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

"I was Confused ? and Still am" Barriers Impacting the Help-Seeking Pathway for an Autism Diagnosis in Urban North India: A Mixed Methods Study / Supriya BHAVNANI in Journal of Autism and Developmental Disorders, 52-4 (April 2022)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 52-4 (April 2022) . - p.1778-1788 Titre : "I was Confused ? and Still am" Barriers Impacting the Help-Seeking Pathway for an Autism Diagnosis in Urban North India: A Mixed Methods Study Type de document : Texte imprimé et/ou numérique Auteurs : Supriya BHAVNANI, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Rashi ARORA, Auteur ; Divya KUMAR, Auteur ; Minal KAKRA, Auteur ; Vivek VAJARATKAR, Auteur ; Monica JUNEJA, Auteur ; Sheffali GULATI, Auteur ; Vikram PATEL, Auteur ; Jonathan GREEN, Auteur ; Gauri DIVAN, Auteur Article en page(s) : p.1778-1788 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Caregivers  Child  Child, Preschool  Humans  India  Autism Spectrum Disorders  Delay  Diagnosis  Help-seeking pathway  content of this article. Index. décimale : PER Périodiques Résumé : Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools. En ligne : http://dx.doi.org/10.1007/s10803-021-05047-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=476 [article] "I was Confused ? and Still am" Barriers Impacting the Help-Seeking Pathway for an Autism Diagnosis in Urban North India: A Mixed Methods Study [Texte imprimé et/ou numérique] / Supriya BHAVNANI, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Rashi ARORA, Auteur ; Divya KUMAR, Auteur ; Minal KAKRA, Auteur ; Vivek VAJARATKAR, Auteur ; Monica JUNEJA, Auteur ; Sheffali GULATI, Auteur ; Vikram PATEL, Auteur ; Jonathan GREEN, Auteur ; Gauri DIVAN, Auteur . - p.1778-1788. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 52-4 (April 2022) . - p.1778-1788 Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Caregivers  Child  Child, Preschool  Humans  India  Autism Spectrum Disorders  Delay  Diagnosis  Help-seeking pathway  content of this article. Index. décimale : PER Périodiques Résumé : Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools. En ligne : http://dx.doi.org/10.1007/s10803-021-05047-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=476

Mapping the link between socio-economic factors, autistic traits and mental health across different settings / Teresa DEL BIANCO in Autism, 28-5 (May 2024)  

Public ISBD [article]  inAutism > 28-5 (May 2024) . - p.1280-1296 Titre : Mapping the link between socio-economic factors, autistic traits and mental health across different settings Type de document : Texte imprimé et/ou numérique Auteurs : Teresa DEL BIANCO, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Julian TILLMANN, Auteur ; Bethany F. OAKLEY, Auteur ; Daisy CRAWLEY, Auteur ; Antonia SAN JOSE CACERES, Auteur ; Hannah HAYWARD, Auteur ; Mandy POTTER, Auteur ; Wendy MACKAY, Auteur ; Petrusa SMIT, Auteur ; Carlie DU PLESSIS, Auteur ; Lucy BRINK, Auteur ; Priscilla SPRINGER, Auteur ; Hein ODENDAAL, Auteur ; Tony CHARMAN, Auteur ; Tobias BANASCHEWSKI, Auteur ; Simon BARON-COHEN, Auteur ; Sven BÖLTE, Auteur ; Mark JOHNSON, Auteur ; Declan MURPHY, Auteur ; Jan BUITELAAR, Auteur ; Eva LOTH, Auteur ; Emily JH JONES, Auteur Article en page(s) : p.1280-1296 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  environmental factors Index. décimale : PER Périodiques Résumé : Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample (n = 764; 453 autistic; 311 non-autistic; 6-30?years), and a South African sample (n = 100 non-autistic; 3-11?years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The 'Family System' factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings - in Europe and South Africa - to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific 'factors'. We found that four similar 'factors' could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just 'Family System' was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people. En ligne : https://dx.doi.org/10.1177/13623613231200297 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=527 [article] Mapping the link between socio-economic factors, autistic traits and mental health across different settings [Texte imprimé et/ou numérique] / Teresa DEL BIANCO, Auteur ; Georgia LOCKWOOD ESTRIN, Auteur ; Julian TILLMANN, Auteur ; Bethany F. OAKLEY, Auteur ; Daisy CRAWLEY, Auteur ; Antonia SAN JOSE CACERES, Auteur ; Hannah HAYWARD, Auteur ; Mandy POTTER, Auteur ; Wendy MACKAY, Auteur ; Petrusa SMIT, Auteur ; Carlie DU PLESSIS, Auteur ; Lucy BRINK, Auteur ; Priscilla SPRINGER, Auteur ; Hein ODENDAAL, Auteur ; Tony CHARMAN, Auteur ; Tobias BANASCHEWSKI, Auteur ; Simon BARON-COHEN, Auteur ; Sven BÖLTE, Auteur ; Mark JOHNSON, Auteur ; Declan MURPHY, Auteur ; Jan BUITELAAR, Auteur ; Eva LOTH, Auteur ; Emily JH JONES, Auteur . - p.1280-1296. Langues : Anglais (eng) in Autism > 28-5 (May 2024) . - p.1280-1296 Mots-clés : autism spectrum disorders  environmental factors Index. décimale : PER Périodiques Résumé : Autistic individuals experience higher rates of externalising and internalising symptoms that may vary with environmental factors. However, there is limited research on variation across settings that may highlight common factors with globally generalisable effects. Data were taken from two cohorts: a multinational European sample (n = 764; 453 autistic; 311 non-autistic; 6-30?years), and a South African sample (n = 100 non-autistic; 3-11?years). An exploratory factor analysis aggregated clinical (Verbal Comprehension and Perceptual Index), adaptive traits (Vineland Adaptive Behaviour Scale) and socio-economic variables (parental employment and education, home and family characteristics) in each cohort separately. With regression, we investigated the effect of these factors and autistic traits on internalising and externalising scores (measured with the Strengths and Difficulties Questionnaire). Cohorts showed similar four-factor structures (Person Characteristics, Family System, Parental and Material Resources). The 'Family System' factor captured family size and maternal factors and was associated with lower internalising and externalising symptoms in both cohorts. In the European cohort, high autistic traits reduced this effect; the opposite was found in the South Africa cohort. Our exploratory findings from two separate analyses represent consistent evidence that Family System is associated with internalising and externalising symptoms, with a context-specific impact in persons with high autism traits. Lay Abstract Autistic individuals are more likely than non-autistic individuals to experience a mental health condition in their lifetime, and this includes externalising and internalising symptoms. We know very little about how different environments and family conditions impact these symptoms for autistic individuals. Improving our understanding of these relationships is important so that we can identify individuals who may be in greater need of support. In this article, we seek to improve our understanding of how environmental and family conditions impact externalising and internalising symptoms in autistic and non-autistic people. To do this, we conducted analyses with two cohorts in very different settings - in Europe and South Africa - to ensure our findings are globally representative. We used advanced statistical methods to establish environmental and family conditions that were similar to each other, and which could be combined into specific 'factors'. We found that four similar 'factors' could be identified in the two cohorts. These were distinguished by personal characteristics and environmental conditions of individuals, and were named Person Characteristics, Family System, Parental and Material Resources. Interestingly, just 'Family System' was associated with internalising and externalising symptoms, and this was the same in both cohorts. We also found that having high traits of autism impacted this relationship between Family System and mental health conditions with opposite directions in the two settings. These results show that characteristics in the Family System are associated with internalising and externalising symptoms, and autistic persons are particularly impacted, reinforcing the notion that family stressors are important to consider when implementing policy and practice related to improving the mental health of autistic people. En ligne : https://dx.doi.org/10.1177/13623613231200297 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=527

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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