Autism severity and its relationship to disability / Einat WAIZBARD-BARTOV in Autism Research, 16-4 (April 2023)  

Public ISBD [article]  inAutism Research > 16-4 (April 2023) . - p.685-696 Titre : Autism severity and its relationship to disability Type de document : Texte imprimé et/ou numérique Auteurs : Einat WAIZBARD-BARTOV, Auteur ; Deborah FEIN, Auteur ; Catherine LORD, Auteur ; David G. AMARAL, Auteur Article en page(s) : p.685-696 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Abstract Autism severity is currently defined and measured based exclusively on the severity levels of the two core symptom domains: social-communication and restricted or repetitive patterns of behaviors and interests. Autistic individuals, however, are often diagnosed with other medical, developmental, and psychological co-occurring conditions. These additional challenges such as intellectual disability, limited expressive and/or receptive language, and anxiety disorders, can have a tremendous impact on the day-to-day lives of autistic individuals, for both their adaptive functioning as well as their sense of wellbeing. Furthermore, the initial presentation of core symptoms and their likelihood of changing over time are influenced by the presence of such co-occurring conditions. In order to truly understand how a person's autism impacts their life, both core symptoms as well as other challenges should be considered. This approach was recently taken byThe Lancet Commission on the future of care and clinical research in autism, which proposed the term ''profound autism'' for a subgroup of individuals presenting with high core symptom severity, co-occurring intellectual disability, and little or no language, who require extensive long-term care. Considering other individual factors such as daily living skills, specific support needs and environmental resources would also enhance the evaluation of disability in autistic individuals. As currently employed in the assessment of intellectual disability, a multidimensional approach to autism could provide a more comprehensive system for classification of impairment. At present, however, there is no formal way to designate the combined effect of these different aspects of autism on a person's life. A comprehensive outlook that acknowledges impairments, capabilities, co-occurring conditions, and environmental factors would be useful for identifying subgroups of individuals as well as for determining individual needs and strengths in clinical assessments. En ligne : https://doi.org/10.1002/aur.2898 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499 [article] Autism severity and its relationship to disability [Texte imprimé et/ou numérique] / Einat WAIZBARD-BARTOV, Auteur ; Deborah FEIN, Auteur ; Catherine LORD, Auteur ; David G. AMARAL, Auteur . - p.685-696. Langues : Anglais (eng) in Autism Research > 16-4 (April 2023) . - p.685-696 Index. décimale : PER Périodiques Résumé : Abstract Autism severity is currently defined and measured based exclusively on the severity levels of the two core symptom domains: social-communication and restricted or repetitive patterns of behaviors and interests. Autistic individuals, however, are often diagnosed with other medical, developmental, and psychological co-occurring conditions. These additional challenges such as intellectual disability, limited expressive and/or receptive language, and anxiety disorders, can have a tremendous impact on the day-to-day lives of autistic individuals, for both their adaptive functioning as well as their sense of wellbeing. Furthermore, the initial presentation of core symptoms and their likelihood of changing over time are influenced by the presence of such co-occurring conditions. In order to truly understand how a person's autism impacts their life, both core symptoms as well as other challenges should be considered. This approach was recently taken byThe Lancet Commission on the future of care and clinical research in autism, which proposed the term ''profound autism'' for a subgroup of individuals presenting with high core symptom severity, co-occurring intellectual disability, and little or no language, who require extensive long-term care. Considering other individual factors such as daily living skills, specific support needs and environmental resources would also enhance the evaluation of disability in autistic individuals. As currently employed in the assessment of intellectual disability, a multidimensional approach to autism could provide a more comprehensive system for classification of impairment. At present, however, there is no formal way to designate the combined effect of these different aspects of autism on a person's life. A comprehensive outlook that acknowledges impairments, capabilities, co-occurring conditions, and environmental factors would be useful for identifying subgroups of individuals as well as for determining individual needs and strengths in clinical assessments. En ligne : https://doi.org/10.1002/aur.2898 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499

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

Investigating frank autism: clinician initial impressions and autism characteristics / Caroline LARSON ; Rebecca P THOMAS ; Marianne BARTON ; Deborah FEIN ; Inge-Marie EIGSTI in Molecular Autism, 15 (2024)  

Public ISBD [article]  inMolecular Autism > 15 (2024) . - 48 Titre : Investigating frank autism: clinician initial impressions and autism characteristics Type de document : Texte imprimé et/ou numérique Auteurs : Caroline LARSON, Auteur ; Rebecca P THOMAS, Auteur ; Marianne BARTON, Auteur ; Deborah FEIN, Auteur ; Inge-Marie EIGSTI, Auteur Article en page(s) : 48 Langues : Anglais (eng) Mots-clés : Humans  Adolescent  Male  Female  Adult  Child  Young Adult  *Autistic Disorder/diagnosis/psychology  Autism Spectrum Disorder/diagnosis  Autism diagnosis  Autism in adulthood  Five-minute impressions  Loss of autism diagnosis  Optimal outcomes  Prototypical autism  was approved by the University of Connecticut IRB. Consent for publication Not  applicable. Competing interests Dr. Fein and Dr. Barton are co-owners of M-CHAT  LLC, which licenses use of the M-CHAT-R in electronic products. The other authors  declare that they have no conflict of interest. Index. décimale : PER Périodiques Résumé : BACKGROUND: "Frank autism," recognizable through the first minutes of an interaction, describes a behavioral presentation of a subset of autistic individuals that is closely tied to social communication challenges, and may be linked to so-called "prototypical autism." To date, there is no research on frank autism presentations of autistic adolescents and young adults, nor individuals diagnosed with autism spectrum disorder (ASD) in childhood who do not meet diagnostic criteria during or after adolescence (loss of autism diagnosis, LAD). In addition, there are currently no data on the factors that drive frank autism impressions in these adolescent groups. METHODS: This study quantifies initial impressions of autistic characteristics in 24 autistic, 24 LAD and 26 neurotypical (NT) individuals ages 12 to 39 years. Graduate student and expert clinicians completed five-minute impressions, rated confidence in their own impressions, and scored the atypicality of behaviors associated with impressions; impressions were compared with current gold-standard diagnostic outcomes. RESULTS: Overall, clinicians' impressions within the first five minutes generally matched current gold-standard diagnostic status (clinical best estimate), were highly correlated with ADOS-2 CSS, and were driven primarily by prosodic and facial cues. However, this brief observation did not detect autism in all cases. While clinicians noted some subclinical atypicalities in the LAD group, impressions of the LAD and NT groups were similar. LIMITATIONS: The brief observations in this study were conducted during clinical research, including some semi-structured assessments. While results suggest overall concordance between initial impressions and diagnoses following more thorough evaluation, findings may not generalize to less structured, informal contexts. In addition, our sample was demographically homogeneous and comprised only speaking autistic participants. They were also unmatched for sex, with more females in the non-autistic group. Future studies should recruit samples that are diverse in demographic variables and ability level to replicate these findings and explore their implications. CONCLUSIONS: Results provide insights into the behavioral characteristics that contribute to the diagnosis of adolescents and young adults and may help inform diagnostic decision making in the wake of an increase in the demand for autism evaluations later than childhood. They also substantiate claims of an absence of apparent autistic characteristics in individuals who have lost the diagnosis. En ligne : https://dx.doi.org/10.1186/s13229-024-00627-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=555 [article] Investigating frank autism: clinician initial impressions and autism characteristics [Texte imprimé et/ou numérique] / Caroline LARSON, Auteur ; Rebecca P THOMAS, Auteur ; Marianne BARTON, Auteur ; Deborah FEIN, Auteur ; Inge-Marie EIGSTI, Auteur . - 48. Langues : Anglais (eng) in Molecular Autism > 15 (2024) . - 48 Mots-clés : Humans  Adolescent  Male  Female  Adult  Child  Young Adult  *Autistic Disorder/diagnosis/psychology  Autism Spectrum Disorder/diagnosis  Autism diagnosis  Autism in adulthood  Five-minute impressions  Loss of autism diagnosis  Optimal outcomes  Prototypical autism  was approved by the University of Connecticut IRB. Consent for publication Not  applicable. Competing interests Dr. Fein and Dr. Barton are co-owners of M-CHAT  LLC, which licenses use of the M-CHAT-R in electronic products. The other authors  declare that they have no conflict of interest. Index. décimale : PER Périodiques Résumé : BACKGROUND: "Frank autism," recognizable through the first minutes of an interaction, describes a behavioral presentation of a subset of autistic individuals that is closely tied to social communication challenges, and may be linked to so-called "prototypical autism." To date, there is no research on frank autism presentations of autistic adolescents and young adults, nor individuals diagnosed with autism spectrum disorder (ASD) in childhood who do not meet diagnostic criteria during or after adolescence (loss of autism diagnosis, LAD). In addition, there are currently no data on the factors that drive frank autism impressions in these adolescent groups. METHODS: This study quantifies initial impressions of autistic characteristics in 24 autistic, 24 LAD and 26 neurotypical (NT) individuals ages 12 to 39 years. Graduate student and expert clinicians completed five-minute impressions, rated confidence in their own impressions, and scored the atypicality of behaviors associated with impressions; impressions were compared with current gold-standard diagnostic outcomes. RESULTS: Overall, clinicians' impressions within the first five minutes generally matched current gold-standard diagnostic status (clinical best estimate), were highly correlated with ADOS-2 CSS, and were driven primarily by prosodic and facial cues. However, this brief observation did not detect autism in all cases. While clinicians noted some subclinical atypicalities in the LAD group, impressions of the LAD and NT groups were similar. LIMITATIONS: The brief observations in this study were conducted during clinical research, including some semi-structured assessments. While results suggest overall concordance between initial impressions and diagnoses following more thorough evaluation, findings may not generalize to less structured, informal contexts. In addition, our sample was demographically homogeneous and comprised only speaking autistic participants. They were also unmatched for sex, with more females in the non-autistic group. Future studies should recruit samples that are diverse in demographic variables and ability level to replicate these findings and explore their implications. CONCLUSIONS: Results provide insights into the behavioral characteristics that contribute to the diagnosis of adolescents and young adults and may help inform diagnostic decision making in the wake of an increase in the demand for autism evaluations later than childhood. They also substantiate claims of an absence of apparent autistic characteristics in individuals who have lost the diagnosis. En ligne : https://dx.doi.org/10.1186/s13229-024-00627-z Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=555

Response to Mottron et al. (2023) and Woods et al. (2023) / Einat WAIZBARD-BARTOV in Autism Research, 16-9 (September 2023)  

Public ISBD [article]  inAutism Research > 16-9 (September 2023) . - p.1660-1661 Titre : Response to Mottron et al. (2023) and Woods et al. (2023) Type de document : Texte imprimé et/ou numérique Auteurs : Einat WAIZBARD-BARTOV, Auteur ; Deborah FEIN, Auteur ; Catherine LORD, Auteur ; David G. AMARAL, Auteur Article en page(s) : p.1660-1661 Langues : Anglais (eng) Index. décimale : PER Périodiques En ligne : https://doi.org/10.1002/aur.2982 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510 [article] Response to Mottron et al. (2023) and Woods et al. (2023) [Texte imprimé et/ou numérique] / Einat WAIZBARD-BARTOV, Auteur ; Deborah FEIN, Auteur ; Catherine LORD, Auteur ; David G. AMARAL, Auteur . - p.1660-1661. Langues : Anglais (eng) in Autism Research > 16-9 (September 2023) . - p.1660-1661 Index. décimale : PER Périodiques En ligne : https://doi.org/10.1002/aur.2982 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510

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