Beyond pass-fail: Examining the potential utility of two thresholds in the autism screening process / Megan Y. ROBERTS in Autism Research, 12-1 (January 2019)  

Public ISBD [article]  inAutism Research > 12-1 (January 2019) . - p.112-122 Titre : Beyond pass-fail: Examining the potential utility of two thresholds in the autism screening process Type de document : texte imprimé Auteurs : Megan Y. ROBERTS, Auteur ; Yael STERN, Auteur ; Lauren H. HAMPTON, Auteur ; Jeffrey M. GRAUZER, Auteur ; Amanda MILLER, Auteur ; Amy LEVIN, Auteur ; Benjamin KORNFELD, Auteur ; M.M. DAVIS, Auteur ; Aaron J. KAAT, Auteur ; Ryne ESTABROOK, Auteur Article en page(s) : p.112-122 Langues : Anglais (eng) Mots-clés : Children  autism  early detection  early signs Index. décimale : PER Périodiques Résumé : Access to early intervention as early in development as possible is critical to maximizing long-term outcomes for children with autism spectrum disorders (ASD). However, despite the fact that ASD can be reliably diagnosed by 24 months, the average age of diagnosis is 2 years later. Waitlists for specialized developmental evaluations are one barrier to early diagnosis. The purpose of this study was to examine one potential approach to reducing wait time for an ASD diagnostic evaluation by examining the utility of using more than one threshold for an autism screening tool, the Screening Tool for Autism in Toddlers and Young Children (STAT). Participants included 171 children between 24 and 36 months of age who received a medical diagnostic evaluation through Illinois' Early Intervention Program. This study directly compared the performance of the STAT when scored: (a) using the original single threshold, (b) using seven equally weighted items using a single threshold, and (c) using all items differentially weighted based on how strongly that item predicts a later ASD diagnosis. In addition, this study explored the potential utility of using two thresholds rather than a single threshold for each scoring method. Results of this study suggest that using a two-threshold logistic regression method has potential psychometric advantages over a single threshold and categorical scoring. Using this approach may reduce the wait time for specialty ASD diagnostic evaluations by maximizing true negatives and true positives, such that specialty evaluations may be reserved for those cases that are more ambiguous or more complex. Autism Research 2019, 12: 112-122. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study examined the benefits of using two versus one cutoff score when screening for autism. Results indicate that having two scores and weighting test items based on predictive association with an autism diagnosis is better than using a single score and weighting each item equally. Using such an approach may reduce the wait time for specialty autism diagnostic evaluations, such that specialty evaluations may be reserved for those cases that are more ambiguous or more complex. En ligne : http://dx.doi.org/10.1002/aur.2045 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=376 [article] Beyond pass-fail: Examining the potential utility of two thresholds in the autism screening process [texte imprimé] / Megan Y. ROBERTS, Auteur ; Yael STERN, Auteur ; Lauren H. HAMPTON, Auteur ; Jeffrey M. GRAUZER, Auteur ; Amanda MILLER, Auteur ; Amy LEVIN, Auteur ; Benjamin KORNFELD, Auteur ; M.M. DAVIS, Auteur ; Aaron J. KAAT, Auteur ; Ryne ESTABROOK, Auteur . - p.112-122. Langues : Anglais (eng) in Autism Research > 12-1 (January 2019) . - p.112-122 Mots-clés : Children  autism  early detection  early signs Index. décimale : PER Périodiques Résumé : Access to early intervention as early in development as possible is critical to maximizing long-term outcomes for children with autism spectrum disorders (ASD). However, despite the fact that ASD can be reliably diagnosed by 24 months, the average age of diagnosis is 2 years later. Waitlists for specialized developmental evaluations are one barrier to early diagnosis. The purpose of this study was to examine one potential approach to reducing wait time for an ASD diagnostic evaluation by examining the utility of using more than one threshold for an autism screening tool, the Screening Tool for Autism in Toddlers and Young Children (STAT). Participants included 171 children between 24 and 36 months of age who received a medical diagnostic evaluation through Illinois' Early Intervention Program. This study directly compared the performance of the STAT when scored: (a) using the original single threshold, (b) using seven equally weighted items using a single threshold, and (c) using all items differentially weighted based on how strongly that item predicts a later ASD diagnosis. In addition, this study explored the potential utility of using two thresholds rather than a single threshold for each scoring method. Results of this study suggest that using a two-threshold logistic regression method has potential psychometric advantages over a single threshold and categorical scoring. Using this approach may reduce the wait time for specialty ASD diagnostic evaluations by maximizing true negatives and true positives, such that specialty evaluations may be reserved for those cases that are more ambiguous or more complex. Autism Research 2019, 12: 112-122. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study examined the benefits of using two versus one cutoff score when screening for autism. Results indicate that having two scores and weighting test items based on predictive association with an autism diagnosis is better than using a single score and weighting each item equally. Using such an approach may reduce the wait time for specialty autism diagnostic evaluations, such that specialty evaluations may be reserved for those cases that are more ambiguous or more complex. En ligne : http://dx.doi.org/10.1002/aur.2045 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=376

Characterizing mechanisms of caregiver-mediated naturalistic developmental behavioral interventions for autistic toddlers: A randomized clinical trial / Bailey J. SONE ; Jeffrey GRAUZER ; Laura SUDEC ; Aaron J. KAAT ; Megan Y. ROBERTS in Autism, 28-7 (July 2024)  

Public ISBD [article]  inAutism > 28-7 (July 2024) . - p.1847-1860 Titre : Characterizing mechanisms of caregiver-mediated naturalistic developmental behavioral interventions for autistic toddlers: A randomized clinical trial Type de document : texte imprimé Auteurs : Bailey J. SONE, Auteur ; Jeffrey GRAUZER, Auteur ; Laura SUDEC, Auteur ; Aaron J. KAAT, Auteur ; Megan Y. ROBERTS, Auteur Article en page(s) : p.1847-1860 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  communication and language  interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : To address the variability of naturalistic developmental behavioral intervention outcomes, the current study sought to isolate the effects of the instructional strategies of caregiver-mediated naturalistic developmental behavioral interventions. In this comparative efficacy trial, mothers of 111 autistic children (18-48 months) were randomized to learn one of two sets of naturalistic developmental behavioral intervention language facilitation strategies (responsive or directive). We aimed to characterize the effect of strategy type on language outcomes and explore the extent to which joint engagement outcomes mediated language outcomes. Children in the directive condition had significantly greater scores across multiple language assessments. At follow-up, the effect of strategy type on the frequency of spontaneous directed communication acts was fully mediated by coordinated joint engagement (indirect effect = 2.070, 95% CI = [ 4.394, 0.06], p <0.05). Thus, children may benefit from caregiver prompts to facilitate long-term language outcomes. The current study is an initial step in the identification of the mechanisms of caregiver-mediated NDBIs. Lay abstract Caregiver-mediated early interventions support caregivers' use of strategies to improve their young autistic child?s communication. In the current clinical trial, we sought to isolate the most effective strategies to improve short-term and long-term child communication outcomes. Results demonstrated how children may benefit from caregiver prompts to facilitate long-term language outcomes. In conclusion, the current study improves our understanding of how early intervention facilitates child communication outcomes. En ligne : https://dx.doi.org/10.1177/13623613231213283 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=532 [article] Characterizing mechanisms of caregiver-mediated naturalistic developmental behavioral interventions for autistic toddlers: A randomized clinical trial [texte imprimé] / Bailey J. SONE, Auteur ; Jeffrey GRAUZER, Auteur ; Laura SUDEC, Auteur ; Aaron J. KAAT, Auteur ; Megan Y. ROBERTS, Auteur . - p.1847-1860. Langues : Anglais (eng) in Autism > 28-7 (July 2024) . - p.1847-1860 Mots-clés : autism spectrum disorders  communication and language  interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : To address the variability of naturalistic developmental behavioral intervention outcomes, the current study sought to isolate the effects of the instructional strategies of caregiver-mediated naturalistic developmental behavioral interventions. In this comparative efficacy trial, mothers of 111 autistic children (18-48 months) were randomized to learn one of two sets of naturalistic developmental behavioral intervention language facilitation strategies (responsive or directive). We aimed to characterize the effect of strategy type on language outcomes and explore the extent to which joint engagement outcomes mediated language outcomes. Children in the directive condition had significantly greater scores across multiple language assessments. At follow-up, the effect of strategy type on the frequency of spontaneous directed communication acts was fully mediated by coordinated joint engagement (indirect effect = 2.070, 95% CI = [ 4.394, 0.06], p <0.05). Thus, children may benefit from caregiver prompts to facilitate long-term language outcomes. The current study is an initial step in the identification of the mechanisms of caregiver-mediated NDBIs. Lay abstract Caregiver-mediated early interventions support caregivers' use of strategies to improve their young autistic child?s communication. In the current clinical trial, we sought to isolate the most effective strategies to improve short-term and long-term child communication outcomes. Results demonstrated how children may benefit from caregiver prompts to facilitate long-term language outcomes. In conclusion, the current study improves our understanding of how early intervention facilitates child communication outcomes. En ligne : https://dx.doi.org/10.1177/13623613231213283 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=532

One size does not fit all for parent-mediated autism interventions: A randomized clinical trial / Megan Y. ROBERTS in Autism, 27-2 (February 2023)  

Public ISBD [article]  inAutism > 27-2 (February 2023) . - p.443-455 Titre : One size does not fit all for parent-mediated autism interventions: A randomized clinical trial Type de document : texte imprimé Auteurs : Megan Y. ROBERTS, Auteur ; Bailey J. SONE, Auteur ; Maranda JONES, Auteur ; Jeffrey GRAUZER, Auteur ; Laura SUDEC, Auteur ; Yael S. STERN, Auteur ; Elaine Y.L. KWOK, Auteur ; Molly LOSH, Auteur ; Aaron J. KAAT, Auteur Article en page(s) : p.443-455 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  communication and language  interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : Coaching parents to use language facilitation strategies improves long-term language outcomes for autistic children. To optimize parent-mediated interventions, more studies need to explore factors that influence parents’ learning. This study involved 119 autistic children (18 “48 months) and their biological mothers enrolled in a single-site, factorial randomized clinical trial. Mothers were taught to use one of two types of language facilitation strategies (responsive or directive) during eight weekly, hour-long instructional sessions. We explored the impact of (a) type of language facilitation strategy, (b) maternal Broad Autism Phenotype (subclinical traits of autism spectrum disorder), and (c) preintervention strategy use on mothers’ outcomes measured immediately and 3 months after intervention sessions. At postintervention, mothers who learned responsive strategies demonstrated significantly greater use of taught strategies than mothers who learned directive strategies (d=0.90, 95% CI =[0.47, 1.32]). Mothers’ use of taught strategies did not differ by Broad Autism Phenotype status. However, a significant two-way interaction was found between preintervention strategy use and Broad Autism Phenotype status on taught strategy use (F(1, 107)=6.04, p=0.016, ΔR2=0.053). Findings suggest that strategy type, maternal Broad Autism Phenotype status, and preintervention strategy use may be important factors to be considered to individualize parent-mediated interventions. En ligne : http://dx.doi.org/10.1177/13623613221102736 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=493 [article] One size does not fit all for parent-mediated autism interventions: A randomized clinical trial [texte imprimé] / Megan Y. ROBERTS, Auteur ; Bailey J. SONE, Auteur ; Maranda JONES, Auteur ; Jeffrey GRAUZER, Auteur ; Laura SUDEC, Auteur ; Yael S. STERN, Auteur ; Elaine Y.L. KWOK, Auteur ; Molly LOSH, Auteur ; Aaron J. KAAT, Auteur . - p.443-455. Langues : Anglais (eng) in Autism > 27-2 (February 2023) . - p.443-455 Mots-clés : autism spectrum disorders  communication and language  interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : Coaching parents to use language facilitation strategies improves long-term language outcomes for autistic children. To optimize parent-mediated interventions, more studies need to explore factors that influence parents’ learning. This study involved 119 autistic children (18 “48 months) and their biological mothers enrolled in a single-site, factorial randomized clinical trial. Mothers were taught to use one of two types of language facilitation strategies (responsive or directive) during eight weekly, hour-long instructional sessions. We explored the impact of (a) type of language facilitation strategy, (b) maternal Broad Autism Phenotype (subclinical traits of autism spectrum disorder), and (c) preintervention strategy use on mothers’ outcomes measured immediately and 3 months after intervention sessions. At postintervention, mothers who learned responsive strategies demonstrated significantly greater use of taught strategies than mothers who learned directive strategies (d=0.90, 95% CI =[0.47, 1.32]). Mothers’ use of taught strategies did not differ by Broad Autism Phenotype status. However, a significant two-way interaction was found between preintervention strategy use and Broad Autism Phenotype status on taught strategy use (F(1, 107)=6.04, p=0.016, ΔR2=0.053). Findings suggest that strategy type, maternal Broad Autism Phenotype status, and preintervention strategy use may be important factors to be considered to individualize parent-mediated interventions. En ligne : http://dx.doi.org/10.1177/13623613221102736 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=493

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