Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers / Andrea TRUBANOVA WIECKOWSKI in Autism Research, 15-12 (December 2022)  

Public ISBD [article]  inAutism Research > 15-12 (December 2022) . - p.2216-2222 Titre : Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers Type de document : Texte imprimé et/ou numérique Auteurs : Andrea TRUBANOVA WIECKOWSKI, Auteur ; Katharine E. ZUCKERMAN, Auteur ; Sarabeth BRODER-FINGERT, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.2216-2222 Langues : Anglais (eng) Mots-clés : Child  Humans  Child, Preschool  Autistic Disorder  Autism Spectrum Disorder/diagnosis/therapy  Primary Health Care  autism spectrum disorder  diagnosis  early detection  primary care Index. décimale : PER Périodiques Résumé : Formal autism diagnosis from a specialist trained in autism assessment is customary prior to a child accessing early, intensive autism-specific services. However, long wait lists for diagnostic evaluations and limited specialty workforce have created substantial delays. Additionally, lengthy multidisciplinary evaluations are costly to insurers, inconvenient to families, and disproportionally impact under-resourced families. Diagnostic delays can impede access to intervention services. These barriers, combined with evidence regarding the importance of receiving early, autism-specific treatment, demand new approaches enabling access to autism specific services before comprehensive evaluation. Pediatric primary care providers (PCPs) are often the only health care professionals with whom a family interacts during early childhood and can play a crucial role in helping children with autism symptoms access services. Many strategies for autism diagnosis in primary care are being developed and tested; however, they have yet to be broadly adopted by PCPs, primarily due to critical implementation barriers in primary care settings. There is also not enough evidence on the accuracy of PCPs' diagnostic impressions without extensive specialty support, resulting in PCP hesitancy in diagnosing ASD, as well as family and service provider hesitancy in accepting a PCP autism diagnosis. In this commentary, we explore the acute need for shortening waitlists for autism evaluations through a tiered diagnostic approach, in which PCPs can rule in or rule out autism in children, for whom diagnosis is clear, and refer more complex cases for specialist evaluations, and explore implementation challenges to this approach. En ligne : http://dx.doi.org/10.1002/aur.2832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488 [article] Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers [Texte imprimé et/ou numérique] / Andrea TRUBANOVA WIECKOWSKI, Auteur ; Katharine E. ZUCKERMAN, Auteur ; Sarabeth BRODER-FINGERT, Auteur ; Diana L. ROBINS, Auteur . - p.2216-2222. Langues : Anglais (eng) in Autism Research > 15-12 (December 2022) . - p.2216-2222 Mots-clés : Child  Humans  Child, Preschool  Autistic Disorder  Autism Spectrum Disorder/diagnosis/therapy  Primary Health Care  autism spectrum disorder  diagnosis  early detection  primary care Index. décimale : PER Périodiques Résumé : Formal autism diagnosis from a specialist trained in autism assessment is customary prior to a child accessing early, intensive autism-specific services. However, long wait lists for diagnostic evaluations and limited specialty workforce have created substantial delays. Additionally, lengthy multidisciplinary evaluations are costly to insurers, inconvenient to families, and disproportionally impact under-resourced families. Diagnostic delays can impede access to intervention services. These barriers, combined with evidence regarding the importance of receiving early, autism-specific treatment, demand new approaches enabling access to autism specific services before comprehensive evaluation. Pediatric primary care providers (PCPs) are often the only health care professionals with whom a family interacts during early childhood and can play a crucial role in helping children with autism symptoms access services. Many strategies for autism diagnosis in primary care are being developed and tested; however, they have yet to be broadly adopted by PCPs, primarily due to critical implementation barriers in primary care settings. There is also not enough evidence on the accuracy of PCPs' diagnostic impressions without extensive specialty support, resulting in PCP hesitancy in diagnosing ASD, as well as family and service provider hesitancy in accepting a PCP autism diagnosis. In this commentary, we explore the acute need for shortening waitlists for autism evaluations through a tiered diagnostic approach, in which PCPs can rule in or rule out autism in children, for whom diagnosis is clear, and refer more complex cases for specialist evaluations, and explore implementation challenges to this approach. En ligne : http://dx.doi.org/10.1002/aur.2832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488

Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample / Andrea TRUBANOVA WIECKOWSKI in Autism Research, 13-8 (August 2020)  

Public ISBD [article]  inAutism Research > 13-8 (August 2020) . - p.1343-1348 Titre : Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample Type de document : Texte imprimé et/ou numérique Auteurs : Andrea TRUBANOVA WIECKOWSKI, Auteur ; Stephanie LUALLIN, Auteur ; Zhaoxing PAN, Auteur ; Giulia RIGHI, Auteur ; Robin L. GABRIELS, Auteur ; Carla MAZEFSKY, Auteur Article en page(s) : p.1343-1348 Langues : Anglais (eng) Mots-clés : Autism Inpatient Collection  autism spectrum disorder  emotion regulation  gender differences  psychiatric inpatients Index. décimale : PER Périodiques Résumé : There is a wide range of emotion regulation (ER)-related impairment observed in autism spectrum disorder (ASD), which is associated with both internalizing and externalizing problems. Although the importance of ER is widely acknowledged in the ASD literature, little is known about factors associated with variability in ER impairment. Given the identified gender differences in ASD, gender may be a potential contributor to ER. This study examined gender differences in ER in an ASD inpatient psychiatric sample (n = 722; 146 females) aged 4-20?years, collected as part of the Autism Inpatient Collection. In addition, the study investigated whether age, nonverbal intelligence quotient (NVIQ), or verbal ability moderate the association between ER and gender. While both male and female inpatients with ASD presented with clinically elevated emotion dysregulation compared to general population norms, results suggest that female psychiatric inpatients have more severe dysregulation, including higher reactivity and dysphoria, than inpatient males. NVIQ and verbal ability did not moderate the association between gender and ER. Age moderated the association between gender and ER, with greater gender difference seen in older individuals, but only for dysphoria. However, overall, these effects were small. Improved understanding of ER presentation in males and females with ASD is critical, as these symptoms may differentially impact individuals with ASD and may warrant a different treatment emphasis. LAY SUMMARY: Previous research has identified several gender differences in presentation of autism spectrum disorder (ASD) symptoms, as well as difficulties with emotion regulation in individuals with ASD. In order to better understand the factors that may contribute to emotion regulation in ASD, this study examined whether psychiatrically hospitalized males and females with ASD differed in emotion regulation and what factors influenced the differences. Results suggest that females with ASD have slightly but significantly more difficulty with emotion regulation compared to males. Autism Res 2020, 13: 1343-1348. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. En ligne : http://dx.doi.org/10.1002/aur.2295 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=430 [article] Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample [Texte imprimé et/ou numérique] / Andrea TRUBANOVA WIECKOWSKI, Auteur ; Stephanie LUALLIN, Auteur ; Zhaoxing PAN, Auteur ; Giulia RIGHI, Auteur ; Robin L. GABRIELS, Auteur ; Carla MAZEFSKY, Auteur . - p.1343-1348. Langues : Anglais (eng) in Autism Research > 13-8 (August 2020) . - p.1343-1348 Mots-clés : Autism Inpatient Collection  autism spectrum disorder  emotion regulation  gender differences  psychiatric inpatients Index. décimale : PER Périodiques Résumé : There is a wide range of emotion regulation (ER)-related impairment observed in autism spectrum disorder (ASD), which is associated with both internalizing and externalizing problems. Although the importance of ER is widely acknowledged in the ASD literature, little is known about factors associated with variability in ER impairment. Given the identified gender differences in ASD, gender may be a potential contributor to ER. This study examined gender differences in ER in an ASD inpatient psychiatric sample (n = 722; 146 females) aged 4-20?years, collected as part of the Autism Inpatient Collection. In addition, the study investigated whether age, nonverbal intelligence quotient (NVIQ), or verbal ability moderate the association between ER and gender. While both male and female inpatients with ASD presented with clinically elevated emotion dysregulation compared to general population norms, results suggest that female psychiatric inpatients have more severe dysregulation, including higher reactivity and dysphoria, than inpatient males. NVIQ and verbal ability did not moderate the association between gender and ER. Age moderated the association between gender and ER, with greater gender difference seen in older individuals, but only for dysphoria. However, overall, these effects were small. Improved understanding of ER presentation in males and females with ASD is critical, as these symptoms may differentially impact individuals with ASD and may warrant a different treatment emphasis. LAY SUMMARY: Previous research has identified several gender differences in presentation of autism spectrum disorder (ASD) symptoms, as well as difficulties with emotion regulation in individuals with ASD. In order to better understand the factors that may contribute to emotion regulation in ASD, this study examined whether psychiatrically hospitalized males and females with ASD differed in emotion regulation and what factors influenced the differences. Results suggest that females with ASD have slightly but significantly more difficulty with emotion regulation compared to males. Autism Res 2020, 13: 1343-1348. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. En ligne : http://dx.doi.org/10.1002/aur.2295 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=430

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