Advances in Autism : 2018 - Issue 2

mardi 4 septembre 2018

1. Chaplin E, McCarthy J. Editorial. Advances in Autism ;2018 ;4(2):37-38.

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2. Rai R, Tromans S, Kapugama C, Chester V, Gunaratna I, Langdon P, Alexander RT. A phenomenological approach to diagnosing psychosis in autism spectrum disorder and intellectual disability : a case series. Advances in Autism ;2018 ;4(2):39-48.

Purpose The diagnosis of psychosis in individuals with autism spectrum disorder (ASD) poses a unique clinical challenge. The presence of intellectual disability (ID) further complicates the diagnostic picture. Reliable and timely diagnosis of psychosis in such individuals minimises the duration of untreated psychotic symptoms and the subsequent impact on the quality of life of the patients concerned. The paper aims to discuss this issue. Design/methodology/approach The authors present four patients with psychosis, ASD and ID, who have received care within forensic mental health and ID settings. These examples demonstrate the interaction between these conditions, as well as issues pertaining to diagnosis and management. Findings In all four patients, sustained use of antipsychotic medication was objectively associated with an improvement in psychotic symptoms and quality of life. In instances where autistic phenomena were accentuated upon development of psychosis, such features returned to the baseline levels evident prior to the onset of psychosis. Practical implications The discussion and related case examples could improve the understanding of the possibility of psychosis in individuals with ASD and ID, and increase awareness of this diagnostic possibility among healthcare professionals. Originality/value This is the first published case series illustrating the challenges of diagnosing psychosis in individuals with ASD and ID.

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3. Adamou M, Johnson M, Alty B. Autism Diagnostic Observation Schedule (ADOS) scores in males and females diagnosed with autism : a naturalistic study. Advances in Autism ;2018 ;4(2):49-55.

Purpose Many tools are available for assessing autism in an adult population ; however, few have been studied for the effects of gender on diagnostic scores. The purpose of this paper is to evaluate the Autism Diagnostic Observation Schedule (ADOS) assessment for gender bias in a clinical population, specifically whether the ADOS favours a “male-type” of autism. Design/methodology/approach The ADOS scores of patients referred to an NHS specialist autism assessment service were retrospectively examined for significant gender differences. The combined ADOS scores and diagnostic outcome were grouped by gender for each participant. The data were analysed in SPSS using independent t-tests to look for significant gender differences between combined ADOS scores and diagnostic outcomes. Findings A significant difference was observed in the mean combined ADOS scores for those participants who later received an autism diagnosis (male=10, female=6, t (13)=3.34, p=10 ; 0.005). However, no significant difference was observed between mean scores of those who did not receive an autism diagnosis (t (26)=1.21, p=0.237). Originality/value The ADOS is a popular assessment used for autism diagnosis. These results provide support for a male gender bias. This could have clinical implications for autism assessment services, whereby lower diagnostic thresholds could be considered for female patients. This could allow more females with autism to receive a diagnosis, and access support services.

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4. Rezaei M, Moradi A, Tehrani-Doost M, Hassanabadi H, Khosrowabadi R. A pilot study on combining risperidone and pivotal response treatment on communication difficulties in children with autism spectrum disorder. Advances in Autism ;2018 ;4(2):56-65.

Purpose The purpose of this paper is to investigate the effects of combined risperidone (RIS) and pivotal response treatment (PRT) in children with autism spectrum disorder (ASD). Design/methodology/approach In all, 34 children diagnosed with ASD (mean age of 12.36 years) were randomly divided into two groups : an RIS treatment group (n=18) and an RIS plus PRT (n=16). Communication skills were evaluated with the child communication checklist (CCC). Findings Total score of the CCC was increased in both groups after three months compared with the score prior to treatment. The total score of the CCC was significantly higher in the combined treatment group than in the RIS group. Originality/value Treatment with RIS combined with PRT may result in a better outcome in communication skill for children with autism than RIS training alone.

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5. Tolchard B, Stuhlmiller C. Chronic health and lifestyle problems for people diagnosed with autism in a student-led clinic. Advances in Autism ;2018 ;4(2):66-72.

Purpose People with autism spectrum disorder (ASD) are at greater risk of developing chronic health and risky lifestyle problems. This is exaggerated further for people living in rural settings and from cultural backgrounds traditionally underserved by healthcare services. The purpose of this paper is to describe an evaluation of health and behavioural lifestyle outcomes of people diagnosed with ASD in a student-led clinic in rural/regional Australia. Design/methodology/approach Routine clinical outcomes and lifestyle measures were routinely collected at a primary acre student-led Clinic in rural/regional Australia. Participants were all attending the clinic who provided consent for their routine date to be reported. Participants ranged in age from new born to 100 years and were representative of the local community. Findings The results indicate there is an increased risk for people with ASD developing chronic conditions compared to those without a diagnosis. This also resulted in higher body mass index and blood sugar levels linked to diabetes and hypertension. Mental health problems were common in people diagnosed with ASD especially anxiety disorders. Smoking was problematic for people with ASD but mainly in non-Aboriginal and Torres Strait Islanders. Alcohol use was not an increase risk in ASD. Originality/value Little is reported on the health and lifestyle experiences of people with ASD in rural/regional settings, especially from Aboriginal and Torres Strait Islander communities. This paper gives an initial insight to the presentation of chronic conditions and harmful lifestyle choices. Possible insights into adapting or modifying care for people with ASD in rural/regional Australia are given.

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6. Campbell B, Curran M, Inkpen R, Katsikitis M, Kannis-Dymand L. A preliminary evaluation of metacognitive beliefs in high functioning children with autism spectrum disorder. Advances in Autism ;2018 ;4(2):73-84.

Purpose Metacognitive beliefs and processes have been found to perpetuate anxiety and depression in youth and adults. However, the presence of metacognitive beliefs in children with autism spectrum disorder is somewhat unclear and has received limited research attention to date. The purpose of this paper is to explore metacognitive beliefs in children with autism and associations with anxiety and depression. Design/methodology/approach In total, 23 high functioning participants (17 male and 6 female) between the ages of 8 and 12 (M=10.38) diagnosed on the autism spectrum completed the study. Participants completed the Revised Children’s Scale of Anxiety and Depression and the Metacognitions Questionnaire for Children. Findings Correlation analyses revealed that positive and negative metacognitive beliefs were found, as hypothesised, to be prevalent in this sample. Originality/value Despite methodological limitations, this is one of the first research evaluations to provide evidence for metacognitive beliefs in high functioning children with autism and comorbid anxiety or low mood.

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