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

Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study / Andrea Trubanova WIECKOWSKI in Journal of Autism and Developmental Disorders, 50-1 (January 2020)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 50-1 (January 2020) . - p.30-41 Titre : Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study Type de document : Texte imprimé et/ou numérique Auteurs : Andrea Trubanova WIECKOWSKI, Auteur ; Susan W. WHITE, Auteur Article en page(s) : p.30-41 Langues : Anglais (eng) Mots-clés : Attention training  Autism spectrum disorder  Eye-tracking  Facial emotion recognition Index. décimale : PER Périodiques Résumé : Diminished attending to faces may contribute to the impairments in emotion recognition and expression in autism spectrum disorder (ASD). The current study evaluated the acceptability, feasibility, and preliminary efficacy of an attention modification intervention designed to attenuate deficits in facial emotion recognition (FER). During the 10-session experimental treatment, children (n = 8) with ASD watched dynamic videos of people expressing different emotions with the facial features highlighted to guide children's attention. Children and their parents generally rated the treatment as acceptable and helpful. Although FER improvement was not apparent on task-based measures, parents reported slight improvements and decreased socioemotional problems following treatment. Results suggest that further research on visual attention retraining for ASD, within an experimental therapeutic program, may be promising. En ligne : http://dx.doi.org/10.1007/s10803-019-04223-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414 [article] Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study [Texte imprimé et/ou numérique] / Andrea Trubanova WIECKOWSKI, Auteur ; Susan W. WHITE, Auteur . - p.30-41. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 50-1 (January 2020) . - p.30-41 Mots-clés : Attention training  Autism spectrum disorder  Eye-tracking  Facial emotion recognition Index. décimale : PER Périodiques Résumé : Diminished attending to faces may contribute to the impairments in emotion recognition and expression in autism spectrum disorder (ASD). The current study evaluated the acceptability, feasibility, and preliminary efficacy of an attention modification intervention designed to attenuate deficits in facial emotion recognition (FER). During the 10-session experimental treatment, children (n = 8) with ASD watched dynamic videos of people expressing different emotions with the facial features highlighted to guide children's attention. Children and their parents generally rated the treatment as acceptable and helpful. Although FER improvement was not apparent on task-based measures, parents reported slight improvements and decreased socioemotional problems following treatment. Results suggest that further research on visual attention retraining for ASD, within an experimental therapeutic program, may be promising. En ligne : http://dx.doi.org/10.1007/s10803-019-04223-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414

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 change in facial emotion recognition in individuals with autism spectrum disorder: A systematic review / Andrea Trubanova WIECKOWSKI in Autism, 24-7 (October 2020)  

Public ISBD [article]  inAutism > 24-7 (October 2020) . - p.1607-1628 Titre : Measuring change in facial emotion recognition in individuals with autism spectrum disorder: A systematic review Type de document : Texte imprimé et/ou numérique Auteurs : Andrea Trubanova WIECKOWSKI, Auteur ; L. Taylor FLYNN, Auteur ; J. Anthony RICHEY, Auteur ; Denis GRACANIN, Auteur ; Susan W. WHITE, Auteur Article en page(s) : p.1607-1628 Langues : Anglais (eng) Mots-clés : *autism spectrum disorder  *facial emotion recognition  *intervention  *measurement Index. décimale : PER Périodiques Résumé : Children and adults with autism spectrum disorder show difficulty recognizing facial emotions in others, which makes social interaction challenging. While there are many treatments developed to improve facial emotion recognition, there is no agreement on the best way to measure such abilities in individuals with autism spectrum disorder. The purpose of this review is to examine studies that were published between January 1998 and November 2019 and have measured change in facial emotion recognition to evaluate the effectiveness of different treatments. Our search yielded 65 studies, and within these studies, 36 different measures were used to evaluate facial emotion recognition in individuals with autism spectrum disorder. Only six of these measures, however, were used in different studies and by different investigators. In this review, we summarize the different measures and outcomes of the studies, in order to identify promising assessment tools and inform future research. En ligne : http://dx.doi.org/10.1177/1362361320925334 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=431 [article] Measuring change in facial emotion recognition in individuals with autism spectrum disorder: A systematic review [Texte imprimé et/ou numérique] / Andrea Trubanova WIECKOWSKI, Auteur ; L. Taylor FLYNN, Auteur ; J. Anthony RICHEY, Auteur ; Denis GRACANIN, Auteur ; Susan W. WHITE, Auteur . - p.1607-1628. Langues : Anglais (eng) in Autism > 24-7 (October 2020) . - p.1607-1628 Mots-clés : *autism spectrum disorder  *facial emotion recognition  *intervention  *measurement Index. décimale : PER Périodiques Résumé : Children and adults with autism spectrum disorder show difficulty recognizing facial emotions in others, which makes social interaction challenging. While there are many treatments developed to improve facial emotion recognition, there is no agreement on the best way to measure such abilities in individuals with autism spectrum disorder. The purpose of this review is to examine studies that were published between January 1998 and November 2019 and have measured change in facial emotion recognition to evaluate the effectiveness of different treatments. Our search yielded 65 studies, and within these studies, 36 different measures were used to evaluate facial emotion recognition in individuals with autism spectrum disorder. Only six of these measures, however, were used in different studies and by different investigators. In this review, we summarize the different measures and outcomes of the studies, in order to identify promising assessment tools and inform future research. En ligne : http://dx.doi.org/10.1177/1362361320925334 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=431

Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) / Sherief Y ELDEEB in Autism, 27-7 (October 2023)  

Public ISBD [article]  inAutism > 27-7 (October 2023) . - p.2112-2123 Titre : Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) Type de document : Texte imprimé et/ou numérique Auteurs : Sherief Y ELDEEB, Auteur ; Natasha N LUDWIG, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Mary FS DIECKHAUS, Auteur ; Yasemin Algur, Auteur ; Victoria RYAN, Auteur ; Sarah DUFEK, Auteur ; Aubyn STAHMER, Auteur ; Diana L ROBINS, Auteur Article en page(s) : p.2112-2123 Langues : Anglais (eng) Mots-clés : autism  screening  sex differences  toddler Index. décimale : PER Périodiques Résumé : Males are more likely to be diagnosed with autism than females, and at earlier ages, yet few studies examine sex differences in screening. This study explored sex differences in psychometric properties, recommended cutoff scores, and overall scores of the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up. Participants were 28,088 toddlers enrolled in four early detection of autism studies. Children (N=731) at high likelihood for autism attended evaluations after screening and/or primary care clinician concern. Females were less likely to screen at high likelihood for autism at each stage of screening and therefore less likely to be invited for evaluations. Positive predictive value was significantly lower among females than males, but sensitivity was similar. False positive females were likely to have another developmental delay. Cutoff scores for males and females matched recommended guidelines. Final scores on the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up did not differ between males and females diagnosed with autism, but did for the overall sample identified at high likelihood for autism. Our findings suggest that females are less likely to be referred for evaluations, but the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identifies both males and females with autism at established cutoffs. Future research should examine methods to reduce false positive in females.Lay abstractThis study examined a widely used autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up to identify differences in screening for autism between toddler males and females. Examining sex differences in screening for autism in toddlerhood is important as it determines who will be referred for evaluations and receive diagnoses, which is critical for access to autism-specific early intervention. This study found that females were less likely to screen positive and be invited for evaluations compared with males. Females at high likelihood for autism were less likely to be diagnosed with autism, which decreases confidence in the screener?s results. Importantly, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identified both males and females with autism. Future research should examine ways to improve accuracy in screening results for females. En ligne : http://dx.doi.org/10.1177/13623613231154728 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510 [article] Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) [Texte imprimé et/ou numérique] / Sherief Y ELDEEB, Auteur ; Natasha N LUDWIG, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Mary FS DIECKHAUS, Auteur ; Yasemin Algur, Auteur ; Victoria RYAN, Auteur ; Sarah DUFEK, Auteur ; Aubyn STAHMER, Auteur ; Diana L ROBINS, Auteur . - p.2112-2123. Langues : Anglais (eng) in Autism > 27-7 (October 2023) . - p.2112-2123 Mots-clés : autism  screening  sex differences  toddler Index. décimale : PER Périodiques Résumé : Males are more likely to be diagnosed with autism than females, and at earlier ages, yet few studies examine sex differences in screening. This study explored sex differences in psychometric properties, recommended cutoff scores, and overall scores of the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up. Participants were 28,088 toddlers enrolled in four early detection of autism studies. Children (N=731) at high likelihood for autism attended evaluations after screening and/or primary care clinician concern. Females were less likely to screen at high likelihood for autism at each stage of screening and therefore less likely to be invited for evaluations. Positive predictive value was significantly lower among females than males, but sensitivity was similar. False positive females were likely to have another developmental delay. Cutoff scores for males and females matched recommended guidelines. Final scores on the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up did not differ between males and females diagnosed with autism, but did for the overall sample identified at high likelihood for autism. Our findings suggest that females are less likely to be referred for evaluations, but the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identifies both males and females with autism at established cutoffs. Future research should examine methods to reduce false positive in females.Lay abstractThis study examined a widely used autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up to identify differences in screening for autism between toddler males and females. Examining sex differences in screening for autism in toddlerhood is important as it determines who will be referred for evaluations and receive diagnoses, which is critical for access to autism-specific early intervention. This study found that females were less likely to screen positive and be invited for evaluations compared with males. Females at high likelihood for autism were less likely to be diagnosed with autism, which decreases confidence in the screener?s results. Importantly, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up accurately identified both males and females with autism. Future research should examine ways to improve accuracy in screening results for females. En ligne : http://dx.doi.org/10.1177/13623613231154728 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510

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