Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions / Rebecca P. THOMAS in Autism Research, 17-3 (March 2024)  

Public ISBD [article]  inAutism Research > 17-3 (March 2024) . - p.568-583 Titre : Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca P. THOMAS, Auteur ; Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Aubyn STAHMER, Auteur ; Stephanie MILAN, Auteur ; Jeffrey D. BURKE, Auteur ; Marianne L. BARTON, Auteur ; Diana L. ROBINS, Auteur ; Deborah A. FEIN, Auteur Article en page(s) : p.568-583 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Clinicians form initial impressions about a child's diagnosis based on behavioral features, but research has not yet identified specific behaviors to guide initial diagnostic impressions. Participants were toddlers (N = 55, mean age 22.9?months) from a multi-site early detection study, referred for concern for ASD due to screening or parent/provider concern. Within 5?min of meeting a child, clinicians noted ASD or non-ASD impression, confidence in impression, and behaviors that informed their impression. These clinicians also determined final diagnoses for each child. When a child's final diagnosis was ASD (n = 35), senior clinicians formed an initial impression of ASD in 22 cases (63%) but missed 13 cases (37%). When final diagnosis was non-ASD (n = 20), senior clinicians made an initial impression of non-ASD in all cases (100%). Results were similar among junior clinicians. Senior and junior clinicians used the same behaviors to form accurate impressions of ASD and non-ASD: social reciprocity, nonverbal communication, and eye contact. Senior clinicians additionally used focus of attention when forming accurate impressions of ASD and non-ASD; junior clinicians used this behavior only when forming accurate non-ASD impressions. Clinicians' initial impressions of ASD are very likely to be consistent with final diagnoses, but initial impressions of non-ASD need follow-up. Toddlers who show all four atypical behaviors (social reciprocity, nonverbal communication, eye contact, and focus of attention) might receive expedited ASD diagnoses. However, presence of apparently typical behaviors should not rule out ASD; for some children a longer evaluation is necessary to allow for more opportunities to observe subtle social behavior. En ligne : https://doi.org/10.1002/aur.3088 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=525 [article] Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions [Texte imprimé et/ou numérique] / Rebecca P. THOMAS, Auteur ; Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Aubyn STAHMER, Auteur ; Stephanie MILAN, Auteur ; Jeffrey D. BURKE, Auteur ; Marianne L. BARTON, Auteur ; Diana L. ROBINS, Auteur ; Deborah A. FEIN, Auteur . - p.568-583. Langues : Anglais (eng) in Autism Research > 17-3 (March 2024) . - p.568-583 Index. décimale : PER Périodiques Résumé : Abstract Clinicians form initial impressions about a child's diagnosis based on behavioral features, but research has not yet identified specific behaviors to guide initial diagnostic impressions. Participants were toddlers (N = 55, mean age 22.9?months) from a multi-site early detection study, referred for concern for ASD due to screening or parent/provider concern. Within 5?min of meeting a child, clinicians noted ASD or non-ASD impression, confidence in impression, and behaviors that informed their impression. These clinicians also determined final diagnoses for each child. When a child's final diagnosis was ASD (n = 35), senior clinicians formed an initial impression of ASD in 22 cases (63%) but missed 13 cases (37%). When final diagnosis was non-ASD (n = 20), senior clinicians made an initial impression of non-ASD in all cases (100%). Results were similar among junior clinicians. Senior and junior clinicians used the same behaviors to form accurate impressions of ASD and non-ASD: social reciprocity, nonverbal communication, and eye contact. Senior clinicians additionally used focus of attention when forming accurate impressions of ASD and non-ASD; junior clinicians used this behavior only when forming accurate non-ASD impressions. Clinicians' initial impressions of ASD are very likely to be consistent with final diagnoses, but initial impressions of non-ASD need follow-up. Toddlers who show all four atypical behaviors (social reciprocity, nonverbal communication, eye contact, and focus of attention) might receive expedited ASD diagnoses. However, presence of apparently typical behaviors should not rule out ASD; for some children a longer evaluation is necessary to allow for more opportunities to observe subtle social behavior. En ligne : https://doi.org/10.1002/aur.3088 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=525

Development of a school-age extension of the Modified Checklist for Autism in Toddlers through expert consensus and stakeholder input / Georgina PEREZ LIZ ; Ashley DE MARCHENA ; Deborah A. FEIN ; Marianne L. BARTON ; Giacomo VIVANTI ; Diana L. ROBINS in Autism, 28-12 (December 2024)  

Public ISBD [article]  inAutism > 28-12 (December 2024) . - p.3033-3042 Titre : Development of a school-age extension of the Modified Checklist for Autism in Toddlers through expert consensus and stakeholder input Type de document : Texte imprimé et/ou numérique Auteurs : Georgina PEREZ LIZ, Auteur ; Ashley DE MARCHENA, Auteur ; Deborah A. FEIN, Auteur ; Marianne L. BARTON, Auteur ; Giacomo VIVANTI, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.3033-3042 Langues : Anglais (eng) Mots-clés : autism screening  Delphi poll  measure development  school-age Index. décimale : PER Périodiques Résumé : Universal autism screening is recommended by the American Academy of Pediatrics at 18 and 24?months. However, many children are not identified until after the age of 4?years, and some not until adulthood, either due to mild or no indication of symptoms early in development, or to co-occurring conditions which may overshadow autism symptoms. This indicates a need for universal autism screening measures for school-age children. This project adapts the widely used toddler autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), for use in school-age children, called M-CHAT-School (M-CHAT-S). The study follows the Patient-Reported Outcomes Measurement Information System guidelines for measure development to create parent- and teacher-report versions of the M-CHAT-S for 4- to 8-year-old children. Through expert consensus feedback via a Delphi pool and cognitive interviewing with stakeholders (i.e. parents and teachers), we developed two versions of the M-CHAT-S to be used for verbal and minimally verbal children. The M-CHAT-S poses several advantages to existing measures, including brevity, items updated based on current knowledge and conventions, and narrow age range to assure items are developmentally appropriate. Future steps include validation of the M-CHAT-S to determine its utility as an autism screener for young school-age children. Lay abstract The American Academy of Pediatrics recommends universal screening to identify children at higher likelihood for autism at 18- and 24-month well-child visits. There are many children, however, that are missed during this toddler age who do not get diagnosed until much later in development, delaying access to autism-specific interventions. Currently, brief measures for universal autism screening for school-age children, however, are lacking. In this project, we adapted a commonly used autism screener for toddlers, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), to be used for school-age children. This measure, called the M-CHAT-School (M-CHAT-S), is a parent- and teacher-report questionnaire to be used to screen for autism in school-age children aged 4 to 8?years of age. M-CHAT-S was developed through feedback from autism experts, as well as interviews with parents and teachers to provide input on the items. Two versions of M-CHAT-S were developed, one for verbally fluent and one for minimally verbal school-age children. M-CHAT-S is a brief measure, with updated items to reflect changes in the way experts think and talk about autism, making it a useful measure to use for autism screening in elementary aged children. The next steps include further testing to ensure that M-CHAT-S performs well in identifying children with increased likelihood of autism, after which it will be made available to parents, educators, and other professionals. En ligne : https://dx.doi.org/10.1177/13623613241252312 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=543 [article] Development of a school-age extension of the Modified Checklist for Autism in Toddlers through expert consensus and stakeholder input [Texte imprimé et/ou numérique] / Georgina PEREZ LIZ, Auteur ; Ashley DE MARCHENA, Auteur ; Deborah A. FEIN, Auteur ; Marianne L. BARTON, Auteur ; Giacomo VIVANTI, Auteur ; Diana L. ROBINS, Auteur . - p.3033-3042. Langues : Anglais (eng) in Autism > 28-12 (December 2024) . - p.3033-3042 Mots-clés : autism screening  Delphi poll  measure development  school-age Index. décimale : PER Périodiques Résumé : Universal autism screening is recommended by the American Academy of Pediatrics at 18 and 24?months. However, many children are not identified until after the age of 4?years, and some not until adulthood, either due to mild or no indication of symptoms early in development, or to co-occurring conditions which may overshadow autism symptoms. This indicates a need for universal autism screening measures for school-age children. This project adapts the widely used toddler autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), for use in school-age children, called M-CHAT-School (M-CHAT-S). The study follows the Patient-Reported Outcomes Measurement Information System guidelines for measure development to create parent- and teacher-report versions of the M-CHAT-S for 4- to 8-year-old children. Through expert consensus feedback via a Delphi pool and cognitive interviewing with stakeholders (i.e. parents and teachers), we developed two versions of the M-CHAT-S to be used for verbal and minimally verbal children. The M-CHAT-S poses several advantages to existing measures, including brevity, items updated based on current knowledge and conventions, and narrow age range to assure items are developmentally appropriate. Future steps include validation of the M-CHAT-S to determine its utility as an autism screener for young school-age children. Lay abstract The American Academy of Pediatrics recommends universal screening to identify children at higher likelihood for autism at 18- and 24-month well-child visits. There are many children, however, that are missed during this toddler age who do not get diagnosed until much later in development, delaying access to autism-specific interventions. Currently, brief measures for universal autism screening for school-age children, however, are lacking. In this project, we adapted a commonly used autism screener for toddlers, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), to be used for school-age children. This measure, called the M-CHAT-School (M-CHAT-S), is a parent- and teacher-report questionnaire to be used to screen for autism in school-age children aged 4 to 8?years of age. M-CHAT-S was developed through feedback from autism experts, as well as interviews with parents and teachers to provide input on the items. Two versions of M-CHAT-S were developed, one for verbally fluent and one for minimally verbal school-age children. M-CHAT-S is a brief measure, with updated items to reflect changes in the way experts think and talk about autism, making it a useful measure to use for autism screening in elementary aged children. The next steps include further testing to ensure that M-CHAT-S performs well in identifying children with increased likelihood of autism, after which it will be made available to parents, educators, and other professionals. En ligne : https://dx.doi.org/10.1177/13623613241252312 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=543

Evaluation of the ADHD Rating Scale in Youth with Autism / Benjamin E. YERYS in Journal of Autism and Developmental Disorders, 47-1 (January 2017)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 47-1 (January 2017) . - p.90-100 Titre : Evaluation of the ADHD Rating Scale in Youth with Autism Type de document : Texte imprimé et/ou numérique Auteurs : Benjamin E. YERYS, Auteur ; Jenelle NISSLEY-TSIOPINIS, Auteur ; Ashley DE MARCHENA, Auteur ; Marley W. WATKINS, Auteur ; Ligia ANTEZANA, Auteur ; Thomas J. POWER, Auteur ; Robert T. SCHULTZ, Auteur Article en page(s) : p.90-100 Langues : Anglais (eng) Mots-clés : Autism  Attention deficit/hyperactivity disorder  Comorbidity  Screening  Factor analysis Index. décimale : PER Périodiques Résumé : Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition (ADHD-RS-IV), the relationship of ADHD-RS-IV ratings with participant characteristics and behaviors, and its underlying factor structure in 386, 7–17 year olds with ASD without intellectual disability. Expected parent prevalence rates, relationships with age and externalizing behaviors were observed, but confirmatory factor analyses revealed unsatisfactory fits for one-, two-, three-factor models. Exploratory analyses revealed several items cross-loading on multiple factors. Implications of screening ADHD in youth with ASD using current diagnostic criteria are discussed. En ligne : http://dx.doi.org/10.1007/s10803-016-2933-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=298 [article] Evaluation of the ADHD Rating Scale in Youth with Autism [Texte imprimé et/ou numérique] / Benjamin E. YERYS, Auteur ; Jenelle NISSLEY-TSIOPINIS, Auteur ; Ashley DE MARCHENA, Auteur ; Marley W. WATKINS, Auteur ; Ligia ANTEZANA, Auteur ; Thomas J. POWER, Auteur ; Robert T. SCHULTZ, Auteur . - p.90-100. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 47-1 (January 2017) . - p.90-100 Mots-clés : Autism  Attention deficit/hyperactivity disorder  Comorbidity  Screening  Factor analysis Index. décimale : PER Périodiques Résumé : Scientists and clinicians regularly use clinical screening tools for attention deficit/hyperactivity disorder (ADHD) to assess comorbidity without empirical evidence that these measures are valid in youth with autism spectrum disorder (ASD). We examined the prevalence of youth meeting ADHD criteria on the ADHD rating scale fourth edition (ADHD-RS-IV), the relationship of ADHD-RS-IV ratings with participant characteristics and behaviors, and its underlying factor structure in 386, 7–17 year olds with ASD without intellectual disability. Expected parent prevalence rates, relationships with age and externalizing behaviors were observed, but confirmatory factor analyses revealed unsatisfactory fits for one-, two-, three-factor models. Exploratory analyses revealed several items cross-loading on multiple factors. Implications of screening ADHD in youth with ASD using current diagnostic criteria are discussed. En ligne : http://dx.doi.org/10.1007/s10803-016-2933-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=298

“Frank” presentations as a novel research construct and element of diagnostic decision-making in autism spectrum disorder / Ashley DE MARCHENA in Autism Research, 10-4 (April 2017)  

Public ISBD [article]  inAutism Research > 10-4 (April 2017) . - p.653-662 Titre : “Frank” presentations as a novel research construct and element of diagnostic decision-making in autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Ashley DE MARCHENA, Auteur ; Judith MILLER, Auteur Article en page(s) : p.653-662 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  diagnostic decision-making  behavioral phenotype Index. décimale : PER Périodiques Résumé : Many individuals with ASD have a distinctive behavioral presentation that is recognizable within moments, a phenomenon we call “frank” ASD. This phenomenon has been discussed informally for decades, perhaps as “classic” ASD; however, there is no unitary “classic” presentation, and classic autism does not seem to correspond to level of functioning. Thus, neither “frank” nor “classic” autism has been delineated or studied as a research construct. To initiate the empirical study of frank ASD, we surveyed 151 clinicians, from a range of disciplines that diagnose ASD, about this phenomenon. Respondents completed a 13-item questionnaire about frank ASD, which was analyzed using a mixed-methods approach. Ninety-seven percentage of respondents were familiar with the phenomenon. Respondents estimated that 40% of the ASD population has a frank presentation. Respondents reported the most highly specific behaviors associated with frank presentations were a general sense of impaired reciprocity, quality of eye contact, atypical vocal prosody, presence of motor mannerisms, and atypical gait or posture. In general, respondents reported detecting frank features rapidly, with the majority forming their impressions within the first ten minutes of interaction or observation. Although unstudied empirically, “frank” presentations of ASD are familiar to diagnosing clinicians, and appear to be based on behaviors both central to ASD diagnostic criteria (e.g., impaired reciprocity), and absent from diagnostic criteria (e.g., atypical gait or posture). We discuss these findings within the context of diagnostic decision-making and behavioral phenotyping of ASD. En ligne : http://dx.doi.org/10.1002/aur.1706 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=307 [article] “Frank” presentations as a novel research construct and element of diagnostic decision-making in autism spectrum disorder [Texte imprimé et/ou numérique] / Ashley DE MARCHENA, Auteur ; Judith MILLER, Auteur . - p.653-662. Langues : Anglais (eng) in Autism Research > 10-4 (April 2017) . - p.653-662 Mots-clés : autism spectrum disorder  diagnostic decision-making  behavioral phenotype Index. décimale : PER Périodiques Résumé : Many individuals with ASD have a distinctive behavioral presentation that is recognizable within moments, a phenomenon we call “frank” ASD. This phenomenon has been discussed informally for decades, perhaps as “classic” ASD; however, there is no unitary “classic” presentation, and classic autism does not seem to correspond to level of functioning. Thus, neither “frank” nor “classic” autism has been delineated or studied as a research construct. To initiate the empirical study of frank ASD, we surveyed 151 clinicians, from a range of disciplines that diagnose ASD, about this phenomenon. Respondents completed a 13-item questionnaire about frank ASD, which was analyzed using a mixed-methods approach. Ninety-seven percentage of respondents were familiar with the phenomenon. Respondents estimated that 40% of the ASD population has a frank presentation. Respondents reported the most highly specific behaviors associated with frank presentations were a general sense of impaired reciprocity, quality of eye contact, atypical vocal prosody, presence of motor mannerisms, and atypical gait or posture. In general, respondents reported detecting frank features rapidly, with the majority forming their impressions within the first ten minutes of interaction or observation. Although unstudied empirically, “frank” presentations of ASD are familiar to diagnosing clinicians, and appear to be based on behaviors both central to ASD diagnostic criteria (e.g., impaired reciprocity), and absent from diagnostic criteria (e.g., atypical gait or posture). We discuss these findings within the context of diagnostic decision-making and behavioral phenotyping of ASD. En ligne : http://dx.doi.org/10.1002/aur.1706 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=307

Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity / Ashley DE MARCHENA in Autism Research, 16-6 (June 2023)  

Public ISBD [article]  inAutism Research > 16-6 (June 2023) . - p.1138-1144 Titre : Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity Type de document : Texte imprimé et/ou numérique Auteurs : Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Yasemin Algur, Auteur ; Lashae N. Williams, Auteur ; Sherira Fernandes, Auteur ; Rebecca P. THOMAS, Auteur ; Leslie A. McClure, Auteur ; Sarah DUFEK, Auteur ; Deborah FEIN, Auteur ; Aubyn C. STAHMER, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.1138-1144 Langues : Anglais (eng) Mots-clés : autism  diagnosis  diagnostic confidence  early detection  initial impression  toddlers Index. décimale : PER Périodiques Résumé : Abstract Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current ?waitlist crisis? for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12?53?months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n?=?29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result. En ligne : https://doi.org/10.1002/aur.2933 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507 [article] Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity [Texte imprimé et/ou numérique] / Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Yasemin Algur, Auteur ; Lashae N. Williams, Auteur ; Sherira Fernandes, Auteur ; Rebecca P. THOMAS, Auteur ; Leslie A. McClure, Auteur ; Sarah DUFEK, Auteur ; Deborah FEIN, Auteur ; Aubyn C. STAHMER, Auteur ; Diana L. ROBINS, Auteur . - p.1138-1144. Langues : Anglais (eng) in Autism Research > 16-6 (June 2023) . - p.1138-1144 Mots-clés : autism  diagnosis  diagnostic confidence  early detection  initial impression  toddlers Index. décimale : PER Périodiques Résumé : Abstract Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current ?waitlist crisis? for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12?53?months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n?=?29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result. En ligne : https://doi.org/10.1002/aur.2933 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507

Measuring dyspraxia in autism using a five-minute praxis exam / Ashley DE MARCHENA in Research in Autism Spectrum Disorders, 106 (August 2023)  

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Methods to reduce fraudulent participation and highlight autistic voices in research / Meghan E CAREY in Autism, 29-4 (April 2025)  

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Sex differences in the first impressions made by girls and boys with autism / Meredith L. COLA in Molecular Autism, 11 (2020)  

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