'Instruments are good at eliciting information; scores are very dangerous': The perspectives of clinical professionals regarding neurodevelopmental assessment / Barry COUGHLAN in Autism, 27-4 (May 2023)  

Public ISBD [article]  inAutism > 27-4 (May 2023) . - p.905-915 Titre : 'Instruments are good at eliciting information; scores are very dangerous': The perspectives of clinical professionals regarding neurodevelopmental assessment Type de document : Texte imprimé et/ou numérique Auteurs : Barry COUGHLAN, Auteur ; Matt WOOLGAR, Auteur ; Emma Jl WEISBLATT, Auteur ; Robbie DUSCHINSKY, Auteur Article en page(s) : p.905-915 Langues : Anglais (eng) Mots-clés : attention deficit hyperactivity disorder,autism,clinical reasoning,qualitative,decision-making,diagnostic upgrading Index. décimale : PER Périodiques Résumé : Clinical judgement is a crucial part of autism and attention deficit hyperactivity disorder (ADHD) assessments. This study aims to harness insights from psychology and sociology to explore clinical perspectives and assessment practices of autism and attention deficit hyperactivity disorder. Qualitative interviews were conducted with health care professionals (n=17). Interviews were conducted between January and May 2019. Data were analysed using a thematic approach. Themes were sorted into two interrelated categories (1) approaches to diagnosis (2) elements of diagnosis. Approaches to diagnosis were comprised of the following subthemes: nature of diagnosis, application of diagnosis: natural and pragmatic, revisiting conceptualisations: sub-optimal practice & unhelpful diagnoses, autism and attention deficit hyperactivity disorder. Elements of diagnosis contained three related subthemes: contextualising standardised assessments, triangulating material, organisational factors. There is sometimes a pragmatic as well as nosological dimension to diagnosis. Competing desires for consistency and utility add further complexity to neurodevelopmental assessment.Lay abstractAutism and attention deficit hyperactivity disorder are common behaviourally diagnosed conditions. One of the key aspects of diagnosis is clinical judgement. Yet despite decades of research, it is only in recent times that researchers have started exploring clinicians' perspectives on diagnosing these conditions. We aimed to add to this body of knowledge by conducting interviews with 17 experienced health care professionals in the United Kingdom to hear their perspectives on diagnosing autism and attention deficit hyperactivity disorder. Clinicians reflected that for some children and young people, diagnosis is reasonably straightforward; however, in other situations, decisions are made on more pragmatic grounds (i.e. will this be helpful). We identified some differences of opinion between professionals and organisation which adds to the complexity of applying a diagnosis. We recommend several areas for future research and point to some practical and philosophical implications of the work. En ligne : https://doi.org/10.1177/13623613221121413 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499 [article] 'Instruments are good at eliciting information; scores are very dangerous': The perspectives of clinical professionals regarding neurodevelopmental assessment [Texte imprimé et/ou numérique] / Barry COUGHLAN, Auteur ; Matt WOOLGAR, Auteur ; Emma Jl WEISBLATT, Auteur ; Robbie DUSCHINSKY, Auteur . - p.905-915. Langues : Anglais (eng) in Autism > 27-4 (May 2023) . - p.905-915 Mots-clés : attention deficit hyperactivity disorder,autism,clinical reasoning,qualitative,decision-making,diagnostic upgrading Index. décimale : PER Périodiques Résumé : Clinical judgement is a crucial part of autism and attention deficit hyperactivity disorder (ADHD) assessments. This study aims to harness insights from psychology and sociology to explore clinical perspectives and assessment practices of autism and attention deficit hyperactivity disorder. Qualitative interviews were conducted with health care professionals (n=17). Interviews were conducted between January and May 2019. Data were analysed using a thematic approach. Themes were sorted into two interrelated categories (1) approaches to diagnosis (2) elements of diagnosis. Approaches to diagnosis were comprised of the following subthemes: nature of diagnosis, application of diagnosis: natural and pragmatic, revisiting conceptualisations: sub-optimal practice & unhelpful diagnoses, autism and attention deficit hyperactivity disorder. Elements of diagnosis contained three related subthemes: contextualising standardised assessments, triangulating material, organisational factors. There is sometimes a pragmatic as well as nosological dimension to diagnosis. Competing desires for consistency and utility add further complexity to neurodevelopmental assessment.Lay abstractAutism and attention deficit hyperactivity disorder are common behaviourally diagnosed conditions. One of the key aspects of diagnosis is clinical judgement. Yet despite decades of research, it is only in recent times that researchers have started exploring clinicians' perspectives on diagnosing these conditions. We aimed to add to this body of knowledge by conducting interviews with 17 experienced health care professionals in the United Kingdom to hear their perspectives on diagnosing autism and attention deficit hyperactivity disorder. Clinicians reflected that for some children and young people, diagnosis is reasonably straightforward; however, in other situations, decisions are made on more pragmatic grounds (i.e. will this be helpful). We identified some differences of opinion between professionals and organisation which adds to the complexity of applying a diagnosis. We recommend several areas for future research and point to some practical and philosophical implications of the work. En ligne : https://doi.org/10.1177/13623613221121413 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499

Overcoming hurdles to intervention studies with autistic children with profound communication difficulties and their families / Ailbhe MCKINNEY in Autism, 26-6 (August 2022)  

Public ISBD [article]  inAutism > 26-6 (August 2022) . - p.1627-1639 Titre : Overcoming hurdles to intervention studies with autistic children with profound communication difficulties and their families Type de document : Texte imprimé et/ou numérique Auteurs : Ailbhe MCKINNEY, Auteur ; Emma Jl WEISBLATT, Auteur ; Kathryn L. HOTSON, Auteur ; Zahra BILAL AHMED, Auteur ; Claudia DIAS, Auteur ; Dorit BENSHALOM, Auteur ; Juliet FOSTER, Auteur ; Suzanne MURPHY, Auteur ; Sofia S. VILLAR, Auteur ; Matthew K. BELMONTE, Auteur Article en page(s) : p.1627-1639 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/therapy  Autistic Disorder/therapy  Child  Communication  Humans  Intellectual Disability/therapy  Parents  autism  clinical trial  inclusion  intellectual disability  intervention  minimally verbal  nonverbal  conflicts of interest with respect to the research, authorship and/or publication  of this article. Index. décimale : PER Périodiques Résumé : Autistic children who speak few or no words or who have an intellectual disability are the most in need of new understandings and treatments, but the most often left out of the research that can bring these benefits. Researchers perceive difficulties around compliance with instructions, testing, challenging behaviours and family stress. Although research with these children can indeed be difficult, their continuing exclusion is unethical and unacceptable. Drawing on our experiences testing a possible treatment for children with profound autism, we provide 10 practical guidelines related to (1) interacting physically, (2) combining play and testing, (3) responding to challenging behaviour, (4) finding suitable tests, (5) relationships with parents, (6) relationships with siblings, (7) involving stakeholders, (8) planning the testing times, (9) the role of the clinical supervisor and (10) recruiting and retaining participants. We hope that these guidelines will prepare and embolden other research teams to work with profoundly autistic children, ending their historical exclusion from research. These guidelines also could be useful for conducting research with children with intellectual disabilities. En ligne : http://dx.doi.org/10.1177/1362361321998916 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=484 [article] Overcoming hurdles to intervention studies with autistic children with profound communication difficulties and their families [Texte imprimé et/ou numérique] / Ailbhe MCKINNEY, Auteur ; Emma Jl WEISBLATT, Auteur ; Kathryn L. HOTSON, Auteur ; Zahra BILAL AHMED, Auteur ; Claudia DIAS, Auteur ; Dorit BENSHALOM, Auteur ; Juliet FOSTER, Auteur ; Suzanne MURPHY, Auteur ; Sofia S. VILLAR, Auteur ; Matthew K. BELMONTE, Auteur . - p.1627-1639. Langues : Anglais (eng) in Autism > 26-6 (August 2022) . - p.1627-1639 Mots-clés : Autism Spectrum Disorder/therapy  Autistic Disorder/therapy  Child  Communication  Humans  Intellectual Disability/therapy  Parents  autism  clinical trial  inclusion  intellectual disability  intervention  minimally verbal  nonverbal  conflicts of interest with respect to the research, authorship and/or publication  of this article. Index. décimale : PER Périodiques Résumé : Autistic children who speak few or no words or who have an intellectual disability are the most in need of new understandings and treatments, but the most often left out of the research that can bring these benefits. Researchers perceive difficulties around compliance with instructions, testing, challenging behaviours and family stress. Although research with these children can indeed be difficult, their continuing exclusion is unethical and unacceptable. Drawing on our experiences testing a possible treatment for children with profound autism, we provide 10 practical guidelines related to (1) interacting physically, (2) combining play and testing, (3) responding to challenging behaviour, (4) finding suitable tests, (5) relationships with parents, (6) relationships with siblings, (7) involving stakeholders, (8) planning the testing times, (9) the role of the clinical supervisor and (10) recruiting and retaining participants. We hope that these guidelines will prepare and embolden other research teams to work with profoundly autistic children, ending their historical exclusion from research. These guidelines also could be useful for conducting research with children with intellectual disabilities. En ligne : http://dx.doi.org/10.1177/1362361321998916 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=484

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