Psychology, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Paula Smith
- 3Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carrie Allison
- 3Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Bonnie Auyeung
- 4Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Bhismadev Chakrabarti
- 5Centre for Autism, School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | | | - Simon Baron-Cohen
- 3Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ioannis Bakolis
- 1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rosa A Hoekstra
- 1Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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28
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Systematic review: cultural adaptation and feasibility of screening for autism in non-English speaking countries. Int J Ment Health Syst 2018; 12:22. [PMID: 29760771 PMCID: PMC5941599 DOI: 10.1186/s13033-018-0200-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/12/2018] [Indexed: 01/30/2023] Open
Abstract
Background Screening children for autism has gained wider acceptance within clinical practice, and early intervention has improved outcomes. Increasingly, adapting an existing screening instrument is a common, fast method to create a usable screening tool, especially for countries with limited resources and/or expertise. However, concerns have been raised regarding adaptation adequacy and the feasibility of screening across cultural groups. This study systematically examined the levels of cultural adaptation and feasibility aspects considered when screening for autism in non-English speaking countries to build upon the sparse knowledge that exists on this topic in the literature. Methods Nineteen studies, obtained from five electronic databases, were examined. PRISMA guidance was used for this review. The Ecological Validity Framework model, and Bowen Recommendations for Feasibility were adopted to extract relevant data, which was synthesised narratively. Results Cultural adaptation within the included studies mostly involved language translation with little information offered to enable conclusions on how the processes were guided and maintained. Few cultural adjustments involved modifying screening methods; clarifying difficult concepts and changing instrument content were employed to address the core values, competence, beliefs, and norms of the adapted culture. However, less attention was given to adapt the screening goals within the context of cultural values, and customs or to consider interactional match between the clients and assessors. The review also highlighted an acceptable level of practicality to screen for autism but did not encourage integrating autism screening within routine practice or beyond the study context for different cultures. Conclusion Concurring with previous literature, we agree that knowledge on cultural adaptation for autism screening instruments is limited and not sufficiently documented to establish adaptation levels (process and/or contents), and prove adequacy. However, this review provides an infrastructure to improve future adaptation processes. Integrating autism screening as routine medical practice is not encouraged and warrants further feasibility studies to minimize wasted resources and improve screening effectiveness in various health care systems.
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Adapting an Autism Screening Tool for Use in the DeKalb County Refugee Pediatric Clinic. J Immigr Minor Health 2017; 20:360-369. [PMID: 28197861 DOI: 10.1007/s10903-017-0553-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Minimal literature exists regarding Autism Spectrum Disorder (ASD) among refugee children in the United States. Reliable ASD screening tools, such as the M-CHAT-R/F, have yet to be culturally adapted and translated into some languages spoken in the homes of these children. METHODS Pediatric refugee patients (n = 13) of caregivers of Bhutanese (Nepali-speaking) descent were screened using a newly translated Nepali M-CHAT-R/F. The M-CHAT-R/F was adapted based on feedback from Bhutanese caregivers and interpreter expertise. Qualitative interviews regarding caregiver awareness of ASD were conducted. RESULTS Caregivers understood the majority of M-CHAT-R/F items (91%). Four items required revision. Interviews revealed minimal awareness among Bhutanese caregivers regarding ASD or child development. DISCUSSION The M-CHAT-R/F was adapted into Nepali using a combination of translation protocols, and is publicly available for clinical use. Future validation studies are needed which will aid in clinical screening for and epidemiologic research of ASD in this population.
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Vanegas SB, Magaña S, Morales M, McNamara E. Clinical Validity of the ADI-R in a US-Based Latino Population. J Autism Dev Disord 2016; 46:1623-35. [PMID: 26742934 DOI: 10.1007/s10803-015-2690-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Autism Diagnostic Interview-Revised (ADI-R) has been validated as a tool to aid in the diagnosis of Autism; however, given the growing diversity in the United States, the ADI-R must be validated for different languages and cultures. This study evaluates the validity of the ADI-R in a US-based Latino, Spanish-speaking population of 50 children and adolescents with ASD and developmental disability. Sensitivity and specificity of the ADI-R as a diagnostic tool were moderate, but lower than previously reported values. Validity of the social reciprocity and restrictive and repetitive behaviors domains was high, but low in the communication domain. Findings suggest that language discordance between caregiver and child may influence reporting of communication symptoms and contribute to lower sensitivity and specificity.
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Affiliation(s)
- Sandra B Vanegas
- Department of Disability and Human Development, University of Illinois at Chicago, M/C 626, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA.
| | - Sandra Magaña
- Department of Disability and Human Development, University of Illinois at Chicago, M/C 626, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA
| | - Miguel Morales
- Department of Disability and Human Development, University of Illinois at Chicago, M/C 626, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA
| | - Ellyn McNamara
- Department of Disability and Human Development, University of Illinois at Chicago, M/C 626, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA
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31
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Carakovac M, Jovanovic J, Kalanj M, Rudic N, Aleksic-Hil O, Aleksic B, Villalobos IB, Kasuya H, Ozaki N, Lecic-Tosevski D, Pejovic-Milovancevic M. Serbian Language version of the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up: Cross-Cultural Adaptation and Assessment of Reliability. Sci Rep 2016; 6:38222. [PMID: 27905541 PMCID: PMC5131297 DOI: 10.1038/srep38222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/07/2016] [Indexed: 11/23/2022] Open
Abstract
Early detection of Autism Spectrum Disorder (ASD) has proven to be of high significance, however there is a limited availability of ASD screening tools in Serbian language. In this study we aim to translate, assess reliability and, in part, test the applicability of Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT R/F) in Serbian Healthcare environment. We screened 128 children in three primary healthcare centres and 20 children in a tertiary psychiatric center, using M-CHAT R/F translated into Serbian language, between December 2014 and October 2015. At the end of the screening process 80% of participants in the risk group screened positive for ASD, while in the control group 4 (3.1%) participants screened positive, with a mean total scores of 8.25 and 0.66 respectively. The Cronbach’s α coefficient was 0.91 and Guttman’s λ6 was 0.93. Test – retest reliability was deemed as acceptable, and no significant correlation was found between M-CHAT-R/F scores and Epworth Sleepiness Scale for children scores. The Serbian version of the M-CHAT-R/F has shown satisfactory reliability. We can therefore assert that it is a reliable tool for identifying ASD and it can be used in clinical practice to improve early detection, assessment and treatment.
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Affiliation(s)
- Mia Carakovac
- Faculty of special education and rehabilitation, University of Belgrade, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Jelena Jovanovic
- Institute of Mental Health, Palmoticeva 37, 11000 Belgrade, Serbia
| | - Marko Kalanj
- Institute of Mental Health, Palmoticeva 37, 11000 Belgrade, Serbia
| | - Nenad Rudic
- Institute of Mental Health, Palmoticeva 37, 11000 Belgrade, Serbia
| | | | - Branko Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi-ken 466-8550, Japan.,Office on international affairs, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi-ken 466-8550, Japan
| | - Itzel Bustos Villalobos
- Office on international affairs, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi-ken 466-8550, Japan
| | - Hideki Kasuya
- Office on international affairs, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi-ken 466-8550, Japan
| | - Norio Ozaki
- Office on international affairs, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi-ken 466-8550, Japan
| | - Dusica Lecic-Tosevski
- Institute of Mental Health, Palmoticeva 37, 11000 Belgrade, Serbia.,School of Medicine, University of Belgrade, Dr Subotica 2, 11000 Belgrade, Serbia.,Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
| | - Milica Pejovic-Milovancevic
- Institute of Mental Health, Palmoticeva 37, 11000 Belgrade, Serbia.,School of Medicine, University of Belgrade, Dr Subotica 2, 11000 Belgrade, Serbia
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Brennan L, Fein D, Como A, Rathwell IC, Chen CM. Use of the Modified Checklist for Autism, Revised with Follow Up-Albanian to Screen for ASD in Albania. J Autism Dev Disord 2016; 46:3392-3407. [PMID: 27491423 PMCID: PMC5074853 DOI: 10.1007/s10803-016-2875-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The Modified Checklist for Autism in Toddlers Revised-Albanian screener (M-CHAT-R-A) was used to screen 2594 toddlers, aged 16-30 months, at well-child visits. Two hundred fifty-three (9.75 %) screened positive; follow up on failed items were conducted by phone with 127 (50 %); the remainder were lost to follow-up. Twenty-six toddlers (21 %) continued to screen positive; 19 received full evaluations, which assessed for ASD with the Autism Diagnostic Observation Schedule and developmental delays with the Parents Assessment of Developmental Status-Developmental Milestones. All evaluated children had significant delays; 17 of the 19 met criteria for Autism/ASD. Removal of three items improved performance. Although Albania and the US are quite different in culture and language, key features of ASD appeared very similar.
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Affiliation(s)
- Laura Brennan
- Dept. of Psychology, University of Connecticut, Storrs, CT
| | - Deborah Fein
- Depts. of Psychology and Pediatrics, University of Connecticut, Storrs, CT, tel: 413-519-1324, fax: 860-486-2760
| | - Ariel Como
- Tirana Medical University, Medical Director, “Domenick Scaglione” Regional Center for Autism, Tirana, Albania
| | | | - Chi-Ming Chen
- Department of Psychology, University of Connecticut, Storrs, CT
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Chaaya M, Saab D, Maalouf FT, Boustany RM. Prevalence of Autism Spectrum Disorder in Nurseries in Lebanon: A Cross Sectional Study. J Autism Dev Disord 2016; 46:514-22. [PMID: 26362151 DOI: 10.1007/s10803-015-2590-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In Lebanon, no estimate for autism prevalence exists. This cross-sectional study examines the prevalence of Autism spectrum disorder (ASD) in toddlers in nurseries in Beirut and Mount-Lebanon. The final sample included 998 toddlers (16-48 months) from 177 nurseries. We sent parents the Modified Checklist for Autism in Toddlers (M-CHAT) for screening, and a self-administered questionnaire (associated factors). We imputed missing M-CHAT data with successful answers. Since there were no follow-up interviews for the M-CHAT, we used the positive predictive value (0.058) from a large study for prevalence estimates. ASD prevalence was 1 in 66 children (comparable to US). Ratios were: male/female: 1.05; Beirut/Mount-Lebanon: 1.2. Using a more representative sample and ascertaining results are needed for better prevalence estimates in Lebanon.
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Affiliation(s)
- Monique Chaaya
- Department of Epidemiology and Population Health, American University of Beirut, Beirut, Lebanon
| | - Dahlia Saab
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, PO-box 11-0236, Riad El Solh Beirut, 1107 2020, Lebanon.
| | - Fadi T Maalouf
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Rose-Mary Boustany
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, PO-box 11-0236, Riad El Solh Beirut, 1107 2020, Lebanon.,Department of Pediatrics and Adolescent Medicine, American University of Beirut, Beirut, Lebanon
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Screening for Autism in Iranian Preschoolers: Contrasting M-CHAT and a Scale Developed in Iran. J Autism Dev Disord 2016; 45:2908-16. [PMID: 25911978 DOI: 10.1007/s10803-015-2454-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Suitable screening instruments for the early diagnosis of autism are not readily available for use with preschoolers in non-Western countries. This study evaluated two tools: M-CHAT which is widely used internationally and one developed in Iran called Hiva. A population sample was recruited of nearly 3000 preschoolers in one Iranian city. Parents self-completed the two tools and children who screened positive were invited for a follow-up interview followed by a diagnostic assessment. The Hiva scale proved to be more efficacious in identifying children with ASD and the resulting prevalence rate was higher than that previously reported for Iranian 5 year olds. The study confirms the need to attune screening tools to the cultural contexts in which they are used.
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Wojcicki JM, Heyman MB, Elwan D, Shiboski S, Lin J, Blackburn E, Epel E. Telomere length is associated with oppositional defiant behavior and maternal clinical depression in Latino preschool children. Transl Psychiatry 2015; 5:e581. [PMID: 26080316 PMCID: PMC4490282 DOI: 10.1038/tp.2015.71] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/15/2015] [Accepted: 04/23/2015] [Indexed: 11/09/2022] Open
Abstract
Exposure to psychological stress and depression are associated with shorter white blood cell telomere length (TL) in adults, possibly via associated lifelong oxidative stressors. Exposure to maternal depression increases risk for future depression and behavior problems in children, and Latino youth are at high risk. Few studies have evaluated the role of exposure to maternal depression or child behavior in relation to TL in children. We assessed early-childhood exposures to maternal depression from birth to the age of 5 years and child behavior from ages 3-5 years in a cohort of Latino children in relation to child leukocyte TL at ages 4 and 5 years. Children who had oppositional defiant behavior at 3, 4 or 5 years had shorter TL than those without by ~450 base pairs (P < 0.01). In multivariate analyses, independent predictors for shorter TL at 4 and 5 years of age included oppositional defiant disorder at 3, 4 or 5 years (β = -359.25, 95% CI -633.84 to 84.66; P = 0.01), exposure to maternal clinical depression at 3 years of age (β = -363.99, 95% CI -651.24 to 764.74; P = 0.01), shorter maternal TL (β = 502.92, 95% CI 189.21-816.63) and younger paternal age at the child's birth (β = 24.63, 95% CI 1.14-48.12). Thus, exposure to maternal clinical depression (versus depressive symptoms) in early childhood was associated with deleterious consequences on child cellular health as indicated by shorter TL at 4 and 5 years of age. Similarly, children with oppositional defiant behavior also had shorter TL, possibly related to early exposures to maternal clinical depression. Our study is the first to link maternal clinical depression and oppositional defiant behavior with shorter TL in the preschool years in a relatively homogenous population of low-income Latino children.
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Affiliation(s)
- J M Wojcicki
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA,Department of Pediatrics, University of California, 550 16th Street, 5th Floor, Mail Stop 0136, San Francisco, CA 94143, USA. E-mail:
| | - M B Heyman
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - D Elwan
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - S Shiboski
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - J Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - E Blackburn
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, USA
| | - E Epel
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
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36
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Nagata JM, Hagan MJ, Heyman MB, Wojcicki JM. No Association between Obesity and Behavior in Low-income, Preschool Latino Children. J Health Care Poor Underserved 2015; 26:410-20. [PMID: 25913339 PMCID: PMC4469650 DOI: 10.1353/hpu.2015.0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The relationship between behavioral problems and obesity in early childhood in Latinos is largely unknown. METHODS Cross-sectional anthropometric and behavioral data of children at three years of age were gathered from a cohort of 174 children of Latina mothers at two San Francisco hospitals. Child behaviors were assessed using the preschool Child Behavior Checklist (CBCL/1½-5). Logistic regression was used to analyze the association between behavior and obesity. RESULTS At three years, 27.7% were obese. There were no associations between affective (OR = 1.89; 95% confidence interval [CI] 0.42-8.59), anxiety (OR = 1.86; 95% CI 0.53-6.47), pervasive developmental (OR = 0.42; 95% CI 0.13-1.36), attention deficit hyperactivity (OR = 0.58; 95% CI 0.12-2.76), or oppositional defiant (OR = 6.49; 95% CI 0.65-64.49) problems and obesity. CONCLUSIONS Though psychological problems and obesity are associated among older children and adolescents, there was no association in Latino three-year olds in a low-income sample.
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Windham GC, Smith KS, Rosen N, Anderson MC, Grether JK, Coolman RB, Harris S. Autism and developmental screening in a public, primary care setting primarily serving Hispanics: challenges and results. J Autism Dev Disord 2014; 44:1621-32. [PMID: 24408091 DOI: 10.1007/s10803-014-2032-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We implemented screening of children 16-30 months of age (n = 1,760) from a typically under-served, primarily Hispanic, population, at routine pediatric appointments using the modified checklist for autism in toddlers (M-CHAT) and Ages and Stages Questionnaire. Screen positive rates of 26 and 39%, respectively, were higher than previous reports. Hispanics were more likely to score M-CHAT positive than non-Hispanics (adjusted OR 1.7, 95% CI 1.2-2.4), as were those screened in Spanish. About 30% of screen-positive children were referred for further assessment, but only half were seen. Thus screening in this population is feasible, but may require additional resources. Attention to the cultural applicability of screening instruments, as well as to explaining the results or need for additional services to parents, is critical to serve the growing Hispanic population.
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Affiliation(s)
- Gayle C Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, 850 Marina Bay Parkway, Building P, Richmond, CA, 94804, USA,
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Kimple KS, Bartelt EA, Wysocki KL, Steiner MJ. Performance of the Modified Checklist for Autism in Toddlers in Spanish-speaking patients. Clin Pediatr (Phila) 2014; 53:632-8. [PMID: 24550559 DOI: 10.1177/0009922814522346] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To compare abnormal screening rates of 2 different Spanish versions of the Modified Checklist for Autism in Toddlers (M-CHAT) in US Spanish-speaking patients. METHOD Quasi-experimental design was used with historical and English language controls. Abnormal screening rates were compared between Spain and Western-hemisphere Spanish versions, as well as to English controls during the same time periods using chi square analysis. RESULTS M-CHAT questionnaires were scored from 589 subjects (English n = 415, Spanish n = 174). There was little difference between Spanish versions. Overall, the Spanish abnormal screening rate was double that of English (23.6% vs 11.3%, P < .001). CONCLUSIONS Spanish M-CHAT questionnaires are abnormal more often than those in English even after changing to appropriate translation, despite lower prevalence of autism in Latinos. Issues with translation, interpretation, or cultural understanding of behaviors may contribute. Given abnormal screening rates for Latinos, the use of the M-CHAT follow-up interview in Spanish-speaking patients is beneficial but may be more time-consuming.
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Affiliation(s)
- Kelly S Kimple
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erica A Bartelt
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen L Wysocki
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Zuckerman KE, Mattox KM, Sinche BK, Blaschke GS, Bethell C. Racial, ethnic, and language disparities in early childhood developmental/behavioral evaluations: a narrative review. Clin Pediatr (Phila) 2014; 53:619-31. [PMID: 24027231 PMCID: PMC3955219 DOI: 10.1177/0009922813501378] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Katharine E. Zuckerman
- Oregon Health & Science University Division of General Pediatrics, Portland, OR,Child and Adolescent Health Measurement Initiative, Portland, OR
| | - Kimber M. Mattox
- Oregon Health & Science University Division of General Pediatrics, Portland, OR,Child and Adolescent Health Measurement Initiative, Portland, OR
| | | | - Gregory S. Blaschke
- Oregon Health & Science University Division of General Pediatrics, Portland, OR
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