Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting / Rebecca MCNALLY KEEHN in Autism, 29-4 (April 2025)  

Public ISBD [article]  inAutism > 29-4 (April 2025) . - p.945-957 Titre : Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting Type de document : texte imprimé Auteurs : Rebecca MCNALLY KEEHN, Auteur ; Noha F. MINSHAWI, Auteur ; Qing TANG, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Ann Marie MARTIN, Auteur ; Angela PAXTON, Auteur ; Patrick O. MONAHAN, Auteur ; Mary CICCARELLI, Auteur ; Brandon KEEHN, Auteur Article en page(s) : p.945-957 Langues : Anglais (eng) Mots-clés : autism  diagnosis  primary care Index. décimale : PER Périodiques Résumé : Feasible and accurate assessment tools developed for non-specialists are needed to scale community-based models of autism evaluation. The purpose of this study was to evaluate use of the Screening Tool for Autism in Toddlers and Young Children (STAT) when used by primary care practitioners (n = 10) across a statewide system of early diagnosis set within seven United States primary care practices. Specifically, for 130, 14- to 48-month-old children, we examined (1) agreement between STAT classification and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) outcome and expert diagnosis of autism, (2) characteristics of children with inaccurate STAT classifications, (3) consistency between STAT classification and primary care practitioner diagnosis, and (4) the relationship between STAT/primary care practitioner classification and expert diagnosis. The STAT demonstrated good concurrent validity with the ADOS-2 (77% agreement). Concordance between specialty trained primary care practitioners with expert diagnosis was 80%-87% across three age-based subgroups of children. Children misclassified by the STAT were older, had higher developmental and adaptive skills, and lower autism symptoms. Primary care practitioner diagnosis aligned with STAT categorical risk classification in 86% of cases, and 73% of consistent classifications between STAT and primary care practitioner diagnosis matched expert diagnosis. Overall, the STAT demonstrates good accuracy when used by non-specialists as part of a diagnostic evaluation.Lay summary Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation. En ligne : https://dx.doi.org/10.1177/13623613241292850 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=552 [article] Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting [texte imprimé] / Rebecca MCNALLY KEEHN, Auteur ; Noha F. MINSHAWI, Auteur ; Qing TANG, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Ann Marie MARTIN, Auteur ; Angela PAXTON, Auteur ; Patrick O. MONAHAN, Auteur ; Mary CICCARELLI, Auteur ; Brandon KEEHN, Auteur . - p.945-957. Langues : Anglais (eng) in Autism > 29-4 (April 2025) . - p.945-957 Mots-clés : autism  diagnosis  primary care Index. décimale : PER Périodiques Résumé : Feasible and accurate assessment tools developed for non-specialists are needed to scale community-based models of autism evaluation. The purpose of this study was to evaluate use of the Screening Tool for Autism in Toddlers and Young Children (STAT) when used by primary care practitioners (n = 10) across a statewide system of early diagnosis set within seven United States primary care practices. Specifically, for 130, 14- to 48-month-old children, we examined (1) agreement between STAT classification and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) outcome and expert diagnosis of autism, (2) characteristics of children with inaccurate STAT classifications, (3) consistency between STAT classification and primary care practitioner diagnosis, and (4) the relationship between STAT/primary care practitioner classification and expert diagnosis. The STAT demonstrated good concurrent validity with the ADOS-2 (77% agreement). Concordance between specialty trained primary care practitioners with expert diagnosis was 80%-87% across three age-based subgroups of children. Children misclassified by the STAT were older, had higher developmental and adaptive skills, and lower autism symptoms. Primary care practitioner diagnosis aligned with STAT categorical risk classification in 86% of cases, and 73% of consistent classifications between STAT and primary care practitioner diagnosis matched expert diagnosis. Overall, the STAT demonstrates good accuracy when used by non-specialists as part of a diagnostic evaluation.Lay summary Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation. En ligne : https://dx.doi.org/10.1177/13623613241292850 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=552

Associations between sensory processing and electrophysiological and neurochemical measures in children with ASD: an EEG-MRS study / Sarah PIERCE in Journal of Neurodevelopmental Disorders, 13 (2021)  

Public ISBD [article]  inJournal of Neurodevelopmental Disorders > 13 (2021) Titre : Associations between sensory processing and electrophysiological and neurochemical measures in children with ASD: an EEG-MRS study Type de document : texte imprimé Auteurs : Sarah PIERCE, Auteur ; Girija KADLASKAR, Auteur ; David A. EDMONDSON, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Ulrike DYDAK, Auteur ; Brandon KEEHN, Auteur Langues : Anglais (eng) Mots-clés : Adolescent  Autism Spectrum Disorder/diagnostic imaging  Child  Electroencephalography  Female  Humans  Magnetic Resonance Imaging  Magnetic Resonance Spectroscopy  Male  Perception  Alpha power  Autism spectrum disorder  Eeg  Gaba  Glutamate  Mrs  Sensory processing Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism spectrum disorder (ASD) is associated with hyper- and/or hypo-sensitivity to sensory input. Spontaneous alpha power, which plays an important role in shaping responsivity to sensory information, is reduced across the lifespan in individuals with ASD. Furthermore, an excitatory/inhibitory imbalance has also been linked to sensory dysfunction in ASD and has been hypothesized to underlie atypical patterns of spontaneous brain activity. The present study examined whether resting-state alpha power differed in children with ASD as compared to TD children, and investigated the relationships between alpha levels, concentrations of excitatory and inhibitory neurotransmitters, and atypical sensory processing in ASD. METHODS: Participants included thirty-one children and adolescents with ASD and thirty-one age- and IQ-matched typically developing (TD) participants. Resting-state electroencephalography (EEG) was used to obtain measures of alpha power. A subset of participants (ASD = 16; TD = 16) also completed a magnetic resonance spectroscopy (MRS) protocol in order to measure concentrations of excitatory (glutamate + glutamine; Glx) and inhibitory (GABA) neurotransmitters. RESULTS: Children with ASD evidenced significantly decreased resting alpha power compared to their TD peers. MRS estimates of GABA and Glx did not differ between groups with the exception of Glx in the temporal-parietal junction. Inter-individual differences in alpha power within the ASD group were not associated with region-specific concentrations of GABA or Glx, nor were they associated with sensory processing differences. However, atypically decreased Glx was associated with increased sensory impairment in children with ASD. CONCLUSIONS: Although we replicated prior reports of decreased alpha power in ASD, atypically reduced alpha was not related to neurochemical differences or sensory symptoms in ASD. Instead, reduced Glx in the temporal-parietal cortex was associated with greater hyper-sensitivity in ASD. Together, these findings may provide insight into the neural underpinnings of sensory processing differences present in ASD. En ligne : https://dx.doi.org/10.1186/s11689-020-09351-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=573 [article] Associations between sensory processing and electrophysiological and neurochemical measures in children with ASD: an EEG-MRS study [texte imprimé] / Sarah PIERCE, Auteur ; Girija KADLASKAR, Auteur ; David A. EDMONDSON, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Ulrike DYDAK, Auteur ; Brandon KEEHN, Auteur. Langues : Anglais (eng) in Journal of Neurodevelopmental Disorders > 13 (2021) Mots-clés : Adolescent  Autism Spectrum Disorder/diagnostic imaging  Child  Electroencephalography  Female  Humans  Magnetic Resonance Imaging  Magnetic Resonance Spectroscopy  Male  Perception  Alpha power  Autism spectrum disorder  Eeg  Gaba  Glutamate  Mrs  Sensory processing Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism spectrum disorder (ASD) is associated with hyper- and/or hypo-sensitivity to sensory input. Spontaneous alpha power, which plays an important role in shaping responsivity to sensory information, is reduced across the lifespan in individuals with ASD. Furthermore, an excitatory/inhibitory imbalance has also been linked to sensory dysfunction in ASD and has been hypothesized to underlie atypical patterns of spontaneous brain activity. The present study examined whether resting-state alpha power differed in children with ASD as compared to TD children, and investigated the relationships between alpha levels, concentrations of excitatory and inhibitory neurotransmitters, and atypical sensory processing in ASD. METHODS: Participants included thirty-one children and adolescents with ASD and thirty-one age- and IQ-matched typically developing (TD) participants. Resting-state electroencephalography (EEG) was used to obtain measures of alpha power. A subset of participants (ASD = 16; TD = 16) also completed a magnetic resonance spectroscopy (MRS) protocol in order to measure concentrations of excitatory (glutamate + glutamine; Glx) and inhibitory (GABA) neurotransmitters. RESULTS: Children with ASD evidenced significantly decreased resting alpha power compared to their TD peers. MRS estimates of GABA and Glx did not differ between groups with the exception of Glx in the temporal-parietal junction. Inter-individual differences in alpha power within the ASD group were not associated with region-specific concentrations of GABA or Glx, nor were they associated with sensory processing differences. However, atypically decreased Glx was associated with increased sensory impairment in children with ASD. CONCLUSIONS: Although we replicated prior reports of decreased alpha power in ASD, atypically reduced alpha was not related to neurochemical differences or sensory symptoms in ASD. Instead, reduced Glx in the temporal-parietal cortex was associated with greater hyper-sensitivity in ASD. Together, these findings may provide insight into the neural underpinnings of sensory processing differences present in ASD. En ligne : https://dx.doi.org/10.1186/s11689-020-09351-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=573

Auditory Attentional Disengagement in Children with Autism Spectrum Disorder / Brandon KEEHN in Journal of Autism and Developmental Disorders, 49-10 (October 2019)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 49-10 (October 2019) . - p.3999-4008 Titre : Auditory Attentional Disengagement in Children with Autism Spectrum Disorder Type de document : texte imprimé Auteurs : Brandon KEEHN, Auteur ; Girija KADLASKAR, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Alexander L. FRANCIS, Auteur Article en page(s) : p.3999-4008 Langues : Anglais (eng) Mots-clés : Attention  Auditory  Autism spectrum disorder  Disengagement  Eog  Eye movements Index. décimale : PER Périodiques Résumé : Despite early differences in orienting to sounds, no study to date has investigated whether children with ASD demonstrate impairments in attentional disengagement in the auditory modality. Twenty-one 9-15-year-old children with ASD and 20 age- and IQ-matched TD children were presented with an auditory gap-overlap paradigm. Evidence of impaired disengagement in ASD was mixed. Differences in saccadic reaction time for overlap and gap conditions did not differ between groups. However, children with ASD did show increased no-shift trials in the overlap condition, as well as reduced disengagement efficiency compared to their TD peers. These results provide further support for disengagement impairments in ASD, and suggest that these deficits include disengaging from and shifting to unimodal auditory information. En ligne : http://dx.doi.org/10.1007/s10803-019-04111-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406 [article] Auditory Attentional Disengagement in Children with Autism Spectrum Disorder [texte imprimé] / Brandon KEEHN, Auteur ; Girija KADLASKAR, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Alexander L. FRANCIS, Auteur . - p.3999-4008. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 49-10 (October 2019) . - p.3999-4008 Mots-clés : Attention  Auditory  Autism spectrum disorder  Disengagement  Eog  Eye movements Index. décimale : PER Périodiques Résumé : Despite early differences in orienting to sounds, no study to date has investigated whether children with ASD demonstrate impairments in attentional disengagement in the auditory modality. Twenty-one 9-15-year-old children with ASD and 20 age- and IQ-matched TD children were presented with an auditory gap-overlap paradigm. Evidence of impaired disengagement in ASD was mixed. Differences in saccadic reaction time for overlap and gap conditions did not differ between groups. However, children with ASD did show increased no-shift trials in the overlap condition, as well as reduced disengagement efficiency compared to their TD peers. These results provide further support for disengagement impairments in ASD, and suggest that these deficits include disengaging from and shifting to unimodal auditory information. En ligne : http://dx.doi.org/10.1007/s10803-019-04111-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=406

Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder / Catharine LORY in Journal of Autism and Developmental Disorders, 50-11 (November 2020)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 50-11 (November 2020) . - p.4183-4190 Titre : Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder Type de document : texte imprimé Auteurs : Catharine LORY, Auteur ; Girija KADLASKAR, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Alexander L. FRANCIS, Auteur ; Brandon KEEHN, Auteur Article en page(s) : p.4183-4190 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Autonomic arousal  Ecg  Heart rate variability Index. décimale : PER Périodiques Résumé : Dysregulation of the autonomic nervous system (ANS), which can be indexed by heart rate variability (HRV), has been posited to contribute to core features of autism spectrum disorder (ASD). However, the relationship between ASD and HRV remains uncertain. We assessed tonic and phasic HRV of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children and examined (1) group differences in HRV and (2) associations between HRV and ASD symptomatology. Children with ASD showed significantly lower tonic HRV, but similar phasic HRV compared to TD children. Additionally, reduced tonic HRV was associated with atypical attentional responsivity in ASD. Our findings suggest ANS dysregulation is present in ASD and may contribute to atypical attentional responses to sensory stimulation. En ligne : http://dx.doi.org/10.1007/s10803-020-04458-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432 [article] Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder [texte imprimé] / Catharine LORY, Auteur ; Girija KADLASKAR, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Alexander L. FRANCIS, Auteur ; Brandon KEEHN, Auteur . - p.4183-4190. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 50-11 (November 2020) . - p.4183-4190 Mots-clés : Autism spectrum disorder  Autonomic arousal  Ecg  Heart rate variability Index. décimale : PER Périodiques Résumé : Dysregulation of the autonomic nervous system (ANS), which can be indexed by heart rate variability (HRV), has been posited to contribute to core features of autism spectrum disorder (ASD). However, the relationship between ASD and HRV remains uncertain. We assessed tonic and phasic HRV of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children and examined (1) group differences in HRV and (2) associations between HRV and ASD symptomatology. Children with ASD showed significantly lower tonic HRV, but similar phasic HRV compared to TD children. Additionally, reduced tonic HRV was associated with atypical attentional responsivity in ASD. Our findings suggest ANS dysregulation is present in ASD and may contribute to atypical attentional responses to sensory stimulation. En ligne : http://dx.doi.org/10.1007/s10803-020-04458-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432

Brief report: Service referral and enrollment following autism diagnosis in primary care / Sarah LANGDON ; Angela PAXTON ; Rebecca MCNALLY KEEHN ; Brandon KEEHN in Research in Autism, 123 (May 2025)  

Public ISBD [article]  inResearch in Autism > 123 (May 2025) . - 202575 Titre : Brief report: Service referral and enrollment following autism diagnosis in primary care Type de document : texte imprimé Auteurs : Sarah LANGDON, Auteur ; Angela PAXTON, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Brandon KEEHN, Auteur Article en page(s) : 202575 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Early intensive behavior intervention  Waitlist  Time lag  Disparities Index. décimale : PER Périodiques Résumé : Background Lag between autism diagnostic evaluation and initiation of intervention results in missed opportunities during a developmental window of optimal impact. However, few studies have examined the rate of referral for early intensive behavioral interventions (EIBI) at the point of diagnosis and the period between diagnosis and entry into EIBI. The current study examines both referral for EIBI at the time of diagnosis and enrollment in EIBI 12-months post-diagnosis. Method Participants included 76, 14- to 48-month-old children diagnosed with autism in the primary care setting. Caregivers completed a brief questionnaire on EIBI referral and enrollment following evaluation and again 12-months later. Results More than 80 % of children were referred for EIBI at the time of diagnosis. At 12-months post-diagnosis, however, only 50 % of children were enrolled in EIBI. For those enrolled in EIBI lag between diagnosis and enrollment was almost 7 months (M = 201 days; SD = 122.7; range = 8-414 days). While race/ethnicity, SES, and urbanicity were not associated with lag, lower caregiver education level was associated with enrollment status and lag for those receiving EIBI. Conclusions There is a significant delay access to EIBI for young children diagnosed with autism. Navigating service referral and access may be particularly challenging for caregivers with limited education backgrounds. En ligne : https://doi.org/10.1016/j.reia.2025.202575 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=556 [article] Brief report: Service referral and enrollment following autism diagnosis in primary care [texte imprimé] / Sarah LANGDON, Auteur ; Angela PAXTON, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Brandon KEEHN, Auteur . - 202575. Langues : Anglais (eng) in Research in Autism > 123 (May 2025) . - 202575 Mots-clés : Autism spectrum disorder  Early intensive behavior intervention  Waitlist  Time lag  Disparities Index. décimale : PER Périodiques Résumé : Background Lag between autism diagnostic evaluation and initiation of intervention results in missed opportunities during a developmental window of optimal impact. However, few studies have examined the rate of referral for early intensive behavioral interventions (EIBI) at the point of diagnosis and the period between diagnosis and entry into EIBI. The current study examines both referral for EIBI at the time of diagnosis and enrollment in EIBI 12-months post-diagnosis. Method Participants included 76, 14- to 48-month-old children diagnosed with autism in the primary care setting. Caregivers completed a brief questionnaire on EIBI referral and enrollment following evaluation and again 12-months later. Results More than 80 % of children were referred for EIBI at the time of diagnosis. At 12-months post-diagnosis, however, only 50 % of children were enrolled in EIBI. For those enrolled in EIBI lag between diagnosis and enrollment was almost 7 months (M = 201 days; SD = 122.7; range = 8-414 days). While race/ethnicity, SES, and urbanicity were not associated with lag, lower caregiver education level was associated with enrollment status and lag for those receiving EIBI. Conclusions There is a significant delay access to EIBI for young children diagnosed with autism. Navigating service referral and access may be particularly challenging for caregivers with limited education backgrounds. En ligne : https://doi.org/10.1016/j.reia.2025.202575 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=556

Case Report: Autism Risk Within the Context of Two Chromosome 15 Syndromes / Ashleigh M. KELLERMAN in Journal of Autism and Developmental Disorders, 53-1 (January 2023)  

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Development of the Interdisciplinary Treatment Team / Christine M. RACHES

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Interdisciplinary Diagnostic Evaluations / Brett ENNEKING

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A Magnetic Resonance Spectroscopy Study of Superior Visual Search Abilities in Children with Autism Spectrum Disorder / David A. EDMONDSON in Autism Research, 13-4 (April 2020)  

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Measures of tonic and phasic activity of the locus coeruleus-norepinephrine system in children with autism spectrum disorder: An event-related potential and pupillometry study / Yesol KIM in Autism Research, 15-12 (December 2022)  

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Provider and Caregiver Satisfaction with Telehealth Evaluation of Autism Spectrum Disorder in Young Children During the COVID-19 Pandemic / Debra L. REISINGER in Journal of Autism and Developmental Disorders, 52-12 (December 2022)  

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Tele-assessment of young children referred for autism spectrum disorder evaluation during COVID-19: Associations among clinical characteristics and diagnostic outcome / Rebecca MCNALLY KEEHN in Autism, 27-5 (July 2023)  

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The Coping Cat Program for Children with Anxiety and Autism Spectrum Disorder: A Pilot Randomized Controlled Trial / Rebecca MCNALLY KEEHN in Journal of Autism and Developmental Disorders, 43-1 (January 2013)  

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