Gender, assigned sex at birth, and gender diversity: Windows into diagnostic timing disparities in autism / Goldie A. MCQUAID in Autism, 28-11 (November 2024)  

Public ISBD [article]  inAutism > 28-11 (November 2024) . - p.2806 - 2820 Titre : Gender, assigned sex at birth, and gender diversity: Windows into diagnostic timing disparities in autism Type de document : Texte imprimé et/ou numérique Auteurs : Goldie A. MCQUAID, Auteur ; Allison B. RATTO, Auteur ; Allison JACK, Auteur ; Alexis KHUU, Auteur ; Jessica V. SMITH, Auteur ; Sean C. DUANE, Auteur ; Ann CLAWSON, Auteur ; Nancy Raitano LEE, Auteur ; Alyssa VERBALIS, Auteur ; Kevin A. PELPHREY, Auteur ; Lauren KENWORTHY, Auteur ; Gregory L. WALLACE, Auteur ; John F. STRANG, Auteur Article en page(s) : p.2806 - 2820 Langues : Anglais (eng) Mots-clés : age at diagnosis  autism  diagnosis  gender  sex Index. décimale : PER Périodiques Résumé : Later autism diagnosis is associated with increased mental health risks. Understanding disparities in diagnostic timing is important to reduce psychiatric burden for autistic people. One characteristic associated with later autism diagnosis is female sex assigned at birth. However, literature to date does not characterize, differentiate, or account for gender identity beyond assigned sex at birth. Gender diversity may be more common in autistic relative to neurotypical people, and autism is proportionally overrepresented in gender-diverse populations. We examined age at autism diagnosis by assigned sex at birth, gender identity, and gender diversity (gender-diverse vs cisgender) status, separately. Three independent cohorts representing different ascertainments were examined: a research-recruited academic medical center sample (N = 193; 8.0 - 18.0?years); a clinic-based sample (N = 1550; 1.3 - 25.4?years); and a community-enriched sample (N = 244, 18.2 - 30.0?years). The clinic-based and community-enriched samples revealed disparities in diagnostic timing: people assigned female at birth, people of female gender, and gender-diverse people were diagnosed with autism significantly later than persons assigned male at birth, persons of male gender, and cisgender persons, respectively. Birth-sex, gender identity, and gender diversity may each uniquely relate to disparities in autism diagnostic timing. The influence of ascertainment strategies, particularly in studies examining assigned sex at birth or gender identity, should be considered. Lay Abstract Later autism diagnosis is associated with risk for mental health problems. Understanding factors related to later autism diagnosis may help reduce mental health risks for autistic people. One characteristic associated with later autism diagnosis is female sex. However, studies often do not distinguish sex assigned at birth and gender identity. Gender diversity may be more common in autistic relative to neurotypical people, and autism is more common in gender-diverse populations. We studied age at autism diagnosis by sex assigned at birth, gender identity, and gender diversity (gender-diverse vs cisgender) status, separately. We studied three separate autistic samples, each of which differed in how they were diagnosed and how they were recruited. The samples included 193 persons (8.0 - 18.0?years) from a research-recruited academic medical center sample; 1,550 people (1.3 - 25.4?years) from a clinic-based sample; and 244 people (18.2 - 30.0?years) from a community-enriched sample. We found significant differences in the clinic-based and community-enriched samples. People assigned female sex at birth were diagnosed with autism significantly later than people assigned male at birth. People of female gender were diagnosed significantly later than people of male gender. Gender-diverse people were diagnosed significantly later than cisgender people. Sex assigned at birth, gender identity, and gender diversity may each show unique relationships with age of autism diagnosis. Differences in how autistic people are diagnosed and recruited are important to consider in studies that examine sex assigned at birth or gender identity. More research into autism diagnosis in adulthood is needed. En ligne : https://dx.doi.org/10.1177/13623613241243117 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=537 [article] Gender, assigned sex at birth, and gender diversity: Windows into diagnostic timing disparities in autism [Texte imprimé et/ou numérique] / Goldie A. MCQUAID, Auteur ; Allison B. RATTO, Auteur ; Allison JACK, Auteur ; Alexis KHUU, Auteur ; Jessica V. SMITH, Auteur ; Sean C. DUANE, Auteur ; Ann CLAWSON, Auteur ; Nancy Raitano LEE, Auteur ; Alyssa VERBALIS, Auteur ; Kevin A. PELPHREY, Auteur ; Lauren KENWORTHY, Auteur ; Gregory L. WALLACE, Auteur ; John F. STRANG, Auteur . - p.2806 - 2820. Langues : Anglais (eng) in Autism > 28-11 (November 2024) . - p.2806 - 2820 Mots-clés : age at diagnosis  autism  diagnosis  gender  sex Index. décimale : PER Périodiques Résumé : Later autism diagnosis is associated with increased mental health risks. Understanding disparities in diagnostic timing is important to reduce psychiatric burden for autistic people. One characteristic associated with later autism diagnosis is female sex assigned at birth. However, literature to date does not characterize, differentiate, or account for gender identity beyond assigned sex at birth. Gender diversity may be more common in autistic relative to neurotypical people, and autism is proportionally overrepresented in gender-diverse populations. We examined age at autism diagnosis by assigned sex at birth, gender identity, and gender diversity (gender-diverse vs cisgender) status, separately. Three independent cohorts representing different ascertainments were examined: a research-recruited academic medical center sample (N = 193; 8.0 - 18.0?years); a clinic-based sample (N = 1550; 1.3 - 25.4?years); and a community-enriched sample (N = 244, 18.2 - 30.0?years). The clinic-based and community-enriched samples revealed disparities in diagnostic timing: people assigned female at birth, people of female gender, and gender-diverse people were diagnosed with autism significantly later than persons assigned male at birth, persons of male gender, and cisgender persons, respectively. Birth-sex, gender identity, and gender diversity may each uniquely relate to disparities in autism diagnostic timing. The influence of ascertainment strategies, particularly in studies examining assigned sex at birth or gender identity, should be considered. Lay Abstract Later autism diagnosis is associated with risk for mental health problems. Understanding factors related to later autism diagnosis may help reduce mental health risks for autistic people. One characteristic associated with later autism diagnosis is female sex. However, studies often do not distinguish sex assigned at birth and gender identity. Gender diversity may be more common in autistic relative to neurotypical people, and autism is more common in gender-diverse populations. We studied age at autism diagnosis by sex assigned at birth, gender identity, and gender diversity (gender-diverse vs cisgender) status, separately. We studied three separate autistic samples, each of which differed in how they were diagnosed and how they were recruited. The samples included 193 persons (8.0 - 18.0?years) from a research-recruited academic medical center sample; 1,550 people (1.3 - 25.4?years) from a clinic-based sample; and 244 people (18.2 - 30.0?years) from a community-enriched sample. We found significant differences in the clinic-based and community-enriched samples. People assigned female sex at birth were diagnosed with autism significantly later than people assigned male at birth. People of female gender were diagnosed significantly later than people of male gender. Gender-diverse people were diagnosed significantly later than cisgender people. Sex assigned at birth, gender identity, and gender diversity may each show unique relationships with age of autism diagnosis. Differences in how autistic people are diagnosed and recruited are important to consider in studies that examine sex assigned at birth or gender identity. More research into autism diagnosis in adulthood is needed. En ligne : https://dx.doi.org/10.1177/13623613241243117 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=537

Inner experiences, mental health, and well-being in autistic and non-autistic adults / Micah O. MAZUREK in Autism Research, 17-12 (December 2024)  

Public ISBD [article]  inAutism Research > 17-12 (December 2024) . - p.2676-2688 Titre : Inner experiences, mental health, and well-being in autistic and non-autistic adults Type de document : Texte imprimé et/ou numérique Auteurs : Micah O. MAZUREK, Auteur ; Jessica PAPPAGIANOPOULOS, Auteur ; Sophie BRUNT, Auteur ; Rose NEVILL, Auteur ; Michelle MENEZES, Auteur ; Christina BURROUGHS, Auteur ; Eleonora SADIKOVA, Auteur ; Jessica V. SMITH, Auteur ; Mya HOWARD, Auteur Article en page(s) : p.2676-2688 Langues : Anglais (eng) Mots-clés : autism  inner speech  mental health  self-talk  verbal thinking  visual thinking Index. décimale : PER Périodiques Résumé : Abstract The nature of autistic adults' everyday inner experiences has been largely unstudied. The purpose of this study was to examine patterns of inner experiences and how they relate to mental health and wellness among autistic and non-autistic adults. Autistic (n?=?303) and non-autistic (n?=?289) adults (ages 21?82) completed online surveys assessing their anxiety, depression, happiness, life satisfaction, and inner thinking patterns, (inner speaking [i.e., verbal thinking], inner seeing [i.e., visual thinking], unsymbolized thinking, feelings, sensory awareness, self-talk). Group differences in inner thinking were examined using Mann?Whitney U and chi-square tests. Correlations and multiple linear regressions examined associations between inner experiences, mental health, and well-being. Autistic adults had greater use of inner speaking and sensory awareness, compared to non-autistic adults. The most common primary mode of inner experience for both groups was inner speaking, while fewer autistic adults reported that experiencing thoughts as feelings was their primary modality. Autistic adults reported greater use of self-talk for social assessment, self-criticism, and self-management purposes, compared to non-autistic adults. Experiencing thoughts as inner speech and as feelings were associated with anxiety in both groups. Using self-talk for social assessment and self-criticism purposes was correlated with anxiety and depression in both groups, while using self-talk for self-management was associated with depression and anxiety only among autistic adults. The results suggest that autistic and non-autistic adults have similarities in overall patterns of inner thinking, yet autistic adults may be more likely to engage in self-talk as a strategy to manage challenging day-to-day experiences. En ligne : https://dx.doi.org/10.1002/aur.3273 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=544 [article] Inner experiences, mental health, and well-being in autistic and non-autistic adults [Texte imprimé et/ou numérique] / Micah O. MAZUREK, Auteur ; Jessica PAPPAGIANOPOULOS, Auteur ; Sophie BRUNT, Auteur ; Rose NEVILL, Auteur ; Michelle MENEZES, Auteur ; Christina BURROUGHS, Auteur ; Eleonora SADIKOVA, Auteur ; Jessica V. SMITH, Auteur ; Mya HOWARD, Auteur . - p.2676-2688. Langues : Anglais (eng) in Autism Research > 17-12 (December 2024) . - p.2676-2688 Mots-clés : autism  inner speech  mental health  self-talk  verbal thinking  visual thinking Index. décimale : PER Périodiques Résumé : Abstract The nature of autistic adults' everyday inner experiences has been largely unstudied. The purpose of this study was to examine patterns of inner experiences and how they relate to mental health and wellness among autistic and non-autistic adults. Autistic (n?=?303) and non-autistic (n?=?289) adults (ages 21?82) completed online surveys assessing their anxiety, depression, happiness, life satisfaction, and inner thinking patterns, (inner speaking [i.e., verbal thinking], inner seeing [i.e., visual thinking], unsymbolized thinking, feelings, sensory awareness, self-talk). Group differences in inner thinking were examined using Mann?Whitney U and chi-square tests. Correlations and multiple linear regressions examined associations between inner experiences, mental health, and well-being. Autistic adults had greater use of inner speaking and sensory awareness, compared to non-autistic adults. The most common primary mode of inner experience for both groups was inner speaking, while fewer autistic adults reported that experiencing thoughts as feelings was their primary modality. Autistic adults reported greater use of self-talk for social assessment, self-criticism, and self-management purposes, compared to non-autistic adults. Experiencing thoughts as inner speech and as feelings were associated with anxiety in both groups. Using self-talk for social assessment and self-criticism purposes was correlated with anxiety and depression in both groups, while using self-talk for self-management was associated with depression and anxiety only among autistic adults. The results suggest that autistic and non-autistic adults have similarities in overall patterns of inner thinking, yet autistic adults may be more likely to engage in self-talk as a strategy to manage challenging day-to-day experiences. En ligne : https://dx.doi.org/10.1002/aur.3273 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=544

Time is of the essence: Age at autism diagnosis, sex assigned at birth, and psychopathology / Jessica V. SMITH in Autism, 28-11 (November 2024)  

Public ISBD [article]  inAutism > 28-11 (November 2024) . - p.2909 - 2922 Titre : Time is of the essence: Age at autism diagnosis, sex assigned at birth, and psychopathology Type de document : Texte imprimé et/ou numérique Auteurs : Jessica V. SMITH, Auteur ; Goldie A. MCQUAID, Auteur ; Gregory L. WALLACE, Auteur ; Emily NEUHAUS, Auteur ; Andrea LOPEZ, Auteur ; Allison B. RATTO, Auteur ; Allison JACK, Auteur ; Alexis KHUU, Auteur ; Sara J. WEBB, Auteur ; Alyssa VERBALIS, Auteur ; Kevin A. PELPHREY, Auteur ; Lauren KENWORTHY, Auteur Article en page(s) : p.2909 - 2922 Langues : Anglais (eng) Mots-clés : autism  diagnostic delay  diagnostic timing  mental health outcomes Index. décimale : PER Périodiques Résumé : Age at autism diagnosis is associated with sex assigned at birth (hereafter, "sex"), such that girls/women are more likely to be delayed or "missed" entirely in the diagnostic process compared to boys/men. Later diagnosed individuals, especially girls/women, demonstrate increased anxious/depressive symptoms. Data on autistic youth from clinic-based (n = 1035; 22.9% assigned female) and sex-balanced research-based (n = 128; 43% assigned female) samples were probed via regression-based mediation models to understand relationships between diagnostic age, sex, and symptoms of anxiety/depression. We hypothesized diagnostic age would mediate the relationship between sex and anxious/depressive symptoms. In both samples, later diagnostic age predicted greater anxious and depressive symptoms, and sex did not directly predict anxious symptoms. In the clinic-based but not the research-based sample, individuals assigned female at birth were later diagnosed than those assigned male, and there was a significant indirect effect of sex on anxious and depressive symptoms through diagnostic age, such that those assigned female and later diagnosed experienced greater symptoms. Within the research-based sample only, sex predicted depressive symptoms. The present study provides an important impetus for further evaluating the implications of diagnostic timing, enhancing tools for recognizing autism in individuals assigned female at birth, and grounding research with real-world ascertainment strategies. Lay Abstract Previous research has shown that girls/women are diagnosed later than boys/men with autism. Individuals who are diagnosed later in life, especially girls/women, have greater anxious and depressive symptoms. Previous research has been limited due to narrow inclusionary criteria for enrollment in studies. The present study uses two samples-one clinic-based, large "real-world" sample and another research-based sample with strict criteria for autism diagnosis-to understand the relationships between diagnostic age, sex assigned at birth, and symptoms of anxiety/depression. In both samples, those who were diagnosed later had greater anxious/depressive symptoms, and anxiety was not predicted by sex. In the clinic-based but not research-based sample, those assigned female at birth were diagnosed later than those assigned male at birth. In the clinic-based sample only, individuals assigned female at birth and who were later diagnosed experienced greater symptoms of anxiety/depression compared to those assigned male who benefited from earlier diagnostic timing. Within the research-based sample, those assigned female at birth had greater depressive symptoms than those assigned male. These findings highlight the importance of timely identification of autism, especially for girls/women who are often diagnosed later. Community-based samples are needed to better understand real-world sex-based and diagnostic age-based disparities in mental health. En ligne : https://dx.doi.org/10.1177/13623613241249878 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=537 [article] Time is of the essence: Age at autism diagnosis, sex assigned at birth, and psychopathology [Texte imprimé et/ou numérique] / Jessica V. SMITH, Auteur ; Goldie A. MCQUAID, Auteur ; Gregory L. WALLACE, Auteur ; Emily NEUHAUS, Auteur ; Andrea LOPEZ, Auteur ; Allison B. RATTO, Auteur ; Allison JACK, Auteur ; Alexis KHUU, Auteur ; Sara J. WEBB, Auteur ; Alyssa VERBALIS, Auteur ; Kevin A. PELPHREY, Auteur ; Lauren KENWORTHY, Auteur . - p.2909 - 2922. Langues : Anglais (eng) in Autism > 28-11 (November 2024) . - p.2909 - 2922 Mots-clés : autism  diagnostic delay  diagnostic timing  mental health outcomes Index. décimale : PER Périodiques Résumé : Age at autism diagnosis is associated with sex assigned at birth (hereafter, "sex"), such that girls/women are more likely to be delayed or "missed" entirely in the diagnostic process compared to boys/men. Later diagnosed individuals, especially girls/women, demonstrate increased anxious/depressive symptoms. Data on autistic youth from clinic-based (n = 1035; 22.9% assigned female) and sex-balanced research-based (n = 128; 43% assigned female) samples were probed via regression-based mediation models to understand relationships between diagnostic age, sex, and symptoms of anxiety/depression. We hypothesized diagnostic age would mediate the relationship between sex and anxious/depressive symptoms. In both samples, later diagnostic age predicted greater anxious and depressive symptoms, and sex did not directly predict anxious symptoms. In the clinic-based but not the research-based sample, individuals assigned female at birth were later diagnosed than those assigned male, and there was a significant indirect effect of sex on anxious and depressive symptoms through diagnostic age, such that those assigned female and later diagnosed experienced greater symptoms. Within the research-based sample only, sex predicted depressive symptoms. The present study provides an important impetus for further evaluating the implications of diagnostic timing, enhancing tools for recognizing autism in individuals assigned female at birth, and grounding research with real-world ascertainment strategies. Lay Abstract Previous research has shown that girls/women are diagnosed later than boys/men with autism. Individuals who are diagnosed later in life, especially girls/women, have greater anxious and depressive symptoms. Previous research has been limited due to narrow inclusionary criteria for enrollment in studies. The present study uses two samples-one clinic-based, large "real-world" sample and another research-based sample with strict criteria for autism diagnosis-to understand the relationships between diagnostic age, sex assigned at birth, and symptoms of anxiety/depression. In both samples, those who were diagnosed later had greater anxious/depressive symptoms, and anxiety was not predicted by sex. In the clinic-based but not research-based sample, those assigned female at birth were diagnosed later than those assigned male at birth. In the clinic-based sample only, individuals assigned female at birth and who were later diagnosed experienced greater symptoms of anxiety/depression compared to those assigned male who benefited from earlier diagnostic timing. Within the research-based sample, those assigned female at birth had greater depressive symptoms than those assigned male. These findings highlight the importance of timely identification of autism, especially for girls/women who are often diagnosed later. Community-based samples are needed to better understand real-world sex-based and diagnostic age-based disparities in mental health. En ligne : https://dx.doi.org/10.1177/13623613241249878 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=537

Understanding autism diagnosis in primary care: Rates of diagnosis from 2004 to 2019 and child age at diagnosis / Jessica V. SMITH in Autism, 28-10 (October 2024)  

Public ISBD [article]  inAutism > 28-10 (October 2024) . - p.2637-2646 Titre : Understanding autism diagnosis in primary care: Rates of diagnosis from 2004 to 2019 and child age at diagnosis Type de document : Texte imprimé et/ou numérique Auteurs : Jessica V. SMITH, Auteur ; Michelle MENEZES, Auteur ; Sophie BRUNT, Auteur ; Jessica PAPPAGIANOPOULOS, Auteur ; Eleonora SADIKOVA, Auteur ; Micah O MAZUREK, Auteur Article en page(s) : p.2637-2646 Langues : Anglais (eng) Mots-clés : age at diagnosis  autism  capacity-building  diagnostic timing  early identification  primary care Index. décimale : PER Périodiques Résumé : The capacity of the workforce lags behind the current demand for timely autism diagnostic assessment. Primary care providers (PCPs) are well-positioned to diagnose autism at earlier ages than providers from other disciplines. Thus, bolstering PCPs' diagnostic capabilities has been the focus of many recent capacity-building initiatives. Using data from the National Survey of Children?s Health, this study aimed to evaluate whether diagnosis of autism in primary care has changed over time and whether diagnosis in primary care relates to age at autism diagnosis. Results indicated that the likelihood of being diagnosed with autism by a PCP decreased by about 2% with every passing year from 2004 to 2019 when controlling for demographic characteristics. PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychiatrists and psychologists), which supports the critical role PCPs can play in timely diagnosis. Further research is needed to understand why the proportion of children diagnosed by PCPs has decreased over time; however, these findings suggest that capacity-building initiatives have not yet reached community practice. Future research should focus on the dissemination and implementation of training initiatives in community-based primary care practices. Lay abstract The current demand for autism diagnostic services exceeds the ability of the workforce to assess and diagnose children in a timely manner. One solution may be to equip primary care providers (PCPs) with the tools and expertise needed to diagnose autism within their practice. PCPs are often trusted professionals who have many touchpoints with children during early development, in which they can identify early signs of autism. Recent initiatives have focused on bolstering PCPs' diagnostic capabilities; however, no studies have examined how the rates of autism diagnosis in primary care have changed over time. We aimed to evaluate whether autism diagnosis in primary care has changed over time and how diagnosis in primary care relates to a child?s age at the time of diagnosis. We found that the likelihood of a child being diagnosed by a PCP decreased by about 2% with every passing year from 2004 to 2019 when accounting for demographic characteristics. In our sample, PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychologists and psychiatrists). Further research is needed to understand why the proportion of children diagnosed by PCPs decreases over time. However, this decrease suggests more work is needed to get capacity-building initiatives into community primary care practice. Though we must continue to find effective ways to build community PCPs' ability to diagnose autism, the present findings support the crucial role PCPs can play in early autism diagnosis. En ligne : https://dx.doi.org/10.1177/13623613241236112 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=536 [article] Understanding autism diagnosis in primary care: Rates of diagnosis from 2004 to 2019 and child age at diagnosis [Texte imprimé et/ou numérique] / Jessica V. SMITH, Auteur ; Michelle MENEZES, Auteur ; Sophie BRUNT, Auteur ; Jessica PAPPAGIANOPOULOS, Auteur ; Eleonora SADIKOVA, Auteur ; Micah O MAZUREK, Auteur . - p.2637-2646. Langues : Anglais (eng) in Autism > 28-10 (October 2024) . - p.2637-2646 Mots-clés : age at diagnosis  autism  capacity-building  diagnostic timing  early identification  primary care Index. décimale : PER Périodiques Résumé : The capacity of the workforce lags behind the current demand for timely autism diagnostic assessment. Primary care providers (PCPs) are well-positioned to diagnose autism at earlier ages than providers from other disciplines. Thus, bolstering PCPs' diagnostic capabilities has been the focus of many recent capacity-building initiatives. Using data from the National Survey of Children?s Health, this study aimed to evaluate whether diagnosis of autism in primary care has changed over time and whether diagnosis in primary care relates to age at autism diagnosis. Results indicated that the likelihood of being diagnosed with autism by a PCP decreased by about 2% with every passing year from 2004 to 2019 when controlling for demographic characteristics. PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychiatrists and psychologists), which supports the critical role PCPs can play in timely diagnosis. Further research is needed to understand why the proportion of children diagnosed by PCPs has decreased over time; however, these findings suggest that capacity-building initiatives have not yet reached community practice. Future research should focus on the dissemination and implementation of training initiatives in community-based primary care practices. Lay abstract The current demand for autism diagnostic services exceeds the ability of the workforce to assess and diagnose children in a timely manner. One solution may be to equip primary care providers (PCPs) with the tools and expertise needed to diagnose autism within their practice. PCPs are often trusted professionals who have many touchpoints with children during early development, in which they can identify early signs of autism. Recent initiatives have focused on bolstering PCPs' diagnostic capabilities; however, no studies have examined how the rates of autism diagnosis in primary care have changed over time. We aimed to evaluate whether autism diagnosis in primary care has changed over time and how diagnosis in primary care relates to a child?s age at the time of diagnosis. We found that the likelihood of a child being diagnosed by a PCP decreased by about 2% with every passing year from 2004 to 2019 when accounting for demographic characteristics. In our sample, PCPs diagnosed children approximately 1 year earlier than non-PCPs (e.g., psychologists and psychiatrists). Further research is needed to understand why the proportion of children diagnosed by PCPs decreases over time. However, this decrease suggests more work is needed to get capacity-building initiatives into community primary care practice. Though we must continue to find effective ways to build community PCPs' ability to diagnose autism, the present findings support the crucial role PCPs can play in early autism diagnosis. En ligne : https://dx.doi.org/10.1177/13623613241236112 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=536

Utility of an Observational Social Skill Assessment as a Measure of Social Cognition in Autism / Grace Lee SIMMONS in Autism Research, 14-4 (April 2021)  

Public ISBD [article]  inAutism Research > 14-4 (April 2021) . - p.709-719 Titre : Utility of an Observational Social Skill Assessment as a Measure of Social Cognition in Autism Type de document : Texte imprimé et/ou numérique Auteurs : Grace Lee SIMMONS, Auteur ; Sara IOANNOU, Auteur ; Jessica V. SMITH, Auteur ; Blythe A. CORBETT, Auteur ; Matthew D LERNER, Auteur ; Susan W. WHITE, Auteur Article en page(s) : p.709-719 Langues : Anglais (eng) Mots-clés : adolescents  children  face processing  social cognition  social cognition and theory of mind Index. décimale : PER Périodiques Résumé : Models of impaired social competence in autism spectrum disorder (ASD) highlight deficits in social cognition and social behavior. The Contextual Assessment of Social Skills (CASS) is a laboratory-based assessment of conversation ability in which participants interact with trained confederates who act interested (CASS-I) and bored (CASS-B), sequentially. The increased ecological validity of the CASS allows for better generalization to real-world social situations. Participants' perceptions of confederate behavior, assessed by the CASS Conversation Rating Scale (CRS), might offer additional utility as a metric of social cognition. The current study examined CASS confederate behavior (adherence to interested or bored condition) and both internal validity and convergent validity of the CASS as a measure of social behavior and social cognition. Fifty adolescents with ASD participated as part of a multisite randomized clinical trial. Adherence ratings were consistent across gender and site, with interested confederates significantly out-performing bored confederates. The ability to distinguish between interested and bored confederates was positively associated with CASS social behavior and social cognition tasks, although social behavior during the CASS was not consistently associated with parent-rated social behavior. Controlling for confederate behavior did not significantly alter these associations. Findings demonstrate strong internal validity of the CASS and, partially, external validity of the CASS as a measure of social cognition. Findings highlight nuanced differences in social behavior and social cognition. The CASS shows promise as an outcome measure for clinical interventions and should be incorporated into a multimethod battery to assess social competence in individuals with ASD. LAY SUMMARY: Social cognition and social behavior should be studied together to examine social competence in youth with autism. The Contextual Assessment of Social Skills (CASS), a behavioral observation measure, shows promise toward this end; findings suggest the CASS taps social cognition and social behavior when administered alongside a participant rating scale of their conversation partner's engagement. Continued research, including examination of the CASS, may inform best practices in comprehensive assessment of social competence in autism. Autism Res 2021, 14: 709-719. © 2020 International Society for Autism Research and Wiley Periodicals LLC. En ligne : http://dx.doi.org/10.1002/aur.2404 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=443 [article] Utility of an Observational Social Skill Assessment as a Measure of Social Cognition in Autism [Texte imprimé et/ou numérique] / Grace Lee SIMMONS, Auteur ; Sara IOANNOU, Auteur ; Jessica V. SMITH, Auteur ; Blythe A. CORBETT, Auteur ; Matthew D LERNER, Auteur ; Susan W. WHITE, Auteur . - p.709-719. Langues : Anglais (eng) in Autism Research > 14-4 (April 2021) . - p.709-719 Mots-clés : adolescents  children  face processing  social cognition  social cognition and theory of mind Index. décimale : PER Périodiques Résumé : Models of impaired social competence in autism spectrum disorder (ASD) highlight deficits in social cognition and social behavior. The Contextual Assessment of Social Skills (CASS) is a laboratory-based assessment of conversation ability in which participants interact with trained confederates who act interested (CASS-I) and bored (CASS-B), sequentially. The increased ecological validity of the CASS allows for better generalization to real-world social situations. Participants' perceptions of confederate behavior, assessed by the CASS Conversation Rating Scale (CRS), might offer additional utility as a metric of social cognition. The current study examined CASS confederate behavior (adherence to interested or bored condition) and both internal validity and convergent validity of the CASS as a measure of social behavior and social cognition. Fifty adolescents with ASD participated as part of a multisite randomized clinical trial. Adherence ratings were consistent across gender and site, with interested confederates significantly out-performing bored confederates. The ability to distinguish between interested and bored confederates was positively associated with CASS social behavior and social cognition tasks, although social behavior during the CASS was not consistently associated with parent-rated social behavior. Controlling for confederate behavior did not significantly alter these associations. Findings demonstrate strong internal validity of the CASS and, partially, external validity of the CASS as a measure of social cognition. Findings highlight nuanced differences in social behavior and social cognition. The CASS shows promise as an outcome measure for clinical interventions and should be incorporated into a multimethod battery to assess social competence in individuals with ASD. LAY SUMMARY: Social cognition and social behavior should be studied together to examine social competence in youth with autism. The Contextual Assessment of Social Skills (CASS), a behavioral observation measure, shows promise toward this end; findings suggest the CASS taps social cognition and social behavior when administered alongside a participant rating scale of their conversation partner's engagement. Continued research, including examination of the CASS, may inform best practices in comprehensive assessment of social competence in autism. Autism Res 2021, 14: 709-719. © 2020 International Society for Autism Research and Wiley Periodicals LLC. En ligne : http://dx.doi.org/10.1002/aur.2404 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=443

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