Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions / Rebecca P. THOMAS in Autism Research, 17-3 (March 2024)  

Public ISBD [article]  inAutism Research > 17-3 (March 2024) . - p.568-583 Titre : Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca P. THOMAS, Auteur ; Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Aubyn STAHMER, Auteur ; Stephanie MILAN, Auteur ; Jeffrey D. BURKE, Auteur ; Marianne L. BARTON, Auteur ; Diana L. ROBINS, Auteur ; Deborah A. FEIN, Auteur Article en page(s) : p.568-583 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Clinicians form initial impressions about a child's diagnosis based on behavioral features, but research has not yet identified specific behaviors to guide initial diagnostic impressions. Participants were toddlers (N = 55, mean age 22.9?months) from a multi-site early detection study, referred for concern for ASD due to screening or parent/provider concern. Within 5?min of meeting a child, clinicians noted ASD or non-ASD impression, confidence in impression, and behaviors that informed their impression. These clinicians also determined final diagnoses for each child. When a child's final diagnosis was ASD (n = 35), senior clinicians formed an initial impression of ASD in 22 cases (63%) but missed 13 cases (37%). When final diagnosis was non-ASD (n = 20), senior clinicians made an initial impression of non-ASD in all cases (100%). Results were similar among junior clinicians. Senior and junior clinicians used the same behaviors to form accurate impressions of ASD and non-ASD: social reciprocity, nonverbal communication, and eye contact. Senior clinicians additionally used focus of attention when forming accurate impressions of ASD and non-ASD; junior clinicians used this behavior only when forming accurate non-ASD impressions. Clinicians' initial impressions of ASD are very likely to be consistent with final diagnoses, but initial impressions of non-ASD need follow-up. Toddlers who show all four atypical behaviors (social reciprocity, nonverbal communication, eye contact, and focus of attention) might receive expedited ASD diagnoses. However, presence of apparently typical behaviors should not rule out ASD; for some children a longer evaluation is necessary to allow for more opportunities to observe subtle social behavior. En ligne : https://doi.org/10.1002/aur.3088 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=525 [article] Accuracy of initial diagnostic impressions of autism in toddlers and behaviors that inform these impressions [Texte imprimé et/ou numérique] / Rebecca P. THOMAS, Auteur ; Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Aubyn STAHMER, Auteur ; Stephanie MILAN, Auteur ; Jeffrey D. BURKE, Auteur ; Marianne L. BARTON, Auteur ; Diana L. ROBINS, Auteur ; Deborah A. FEIN, Auteur . - p.568-583. Langues : Anglais (eng) in Autism Research > 17-3 (March 2024) . - p.568-583 Index. décimale : PER Périodiques Résumé : Abstract Clinicians form initial impressions about a child's diagnosis based on behavioral features, but research has not yet identified specific behaviors to guide initial diagnostic impressions. Participants were toddlers (N = 55, mean age 22.9?months) from a multi-site early detection study, referred for concern for ASD due to screening or parent/provider concern. Within 5?min of meeting a child, clinicians noted ASD or non-ASD impression, confidence in impression, and behaviors that informed their impression. These clinicians also determined final diagnoses for each child. When a child's final diagnosis was ASD (n = 35), senior clinicians formed an initial impression of ASD in 22 cases (63%) but missed 13 cases (37%). When final diagnosis was non-ASD (n = 20), senior clinicians made an initial impression of non-ASD in all cases (100%). Results were similar among junior clinicians. Senior and junior clinicians used the same behaviors to form accurate impressions of ASD and non-ASD: social reciprocity, nonverbal communication, and eye contact. Senior clinicians additionally used focus of attention when forming accurate impressions of ASD and non-ASD; junior clinicians used this behavior only when forming accurate non-ASD impressions. Clinicians' initial impressions of ASD are very likely to be consistent with final diagnoses, but initial impressions of non-ASD need follow-up. Toddlers who show all four atypical behaviors (social reciprocity, nonverbal communication, eye contact, and focus of attention) might receive expedited ASD diagnoses. However, presence of apparently typical behaviors should not rule out ASD; for some children a longer evaluation is necessary to allow for more opportunities to observe subtle social behavior. En ligne : https://doi.org/10.1002/aur.3088 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=525

Categorizing and identifying preferred interests in autistic toddlers / Kirsty L. COULTER ; Rebecca P. THOMAS ; Marianne L. BARTON ; Diana L. ROBINS ; Deborah A. FEIN in Autism Research, 17-7 (July 2024)  

Public ISBD [article]  inAutism Research > 17-7 (July 2024) . - p.1487-1500 Titre : Categorizing and identifying preferred interests in autistic toddlers Type de document : Texte imprimé et/ou numérique Auteurs : Kirsty L. COULTER, Auteur ; Rebecca P. THOMAS, Auteur ; Marianne L. BARTON, Auteur ; Diana L. ROBINS, Auteur ; Deborah A. FEIN, Auteur Article en page(s) : p.1487-1500 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Preferred interests are characteristic of autism spectrum disorder and are reported by parents starting at an early age. However, limited research has explored the presentation of preferred interests in toddlerhood. Previous literature suggests that both the intensity and type of preferred interests held by autistic individuals differ from those held by peers with developmental delay and no diagnosis and that autistic interests are more unusual in nature. While preferred interests are seen in typical child development, previous research suggests that the presence of preferred interests in children with no diagnosis declines with age. Literature also indicates that the sex and cognitive ability of autistic children influences preferred interests. Identification of early preferred interests commonly held by autistic toddlers could serve as a useful clinical indicator of future diagnosis. This article explored whether diagnostic group, age, sex, and cognitive ability predict the likelihood that parents reported preferred interests in children aged 12-36?months with diagnoses of autism, developmental delay, and those with no diagnosis. Additionally, we explored potential diagnostic group differences in interest type. Results suggest that diagnostic group, but not age, sex, or cognitive ability, predicts the likelihood that parents report preferred interests. No differences in the type of interests among diagnostic groups were identified. These results support the use of preferred interests as an early sign of autism but suggest that interest type may not be a helpful clinical indicator of autism in toddlerhood. En ligne : https://dx.doi.org/https://doi.org/10.1002/aur.3169 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=533 [article] Categorizing and identifying preferred interests in autistic toddlers [Texte imprimé et/ou numérique] / Kirsty L. COULTER, Auteur ; Rebecca P. THOMAS, Auteur ; Marianne L. BARTON, Auteur ; Diana L. ROBINS, Auteur ; Deborah A. FEIN, Auteur . - p.1487-1500. Langues : Anglais (eng) in Autism Research > 17-7 (July 2024) . - p.1487-1500 Index. décimale : PER Périodiques Résumé : Abstract Preferred interests are characteristic of autism spectrum disorder and are reported by parents starting at an early age. However, limited research has explored the presentation of preferred interests in toddlerhood. Previous literature suggests that both the intensity and type of preferred interests held by autistic individuals differ from those held by peers with developmental delay and no diagnosis and that autistic interests are more unusual in nature. While preferred interests are seen in typical child development, previous research suggests that the presence of preferred interests in children with no diagnosis declines with age. Literature also indicates that the sex and cognitive ability of autistic children influences preferred interests. Identification of early preferred interests commonly held by autistic toddlers could serve as a useful clinical indicator of future diagnosis. This article explored whether diagnostic group, age, sex, and cognitive ability predict the likelihood that parents reported preferred interests in children aged 12-36?months with diagnoses of autism, developmental delay, and those with no diagnosis. Additionally, we explored potential diagnostic group differences in interest type. Results suggest that diagnostic group, but not age, sex, or cognitive ability, predicts the likelihood that parents report preferred interests. No differences in the type of interests among diagnostic groups were identified. These results support the use of preferred interests as an early sign of autism but suggest that interest type may not be a helpful clinical indicator of autism in toddlerhood. En ligne : https://dx.doi.org/https://doi.org/10.1002/aur.3169 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=533

Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity / Ashley DE MARCHENA in Autism Research, 16-6 (June 2023)  

Public ISBD [article]  inAutism Research > 16-6 (June 2023) . - p.1138-1144 Titre : Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity Type de document : Texte imprimé et/ou numérique Auteurs : Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Yasemin Algur, Auteur ; Lashae N. Williams, Auteur ; Sherira Fernandes, Auteur ; Rebecca P. THOMAS, Auteur ; Leslie A. McClure, Auteur ; Sarah DUFEK, Auteur ; Deborah FEIN, Auteur ; Aubyn C. STAHMER, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.1138-1144 Langues : Anglais (eng) Mots-clés : autism  diagnosis  diagnostic confidence  early detection  initial impression  toddlers Index. décimale : PER Périodiques Résumé : Abstract Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current ?waitlist crisis? for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12?53?months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n?=?29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result. En ligne : https://doi.org/10.1002/aur.2933 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507 [article] Initial diagnostic impressions of trainees during autism evaluations: High specificity but low sensitivity [Texte imprimé et/ou numérique] / Ashley DE MARCHENA, Auteur ; Andrea Trubanova WIECKOWSKI, Auteur ; Yasemin Algur, Auteur ; Lashae N. Williams, Auteur ; Sherira Fernandes, Auteur ; Rebecca P. THOMAS, Auteur ; Leslie A. McClure, Auteur ; Sarah DUFEK, Auteur ; Deborah FEIN, Auteur ; Aubyn C. STAHMER, Auteur ; Diana L. ROBINS, Auteur . - p.1138-1144. Langues : Anglais (eng) in Autism Research > 16-6 (June 2023) . - p.1138-1144 Mots-clés : autism  diagnosis  diagnostic confidence  early detection  initial impression  toddlers Index. décimale : PER Périodiques Résumé : Abstract Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current ?waitlist crisis? for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12?53?months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n?=?29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result. En ligne : https://doi.org/10.1002/aur.2933 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507

Online administration of the ADOS for research with adolescents and adults in response to the pandemic / Inge-Marie EIGSTI in Autism Research, 15-10 (October 2022)  

Public ISBD [article]  inAutism Research > 15-10 (October 2022) . - p.1909-1916 Titre : Online administration of the ADOS for research with adolescents and adults in response to the pandemic Type de document : Texte imprimé et/ou numérique Auteurs : Inge-Marie EIGSTI, Auteur ; Rebecca P. THOMAS, Auteur ; Mackenzie STABILE, Auteur ; Anusha MOHAN, Auteur ; Mary F. S. DIECKHAUS, Auteur ; Jason CRUTCHER, Auteur ; Elise TAVERNA, Auteur ; Deborah A. FEIN, Auteur Article en page(s) : p.1909-1916 Langues : Anglais (eng) Mots-clés : Covid  autism  diagnosis  online  videoconference Index. décimale : PER Périodiques Résumé : This study evaluates an online ADOS-2 Module 4 administration. Adolescents and adults with (n = 24; 7 females) and without (n = 13; 5 females) a history of autism spectrum disorder (ASD) completed the ADOS-2 Module 4 via videoconference. Parents or caregivers completed the Parent/Caregiver Form of the Vineland Adaptive Behavior Scales and the Achenbach Adult Behavior Checklist. The ADOS-2 was reviewed and scored by five trained clinicians and supervised by a senior clinician with established research reliability. The autistic group's scores differed on ADOS total (Calibrated Severity Score, WPS instrument) and domain scores, KSADS domain scores, and Achenbach T-scores. Inter-rater reliability was "moderate" (κ = 0.732), and percentage item-wise agreement was r = 0.69. The online ADOS-2 showed significant convergence with parent-reported assessments of ASD-relevant symptoms and characteristics, suggesting it was a valid assessment. While any online assessments must be used with caution, results suggest that the approach described here could have sufficient validity and reliability to fill the urgent need to assess and evaluate ASD symptomatology, as one component of a thorough clinical evaluation of ASD-related behaviors. LAY SUMMARY: In this exploratory study, we asked whether it was possible to give the ADOS-2 to adolescents and adults in a completely online way. Results showed that expert clinicians agreed on 69% of ADOS-2 items; also, participants with autism had higher scores on all parts of the ADOS-2. The online ADOS-2 scores had strong and significant relationships with parents' reports of friendship and social skills. While we need more research that tests this method, this way of doing the ADOS-2 online may be useful for clinicians and researchers who have an urgent need to evaluate autism during the pandemic. En ligne : http://dx.doi.org/10.1002/aur.2791 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488 [article] Online administration of the ADOS for research with adolescents and adults in response to the pandemic [Texte imprimé et/ou numérique] / Inge-Marie EIGSTI, Auteur ; Rebecca P. THOMAS, Auteur ; Mackenzie STABILE, Auteur ; Anusha MOHAN, Auteur ; Mary F. S. DIECKHAUS, Auteur ; Jason CRUTCHER, Auteur ; Elise TAVERNA, Auteur ; Deborah A. FEIN, Auteur . - p.1909-1916. Langues : Anglais (eng) in Autism Research > 15-10 (October 2022) . - p.1909-1916 Mots-clés : Covid  autism  diagnosis  online  videoconference Index. décimale : PER Périodiques Résumé : This study evaluates an online ADOS-2 Module 4 administration. Adolescents and adults with (n = 24; 7 females) and without (n = 13; 5 females) a history of autism spectrum disorder (ASD) completed the ADOS-2 Module 4 via videoconference. Parents or caregivers completed the Parent/Caregiver Form of the Vineland Adaptive Behavior Scales and the Achenbach Adult Behavior Checklist. The ADOS-2 was reviewed and scored by five trained clinicians and supervised by a senior clinician with established research reliability. The autistic group's scores differed on ADOS total (Calibrated Severity Score, WPS instrument) and domain scores, KSADS domain scores, and Achenbach T-scores. Inter-rater reliability was "moderate" (κ = 0.732), and percentage item-wise agreement was r = 0.69. The online ADOS-2 showed significant convergence with parent-reported assessments of ASD-relevant symptoms and characteristics, suggesting it was a valid assessment. While any online assessments must be used with caution, results suggest that the approach described here could have sufficient validity and reliability to fill the urgent need to assess and evaluate ASD symptomatology, as one component of a thorough clinical evaluation of ASD-related behaviors. LAY SUMMARY: In this exploratory study, we asked whether it was possible to give the ADOS-2 to adolescents and adults in a completely online way. Results showed that expert clinicians agreed on 69% of ADOS-2 items; also, participants with autism had higher scores on all parts of the ADOS-2. The online ADOS-2 scores had strong and significant relationships with parents' reports of friendship and social skills. While we need more research that tests this method, this way of doing the ADOS-2 online may be useful for clinicians and researchers who have an urgent need to evaluate autism during the pandemic. En ligne : http://dx.doi.org/10.1002/aur.2791 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488

Predicting Language in Children with ASD Using Spontaneous Language Samples and Standardized Measures / Rebecca P. THOMAS in Journal of Autism and Developmental Disorders, 53-10 (October 2023)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 53-10 (October 2023) . - p.3916-3931 Titre : Predicting Language in Children with ASD Using Spontaneous Language Samples and Standardized Measures Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca P. THOMAS, Auteur ; Kacie WITTKE, Auteur ; Jessica BLUME, Auteur ; Ann M. MASTERGEORGE, Auteur ; Letitia NAIGLES, Auteur Article en page(s) : p.3916-3931 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : This longitudinal study examined the degree to which standardized measures of language and natural language samples predicted later language usage in a heterogeneous sample of children with autism spectrum disorder (ASD), and how this relationship is impacted by ASD severity and interventions. Participants with a diagnosis of ASD (N=54, 41 males) completed standardized assessments of language and social functioning; natural language samples were transcribed from play-based interactions. Findings indicated that standardized language measures, natural language measures, and ADOS severity were each unique predictors of later lexical use. Intervention types also appeared to impact later language; in particular, participation in mainstream inclusion accounted for significant amounts of variance in children?s mean length of utterance at T3. En ligne : https://doi.org/10.1007/s10803-022-05691-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=511 [article] Predicting Language in Children with ASD Using Spontaneous Language Samples and Standardized Measures [Texte imprimé et/ou numérique] / Rebecca P. THOMAS, Auteur ; Kacie WITTKE, Auteur ; Jessica BLUME, Auteur ; Ann M. MASTERGEORGE, Auteur ; Letitia NAIGLES, Auteur . - p.3916-3931. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 53-10 (October 2023) . - p.3916-3931 Index. décimale : PER Périodiques Résumé : This longitudinal study examined the degree to which standardized measures of language and natural language samples predicted later language usage in a heterogeneous sample of children with autism spectrum disorder (ASD), and how this relationship is impacted by ASD severity and interventions. Participants with a diagnosis of ASD (N=54, 41 males) completed standardized assessments of language and social functioning; natural language samples were transcribed from play-based interactions. Findings indicated that standardized language measures, natural language measures, and ADOS severity were each unique predictors of later lexical use. Intervention types also appeared to impact later language; in particular, participation in mainstream inclusion accounted for significant amounts of variance in children?s mean length of utterance at T3. En ligne : https://doi.org/10.1007/s10803-022-05691-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=511

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