Applying autism screening research to real-world scenarios: a commentary on Sheldrick et al. (2023) / Kate E. WALLIS in Journal of Child Psychology and Psychiatry, 65-5 (May 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.720-722 Titre : Applying autism screening research to real-world scenarios: a commentary on Sheldrick et al. (2023) Type de document : texte imprimé Auteurs : Kate E. WALLIS, Auteur ; Rosalind USHER, Auteur Article en page(s) : p.720-722 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Early identification of autism spectrum disorder (ASD) continues to be a challenge despite universal screening efforts. One explanation is that screening tools have lower sensitivity and specificity than initial studies report when accounting for incomplete follow-up for all children screened. Sheldrick and colleagues used statistical modeling to demonstrate the impact on sensitivity and specificity when assumptions about the diagnostic outcome of children who do not pursue diagnostic evaluation are altered. Crucially, the work of Sheldrick et al. serves as a reminder that autism screening in primary care is just one component of the clinical assessment and should not be conflated with a diagnostic evaluation. Thus, lack of follow-up after a positive screen is a feature, not only a bug when using a screen in a clinical setting. Engaging families in shared decision-making around screening may help encourage follow-up, and thus, screening tool psychometric performance. En ligne : https://doi.org/10.1111/jcpp.13919 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=526 [article] Applying autism screening research to real-world scenarios: a commentary on Sheldrick et al. (2023) [texte imprimé] / Kate E. WALLIS, Auteur ; Rosalind USHER, Auteur . - p.720-722. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 65-5 (May 2024) . - p.720-722 Index. décimale : PER Périodiques Résumé : Early identification of autism spectrum disorder (ASD) continues to be a challenge despite universal screening efforts. One explanation is that screening tools have lower sensitivity and specificity than initial studies report when accounting for incomplete follow-up for all children screened. Sheldrick and colleagues used statistical modeling to demonstrate the impact on sensitivity and specificity when assumptions about the diagnostic outcome of children who do not pursue diagnostic evaluation are altered. Crucially, the work of Sheldrick et al. serves as a reminder that autism screening in primary care is just one component of the clinical assessment and should not be conflated with a diagnostic evaluation. Thus, lack of follow-up after a positive screen is a feature, not only a bug when using a screen in a clinical setting. Engaging families in shared decision-making around screening may help encourage follow-up, and thus, screening tool psychometric performance. En ligne : https://doi.org/10.1111/jcpp.13919 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=526

Evaluating More Granular Options for Socio-Demographic Questions in Autism Research / Kristn CURRANS ; Kate WALLIS ; Amanda E. BENNETT ; Judith S. MILLER in Autism Research, 18-6 (June 2025)  

Public ISBD [article]  inAutism Research > 18-6 (June 2025) . - p.1301-1308 Titre : Evaluating More Granular Options for Socio-Demographic Questions in Autism Research Type de document : texte imprimé Auteurs : Kristn CURRANS, Auteur ; Kate WALLIS, Auteur ; Amanda E. BENNETT, Auteur ; Judith S. MILLER, Auteur Article en page(s) : p.1301-1308 Langues : Anglais (eng) Mots-clés : demographics  inclusive research  surveys Index. décimale : PER Périodiques Résumé : ABSTRACT We evaluated the feasibility and acceptability of adding more detailed choices for race, ethnicity, sex, gender, and socio-economic status for a demographic survey used by families both within and outside a large learning health network, the Autism Care Network (ACNet). We updated our demographic survey using an iterative approach, incorporating qualitative and quantitative feedback from interested parties across the US and Canada. Pilot testing of the revised survey was conducted with families with and without autism served by two large academic pediatric tertiary care centers. Through purposive sampling, recruitment was enriched for families from ethnic, racial, or gender minority backgrounds. The updated demographic survey increased the number of response options for race and ethnicity, sex, gender, and language. 85 families within the ACNet and 242 families outside the ACNet provided feasibility and acceptability data. 41% of respondents were from nonWhite or multiple race groups. 99% of respondents rated the updated form same or better than the original. 91% of respondents rated the updated form as acceptable, while 97% rated the survey as feasible. Despite concerns about the burden on respondents, we found high rates of feasibility and acceptability of more granular response options in demographic surveys. Researchers can adapt this approach to make their own more granular demographic forms focused on the specific variables relevant to their study and local contexts. More granular demographic data can identify strengths and gaps in representation that could impact a study's generalizability. En ligne : https://doi.org/10.1002/aur.70041 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=558 [article] Evaluating More Granular Options for Socio-Demographic Questions in Autism Research [texte imprimé] / Kristn CURRANS, Auteur ; Kate WALLIS, Auteur ; Amanda E. BENNETT, Auteur ; Judith S. MILLER, Auteur . - p.1301-1308. Langues : Anglais (eng) in Autism Research > 18-6 (June 2025) . - p.1301-1308 Mots-clés : demographics  inclusive research  surveys Index. décimale : PER Périodiques Résumé : ABSTRACT We evaluated the feasibility and acceptability of adding more detailed choices for race, ethnicity, sex, gender, and socio-economic status for a demographic survey used by families both within and outside a large learning health network, the Autism Care Network (ACNet). We updated our demographic survey using an iterative approach, incorporating qualitative and quantitative feedback from interested parties across the US and Canada. Pilot testing of the revised survey was conducted with families with and without autism served by two large academic pediatric tertiary care centers. Through purposive sampling, recruitment was enriched for families from ethnic, racial, or gender minority backgrounds. The updated demographic survey increased the number of response options for race and ethnicity, sex, gender, and language. 85 families within the ACNet and 242 families outside the ACNet provided feasibility and acceptability data. 41% of respondents were from nonWhite or multiple race groups. 99% of respondents rated the updated form same or better than the original. 91% of respondents rated the updated form as acceptable, while 97% rated the survey as feasible. Despite concerns about the burden on respondents, we found high rates of feasibility and acceptability of more granular response options in demographic surveys. Researchers can adapt this approach to make their own more granular demographic forms focused on the specific variables relevant to their study and local contexts. More granular demographic data can identify strengths and gaps in representation that could impact a study's generalizability. En ligne : https://doi.org/10.1002/aur.70041 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=558

Prevalence of autism spectrum disorder in a large pediatric primary care network / Kate E. WALLIS in Autism, 27-6 (August 2023)  

Public ISBD [article]  inAutism > 27-6 (August 2023) . - p.1840-1846 Titre : Prevalence of autism spectrum disorder in a large pediatric primary care network Type de document : texte imprimé Auteurs : Kate E. WALLIS, Auteur ; Toore ADEBAJO, Auteur ; Amanda E. BENNETT, Auteur ; Madison DRYE, Auteur ; Marsha GERDES, Auteur ; Judith S. MILLER, Auteur ; Whitney GUTHRIE, Auteur Article en page(s) : p.1840-1846 Langues : Anglais (eng) Mots-clés : autism spectrum disorder;diagnosis;prevalence;screening Index. décimale : PER Périodiques Résumé : In this retrospective cohort study using data from an integrated primary care and subspecialty network, we examined medical records of children seen in primary care at eligible autism spectrum disorder (ASD) screening ages and followed through at least 4 years of age. We examined the prevalence of ASD; age of first documented ASD diagnosis; and whether the prevalence and age of documented diagnosis varied by race, ethnicity, socio-economic status (SES) and site of care (urban versus suburban/rural). The prevalence of ASD across the cohort was 3.2%, with a median age of diagnosis of 3.93 years. ASD prevalence was unexpectedly higher among Asian children, non-Hispanic Black children, children with higher Social Vulnerability Index scores (a neighborhood-level proxy of socio-economic risk), and children who received care in urban primary care sites. There were no statistically significant differences in age at which ASD diagnosis was documented across socio-demographic groups. Receiving primary care at an urban site accounted for most other socio-demographic differences in ASD prevalence rates, except among Asian children, who were found to have higher adjusted odds of ASD diagnosis compared to White children (aOR=1.82, p<.001). Determining what clinical-, individual- or systems-level factors contribute to ASD diagnosis remains important to improve equity.Lay AbstractHistorically, children from non-Hispanic Black and Hispanic backgrounds, those from lower-income families, and girls are less likely to be diagnosed with autism spectrum disorder. Under-identification among these historically and contemporaneously marginalized groups can limit their access to early, autism spectrum disorder-specific interventions, which can have long-term negative impacts. Recent data suggest that some of these trends may be narrowing, or even reversing. Using electronic health record data, we calculated autism spectrum disorder prevalence rates and age of first documented diagnosis across socio-demographic groups. Our cohort included children seen at young ages (when eligible for screening in early childhood) and again at least after 4 years of age in a large primary care network. We found that autism spectrum disorder prevalence was unexpectedly higher among Asian children, non-Hispanic Black children, children with higher Social Vulnerability Index scores (a measure of socio-economic risk at the neighborhood level), and children who received care in urban primary care sites. We did not find differences in the age at which autism spectrum disorder diagnoses were documented in children s records across these groups. Receiving primary care at an urban site (regardless of location of specialty care) appeared to account for most other socio-demographic differences in autism spectrum disorder prevalence rates, except among Asian children, who remained more likely to be diagnosed with autism spectrum disorder after controlling for other factors. We must continue to better understand the process by which children with autism spectrum disorder from traditionally under-identified and under-served backgrounds come to be recognized, to continue to improve the equity of care. En ligne : http://dx.doi.org/10.1177/13623613221147396 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=509 [article] Prevalence of autism spectrum disorder in a large pediatric primary care network [texte imprimé] / Kate E. WALLIS, Auteur ; Toore ADEBAJO, Auteur ; Amanda E. BENNETT, Auteur ; Madison DRYE, Auteur ; Marsha GERDES, Auteur ; Judith S. MILLER, Auteur ; Whitney GUTHRIE, Auteur . - p.1840-1846. Langues : Anglais (eng) in Autism > 27-6 (August 2023) . - p.1840-1846 Mots-clés : autism spectrum disorder;diagnosis;prevalence;screening Index. décimale : PER Périodiques Résumé : In this retrospective cohort study using data from an integrated primary care and subspecialty network, we examined medical records of children seen in primary care at eligible autism spectrum disorder (ASD) screening ages and followed through at least 4 years of age. We examined the prevalence of ASD; age of first documented ASD diagnosis; and whether the prevalence and age of documented diagnosis varied by race, ethnicity, socio-economic status (SES) and site of care (urban versus suburban/rural). The prevalence of ASD across the cohort was 3.2%, with a median age of diagnosis of 3.93 years. ASD prevalence was unexpectedly higher among Asian children, non-Hispanic Black children, children with higher Social Vulnerability Index scores (a neighborhood-level proxy of socio-economic risk), and children who received care in urban primary care sites. There were no statistically significant differences in age at which ASD diagnosis was documented across socio-demographic groups. Receiving primary care at an urban site accounted for most other socio-demographic differences in ASD prevalence rates, except among Asian children, who were found to have higher adjusted odds of ASD diagnosis compared to White children (aOR=1.82, p<.001). Determining what clinical-, individual- or systems-level factors contribute to ASD diagnosis remains important to improve equity.Lay AbstractHistorically, children from non-Hispanic Black and Hispanic backgrounds, those from lower-income families, and girls are less likely to be diagnosed with autism spectrum disorder. Under-identification among these historically and contemporaneously marginalized groups can limit their access to early, autism spectrum disorder-specific interventions, which can have long-term negative impacts. Recent data suggest that some of these trends may be narrowing, or even reversing. Using electronic health record data, we calculated autism spectrum disorder prevalence rates and age of first documented diagnosis across socio-demographic groups. Our cohort included children seen at young ages (when eligible for screening in early childhood) and again at least after 4 years of age in a large primary care network. We found that autism spectrum disorder prevalence was unexpectedly higher among Asian children, non-Hispanic Black children, children with higher Social Vulnerability Index scores (a measure of socio-economic risk at the neighborhood level), and children who received care in urban primary care sites. We did not find differences in the age at which autism spectrum disorder diagnoses were documented in children s records across these groups. Receiving primary care at an urban site (regardless of location of specialty care) appeared to account for most other socio-demographic differences in autism spectrum disorder prevalence rates, except among Asian children, who remained more likely to be diagnosed with autism spectrum disorder after controlling for other factors. We must continue to better understand the process by which children with autism spectrum disorder from traditionally under-identified and under-served backgrounds come to be recognized, to continue to improve the equity of care. En ligne : http://dx.doi.org/10.1177/13623613221147396 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=509

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