Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation / Rebecca W LIEB in Autism, 29-11 (November 2025)  

Public ISBD [article]  inAutism > 29-11 (November 2025) . - p.2846-2857 Titre : Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation Type de document : texte imprimé Auteurs : Rebecca W LIEB, Auteur ; Luther G KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N LUDWIG, Auteur ; Christina E LOVE, Auteur ; Rowena NG, Auteur ; Danielle WEXLER, Auteur ; Allison E GORNIK, Auteur ; Calliope HOLINGUE, Auteur ; Ji Su HONG, Auteur Article en page(s) : p.2846-2857 Langues : Anglais (eng) Mots-clés : ADOS-2  assessment  autism  autism spectrum disorder  clinician ratings  E codes  emotional and behavioral problems Index. décimale : PER Périodiques Résumé : While the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is considered a “reference standard” measure to observe symptoms of autism spectrum disorder (ASD), little is known about the utility of its Other Abnormal Behaviors or “E codes.” This study investigated the unique influence of each E code (overactivity, disruptive behavior, anxiety) on ADOS-2 scoring. Data from ADOS-2 administrations (Modules 1, 2, 3) were collected from 3364 children (mean age = 6.73 years) at an outpatient ASD clinic. For those with ASD, ADOS-2 Calibrated Severity Scores (CSS) were descriptively higher for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without ASD, no patterns emerged when comparing means. After controlling for age, sex, and language level, multivariable linear models indicated the presence of overactivity was significantly associated with increased CSS for children with ASD compared to those without. No significant interaction was present for disruptive behavior. The presence of anxiety was significantly associated with increased Social Affect CSS only for those without ASD. All effect sizes were small. This is one of the first studies to evaluate the effect of each individual E code on ADOS-2 CSS. Unique differences emerged across diagnostic groups, suggesting implications for ADOS-2 interpretation.Lay Summary The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is a common assessment tool used during an autism evaluation. As part of the ADOS-2, the examiner rates “E codes,” which are levels of hyperactivity, disruptive behavior, and anxiety during testing. These codes are not part of the final ADOS-2 score. While there is a lot of research on the ADOS-2, less is known about these E codes. This study looked at how the E codes might affect the final ADOS-2 scoring. Information came from 3364 in-person autism assessments (average age = 6.73 years) who were evaluated at an autism specialty clinic. For autistic children, ADOS-2 scores were higher (i.e. more autism-related behaviors) for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without autism, there was no pattern. After accounting for the child’s age, sex, and language level, there were unique results for each E code, depending on whether the child received an autism diagnosis. This study is important as it is one of the first to evaluate the effects of each E code on ADOS-2 scores and could impact how scores are interpreted when considering an autism diagnosis. En ligne : https://dx.doi.org/10.1177/13623613251355231 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] Associations between emotion and behavior codes and ADOS-2 scores in a sample of children referred for autism evaluation [texte imprimé] / Rebecca W LIEB, Auteur ; Luther G KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N LUDWIG, Auteur ; Christina E LOVE, Auteur ; Rowena NG, Auteur ; Danielle WEXLER, Auteur ; Allison E GORNIK, Auteur ; Calliope HOLINGUE, Auteur ; Ji Su HONG, Auteur . - p.2846-2857. Langues : Anglais (eng) in Autism > 29-11 (November 2025) . - p.2846-2857 Mots-clés : ADOS-2  assessment  autism  autism spectrum disorder  clinician ratings  E codes  emotional and behavioral problems Index. décimale : PER Périodiques Résumé : While the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is considered a “reference standard” measure to observe symptoms of autism spectrum disorder (ASD), little is known about the utility of its Other Abnormal Behaviors or “E codes.” This study investigated the unique influence of each E code (overactivity, disruptive behavior, anxiety) on ADOS-2 scoring. Data from ADOS-2 administrations (Modules 1, 2, 3) were collected from 3364 children (mean age = 6.73 years) at an outpatient ASD clinic. For those with ASD, ADOS-2 Calibrated Severity Scores (CSS) were descriptively higher for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without ASD, no patterns emerged when comparing means. After controlling for age, sex, and language level, multivariable linear models indicated the presence of overactivity was significantly associated with increased CSS for children with ASD compared to those without. No significant interaction was present for disruptive behavior. The presence of anxiety was significantly associated with increased Social Affect CSS only for those without ASD. All effect sizes were small. This is one of the first studies to evaluate the effect of each individual E code on ADOS-2 CSS. Unique differences emerged across diagnostic groups, suggesting implications for ADOS-2 interpretation.Lay Summary The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) is a common assessment tool used during an autism evaluation. As part of the ADOS-2, the examiner rates “E codes,” which are levels of hyperactivity, disruptive behavior, and anxiety during testing. These codes are not part of the final ADOS-2 score. While there is a lot of research on the ADOS-2, less is known about these E codes. This study looked at how the E codes might affect the final ADOS-2 scoring. Information came from 3364 in-person autism assessments (average age = 6.73 years) who were evaluated at an autism specialty clinic. For autistic children, ADOS-2 scores were higher (i.e. more autism-related behaviors) for those with overactivity and disruptive behavior, but lower for those with anxiety. For those without autism, there was no pattern. After accounting for the child’s age, sex, and language level, there were unique results for each E code, depending on whether the child received an autism diagnosis. This study is important as it is one of the first to evaluate the effects of each E code on ADOS-2 scores and could impact how scores are interpreted when considering an autism diagnosis. En ligne : https://dx.doi.org/10.1177/13623613251355231 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

Early behavioral profiles elucidating vulnerability and resiliency to later ASD outcomes / Rebecca J. LANDA in Development and Psychopathology, 32-4 (October 2020)  

Public ISBD [article]  inDevelopment and Psychopathology > 32-4 (October 2020) . - p.1217-1229 Titre : Early behavioral profiles elucidating vulnerability and resiliency to later ASD outcomes Type de document : texte imprimé Auteurs : Rebecca J. LANDA, Auteur ; Rachel REETZKE, Auteur ; Madiha TAHSEEN, Auteur ; Christine Reiner HESS, Auteur Article en page(s) : p.1217-1229 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  high-risk siblings  resilience  symptomology  vulnerability Index. décimale : PER Périodiques Résumé : Infant siblings of children with autism spectrum disorder (ASD) exhibit greater heterogeneity in behavioral presentation and outcomes relative to infants at low familial risk (LR), yet there is limited understanding of the diverse developmental profiles that characterize these infants. We applied a hierarchical agglomerative cluster analysis approach to parse developmental heterogeneity in 420 toddlers with heightened (HR) and low (LR) familial risk for ASD using measures of four dimensions of development: language, social, play, and restricted and repetitive behaviors (RRB). Results revealed a two-cluster solution. Comparisons of clusters revealed significantly lower language, social, and play performance, and higher levels of restricted and repetitive behaviors in Cluster 1 relative to Cluster 2. In Cluster 1, 25% of children were later diagnosed with ASD compared to 8% in Cluster 2. Comparisons within Cluster 1 between subgroups of toddlers having ASD+ versus ASD- 36-month outcomes revealed significantly lower functioning in the ASD+ subgroup across cognitive, motor, social, language, symbolic, and speech dimensions. Findings suggest profiles of early development associated with resiliency and vulnerability to later ASD diagnosis, with multidimensional developmental lags signaling vulnerability to ASD diagnosis. En ligne : http://dx.doi.org/10.1017/s0954579420000814 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=433 [article] Early behavioral profiles elucidating vulnerability and resiliency to later ASD outcomes [texte imprimé] / Rebecca J. LANDA, Auteur ; Rachel REETZKE, Auteur ; Madiha TAHSEEN, Auteur ; Christine Reiner HESS, Auteur . - p.1217-1229. Langues : Anglais (eng) in Development and Psychopathology > 32-4 (October 2020) . - p.1217-1229 Mots-clés : autism spectrum disorder  high-risk siblings  resilience  symptomology  vulnerability Index. décimale : PER Périodiques Résumé : Infant siblings of children with autism spectrum disorder (ASD) exhibit greater heterogeneity in behavioral presentation and outcomes relative to infants at low familial risk (LR), yet there is limited understanding of the diverse developmental profiles that characterize these infants. We applied a hierarchical agglomerative cluster analysis approach to parse developmental heterogeneity in 420 toddlers with heightened (HR) and low (LR) familial risk for ASD using measures of four dimensions of development: language, social, play, and restricted and repetitive behaviors (RRB). Results revealed a two-cluster solution. Comparisons of clusters revealed significantly lower language, social, and play performance, and higher levels of restricted and repetitive behaviors in Cluster 1 relative to Cluster 2. In Cluster 1, 25% of children were later diagnosed with ASD compared to 8% in Cluster 2. Comparisons within Cluster 1 between subgroups of toddlers having ASD+ versus ASD- 36-month outcomes revealed significantly lower functioning in the ASD+ subgroup across cognitive, motor, social, language, symbolic, and speech dimensions. Findings suggest profiles of early development associated with resiliency and vulnerability to later ASD diagnosis, with multidimensional developmental lags signaling vulnerability to ASD diagnosis. En ligne : http://dx.doi.org/10.1017/s0954579420000814 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=433

Infant Achievements Intervention Improves Caregiver Implementation Fidelity and Infant Social Communication Outcomes: A Preliminary Randomized Clinical Trial / Rachel REETZKE ; Christine Reiner HESS in Autism Research, 18-5 (May 2025)  

Public ISBD [article]  inAutism Research > 18-5 (May 2025) . - p.1104-1116 Titre : Infant Achievements Intervention Improves Caregiver Implementation Fidelity and Infant Social Communication Outcomes: A Preliminary Randomized Clinical Trial Type de document : texte imprimé Auteurs : Rachel REETZKE, Auteur ; Christine Reiner HESS, Auteur Article en page(s) : p.1104-1116 Langues : Anglais (eng) Mots-clés : caregiver  communication  delay  infants  intervention  randomized controlled trial  social Index. décimale : PER Périodiques Résumé : ABSTRACT Randomized controlled trials (RCTs) focused on idiopathic social communication delay (SCD) in the first year of life are rare. We preliminarily tested the efficacy of an 8-week caregiver-implemented intervention for infants with idiopathic SCD. Infants (8 12 months) with SCD were block-randomized with caregivers to the Infant Achievements (IA) (n 18) or Caregiver Education (CE) (n 20) group in this assessor-masked RCT. Assessments were completed at baseline, post-intervention, and 8-week follow-up. IA caregivers received reflective, home-based coaching to implement naturalistic developmental behavioral intervention (NDBI) strategies. Primary outcomes: masked ratings of caregiver implementation fidelity, frequency of infant initiation of joint attention (IJA), and percent of coordination of joint engagement (CJE). Secondary outcomes: masked researcher-administered and scored Mullen Scales of Early Learning (MSEL) language and Visual Reception scaled scores; nonmasked caregiver-reported Communication and Symbolic Behavior Scales Caregiver Questionnaire (CSBS CQ) Social, Speech, and Symbolic composite scores and McArthur-Bates Communication Development Inventories Words Understood and Produced scores. Prespecified analyses followed an intent-to-treat approach using Generalized Linear Mixed Models for non-normally distributed outcomes and linear mixed-effects models for those with normal distributions. Significant group by time effects favored the IA group relative to the CE group on all primary outcomes at post-intervention (p's?? 0.001), and for caregiver fidelity and IJA, at follow-up (? 0.03). Significant IA intervention effects were detected on secondary outcomes of nonverbal cognition (MSEL Visual Reception) and CSBS CQ Speech composite at post-intervention (< 0.01) and follow-up (? 0.02). IA equips caregivers to learn and generalize the implementation of child-responsive NDBI strategies and propels pre-linguistic social communication advances in SCD infants. Trial Registration: ClinicalTrials.gov identifier: NCT03404505. En ligne : https://doi.org/10.1002/aur.70051 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=558 [article] Infant Achievements Intervention Improves Caregiver Implementation Fidelity and Infant Social Communication Outcomes: A Preliminary Randomized Clinical Trial [texte imprimé] / Rachel REETZKE, Auteur ; Christine Reiner HESS, Auteur . - p.1104-1116. Langues : Anglais (eng) in Autism Research > 18-5 (May 2025) . - p.1104-1116 Mots-clés : caregiver  communication  delay  infants  intervention  randomized controlled trial  social Index. décimale : PER Périodiques Résumé : ABSTRACT Randomized controlled trials (RCTs) focused on idiopathic social communication delay (SCD) in the first year of life are rare. We preliminarily tested the efficacy of an 8-week caregiver-implemented intervention for infants with idiopathic SCD. Infants (8 12 months) with SCD were block-randomized with caregivers to the Infant Achievements (IA) (n 18) or Caregiver Education (CE) (n 20) group in this assessor-masked RCT. Assessments were completed at baseline, post-intervention, and 8-week follow-up. IA caregivers received reflective, home-based coaching to implement naturalistic developmental behavioral intervention (NDBI) strategies. Primary outcomes: masked ratings of caregiver implementation fidelity, frequency of infant initiation of joint attention (IJA), and percent of coordination of joint engagement (CJE). Secondary outcomes: masked researcher-administered and scored Mullen Scales of Early Learning (MSEL) language and Visual Reception scaled scores; nonmasked caregiver-reported Communication and Symbolic Behavior Scales Caregiver Questionnaire (CSBS CQ) Social, Speech, and Symbolic composite scores and McArthur-Bates Communication Development Inventories Words Understood and Produced scores. Prespecified analyses followed an intent-to-treat approach using Generalized Linear Mixed Models for non-normally distributed outcomes and linear mixed-effects models for those with normal distributions. Significant group by time effects favored the IA group relative to the CE group on all primary outcomes at post-intervention (p's?? 0.001), and for caregiver fidelity and IJA, at follow-up (? 0.03). Significant IA intervention effects were detected on secondary outcomes of nonverbal cognition (MSEL Visual Reception) and CSBS CQ Speech composite at post-intervention (< 0.01) and follow-up (? 0.02). IA equips caregivers to learn and generalize the implementation of child-responsive NDBI strategies and propels pre-linguistic social communication advances in SCD infants. Trial Registration: ClinicalTrials.gov identifier: NCT03404505. En ligne : https://doi.org/10.1002/aur.70051 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=558

Objective measurement of movement variability using wearable sensors predicts ASD outcomes in infants at high likelihood for ASD and ADHD / Sitaram VANGALA ; Rachel REETZKE ; Antonia PIERGIES ; Sally OZONOFF ; Meghan MILLER in Autism Research, 17-6 (June 2024)  

Public ISBD [article]  inAutism Research > 17-6 (June 2024) . - p.1094-1105 Titre : Objective measurement of movement variability using wearable sensors predicts ASD outcomes in infants at high likelihood for ASD and ADHD Type de document : texte imprimé Auteurs : Sitaram VANGALA, Auteur ; Rachel REETZKE, Auteur ; Antonia PIERGIES, Auteur ; Sally OZONOFF, Auteur ; Meghan MILLER, Auteur Article en page(s) : p.1094-1105 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Early motor delays and differences are common among children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Yet, little work has shown whether there are early atypical motor signs that differentiate these groups. Quantitative measures of movement variability hold promise for improving the identification of subtle and specific differences in motor function among infants and toddlers at high likelihood for ASD and ADHD. To this end, we created a novel quantitative measure of movement variability (movement curvature) and conducted a preliminary investigation as to whether this measure improves outcome predictions. We used a wearable triaxial accelerometer to evaluate continuous motion-based activity in infants at high and low likelihood for ASD and ADHD at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into three outcome groups: ASD (n = 19), ADHD concerns (n = 17), and a comparison group (n = 82). We examined group differences in movement curvature and whether movement curvature is predictive of a later ASD or ADHD concerns classification. We found that movement curvature was significantly lower in infants with later ASD diagnosis at 18, 24, and 36 months of age compared to infants with either ADHD concerns or those in the comparison group. Movement curvature was also a significant predictor of ASD at 18, 24, and 36 months (AUC 0.66-0.71; p = 0.005-0.039) and when adjusting for high ASD likelihood at 18 and 24 months (AUC 0.90, p = 0.05-0.019). These results indicate that lower movement curvature may be a feature of early motor differences in infants with later ASD diagnosis as early as 18 months of age. En ligne : https://doi.org/10.1002/aur.3150 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=531 [article] Objective measurement of movement variability using wearable sensors predicts ASD outcomes in infants at high likelihood for ASD and ADHD [texte imprimé] / Sitaram VANGALA, Auteur ; Rachel REETZKE, Auteur ; Antonia PIERGIES, Auteur ; Sally OZONOFF, Auteur ; Meghan MILLER, Auteur . - p.1094-1105. Langues : Anglais (eng) in Autism Research > 17-6 (June 2024) . - p.1094-1105 Index. décimale : PER Périodiques Résumé : Abstract Early motor delays and differences are common among children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Yet, little work has shown whether there are early atypical motor signs that differentiate these groups. Quantitative measures of movement variability hold promise for improving the identification of subtle and specific differences in motor function among infants and toddlers at high likelihood for ASD and ADHD. To this end, we created a novel quantitative measure of movement variability (movement curvature) and conducted a preliminary investigation as to whether this measure improves outcome predictions. We used a wearable triaxial accelerometer to evaluate continuous motion-based activity in infants at high and low likelihood for ASD and ADHD at 12, 18, 24, and 36 months of age. At 36 months, participants were categorized into three outcome groups: ASD (n = 19), ADHD concerns (n = 17), and a comparison group (n = 82). We examined group differences in movement curvature and whether movement curvature is predictive of a later ASD or ADHD concerns classification. We found that movement curvature was significantly lower in infants with later ASD diagnosis at 18, 24, and 36 months of age compared to infants with either ADHD concerns or those in the comparison group. Movement curvature was also a significant predictor of ASD at 18, 24, and 36 months (AUC 0.66-0.71; p = 0.005-0.039) and when adjusting for high ASD likelihood at 18 and 24 months (AUC 0.90, p = 0.05-0.019). These results indicate that lower movement curvature may be a feature of early motor differences in infants with later ASD diagnosis as early as 18 months of age. En ligne : https://doi.org/10.1002/aur.3150 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=531

Parental concerns of children with ASD by age: A qualitative analysis / Danika PFEIFFER in Research in Autism Spectrum Disorders, 86 (August 2021)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 86 (August 2021) . - 101817 Titre : Parental concerns of children with ASD by age: A qualitative analysis Type de document : texte imprimé Auteurs : Danika PFEIFFER, Auteur ; Calliope HOLINGUE, Auteur ; Emily DILLON, Auteur ; Luke G. KALB, Auteur ; Rachel REETZKE, Auteur ; Rebecca LANDA, Auteur Article en page(s) : 101817 Langues : Anglais (eng) Mots-clés : Autism spectrum disorders  Parental concerns  Children  Age  Qualitative Index. décimale : PER Périodiques Résumé : Background Eliciting parents’ concerns about their children is an important initial step in the ASD diagnostic process. This information is often collected through forced-choice questionnaires utilizing professional terminology and may limit the potential concerns that can be reported. Parent concern studies to date have largely used deductive qualitative methods with only one age group of children. Inductive qualitative studies are needed to examine parental concerns of children with ASD across age groups with one coding scheme. Method We used an inductive qualitative analysis process to analyze concerns reported by parents of children ages 1–11 years on intake forms (n = 455) at an urban outpatient ASD specialty clinic. Analyses were based on three age groups (toddler, preschooler, middle childhood). Results Using conventional content analysis, 12 categories of concerns emerged from parents’ responses: communication, social, behavioral/emotional, cognition, life skills, atypical behaviors, sensory, academic, health, seeking diagnostic clarity or resources, developmental, and motor skills. We found that parents reported the same concerns about their children across age groups in six of the 12 categories. The biggest difference in reported concerns across age groups was that parents of children in the preschooler and middle childhood groups reported a greater number of concerns related to mental health than parents of toddlers. Conclusion Our analysis yields specific information about similarities and differences in parents’ concerns depending on their child’s age. Ensuring that ASD evaluations are tailored to children’s unique needs has implications for timely diagnosis and access to care. En ligne : https://doi.org/10.1016/j.rasd.2021.101817 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458 [article] Parental concerns of children with ASD by age: A qualitative analysis [texte imprimé] / Danika PFEIFFER, Auteur ; Calliope HOLINGUE, Auteur ; Emily DILLON, Auteur ; Luke G. KALB, Auteur ; Rachel REETZKE, Auteur ; Rebecca LANDA, Auteur . - 101817. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 86 (August 2021) . - 101817 Mots-clés : Autism spectrum disorders  Parental concerns  Children  Age  Qualitative Index. décimale : PER Périodiques Résumé : Background Eliciting parents’ concerns about their children is an important initial step in the ASD diagnostic process. This information is often collected through forced-choice questionnaires utilizing professional terminology and may limit the potential concerns that can be reported. Parent concern studies to date have largely used deductive qualitative methods with only one age group of children. Inductive qualitative studies are needed to examine parental concerns of children with ASD across age groups with one coding scheme. Method We used an inductive qualitative analysis process to analyze concerns reported by parents of children ages 1–11 years on intake forms (n = 455) at an urban outpatient ASD specialty clinic. Analyses were based on three age groups (toddler, preschooler, middle childhood). Results Using conventional content analysis, 12 categories of concerns emerged from parents’ responses: communication, social, behavioral/emotional, cognition, life skills, atypical behaviors, sensory, academic, health, seeking diagnostic clarity or resources, developmental, and motor skills. We found that parents reported the same concerns about their children across age groups in six of the 12 categories. The biggest difference in reported concerns across age groups was that parents of children in the preschooler and middle childhood groups reported a greater number of concerns related to mental health than parents of toddlers. Conclusion Our analysis yields specific information about similarities and differences in parents’ concerns depending on their child’s age. Ensuring that ASD evaluations are tailored to children’s unique needs has implications for timely diagnosis and access to care. En ligne : https://doi.org/10.1016/j.rasd.2021.101817 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458

Patterns of objectively measured motor activity among infants developing ASD and concerns for ADHD / Rachel REETZKE in Journal of Child Psychology and Psychiatry, 63-6 (June 2022)  

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Prevalence of gastrointestinal symptoms among autistic individuals, with and without co-occurring intellectual disability / Calliope HOLINGUE in Autism Research, 16-8 (August 2023)  

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Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder / Ji Su HONG in Autism Research, 15-11 (November 2022)  

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