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 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] / 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

Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments / Andrea Trubanova WIECKOWSKI in Autism, 29-11 (November 2025)  

Public ISBD [article]  inAutism > 29-11 (November 2025) . - p.2898-2905 Titre : Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments Type de document : texte imprimé Auteurs : Andrea Trubanova WIECKOWSKI, Auteur ; Ashley DE MARCHENA, Auteur ; Alexia F DICKERSON, Auteur ; Erika FRICK, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley DUBIN, Auteur ; Diana L ROBINS, Auteur Article en page(s) : p.2898-2905 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  diagnosis  early detection  primary care diagnosis  telehealth  toddlers Index. décimale : PER Périodiques Résumé : Formal autism diagnosis is often critical for children to access early, autism-specific services and supports. However, barriers to traditional in-person evaluations, including long waitlists, delay diagnosis. The goal of the current study was to compare diagnostic impressions (i.e. clinical judgments) made by primary care clinicians and autism experts conducting brief telehealth sessions, with expert diagnosis from in-person gold-standard evaluations. Participants were toddlers (n = 32, age 12–36 months) referred for any developmental concerns by four primary care clinicians from one pediatric practice in the United States. Primary care clinicians indicated their diagnostic classification and families then completed telehealth evaluations and in-person evaluations with one of five autism diagnostic expert clinicians. When primary care clinicians classified a child as having definite autism (n = 11), they were 100% accurate, but only 57% accurate when they indicated a child definitely did not have autism. Experts providing classification after a telehealth evaluation accurately classified 72% of children and were confident in the diagnosis for 55% of cases. In high-confidence cases, telehealth diagnosis matched final diagnosis 88% of the time. These findings indicate that when primary care clinicians believe a toddler is autistic, or when autism experts indicate autism telehealth classification with confidence, the child should begin receiving autism-specific services and supports right away.Lay abstract There are long waitlists for autism evaluations, which greatly delay the start of interventions that are known to improve children’s outcomes. We tested the accuracy of primary care clinicians’ impressions of autism versus other developmental delays during well-child visits, and of experts during brief telemedicine visits, and found that more than half of the children were accurately identified through these streamlined methods. These findings support a tiered approach in which children identified through these more efficient methods begin autism intervention immediately; this approach also benefits children with more complex differentials by shortening waitlists for comprehensive evaluations for those who require them prior to treatment entry. En ligne : https://dx.doi.org/10.1177/13623613251355257 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments [texte imprimé] / Andrea Trubanova WIECKOWSKI, Auteur ; Ashley DE MARCHENA, Auteur ; Alexia F DICKERSON, Auteur ; Erika FRICK, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley DUBIN, Auteur ; Diana L ROBINS, Auteur . - p.2898-2905. Langues : Anglais (eng) in Autism > 29-11 (November 2025) . - p.2898-2905 Mots-clés : autism spectrum disorder  diagnosis  early detection  primary care diagnosis  telehealth  toddlers Index. décimale : PER Périodiques Résumé : Formal autism diagnosis is often critical for children to access early, autism-specific services and supports. However, barriers to traditional in-person evaluations, including long waitlists, delay diagnosis. The goal of the current study was to compare diagnostic impressions (i.e. clinical judgments) made by primary care clinicians and autism experts conducting brief telehealth sessions, with expert diagnosis from in-person gold-standard evaluations. Participants were toddlers (n = 32, age 12–36 months) referred for any developmental concerns by four primary care clinicians from one pediatric practice in the United States. Primary care clinicians indicated their diagnostic classification and families then completed telehealth evaluations and in-person evaluations with one of five autism diagnostic expert clinicians. When primary care clinicians classified a child as having definite autism (n = 11), they were 100% accurate, but only 57% accurate when they indicated a child definitely did not have autism. Experts providing classification after a telehealth evaluation accurately classified 72% of children and were confident in the diagnosis for 55% of cases. In high-confidence cases, telehealth diagnosis matched final diagnosis 88% of the time. These findings indicate that when primary care clinicians believe a toddler is autistic, or when autism experts indicate autism telehealth classification with confidence, the child should begin receiving autism-specific services and supports right away.Lay abstract There are long waitlists for autism evaluations, which greatly delay the start of interventions that are known to improve children’s outcomes. We tested the accuracy of primary care clinicians’ impressions of autism versus other developmental delays during well-child visits, and of experts during brief telemedicine visits, and found that more than half of the children were accurately identified through these streamlined methods. These findings support a tiered approach in which children identified through these more efficient methods begin autism intervention immediately; this approach also benefits children with more complex differentials by shortening waitlists for comprehensive evaluations for those who require them prior to treatment entry. En ligne : https://dx.doi.org/10.1177/13623613251355257 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

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 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] / 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 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] / 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 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] / 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)  

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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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