Expert Clinician Certainty in Diagnosing Autism Spectrum Disorder in 16?30-Month-Olds: A Multi-site Trial Secondary Analysis / Stormi WHITE ; Shana RICHARDSON ; Emma MCQUEEN ; Hasse WALUM ; Christa AOKI ; Christopher SMITH ; Mendy MINJAREZ ; Raphael BERNIER ; Ernest PEDAPATI ; Somer BISHOP ; Whitney ENCE ; Allison WAINER ; Jennifer MORIUCHI ; Sew-Wah TAY ; Yiming DENG ; Warren JONES ; Scott GILLESPIE ; Ami KLIN in Journal of Autism and Developmental Disorders, 54-2 (February 2024)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 54-2 (February 2024) . - p.393-408 Titre : Expert Clinician Certainty in Diagnosing Autism Spectrum Disorder in 16?30-Month-Olds: A Multi-site Trial Secondary Analysis Type de document : Texte imprimé et/ou numérique Auteurs : Stormi WHITE, Auteur ; Shana RICHARDSON, Auteur ; Emma MCQUEEN, Auteur ; Hasse WALUM, Auteur ; Christa AOKI, Auteur ; Christopher SMITH, Auteur ; Mendy MINJAREZ, Auteur ; Raphael BERNIER, Auteur ; Ernest PEDAPATI, Auteur ; Somer BISHOP, Auteur ; Whitney ENCE, Auteur ; Allison WAINER, Auteur ; Jennifer MORIUCHI, Auteur ; Sew-Wah TAY, Auteur ; Yiming DENG, Auteur ; Warren JONES, Auteur ; Scott GILLESPIE, Auteur ; Ami KLIN, Auteur Article en page(s) : p.393-408 Index. décimale : PER Périodiques Résumé : Differential diagnosis of young children with suspected autism spectrum disorder (ASD) is challenging, and clinician uncertainty about a child?s diagnosis may contribute to misdiagnosis and subsequent delays in access to early treatment. The current study was designed to replicate and expand a recent report in this Journal (McDonnell et al. in J Autism Dev Disord 49:1391?1401, https://doi.org/10.1080/15374416.2020.1823850, 2019), in which only 60% of diagnoses were made with complete certainty by clinicians evaluating 478 toddlers and preschool children referred for possible ASD to specialized clinics. In this study, secondary analyses were performed on diagnostic, demographic and clinical data for 496 16?30-month-old children who were consecutive referrals to a 6-site clinical trial executed by specialized centers with experienced clinicians following best-practice procedures for the diagnosis of ASD. Overall, 70.2% of diagnoses were made with complete certainty. The most important factor associated with clinician uncertainty was mid-level autism-related symptomatology. Mid-level verbal age equivalents were also associated with clinician uncertainty, but measures of symptomatology were stronger predictors. None of the socio-demographic variables, including sex of the child, was significantly associated with clinician certainty. Close to one third of early diagnoses of ASD are made with a degree of uncertainty. The delineation of specific ranges on the ADOS-2 most likely to result in clinician uncertainty identified in this study may provide an opportunity to reduce random subjectivity in diagnostic decision-making via calibration of young-child diagnostic thresholds based on later-age longitudinal diagnostic outcome data, and via standardization of decision-making in regard to clinical scenarios frequently encountered by clinicians. En ligne : https://doi.org/10.1007/s10803-022-05812-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=520 [article] Expert Clinician Certainty in Diagnosing Autism Spectrum Disorder in 16?30-Month-Olds: A Multi-site Trial Secondary Analysis [Texte imprimé et/ou numérique] / Stormi WHITE, Auteur ; Shana RICHARDSON, Auteur ; Emma MCQUEEN, Auteur ; Hasse WALUM, Auteur ; Christa AOKI, Auteur ; Christopher SMITH, Auteur ; Mendy MINJAREZ, Auteur ; Raphael BERNIER, Auteur ; Ernest PEDAPATI, Auteur ; Somer BISHOP, Auteur ; Whitney ENCE, Auteur ; Allison WAINER, Auteur ; Jennifer MORIUCHI, Auteur ; Sew-Wah TAY, Auteur ; Yiming DENG, Auteur ; Warren JONES, Auteur ; Scott GILLESPIE, Auteur ; Ami KLIN, Auteur . - p.393-408. in Journal of Autism and Developmental Disorders > 54-2 (February 2024) . - p.393-408 Index. décimale : PER Périodiques Résumé : Differential diagnosis of young children with suspected autism spectrum disorder (ASD) is challenging, and clinician uncertainty about a child?s diagnosis may contribute to misdiagnosis and subsequent delays in access to early treatment. The current study was designed to replicate and expand a recent report in this Journal (McDonnell et al. in J Autism Dev Disord 49:1391?1401, https://doi.org/10.1080/15374416.2020.1823850, 2019), in which only 60% of diagnoses were made with complete certainty by clinicians evaluating 478 toddlers and preschool children referred for possible ASD to specialized clinics. In this study, secondary analyses were performed on diagnostic, demographic and clinical data for 496 16?30-month-old children who were consecutive referrals to a 6-site clinical trial executed by specialized centers with experienced clinicians following best-practice procedures for the diagnosis of ASD. Overall, 70.2% of diagnoses were made with complete certainty. The most important factor associated with clinician uncertainty was mid-level autism-related symptomatology. Mid-level verbal age equivalents were also associated with clinician uncertainty, but measures of symptomatology were stronger predictors. None of the socio-demographic variables, including sex of the child, was significantly associated with clinician certainty. Close to one third of early diagnoses of ASD are made with a degree of uncertainty. The delineation of specific ranges on the ADOS-2 most likely to result in clinician uncertainty identified in this study may provide an opportunity to reduce random subjectivity in diagnostic decision-making via calibration of young-child diagnostic thresholds based on later-age longitudinal diagnostic outcome data, and via standardization of decision-making in regard to clinical scenarios frequently encountered by clinicians. En ligne : https://doi.org/10.1007/s10803-022-05812-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=520

Overcoming tensions between family-centered care and fidelity within Early Intervention implementation research / Katherine PICKARD in Autism, 27-3 (April 2023)  

Public ISBD [article]  inAutism > 27-3 (April 2023) . - p.858-863 Titre : Overcoming tensions between family-centered care and fidelity within Early Intervention implementation research Type de document : Texte imprimé et/ou numérique Auteurs : Katherine PICKARD, Auteur ; Allison WAINER, Auteur ; Sarabeth BRODER-FINGERT, Auteur ; R. Christopher SHELDRICK, Auteur ; Aubyn C. STAHMER, Auteur Article en page(s) : p.858-863 Langues : Anglais (eng) Mots-clés : autism spectrum disorders,early intervention,family-centered care,family functioning and support,fidelity,interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : The Part C Early Intervention system has been a focus of translational efforts in the autism field, as it is an entry point to services during a critical window of early development. Although Early Intervention systems are perceived as a promising setting in which to implement evidence-based practices for autism, implementation efforts seldom account for the unique service delivery model of Early Intervention systems, which emphasize family-centered care. The principles of family-centered care may at times pose tradeoffs to the implementation of manualized evidence-based practices and, thus, are pertinent to consider within implementation research being conducted within these systems. This commentary highlights family-centered care as an important factor of service delivery in Early Intervention systems that deserve greater attention. We lay out how family-centered care provides a framework for evaluating evidence-based practice adaptation in Early Intervention systems, how it may impact the adoption and implementation of evidence-based practices, and directions for future research to evaluate the impact of family-centered care alongside evidence-based practice delivery. Measuring family-centered care as part of research within Early Intervention systems may shift the autism field to a more balanced view of fidelity as both delivering core evidence-based practice components in a manner that closely align with fundamental tenants of Early Intervention systems.Lay AbstractEarly Intervention systems provide therapeutic services to families of young children birth to 3?years with developmental delays and are considered a natural access point to services for young children and their families. Research studies in the autism field have been interested in training providers to deliver evidence-based practices in Early Intervention systems to increase access to services for young children with an increased likelihood of being autistic. However, research has often overlooked that Early Intervention systems prioritize family-centered care, an approach to working with families that honors and respects their values and choices and that provides supports to strengthen family functioning. This commentary points out that family-centered care deserves greater attention in research being done in Early Intervention systems. We describe how family-centered care may shape how interventions are delivered, and discuss directions for future research to evaluate the impact of family-centered care alongside intervention delivery. En ligne : https://doi.org/10.1177/13623613221133641 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499 [article] Overcoming tensions between family-centered care and fidelity within Early Intervention implementation research [Texte imprimé et/ou numérique] / Katherine PICKARD, Auteur ; Allison WAINER, Auteur ; Sarabeth BRODER-FINGERT, Auteur ; R. Christopher SHELDRICK, Auteur ; Aubyn C. STAHMER, Auteur . - p.858-863. Langues : Anglais (eng) in Autism > 27-3 (April 2023) . - p.858-863 Mots-clés : autism spectrum disorders,early intervention,family-centered care,family functioning and support,fidelity,interventions-psychosocial/behavioral Index. décimale : PER Périodiques Résumé : The Part C Early Intervention system has been a focus of translational efforts in the autism field, as it is an entry point to services during a critical window of early development. Although Early Intervention systems are perceived as a promising setting in which to implement evidence-based practices for autism, implementation efforts seldom account for the unique service delivery model of Early Intervention systems, which emphasize family-centered care. The principles of family-centered care may at times pose tradeoffs to the implementation of manualized evidence-based practices and, thus, are pertinent to consider within implementation research being conducted within these systems. This commentary highlights family-centered care as an important factor of service delivery in Early Intervention systems that deserve greater attention. We lay out how family-centered care provides a framework for evaluating evidence-based practice adaptation in Early Intervention systems, how it may impact the adoption and implementation of evidence-based practices, and directions for future research to evaluate the impact of family-centered care alongside evidence-based practice delivery. Measuring family-centered care as part of research within Early Intervention systems may shift the autism field to a more balanced view of fidelity as both delivering core evidence-based practice components in a manner that closely align with fundamental tenants of Early Intervention systems.Lay AbstractEarly Intervention systems provide therapeutic services to families of young children birth to 3?years with developmental delays and are considered a natural access point to services for young children and their families. Research studies in the autism field have been interested in training providers to deliver evidence-based practices in Early Intervention systems to increase access to services for young children with an increased likelihood of being autistic. However, research has often overlooked that Early Intervention systems prioritize family-centered care, an approach to working with families that honors and respects their values and choices and that provides supports to strengthen family functioning. This commentary points out that family-centered care deserves greater attention in research being done in Early Intervention systems. We describe how family-centered care may shape how interventions are delivered, and discuss directions for future research to evaluate the impact of family-centered care alongside intervention delivery. En ligne : https://doi.org/10.1177/13623613221133641 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499

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