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

The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longitudinal Evidence from the UK Millennium Cohort Study / M. HOSOZAWA in Journal of Autism and Developmental Disorders, 51-9 (September 2021)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 51-9 (September 2021) . - p.3212-3223 Titre : The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longitudinal Evidence from the UK Millennium Cohort Study Type de document : Texte imprimé et/ou numérique Auteurs : M. HOSOZAWA, Auteur ; W. MANDY, Auteur ; Noriko CABLE, Auteur ; E. FLOURI, Auteur Article en page(s) : p.3212-3223 Langues : Anglais (eng) Mots-clés : Adolescent  Aged  Attention Deficit Disorder with Hyperactivity/epidemiology  Autism Spectrum Disorder  Autistic Disorder  Child  Cohort Studies  Decision Making  Humans  Risk-Taking  United Kingdom/epidemiology  Adolescence  Antisocial behaviours  Autism spectrum disorder  Decision-making  Gambling task  Psychological wellbeing Index. décimale : PER Périodiques Résumé : This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes. En ligne : http://dx.doi.org/10.1007/s10803-020-04783-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=453 [article] The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longitudinal Evidence from the UK Millennium Cohort Study [Texte imprimé et/ou numérique] / M. HOSOZAWA, Auteur ; W. MANDY, Auteur ; Noriko CABLE, Auteur ; E. FLOURI, Auteur . - p.3212-3223. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 51-9 (September 2021) . - p.3212-3223 Mots-clés : Adolescent  Aged  Attention Deficit Disorder with Hyperactivity/epidemiology  Autism Spectrum Disorder  Autistic Disorder  Child  Cohort Studies  Decision Making  Humans  Risk-Taking  United Kingdom/epidemiology  Adolescence  Antisocial behaviours  Autism spectrum disorder  Decision-making  Gambling task  Psychological wellbeing Index. décimale : PER Périodiques Résumé : This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes. En ligne : http://dx.doi.org/10.1007/s10803-020-04783-y Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=453

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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