Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low- and middle-income countries: a review of reviews / Gauri DIVAN in Journal of Child Psychology and Psychiatry, 62-5 (May 2021)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 62-5 (May 2021) . - p.514-535 Titre : Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low- and middle-income countries: a review of reviews Type de document : Texte imprimé et/ou numérique Auteurs : Gauri DIVAN, Auteur ; Supriya BHAVNANI, Auteur ; Kathy LEADBITTER, Auteur ; Ceri ELLIS, Auteur ; Jayashree DASGUPTA, Auteur ; Amina ABUBAKAR, Auteur ; Mayada ELSABBAGH, Auteur ; Syed Usman HAMDANI, Auteur ; Chiara SERVILI, Auteur ; Vikram PATEL, Auteur ; Jonathan GREEN, Auteur Article en page(s) : p.514-535 Langues : Anglais (eng) Mots-clés : Autism  detection gap  low- and middle-income countries  low-resource settings  scoping review  treatment gap Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism presents with similar prevalence and core impairments in diverse populations. We conducted a scoping review of reviews to determine key barriers and innovative strategies which can contribute to attaining universal health coverage (UHC), from early detection to effective interventions for autism in low- and middle-income countries (LAMIC). METHODS: A systematic literature search of review articles was conducted. Reviews relevant to the study research question were included if they incorporated papers from LAMIC and focused on children ( En ligne : http://dx.doi.org/10.1111/jcpp.13404 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=445 [article] Annual Research Review: Achieving universal health coverage for young children with autism spectrum disorder in low- and middle-income countries: a review of reviews [Texte imprimé et/ou numérique] / Gauri DIVAN, Auteur ; Supriya BHAVNANI, Auteur ; Kathy LEADBITTER, Auteur ; Ceri ELLIS, Auteur ; Jayashree DASGUPTA, Auteur ; Amina ABUBAKAR, Auteur ; Mayada ELSABBAGH, Auteur ; Syed Usman HAMDANI, Auteur ; Chiara SERVILI, Auteur ; Vikram PATEL, Auteur ; Jonathan GREEN, Auteur . - p.514-535. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 62-5 (May 2021) . - p.514-535 Mots-clés : Autism  detection gap  low- and middle-income countries  low-resource settings  scoping review  treatment gap Index. décimale : PER Périodiques Résumé : BACKGROUND: Autism presents with similar prevalence and core impairments in diverse populations. We conducted a scoping review of reviews to determine key barriers and innovative strategies which can contribute to attaining universal health coverage (UHC), from early detection to effective interventions for autism in low- and middle-income countries (LAMIC). METHODS: A systematic literature search of review articles was conducted. Reviews relevant to the study research question were included if they incorporated papers from LAMIC and focused on children ( En ligne : http://dx.doi.org/10.1111/jcpp.13404 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=445

Attention control in autism: Eye-tracking findings from pre-school children in a low- and middle-income country setting / Luke MASON ; Rashi ARORA ; Supriya BHAVNANI ; Jayashree DASGUPTA ; Sheffali GULATI ; Teodora GLIGA ; Mark H. JOHNSON in Autism, 28-1 (January 2024)  

Public ISBD [article]  inAutism > 28-1 (January 2024) . - p.43?57 Titre : Attention control in autism: Eye-tracking findings from pre-school children in a low- and middle-income country setting Type de document : Texte imprimé et/ou numérique Auteurs : Luke MASON, Auteur ; Rashi ARORA, Auteur ; Supriya BHAVNANI, Auteur ; Jayashree DASGUPTA, Auteur ; Sheffali GULATI, Auteur ; Teodora GLIGA, Auteur ; Mark H. JOHNSON, Auteur Article en page(s) : p.43?57 Mots-clés : autism spectrum disorders  cognition (attention  learning  memory)  development  pre-school children Index. décimale : PER Périodiques Résumé : Alterations in the development of attention control and learning have been associated with autism and can be measured using the ?antisaccade task?, which assesses a child?s ability to make an oculomotor response away from a distracting stimulus, and learn to instead anticipate a later reward. We aimed to assess these cognitive processes using portable eye-tracking in an understudied population of pre-school children with and without a diagnosis of autism spectrum disorder in community settings in New Delhi, India. The eye-tracking antisaccade task was presented to children in three groups (n?=?104) (children with a clinical diagnosis of autism spectrum disorder or intellectual disability and children meeting developmental milestones). In accordance with findings from high-income, laboratory-based environments, children learnt to anticipate looks towards a reward, as well as inhibit eye-movements towards a distractor stimulus. We also provide novel evidence that while differences in inhibition responses might be applicable to multiple developmental conditions, a reduced learning to anticipate looks towards a target in this age group may be specific to autism. This eye-tracking task may, therefore, have the potential to identify and assess autism specific traits across development, and be used in longitudinal research studies such as investigating response to intervention in low-resource settings. Lay abstract The development of cognitive processes, such as attention control and learning, has been suggested to be altered in children with a diagnosis of autism spectrum disorder. However, nearly all of our understanding of the development of these cognitive processes comes from studies with school-aged or older children in high-income countries, and from research conducted in a controlled laboratory environment, thereby restricting the potential generalisability of results and away from the majority of the world?s population. We need to expand our research to investigate abilities beyond these limited settings. We address shortcomings in the literature by (1) studying attention control and learning in an understudied population of children in a low- and middle-income country setting in India, (2) focusing research on a critical younger age group of children and (3) using portable eye-tracking technology that can be taken into communities and healthcare settings to increase the accessibility of research in hard-to-reach populations. Our results provide novel evidence on differences in attention control and learning responses in groups of children with and without a diagnosis of autism spectrum disorder. We show that learning responses in children that we assessed through a portable eye-tracking task, called the ?antisaccade task?, may be specific to autism. This suggests that the methods we use may have the potential to identify and assess autism-specific traits across development, and be used in research in low-resource settings. En ligne : https://dx.doi.org/10.1177/13623613221149541 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=519 [article] Attention control in autism: Eye-tracking findings from pre-school children in a low- and middle-income country setting [Texte imprimé et/ou numérique] / Luke MASON, Auteur ; Rashi ARORA, Auteur ; Supriya BHAVNANI, Auteur ; Jayashree DASGUPTA, Auteur ; Sheffali GULATI, Auteur ; Teodora GLIGA, Auteur ; Mark H. JOHNSON, Auteur . - p.43?57. in Autism > 28-1 (January 2024) . - p.43?57 Mots-clés : autism spectrum disorders  cognition (attention  learning  memory)  development  pre-school children Index. décimale : PER Périodiques Résumé : Alterations in the development of attention control and learning have been associated with autism and can be measured using the ?antisaccade task?, which assesses a child?s ability to make an oculomotor response away from a distracting stimulus, and learn to instead anticipate a later reward. We aimed to assess these cognitive processes using portable eye-tracking in an understudied population of pre-school children with and without a diagnosis of autism spectrum disorder in community settings in New Delhi, India. The eye-tracking antisaccade task was presented to children in three groups (n?=?104) (children with a clinical diagnosis of autism spectrum disorder or intellectual disability and children meeting developmental milestones). In accordance with findings from high-income, laboratory-based environments, children learnt to anticipate looks towards a reward, as well as inhibit eye-movements towards a distractor stimulus. We also provide novel evidence that while differences in inhibition responses might be applicable to multiple developmental conditions, a reduced learning to anticipate looks towards a target in this age group may be specific to autism. This eye-tracking task may, therefore, have the potential to identify and assess autism specific traits across development, and be used in longitudinal research studies such as investigating response to intervention in low-resource settings. Lay abstract The development of cognitive processes, such as attention control and learning, has been suggested to be altered in children with a diagnosis of autism spectrum disorder. However, nearly all of our understanding of the development of these cognitive processes comes from studies with school-aged or older children in high-income countries, and from research conducted in a controlled laboratory environment, thereby restricting the potential generalisability of results and away from the majority of the world?s population. We need to expand our research to investigate abilities beyond these limited settings. We address shortcomings in the literature by (1) studying attention control and learning in an understudied population of children in a low- and middle-income country setting in India, (2) focusing research on a critical younger age group of children and (3) using portable eye-tracking technology that can be taken into communities and healthcare settings to increase the accessibility of research in hard-to-reach populations. Our results provide novel evidence on differences in attention control and learning responses in groups of children with and without a diagnosis of autism spectrum disorder. We show that learning responses in children that we assessed through a portable eye-tracking task, called the ?antisaccade task?, may be specific to autism. This suggests that the methods we use may have the potential to identify and assess autism-specific traits across development, and be used in research in low-resource settings. En ligne : https://dx.doi.org/10.1177/13623613221149541 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=519

Digital tools for direct assessment of autism risk during early childhood: A systematic review / Supriya BHAVNANI ; Georgia LOCKWOOD ESTRIN ; Vaisnavi RAO ; Jayashree DASGUPTA ; Hiba IRFAN ; Bhismadev CHAKRABARTI ; Vikram PATEL ; Matthew K. BELMONTE in Autism, 28-1 (January 2024)  

Public ISBD [article]  inAutism > 28-1 (January 2024) . - p.6?31 Titre : Digital tools for direct assessment of autism risk during early childhood: A systematic review Type de document : Texte imprimé et/ou numérique Auteurs : Supriya BHAVNANI, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Vaisnavi RAO, Auteur ; Jayashree DASGUPTA, Auteur ; Hiba IRFAN, Auteur ; Bhismadev CHAKRABARTI, Auteur ; Vikram PATEL, Auteur ; Matthew K. BELMONTE, Auteur Article en page(s) : p.6?31 Mots-clés : ASD  assessments  computer  digital  gamified  low-resource  mHealth  scalable  smartphone  tablet  virtual reality Index. décimale : PER Périodiques Résumé : Current challenges in early identification of autism spectrum disorder lead to significant delays in starting interventions, thereby compromising outcomes. Digital tools can potentially address this barrier as they are accessible, can measure autism-relevant phenotypes and can be administered in children?s natural environments by non-specialists. The purpose of this systematic review is to identify and characterise potentially scalable digital tools for direct assessment of autism spectrum disorder risk in early childhood. In total, 51,953 titles, 6884 abstracts and 567 full-text articles from four databases were screened using predefined criteria. Of these, 38 met inclusion criteria. Tasks are presented on both portable and non-portable technologies, typically by researchers in laboratory or clinic settings. Gamified tasks, virtual-reality platforms and automated analysis of video or audio recordings of children?s behaviours and speech are used to assess autism spectrum disorder risk. Tasks tapping social communication/interaction and motor domains most reliably discriminate between autism spectrum disorder and typically developing groups. Digital tools employing objective data collection and analysis methods hold immense potential for early identification of autism spectrum disorder risk. Next steps should be to further validate these tools, evaluate their generalisability outside laboratory or clinic settings, and standardise derived measures across tasks. Furthermore, stakeholders from underserved communities should be involved in the research and development process. Lay abstract The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children?s homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the ?proof-of-concept? stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children?s behaviours or speech. Computerised analysis of children?s interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing. En ligne : https://dx.doi.org/10.1177/13623613221133176 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=519 [article] Digital tools for direct assessment of autism risk during early childhood: A systematic review [Texte imprimé et/ou numérique] / Supriya BHAVNANI, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Vaisnavi RAO, Auteur ; Jayashree DASGUPTA, Auteur ; Hiba IRFAN, Auteur ; Bhismadev CHAKRABARTI, Auteur ; Vikram PATEL, Auteur ; Matthew K. BELMONTE, Auteur . - p.6?31. in Autism > 28-1 (January 2024) . - p.6?31 Mots-clés : ASD  assessments  computer  digital  gamified  low-resource  mHealth  scalable  smartphone  tablet  virtual reality Index. décimale : PER Périodiques Résumé : Current challenges in early identification of autism spectrum disorder lead to significant delays in starting interventions, thereby compromising outcomes. Digital tools can potentially address this barrier as they are accessible, can measure autism-relevant phenotypes and can be administered in children?s natural environments by non-specialists. The purpose of this systematic review is to identify and characterise potentially scalable digital tools for direct assessment of autism spectrum disorder risk in early childhood. In total, 51,953 titles, 6884 abstracts and 567 full-text articles from four databases were screened using predefined criteria. Of these, 38 met inclusion criteria. Tasks are presented on both portable and non-portable technologies, typically by researchers in laboratory or clinic settings. Gamified tasks, virtual-reality platforms and automated analysis of video or audio recordings of children?s behaviours and speech are used to assess autism spectrum disorder risk. Tasks tapping social communication/interaction and motor domains most reliably discriminate between autism spectrum disorder and typically developing groups. Digital tools employing objective data collection and analysis methods hold immense potential for early identification of autism spectrum disorder risk. Next steps should be to further validate these tools, evaluate their generalisability outside laboratory or clinic settings, and standardise derived measures across tasks. Furthermore, stakeholders from underserved communities should be involved in the research and development process. Lay abstract The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children?s homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the ?proof-of-concept? stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children?s behaviours or speech. Computerised analysis of children?s interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing. En ligne : https://dx.doi.org/10.1177/13623613221133176 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=519

Using mobile health technology to assess childhood autism in low-resource community settings in India: An innovation to address the detection gap / Indu DUBEY in Autism, 28-3 (March 2024)  

Public ISBD [article]  inAutism > 28-3 (March 2024) . - p.755-769 Titre : Using mobile health technology to assess childhood autism in low-resource community settings in India: An innovation to address the detection gap Type de document : Texte imprimé et/ou numérique Auteurs : Indu DUBEY, Auteur ; Rahul BISHAIN, Auteur ; Jayashree DASGUPTA, Auteur ; Supriya BHAVNANI, Auteur ; Matthew K. BELMONTE, Auteur ; Teodora GLIGA, Auteur ; Debarati MUKHERJEE, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Mark H. JOHNSON, Auteur ; Sharat CHANDRAN, Auteur ; Vikram PATEL, Auteur ; Sheffali GULATI, Auteur ; Gauri DIVAN, Auteur ; Bhismadev CHAKRABARTI, Auteur Article en page(s) : p.755-769 Langues : Anglais (eng) Mots-clés : Autism  digital health  global  LMIC Index. décimale : PER Périodiques Résumé : A diagnosis of autism typically depends on clinical assessments by highly trained professionals. This high resource demand poses a challenge in low-resource settings. Digital assessment of neurodevelopmental symptoms by non-specialists provides a potential avenue to address this challenge. This cross-sectional case-control field study establishes proof of principle for such a digital assessment. We developed and tested an app, START, that can be administered by non-specialists to assess autism phenotypic domains (social, sensory, motor) through child performance and parent reports. N = 131 children (2-7?years old; 48 autistic, 43 intellectually disabled and 40 non-autistic typically developing) from low-resource settings in Delhi-NCR, India were assessed using START in home settings by non-specialist health workers. The two groups of children with neurodevelopmental disorders manifested lower social preference, greater sensory interest and lower fine-motor accuracy compared to their typically developing counterparts. Parent report further distinguished autistic from non-autistic children. Machine-learning analysis combining all START-derived measures demonstrated 78% classification accuracy for the three groups. Qualitative analysis of the interviews with health workers and families of the participants demonstrated high acceptability and feasibility of the app. These results provide feasibility, acceptability and proof of principle for START, and demonstrate the potential of a scalable, mobile tool for assessing neurodevelopmental conditions in low-resource settings. Lay abstract Autism is diagnosed by highly trained professionals- but most autistic people live in parts of the world that harbour few or no such autism specialists and little autism awareness. So many autistic people go undiagnosed, misdiagnosed, and misunderstood. We designed an app (START) to identify autism and related conditions in such places, in an attempt to address this global gap in access to specialists. START uses computerised games and activities for children and a questionnaire for parents to measure social, sensory, and motor skills. To check whether START can flag undiagnosed children likely to have neurodevelopmental conditions, we tested START with children whose diagnoses already were known: Non-specialist health workers with just a high-school education took START to family homes in poor neighbourhoods of Delhi, India to work with 131 two-to-seven-year-olds. Differences between typically and atypically developing children were highlighted in all three types of skills that START assesses: children with neurodevelopmental conditions preferred looking at geometric patterns rather than social scenes, were fascinated by predictable, repetitive sensory stimuli, and had more trouble with precise hand movements. Parents' responses to surveys further distinguished autistic from non-autistic children. An artificial-intelligence technique combining all these measures demonstrated that START can fairly accurately flag atypically developing children. Health workers and families endorsed START as attractive to most children, understandable to health workers, and adaptable within sometimes chaotic home and family environments. This study provides a proof of principle for START in digital screening of autism and related conditions in community settings. En ligne : https://dx.doi.org/10.1177/13623613231182801 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523 [article] Using mobile health technology to assess childhood autism in low-resource community settings in India: An innovation to address the detection gap [Texte imprimé et/ou numérique] / Indu DUBEY, Auteur ; Rahul BISHAIN, Auteur ; Jayashree DASGUPTA, Auteur ; Supriya BHAVNANI, Auteur ; Matthew K. BELMONTE, Auteur ; Teodora GLIGA, Auteur ; Debarati MUKHERJEE, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Mark H. JOHNSON, Auteur ; Sharat CHANDRAN, Auteur ; Vikram PATEL, Auteur ; Sheffali GULATI, Auteur ; Gauri DIVAN, Auteur ; Bhismadev CHAKRABARTI, Auteur . - p.755-769. Langues : Anglais (eng) in Autism > 28-3 (March 2024) . - p.755-769 Mots-clés : Autism  digital health  global  LMIC Index. décimale : PER Périodiques Résumé : A diagnosis of autism typically depends on clinical assessments by highly trained professionals. This high resource demand poses a challenge in low-resource settings. Digital assessment of neurodevelopmental symptoms by non-specialists provides a potential avenue to address this challenge. This cross-sectional case-control field study establishes proof of principle for such a digital assessment. We developed and tested an app, START, that can be administered by non-specialists to assess autism phenotypic domains (social, sensory, motor) through child performance and parent reports. N = 131 children (2-7?years old; 48 autistic, 43 intellectually disabled and 40 non-autistic typically developing) from low-resource settings in Delhi-NCR, India were assessed using START in home settings by non-specialist health workers. The two groups of children with neurodevelopmental disorders manifested lower social preference, greater sensory interest and lower fine-motor accuracy compared to their typically developing counterparts. Parent report further distinguished autistic from non-autistic children. Machine-learning analysis combining all START-derived measures demonstrated 78% classification accuracy for the three groups. Qualitative analysis of the interviews with health workers and families of the participants demonstrated high acceptability and feasibility of the app. These results provide feasibility, acceptability and proof of principle for START, and demonstrate the potential of a scalable, mobile tool for assessing neurodevelopmental conditions in low-resource settings. Lay abstract Autism is diagnosed by highly trained professionals- but most autistic people live in parts of the world that harbour few or no such autism specialists and little autism awareness. So many autistic people go undiagnosed, misdiagnosed, and misunderstood. We designed an app (START) to identify autism and related conditions in such places, in an attempt to address this global gap in access to specialists. START uses computerised games and activities for children and a questionnaire for parents to measure social, sensory, and motor skills. To check whether START can flag undiagnosed children likely to have neurodevelopmental conditions, we tested START with children whose diagnoses already were known: Non-specialist health workers with just a high-school education took START to family homes in poor neighbourhoods of Delhi, India to work with 131 two-to-seven-year-olds. Differences between typically and atypically developing children were highlighted in all three types of skills that START assesses: children with neurodevelopmental conditions preferred looking at geometric patterns rather than social scenes, were fascinated by predictable, repetitive sensory stimuli, and had more trouble with precise hand movements. Parents' responses to surveys further distinguished autistic from non-autistic children. An artificial-intelligence technique combining all these measures demonstrated that START can fairly accurately flag atypically developing children. Health workers and families endorsed START as attractive to most children, understandable to health workers, and adaptable within sometimes chaotic home and family environments. This study provides a proof of principle for START in digital screening of autism and related conditions in community settings. En ligne : https://dx.doi.org/10.1177/13623613231182801 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523

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