Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation / Whitney GUTHRIE in Journal of Child Psychology and Psychiatry, 54-5 (May 2013)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 54-5 (May 2013) . - p.582-590 Titre : Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation Type de document : Texte imprimé et/ou numérique Auteurs : Whitney GUTHRIE, Auteur ; Lauren B. SWINEFORD, Auteur ; Charly NOTTKE, Auteur ; Amy M. WETHERBY, Auteur Article en page(s) : p.582-590 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  developmental delay  diagnosis  development  assessment Index. décimale : PER Périodiques Résumé : Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most findings come from high-risk samples, but reports on children screened in community settings are also needed. Methods: Stability of diagnosis and Autism Diagnostic Observation Schedule – Toddler Module (ADOS-T) classifications and scores was examined across two time points in a sample of 82 children identified through the FIRST WORDS® Project. Children received two comprehensive diagnostic evaluations at average ages of 19.39 (SD = 2.12) and 36.89 (SD = 3.85) months. Results: Stability was 100% when confirming and ruling out a diagnosis of ASD based on a comprehensive diagnostic evaluation that included clinic and home observations, although diagnosis was initially deferred for 17% of the sample. Receiver Operating Characteristic curves revealed excellent sensitivity and acceptable specificity for the ADOS-T compared to concurrent diagnosis. Logistic regressions indicated good predictive value of initial ADOS-T scores for follow-up diagnosis. Finally, both ASD and Non-ASD children demonstrated a decrease in Social Affect scores (i.e., improvement), whereas children with ASD demonstrated an increase in Restricted and Repetitive Behavior scores (i.e., worsening), changes that were accounted for by nonverbal developmental level in mixed model analyses. Conclusions: Short-term stability was documented for children diagnosed at 19 months on average, although a minority of children initially showed unclear diagnostic presentations. Findings highlight utility of the ADOS-T in making early diagnoses and predicting follow-up diagnoses. Children with ASD demonstrated improvement in social communication behaviors and unfolding of repetitive behaviors, suggesting that certain early patterns of change in symptoms may be characteristic of ASD. En ligne : http://dx.doi.org/10.1111/jcpp.12008 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=196 [article] Early diagnosis of autism spectrum disorder: stability and change in clinical diagnosis and symptom presentation [Texte imprimé et/ou numérique] / Whitney GUTHRIE, Auteur ; Lauren B. SWINEFORD, Auteur ; Charly NOTTKE, Auteur ; Amy M. WETHERBY, Auteur . - p.582-590. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 54-5 (May 2013) . - p.582-590 Mots-clés : Autism spectrum disorder  developmental delay  diagnosis  development  assessment Index. décimale : PER Périodiques Résumé : Background: Although a diagnosis of autism spectrum disorder (ASD) appears to be stable in children as young as age three, few studies have explored stability of a diagnosis in younger children. Predictive value of diagnostic tools for toddlers and patterns of symptom change are important considerations for clinicians making early diagnoses. Most findings come from high-risk samples, but reports on children screened in community settings are also needed. Methods: Stability of diagnosis and Autism Diagnostic Observation Schedule – Toddler Module (ADOS-T) classifications and scores was examined across two time points in a sample of 82 children identified through the FIRST WORDS® Project. Children received two comprehensive diagnostic evaluations at average ages of 19.39 (SD = 2.12) and 36.89 (SD = 3.85) months. Results: Stability was 100% when confirming and ruling out a diagnosis of ASD based on a comprehensive diagnostic evaluation that included clinic and home observations, although diagnosis was initially deferred for 17% of the sample. Receiver Operating Characteristic curves revealed excellent sensitivity and acceptable specificity for the ADOS-T compared to concurrent diagnosis. Logistic regressions indicated good predictive value of initial ADOS-T scores for follow-up diagnosis. Finally, both ASD and Non-ASD children demonstrated a decrease in Social Affect scores (i.e., improvement), whereas children with ASD demonstrated an increase in Restricted and Repetitive Behavior scores (i.e., worsening), changes that were accounted for by nonverbal developmental level in mixed model analyses. Conclusions: Short-term stability was documented for children diagnosed at 19 months on average, although a minority of children initially showed unclear diagnostic presentations. Findings highlight utility of the ADOS-T in making early diagnoses and predicting follow-up diagnoses. Children with ASD demonstrated improvement in social communication behaviors and unfolding of repetitive behaviors, suggesting that certain early patterns of change in symptoms may be characteristic of ASD. En ligne : http://dx.doi.org/10.1111/jcpp.12008 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=196

Screening for autism spectrum disorder in a naturalistic home setting using the systematic observation of red flags (SORF) at 18-24 months / Deanna DOW in Autism Research, 13-1 (January 2020)  

Public ISBD [article]  inAutism Research > 13-1 (January 2020) . - p.122-133 Titre : Screening for autism spectrum disorder in a naturalistic home setting using the systematic observation of red flags (SORF) at 18-24 months Type de document : Texte imprimé et/ou numérique Auteurs : Deanna DOW, Auteur ; Taylor N. DAY, Auteur ; Timothy J. KUTTA, Auteur ; Charly NOTTKE, Auteur ; Amy M. WETHERBY, Auteur Article en page(s) : p.122-133 Langues : Anglais (eng) Mots-clés : early detection  early signs  psychometrics  red flags Index. décimale : PER Périodiques Résumé : The purpose of this study was to examine the utility of the Systematic Observation of Red Flags (SORF; Dow et al., 2016) as a level 2 screener for autism spectrum disorder (ASD) in toddlers during a naturalistic video-recorded home observation. Psychometric properties of the SORF were examined in a sample of 228 toddlers-84 with ASD, 82 with developmental delay (DD), and 62 with typical development (TD). Trained undergraduate research assistants blind to diagnosis rated 22 red flags (RF) of ASD associated with DSM-5 diagnostic criteria using a 4-point scale. The following scores were computed: a total score summing all items, domain scores summing social communication and restricted, repetitive behavior items, and number of RF counting items with scores of 2 or 3 indicating clear symptom presence. The performance of the total, domain, and RF scores and individual items were examined. A composite score was formed with six items with the best psychometric performance: poor eye gaze directed to faces, limited showing and pointing, limited coordination of nonverbal communication, less interest in people than objects, repetitive use of objects, and excessive interest in particular objects, actions, or activities. The 6-item composite provides a brief measure with optimal performance, while the RF may be instrumental for clinicians who are interested in characterizing the range of observed symptoms. The SORF shows promise as a practical alternative to currently available screening methods for implementation by nonexperts with the potential to increase feasibility and reduce common obstacles to access to care. Autism Res 2020, 13: 122-133. (c) The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: Research suggests that current autism spectrum disorder (ASD) screening tools are not accurate enough to use in routine screening. The Systematic Observation of Red Flags was developed as a practical option for children at high risk for ASD. It can be used with video-recorded samples of parent-child interactions in the home and by raters who are not experts in ASD. It shows promise in predicting ASD risk in toddlers to determine if a full diagnostic evaluation is necessary. En ligne : http://dx.doi.org/10.1002/aur.2226 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=415 [article] Screening for autism spectrum disorder in a naturalistic home setting using the systematic observation of red flags (SORF) at 18-24 months [Texte imprimé et/ou numérique] / Deanna DOW, Auteur ; Taylor N. DAY, Auteur ; Timothy J. KUTTA, Auteur ; Charly NOTTKE, Auteur ; Amy M. WETHERBY, Auteur . - p.122-133. Langues : Anglais (eng) in Autism Research > 13-1 (January 2020) . - p.122-133 Mots-clés : early detection  early signs  psychometrics  red flags Index. décimale : PER Périodiques Résumé : The purpose of this study was to examine the utility of the Systematic Observation of Red Flags (SORF; Dow et al., 2016) as a level 2 screener for autism spectrum disorder (ASD) in toddlers during a naturalistic video-recorded home observation. Psychometric properties of the SORF were examined in a sample of 228 toddlers-84 with ASD, 82 with developmental delay (DD), and 62 with typical development (TD). Trained undergraduate research assistants blind to diagnosis rated 22 red flags (RF) of ASD associated with DSM-5 diagnostic criteria using a 4-point scale. The following scores were computed: a total score summing all items, domain scores summing social communication and restricted, repetitive behavior items, and number of RF counting items with scores of 2 or 3 indicating clear symptom presence. The performance of the total, domain, and RF scores and individual items were examined. A composite score was formed with six items with the best psychometric performance: poor eye gaze directed to faces, limited showing and pointing, limited coordination of nonverbal communication, less interest in people than objects, repetitive use of objects, and excessive interest in particular objects, actions, or activities. The 6-item composite provides a brief measure with optimal performance, while the RF may be instrumental for clinicians who are interested in characterizing the range of observed symptoms. The SORF shows promise as a practical alternative to currently available screening methods for implementation by nonexperts with the potential to increase feasibility and reduce common obstacles to access to care. Autism Res 2020, 13: 122-133. (c) The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: Research suggests that current autism spectrum disorder (ASD) screening tools are not accurate enough to use in routine screening. The Systematic Observation of Red Flags was developed as a practical option for children at high risk for ASD. It can be used with video-recorded samples of parent-child interactions in the home and by raters who are not experts in ASD. It shows promise in predicting ASD risk in toddlers to determine if a full diagnostic evaluation is necessary. En ligne : http://dx.doi.org/10.1002/aur.2226 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=415

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