Determinants of an autism spectrum disorder diagnosis in childhood and adolescence: Evidence from the UK Millennium Cohort Study / Mariko HOSOZAWA in Autism, 24-6 (August 2020)  

Public ISBD [article]  inAutism > 24-6 (August 2020) . - p.1557-1565 Titre : Determinants of an autism spectrum disorder diagnosis in childhood and adolescence: Evidence from the UK Millennium Cohort Study Type de document : Texte imprimé et/ou numérique Auteurs : Mariko HOSOZAWA, Auteur ; Amanda SACKER, Auteur ; William MANDY, Auteur ; Emily MIDOUHAS, Auteur ; Eirini FLOURI, Auteur ; Noriko CABLE, Auteur Article en page(s) : p.1557-1565 Langues : Anglais (eng) Mots-clés : Millennium Cohort Study  adolescents  autism spectrum disorder  diagnosis Index. décimale : PER Périodiques Résumé : This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made 'very late' (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N?=?581) were included and grouped by the parent-reported timing of diagnosis: before school (up to age 5), during primary school (age 5-11) and during secondary school (age 11-14). Predictors of diagnostic timing, at the child, family and school levels, were investigated using multinomial logistic regression. Most (79%) children with autism spectrum disorder were diagnosed after school entry, and 28% were not diagnosed until secondary school. Among those not diagnosed until secondary school, 75% had been identified at age 5?years by a parent and/or teacher as having socio-behavioural difficulties. Being diagnosed after starting school was predicted by living in poverty (adjusted relative risk ratio: primary?=?1.90, 95% confidence interval: 1.03-3.53; secondary?=?2.15, 1.05-4.42) and/or having no initial parental concerns (primary?=?0.32, 0.15-0.70; secondary?=?0.19, 0.09-0.43). Having typical-range intelligence also predicted diagnosis during secondary school. The result indicates that those without cognitive delays and poorer children were at risk of 'very late' (i.e. adolescent) diagnosis. Strategies to promote earlier identification, targeting age at primary school entry, could help those more likely to be diagnosed late.Lay abstractDespite policy emphasis on early identification, many children with autism spectrum disorder are diagnosed late, with some being diagnosed as late as in adolescence. However, evidence on what determines the timing of autism spectrum disorder diagnosis including children diagnosed in adolescence is lacking. Understanding these determinants, particularly in those diagnosed later than is ideal, can inform the development of effective strategies to improve earlier identification of autism spectrum disorder. This study used a nationally representative population-based cohort in the United Kingdom to explore child, family and school level predictors of timing of autism spectrum disorder diagnosis. In the United Kingdom, 79% of the children with autism spectrum disorder were diagnosed after entering primary school and 28% during secondary school. Among those not diagnosed until secondary school, 75% had shown social difficulties noticed by parents and/or teachers at age 5?years. The results suggest that healthcare providers should be aware that, even for universal systems of care, those living in poverty and having higher intelligence are most likely to miss out on a timely diagnosis. Strategies to promote earlier identification among school-aged children, including targeting primary school entry age (i.e. around age 5) and that encouraging referrals for a formal assessment at the first report of concerns over the child's social development may benefit those children who would otherwise be diagnosed later. En ligne : http://dx.doi.org/10.1177/1362361320913671 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=428 [article] Determinants of an autism spectrum disorder diagnosis in childhood and adolescence: Evidence from the UK Millennium Cohort Study [Texte imprimé et/ou numérique] / Mariko HOSOZAWA, Auteur ; Amanda SACKER, Auteur ; William MANDY, Auteur ; Emily MIDOUHAS, Auteur ; Eirini FLOURI, Auteur ; Noriko CABLE, Auteur . - p.1557-1565. Langues : Anglais (eng) in Autism > 24-6 (August 2020) . - p.1557-1565 Mots-clés : Millennium Cohort Study  adolescents  autism spectrum disorder  diagnosis Index. décimale : PER Périodiques Résumé : This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made 'very late' (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N?=?581) were included and grouped by the parent-reported timing of diagnosis: before school (up to age 5), during primary school (age 5-11) and during secondary school (age 11-14). Predictors of diagnostic timing, at the child, family and school levels, were investigated using multinomial logistic regression. Most (79%) children with autism spectrum disorder were diagnosed after school entry, and 28% were not diagnosed until secondary school. Among those not diagnosed until secondary school, 75% had been identified at age 5?years by a parent and/or teacher as having socio-behavioural difficulties. Being diagnosed after starting school was predicted by living in poverty (adjusted relative risk ratio: primary?=?1.90, 95% confidence interval: 1.03-3.53; secondary?=?2.15, 1.05-4.42) and/or having no initial parental concerns (primary?=?0.32, 0.15-0.70; secondary?=?0.19, 0.09-0.43). Having typical-range intelligence also predicted diagnosis during secondary school. The result indicates that those without cognitive delays and poorer children were at risk of 'very late' (i.e. adolescent) diagnosis. Strategies to promote earlier identification, targeting age at primary school entry, could help those more likely to be diagnosed late.Lay abstractDespite policy emphasis on early identification, many children with autism spectrum disorder are diagnosed late, with some being diagnosed as late as in adolescence. However, evidence on what determines the timing of autism spectrum disorder diagnosis including children diagnosed in adolescence is lacking. Understanding these determinants, particularly in those diagnosed later than is ideal, can inform the development of effective strategies to improve earlier identification of autism spectrum disorder. This study used a nationally representative population-based cohort in the United Kingdom to explore child, family and school level predictors of timing of autism spectrum disorder diagnosis. In the United Kingdom, 79% of the children with autism spectrum disorder were diagnosed after entering primary school and 28% during secondary school. Among those not diagnosed until secondary school, 75% had shown social difficulties noticed by parents and/or teachers at age 5?years. The results suggest that healthcare providers should be aware that, even for universal systems of care, those living in poverty and having higher intelligence are most likely to miss out on a timely diagnosis. Strategies to promote earlier identification among school-aged children, including targeting primary school entry age (i.e. around age 5) and that encouraging referrals for a formal assessment at the first report of concerns over the child's social development may benefit those children who would otherwise be diagnosed later. En ligne : http://dx.doi.org/10.1177/1362361320913671 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=428

Mental health and social difficulties of late-diagnosed autistic children, across childhood and adolescence / Will MANDY in Journal of Child Psychology and Psychiatry, 63-11 (November 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1405-1414 Titre : Mental health and social difficulties of late-diagnosed autistic children, across childhood and adolescence Type de document : Texte imprimé et/ou numérique Auteurs : Will MANDY, Auteur ; Emily MIDOUHAS, Auteur ; Mariko HOSOZAWA, Auteur ; Noriko CABLE, Auteur ; Amanda SACKER, Auteur ; Eirini FLOURI, Auteur Article en page(s) : p.1405-1414 Langues : Anglais (eng) Mots-clés : Female  Child  Adolescent  Humans  Autistic Disorder/diagnosis/psychology  Cohort Studies  Mental Health  Attention Deficit Disorder with Hyperactivity  Educational Status  Autism Spectrum Disorder  Millennium Cohort Study  co-occurring mental health conditions  diagnosis  trajectories Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism can be diagnosed from 2 years of age, although most autistic people receive their diagnosis later than this after they have started education. Research is required to understand why some autistic children are diagnosed late, and the level and nature of unmet need prior to diagnosis for late-diagnosed children. METHODS: We examined trajectories of emotional, behavioural and social difficulties (EBSDs) across childhood and adolescence, comparing 'earlier-diagnosed' (diagnosed 7 years or younger) with 'late-diagnosed' (diagnosed between 8 and 14 years) autistic children. Data were from the Millennium Cohort Study, a population-based UK birth cohort. EBSDs were measured using the parent-report Strengths and Difficulties Questionnaire, at 3, 5, 7, 11 and 14 years. We used Growth Curve Modelling to investigate levels and rates of change in these difficulties, and to compare earlier- (n=146) and late-diagnosed (n=284) autistic children. RESULTS: Aged 5, earlier-diagnosed autistic children had more emotional (i.e., internalising), conduct, hyperactivity and social difficulties; although clinical difficulties in these areas were nevertheless common in late-diagnosed children. There was a faster annual increase in scores for all domains for late-diagnosed children, and by age 14 years, they had higher levels of EBSDs. These results persisted when we ran adjusted models, to account for the late-diagnosed group having higher rates of late-diagnosed attention deficit/hyperactivity disorder, higher IQ, a higher proportion of females and older and more educated mothers. CONCLUSIONS: Emotional, behavioural and social difficulties are associated with, and may influence, the timing of autism diagnosis. Late-diagnosed autistic children often have high levels of mental health and social difficulties prior to their autism diagnosis, and tend to develop even more severe problems as they enter adolescence. En ligne : http://dx.doi.org/10.1111/jcpp.13587 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490 [article] Mental health and social difficulties of late-diagnosed autistic children, across childhood and adolescence [Texte imprimé et/ou numérique] / Will MANDY, Auteur ; Emily MIDOUHAS, Auteur ; Mariko HOSOZAWA, Auteur ; Noriko CABLE, Auteur ; Amanda SACKER, Auteur ; Eirini FLOURI, Auteur . - p.1405-1414. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-11 (November 2022) . - p.1405-1414 Mots-clés : Female  Child  Adolescent  Humans  Autistic Disorder/diagnosis/psychology  Cohort Studies  Mental Health  Attention Deficit Disorder with Hyperactivity  Educational Status  Autism Spectrum Disorder  Millennium Cohort Study  co-occurring mental health conditions  diagnosis  trajectories Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism can be diagnosed from 2 years of age, although most autistic people receive their diagnosis later than this after they have started education. Research is required to understand why some autistic children are diagnosed late, and the level and nature of unmet need prior to diagnosis for late-diagnosed children. METHODS: We examined trajectories of emotional, behavioural and social difficulties (EBSDs) across childhood and adolescence, comparing 'earlier-diagnosed' (diagnosed 7 years or younger) with 'late-diagnosed' (diagnosed between 8 and 14 years) autistic children. Data were from the Millennium Cohort Study, a population-based UK birth cohort. EBSDs were measured using the parent-report Strengths and Difficulties Questionnaire, at 3, 5, 7, 11 and 14 years. We used Growth Curve Modelling to investigate levels and rates of change in these difficulties, and to compare earlier- (n=146) and late-diagnosed (n=284) autistic children. RESULTS: Aged 5, earlier-diagnosed autistic children had more emotional (i.e., internalising), conduct, hyperactivity and social difficulties; although clinical difficulties in these areas were nevertheless common in late-diagnosed children. There was a faster annual increase in scores for all domains for late-diagnosed children, and by age 14 years, they had higher levels of EBSDs. These results persisted when we ran adjusted models, to account for the late-diagnosed group having higher rates of late-diagnosed attention deficit/hyperactivity disorder, higher IQ, a higher proportion of females and older and more educated mothers. CONCLUSIONS: Emotional, behavioural and social difficulties are associated with, and may influence, the timing of autism diagnosis. Late-diagnosed autistic children often have high levels of mental health and social difficulties prior to their autism diagnosis, and tend to develop even more severe problems as they enter adolescence. En ligne : http://dx.doi.org/10.1111/jcpp.13587 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=490

Testing lifecourse theories characterising associations between maternal depression and offspring depression in emerging adulthood: the Avon Longitudinal Study of Parents and Children / Rebecca E. LACEY in Journal of Child Psychology and Psychiatry, 64-8 (August 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-8 (August 2023) . - p.1149-1158 Titre : Testing lifecourse theories characterising associations between maternal depression and offspring depression in emerging adulthood: the Avon Longitudinal Study of Parents and Children Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca E. LACEY, Auteur ; Dawid GONDEK, Auteur ; Brooke J. SMITH, Auteur ; Andrew D. A. C. SMITH, Auteur ; Erin C. DUNN, Auteur ; Amanda SACKER, Auteur Article en page(s) : p.1149-1158 Langues : Anglais (eng) Mots-clés : accumulation  ALSPAC  depression  depressive symptoms  lifecourse  sensitive periods Index. décimale : PER Périodiques Résumé : Background Maternal depression is a major determinant of offspring mental health. Yet, little is understood about how the duration and timing of maternal depression shapes youth risk for depressive symptoms, which if understood could inform when best to intervene. This study aimed to determine how the timing and duration of maternal depression was related to offspring depression in emerging adulthood, and if these associations varied by sex. Methods We analysed data from the Avon Longitudinal Study of Parents and Children (a prenatal cohort in the Avon area of England, 1991 2003), n = 3,301. We applied the structured lifecourse modelling approach to maternal depression (assessed at 13 points from prenatal period to adolescence) and emerging adult depressive symptoms (age 21). Lifecourse models assessed were accumulation (sum of timepoints when maternal depression was reported), sensitive periods (each period assessed as one during which maternal depression has a stronger effect) and instability (frequent fluctuations in maternal depression). Results Female adolescents (n = 2,132) had higher SMFQ scores (mean = 6.15, SD = 5.90) than males (n = 1,169, mean = 4.87, SD = 4.82). Maternal depression was most common in the infancy period (21.2% males; 21.4% females). For males, accumulation was the most appropriate lifecourse model; for each additional period of maternal depression, depressive symptoms in emerging adulthood increased by 0.11 (95% CI: 0.07, 0.15, one-sided p value ? .001). For females, exposure to maternal depression was associated with increasing depressive symptoms in emerging adulthood, with the largest effect in mid-childhood (increase of 0.27 units, 95% CI 0.03 0.50, p = .015 for difference between mid-childhood and other time-periods) and a smaller, equal effect at all other time-periods (increase of 0.07 units per time-period, 95% CI: 0.03 0.12, p = .002). Conclusions This study highlights the importance of ongoing maternal depression for the development of depression in offspring through to emerging adulthood. Because long-term exposure to maternal depression was particularly important, early interventions are warranted. En ligne : https://doi.org/10.1111/jcpp.13699 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=508 [article] Testing lifecourse theories characterising associations between maternal depression and offspring depression in emerging adulthood: the Avon Longitudinal Study of Parents and Children [Texte imprimé et/ou numérique] / Rebecca E. LACEY, Auteur ; Dawid GONDEK, Auteur ; Brooke J. SMITH, Auteur ; Andrew D. A. C. SMITH, Auteur ; Erin C. DUNN, Auteur ; Amanda SACKER, Auteur . - p.1149-1158. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-8 (August 2023) . - p.1149-1158 Mots-clés : accumulation  ALSPAC  depression  depressive symptoms  lifecourse  sensitive periods Index. décimale : PER Périodiques Résumé : Background Maternal depression is a major determinant of offspring mental health. Yet, little is understood about how the duration and timing of maternal depression shapes youth risk for depressive symptoms, which if understood could inform when best to intervene. This study aimed to determine how the timing and duration of maternal depression was related to offspring depression in emerging adulthood, and if these associations varied by sex. Methods We analysed data from the Avon Longitudinal Study of Parents and Children (a prenatal cohort in the Avon area of England, 1991 2003), n = 3,301. We applied the structured lifecourse modelling approach to maternal depression (assessed at 13 points from prenatal period to adolescence) and emerging adult depressive symptoms (age 21). Lifecourse models assessed were accumulation (sum of timepoints when maternal depression was reported), sensitive periods (each period assessed as one during which maternal depression has a stronger effect) and instability (frequent fluctuations in maternal depression). Results Female adolescents (n = 2,132) had higher SMFQ scores (mean = 6.15, SD = 5.90) than males (n = 1,169, mean = 4.87, SD = 4.82). Maternal depression was most common in the infancy period (21.2% males; 21.4% females). For males, accumulation was the most appropriate lifecourse model; for each additional period of maternal depression, depressive symptoms in emerging adulthood increased by 0.11 (95% CI: 0.07, 0.15, one-sided p value ? .001). For females, exposure to maternal depression was associated with increasing depressive symptoms in emerging adulthood, with the largest effect in mid-childhood (increase of 0.27 units, 95% CI 0.03 0.50, p = .015 for difference between mid-childhood and other time-periods) and a smaller, equal effect at all other time-periods (increase of 0.07 units per time-period, 95% CI: 0.03 0.12, p = .002). Conclusions This study highlights the importance of ongoing maternal depression for the development of depression in offspring through to emerging adulthood. Because long-term exposure to maternal depression was particularly important, early interventions are warranted. En ligne : https://doi.org/10.1111/jcpp.13699 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=508

Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder / Mariko HOSOZAWA in Autism, 25-1 (January 2021)  

Public ISBD [article]  inAutism > 25-1 (January 2021) . - p.70-78 Titre : Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Mariko HOSOZAWA, Auteur ; Amanda SACKER, Auteur ; Noriko CABLE, Auteur Article en page(s) : p.70-78 Langues : Anglais (eng) Mots-clés : adolescence  autism spectrum disorder  depression  diagnosis  self-harming behaviour Index. décimale : PER Périodiques Résumé : Children with autism spectrum disorder are at increased risk of depression and self-harming behaviours. The question of whether timing of diagnosis of autism spectrum disorder is associated with these consequences in adolescence has not yet been studied. This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the parent-reported timing of diagnosis for autism spectrum disorder using a large population-based cohort in the United Kingdom. Most of the children with autism spectrum disorder in our study had within-typical-range cognitive ability. We found a linear association between timing of autism spectrum disorder diagnosis and depression and self-harming behaviour in adolescence; later diagnosis of autism spectrum disorder, particularly diagnosis in adolescence, was associated with the increased risk of self-reported depressive symptoms and self-harming behaviour in adolescence among children with autism spectrum disorder. Our findings, albeit observational, suggest that interventions targeting the earlier diagnosis of autism spectrum disorder and approaches to improve person-environment fit may help prevent secondary mental health problems in this population, particularly among those without cognitive delays and those diagnosed late. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted. En ligne : http://dx.doi.org/10.1177/1362361320945540 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437 [article] Timing of diagnosis, depression and self-harm in adolescents with autism spectrum disorder [Texte imprimé et/ou numérique] / Mariko HOSOZAWA, Auteur ; Amanda SACKER, Auteur ; Noriko CABLE, Auteur . - p.70-78. Langues : Anglais (eng) in Autism > 25-1 (January 2021) . - p.70-78 Mots-clés : adolescence  autism spectrum disorder  depression  diagnosis  self-harming behaviour Index. décimale : PER Périodiques Résumé : Children with autism spectrum disorder are at increased risk of depression and self-harming behaviours. The question of whether timing of diagnosis of autism spectrum disorder is associated with these consequences in adolescence has not yet been studied. This exploratory study aimed to explore the association between depression and self-harming behaviour in adolescence and the parent-reported timing of diagnosis for autism spectrum disorder using a large population-based cohort in the United Kingdom. Most of the children with autism spectrum disorder in our study had within-typical-range cognitive ability. We found a linear association between timing of autism spectrum disorder diagnosis and depression and self-harming behaviour in adolescence; later diagnosis of autism spectrum disorder, particularly diagnosis in adolescence, was associated with the increased risk of self-reported depressive symptoms and self-harming behaviour in adolescence among children with autism spectrum disorder. Our findings, albeit observational, suggest that interventions targeting the earlier diagnosis of autism spectrum disorder and approaches to improve person-environment fit may help prevent secondary mental health problems in this population, particularly among those without cognitive delays and those diagnosed late. Further studies replicating across a wider intellectual spectrum and clarifying the underlying mechanism are warranted. En ligne : http://dx.doi.org/10.1177/1362361320945540 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437

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