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Simcoe SM, Gilmour J, Garnett MS, Attwood T, Donovan C, Kelly AB. Are there gender-based variations in the presentation of Autism amongst female and male children? J Autism Dev Disord 2023; 53:3627-3635. [PMID: 35829944 PMCID: PMC10465371 DOI: 10.1007/s10803-022-05552-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/29/2022]
Abstract
The Questionnaire for Autism Spectrum Conditions (Q-ASC; Attwood, Garnett & Rynkiewicz, 2011) is one of the few screening instruments that includes items designed to assess female-specific ASD-Level 1 traits. This study examined the ability of a modified version of the Q-ASC (Q-ASC-M; Ormond et al., 2018) to differentiate children with and without ASD-Level 1. Participants included 111 parents of autistic children and 212 parents of neurotypical children (5-12 years). Results suggested that the gendered behaviour, sensory sensitivity, compliant behaviours, imagination, and imitation subscales differentiated autistic females from neurotypical females. Compared to autistic males, autistic females had higher scores on gendered behaviour, sensory sensitivity, social masking, and imitation. Results are discussed in relation to early detection of autistic female children.
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Affiliation(s)
- Sarah Mae Simcoe
- School of Applied Psychology, Griffith University, Mt Gravatt, Brisbane, Australia
| | - John Gilmour
- Institute of Social Science Research, University of Queensland, St Lucia, Brisbane, Australia
| | | | - Tony Attwood
- School of Applied Psychology, Griffith University, Mt Gravatt, Brisbane, Australia
- Attwood and Garnett Events, Brisbane, Australia
| | - Caroline Donovan
- School of Applied Psychology, Griffith University, Mt Gravatt, Brisbane, Australia
| | - Adrian B Kelly
- School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, Brisbane, Australia
- Centre for Child Health and Well-being, Mental Health and Resilience Theme, Queensland University of Technology, Kelvin Grove, Child Adversity, Brisbane, Australia
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Mwaura M, Kao K, Wambugu J, Trollip A, Sikhondze W, Omesa E, Dlamini S, Mzizi N, Dlamini M, Sibandze B, Dlamini B, Albert H, Dondorp W, Engel N. Situating trade-offs: Stakeholder perspectives on overtreatment versus missed diagnosis in transition to Xpert MTB/RIF Ultra in Kenya and Swaziland. PLoS One 2020; 15:e0228669. [PMID: 32074142 PMCID: PMC7029953 DOI: 10.1371/journal.pone.0228669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/20/2020] [Indexed: 11/25/2022] Open
Abstract
Implementing new diagnostics in public health programs can involve difficult trade-off decisions between individual patient benefits and public health considerations. Such decision-making processes are often not documented and may not include engagement of affected communities. This paper examines the perspectives of stakeholders on the trade-off between over-treatment and missed diagnosis captured during decision-making workshops on the transition from use of Xpert MTB/RIF to diagnose tuberculosis to Xpert MTB/RIF Ultra in Kenya and Swaziland. Xpert MTB/RIF Ultra has an overall increase in sensitivity but a decrease in specificity when compared to its predecessor. We conducted a qualitative study using four focus group discussions with a total of 47 participants and non-participant observation. The analysis reveals how participants deemed Xpert MTB/RIF Ultra’s reduced specificity vis-à-vis its increased sensitivity to be an acceptable trade-off. The way participants assessed this trade-off was shaped by their experiences with the general uncertainty of all diagnostic tests, alternative testing options, historical evolution of diagnostic practices, epidemiological factors and resource constraints. In assessing the trade-off community and individual benefit and harm was frequently discussed together. Qualitative research on stakeholder engagement activities for diagnostic development and implementation can identify everyday experiences and situate assessments and perspectives of key stakeholders and as such aid in decision-making, improving implementation as well as patient outcomes. Further research is needed on the intended and unintended consequences of such engagement activities, how findings are being incorporated by decision-makers, and the impact on programmatic implementation.
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Affiliation(s)
- Muthoni Mwaura
- Department of Health, Ethics & Society; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Kekeletso Kao
- Foundation for Innovative New Diagnostics (FIIND), Geneva, Switzerland
| | - Jesse Wambugu
- Foundation for Innovative New Diagnostics (FIIND), Geneva, Switzerland
| | - Andre Trollip
- Foundation for Innovative New Diagnostics (FIIND), Geneva, Switzerland
| | - Welile Sikhondze
- National TB Control Program, Ministry of Health, Mbabane, Swaziland
| | - Eunice Omesa
- National Tuberculosis, Leprosy, and Lung Disease Program, Ministry of Health, Nairobi, Kenya
| | - Sindi Dlamini
- Swaziland Health Laboratory Service, Ministry of Health, Mbabane, Swaziland
| | | | - Muyalo Dlamini
- National TB Control Program, Ministry of Health, Mbabane, Swaziland
| | - Busizwe Sibandze
- National TB Control Program, Ministry of Health, Mbabane, Swaziland
| | - Brian Dlamini
- National TB Control Program, Ministry of Health, Mbabane, Swaziland
| | - Heidi Albert
- Foundation for Innovative New Diagnostics (FIIND), Geneva, Switzerland
| | - Wybo Dondorp
- Department of Health, Ethics & Society; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Nora Engel
- Department of Health, Ethics & Society; Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- * E-mail:
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