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 Auteurs : Rebecca P. THOMAS, Auteur ; Ashley B. 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] / Rebecca P. THOMAS, Auteur ; Ashley B. 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

Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers / Andrea T. WIECKOWSKI in Autism Research, 15-12 (December 2022)  

Public ISBD [article]  inAutism Research > 15-12 (December 2022) . - p.2216-2222 Titre : Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers Type de document : texte imprimé Auteurs : Andrea T. WIECKOWSKI, Auteur ; Katharine E. ZUCKERMAN, Auteur ; Sarabeth BRODER-FINGERT, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.2216-2222 Langues : Anglais (eng) Mots-clés : Child  Humans  Child, Preschool  Autistic Disorder  Autism Spectrum Disorder/diagnosis/therapy  Primary Health Care  autism spectrum disorder  diagnosis  early detection  primary care Index. décimale : PER Périodiques Résumé : Formal autism diagnosis from a specialist trained in autism assessment is customary prior to a child accessing early, intensive autism-specific services. However, long wait lists for diagnostic evaluations and limited specialty workforce have created substantial delays. Additionally, lengthy multidisciplinary evaluations are costly to insurers, inconvenient to families, and disproportionally impact under-resourced families. Diagnostic delays can impede access to intervention services. These barriers, combined with evidence regarding the importance of receiving early, autism-specific treatment, demand new approaches enabling access to autism specific services before comprehensive evaluation. Pediatric primary care providers (PCPs) are often the only health care professionals with whom a family interacts during early childhood and can play a crucial role in helping children with autism symptoms access services. Many strategies for autism diagnosis in primary care are being developed and tested; however, they have yet to be broadly adopted by PCPs, primarily due to critical implementation barriers in primary care settings. There is also not enough evidence on the accuracy of PCPs' diagnostic impressions without extensive specialty support, resulting in PCP hesitancy in diagnosing ASD, as well as family and service provider hesitancy in accepting a PCP autism diagnosis. In this commentary, we explore the acute need for shortening waitlists for autism evaluations through a tiered diagnostic approach, in which PCPs can rule in or rule out autism in children, for whom diagnosis is clear, and refer more complex cases for specialist evaluations, and explore implementation challenges to this approach. En ligne : http://dx.doi.org/10.1002/aur.2832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488 [article] Addressing current barriers to autism diagnoses through a tiered diagnostic approach involving pediatric primary care providers [texte imprimé] / Andrea T. WIECKOWSKI, Auteur ; Katharine E. ZUCKERMAN, Auteur ; Sarabeth BRODER-FINGERT, Auteur ; Diana L. ROBINS, Auteur . - p.2216-2222. Langues : Anglais (eng) in Autism Research > 15-12 (December 2022) . - p.2216-2222 Mots-clés : Child  Humans  Child, Preschool  Autistic Disorder  Autism Spectrum Disorder/diagnosis/therapy  Primary Health Care  autism spectrum disorder  diagnosis  early detection  primary care Index. décimale : PER Périodiques Résumé : Formal autism diagnosis from a specialist trained in autism assessment is customary prior to a child accessing early, intensive autism-specific services. However, long wait lists for diagnostic evaluations and limited specialty workforce have created substantial delays. Additionally, lengthy multidisciplinary evaluations are costly to insurers, inconvenient to families, and disproportionally impact under-resourced families. Diagnostic delays can impede access to intervention services. These barriers, combined with evidence regarding the importance of receiving early, autism-specific treatment, demand new approaches enabling access to autism specific services before comprehensive evaluation. Pediatric primary care providers (PCPs) are often the only health care professionals with whom a family interacts during early childhood and can play a crucial role in helping children with autism symptoms access services. Many strategies for autism diagnosis in primary care are being developed and tested; however, they have yet to be broadly adopted by PCPs, primarily due to critical implementation barriers in primary care settings. There is also not enough evidence on the accuracy of PCPs' diagnostic impressions without extensive specialty support, resulting in PCP hesitancy in diagnosing ASD, as well as family and service provider hesitancy in accepting a PCP autism diagnosis. In this commentary, we explore the acute need for shortening waitlists for autism evaluations through a tiered diagnostic approach, in which PCPs can rule in or rule out autism in children, for whom diagnosis is clear, and refer more complex cases for specialist evaluations, and explore implementation challenges to this approach. En ligne : http://dx.doi.org/10.1002/aur.2832 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488

Applying a public health approach to autism research: A framework for action / Diana SCHENDEL in Autism Research, 15-4 (April 2022)  

Public ISBD [article]  inAutism Research > 15-4 (April 2022) . - p.592-601 Titre : Applying a public health approach to autism research: A framework for action Type de document : texte imprimé Auteurs : Diana SCHENDEL, Auteur ; Anne M. ROUX, Auteur ; Elizabeth MCGHEE HASSRICK, Auteur ; Kristen LYALL, Auteur ; Lindsay L. SHEA, Auteur ; Giacomo VIVANTI, Auteur ; Andrea T. WIECKOWSKI, Auteur ; Craig J. NEWSCHAFFER, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.592-601 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Humans  Public Health  Quality of Life  autism spectrum disorder  communication  knowledge Index. décimale : PER Périodiques Résumé : Most published autism research, and the funding that supports it, remains focused on basic and clinical science. However, the public health impact of autism drives a compelling argument for utilizing a public health approach to autism research. Fundamental to the public health perspective is a focus on health determinants to improve quality of life and to reduce the potential for adverse outcomes across the general population, including in vulnerable subgroups. While the public health research process can be conceptualized as a linear, 3-stage path consisting of discovery - testing - translation/dissemination/implementation, in this paper we propose an integrated, cyclical research framework to advance autism public health objectives in a more comprehensive manner. This involves discovery of primary, secondary and tertiary determinants of health in autism; and use of this evidence base to develop and test detection, intervention, and dissemination strategies and the means to implement them in 'real world' settings. The proposed framework serves to facilitate identification of knowledge gaps, translational barriers, and shortfalls in implementation; guides an iterative research cycle; facilitates purposeful integration of stakeholders and interdisciplinary researchers; and may yield more efficient achievement of improved health and well-being among persons on the autism spectrum at the population-level. LAY SUMMARY: Scientists need better ways to identify and address gaps in autism research, conduct research with stakeholders, and use findings to improve the lives of autistic people. We recommend an approach, based in public health science, to guide research in ways that might impact lives more quickly. En ligne : https://dx.doi.org/10.1002/aur.2689 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=473 [article] Applying a public health approach to autism research: A framework for action [texte imprimé] / Diana SCHENDEL, Auteur ; Anne M. ROUX, Auteur ; Elizabeth MCGHEE HASSRICK, Auteur ; Kristen LYALL, Auteur ; Lindsay L. SHEA, Auteur ; Giacomo VIVANTI, Auteur ; Andrea T. WIECKOWSKI, Auteur ; Craig J. NEWSCHAFFER, Auteur ; Diana L. ROBINS, Auteur . - p.592-601. Langues : Anglais (eng) in Autism Research > 15-4 (April 2022) . - p.592-601 Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder/diagnosis  Humans  Public Health  Quality of Life  autism spectrum disorder  communication  knowledge Index. décimale : PER Périodiques Résumé : Most published autism research, and the funding that supports it, remains focused on basic and clinical science. However, the public health impact of autism drives a compelling argument for utilizing a public health approach to autism research. Fundamental to the public health perspective is a focus on health determinants to improve quality of life and to reduce the potential for adverse outcomes across the general population, including in vulnerable subgroups. While the public health research process can be conceptualized as a linear, 3-stage path consisting of discovery - testing - translation/dissemination/implementation, in this paper we propose an integrated, cyclical research framework to advance autism public health objectives in a more comprehensive manner. This involves discovery of primary, secondary and tertiary determinants of health in autism; and use of this evidence base to develop and test detection, intervention, and dissemination strategies and the means to implement them in 'real world' settings. The proposed framework serves to facilitate identification of knowledge gaps, translational barriers, and shortfalls in implementation; guides an iterative research cycle; facilitates purposeful integration of stakeholders and interdisciplinary researchers; and may yield more efficient achievement of improved health and well-being among persons on the autism spectrum at the population-level. LAY SUMMARY: Scientists need better ways to identify and address gaps in autism research, conduct research with stakeholders, and use findings to improve the lives of autistic people. We recommend an approach, based in public health science, to guide research in ways that might impact lives more quickly. En ligne : https://dx.doi.org/10.1002/aur.2689 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=473

Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study / Andrea Trubanova WIECKOWSKI in Journal of Autism and Developmental Disorders, 50-1 (January 2020)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 50-1 (January 2020) . - p.30-41 Titre : Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study Type de document : texte imprimé Auteurs : Andrea Trubanova WIECKOWSKI, Auteur ; Susan W. WHITE, Auteur Article en page(s) : p.30-41 Langues : Anglais (eng) Mots-clés : Attention training  Autism spectrum disorder  Eye-tracking  Facial emotion recognition Index. décimale : PER Périodiques Résumé : Diminished attending to faces may contribute to the impairments in emotion recognition and expression in autism spectrum disorder (ASD). The current study evaluated the acceptability, feasibility, and preliminary efficacy of an attention modification intervention designed to attenuate deficits in facial emotion recognition (FER). During the 10-session experimental treatment, children (n = 8) with ASD watched dynamic videos of people expressing different emotions with the facial features highlighted to guide children's attention. Children and their parents generally rated the treatment as acceptable and helpful. Although FER improvement was not apparent on task-based measures, parents reported slight improvements and decreased socioemotional problems following treatment. Results suggest that further research on visual attention retraining for ASD, within an experimental therapeutic program, may be promising. En ligne : http://dx.doi.org/10.1007/s10803-019-04223-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414 [article] Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study [texte imprimé] / Andrea Trubanova WIECKOWSKI, Auteur ; Susan W. WHITE, Auteur . - p.30-41. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 50-1 (January 2020) . - p.30-41 Mots-clés : Attention training  Autism spectrum disorder  Eye-tracking  Facial emotion recognition Index. décimale : PER Périodiques Résumé : Diminished attending to faces may contribute to the impairments in emotion recognition and expression in autism spectrum disorder (ASD). The current study evaluated the acceptability, feasibility, and preliminary efficacy of an attention modification intervention designed to attenuate deficits in facial emotion recognition (FER). During the 10-session experimental treatment, children (n = 8) with ASD watched dynamic videos of people expressing different emotions with the facial features highlighted to guide children's attention. Children and their parents generally rated the treatment as acceptable and helpful. Although FER improvement was not apparent on task-based measures, parents reported slight improvements and decreased socioemotional problems following treatment. Results suggest that further research on visual attention retraining for ASD, within an experimental therapeutic program, may be promising. En ligne : http://dx.doi.org/10.1007/s10803-019-04223-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=414

Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments / Andrea Trubanova WIECKOWSKI in Autism, 29-11 (November 2025)  

Public ISBD [article]  inAutism > 29-11 (November 2025) . - p.2898-2905 Titre : Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments Type de document : texte imprimé Auteurs : Andrea Trubanova WIECKOWSKI, Auteur ; Ashley B. DE MARCHENA, Auteur ; Alexia F DICKERSON, Auteur ; Erika FRICK, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley H. DUBIN, Auteur ; Diana L. ROBINS, Auteur Article en page(s) : p.2898-2905 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  diagnosis  early detection  primary care diagnosis  telehealth  toddlers Index. décimale : PER Périodiques Résumé : Formal autism diagnosis is often critical for children to access early, autism-specific services and supports. However, barriers to traditional in-person evaluations, including long waitlists, delay diagnosis. The goal of the current study was to compare diagnostic impressions (i.e. clinical judgments) made by primary care clinicians and autism experts conducting brief telehealth sessions, with expert diagnosis from in-person gold-standard evaluations. Participants were toddlers (n = 32, age 12–36 months) referred for any developmental concerns by four primary care clinicians from one pediatric practice in the United States. Primary care clinicians indicated their diagnostic classification and families then completed telehealth evaluations and in-person evaluations with one of five autism diagnostic expert clinicians. When primary care clinicians classified a child as having definite autism (n = 11), they were 100% accurate, but only 57% accurate when they indicated a child definitely did not have autism. Experts providing classification after a telehealth evaluation accurately classified 72% of children and were confident in the diagnosis for 55% of cases. In high-confidence cases, telehealth diagnosis matched final diagnosis 88% of the time. These findings indicate that when primary care clinicians believe a toddler is autistic, or when autism experts indicate autism telehealth classification with confidence, the child should begin receiving autism-specific services and supports right away.Lay abstract There are long waitlists for autism evaluations, which greatly delay the start of interventions that are known to improve children’s outcomes. We tested the accuracy of primary care clinicians’ impressions of autism versus other developmental delays during well-child visits, and of experts during brief telemedicine visits, and found that more than half of the children were accurately identified through these streamlined methods. These findings support a tiered approach in which children identified through these more efficient methods begin autism intervention immediately; this approach also benefits children with more complex differentials by shortening waitlists for comprehensive evaluations for those who require them prior to treatment entry. En ligne : https://dx.doi.org/10.1177/13623613251355257 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570 [article] Autism diagnostic impressions in young children formed by primary care clinicians and through telemedicine expert assessments [texte imprimé] / Andrea Trubanova WIECKOWSKI, Auteur ; Ashley B. DE MARCHENA, Auteur ; Alexia F DICKERSON, Auteur ; Erika FRICK, Auteur ; Georgina PEREZ LIZ, Auteur ; Ashley H. DUBIN, Auteur ; Diana L. ROBINS, Auteur . - p.2898-2905. Langues : Anglais (eng) in Autism > 29-11 (November 2025) . - p.2898-2905 Mots-clés : autism spectrum disorder  diagnosis  early detection  primary care diagnosis  telehealth  toddlers Index. décimale : PER Périodiques Résumé : Formal autism diagnosis is often critical for children to access early, autism-specific services and supports. However, barriers to traditional in-person evaluations, including long waitlists, delay diagnosis. The goal of the current study was to compare diagnostic impressions (i.e. clinical judgments) made by primary care clinicians and autism experts conducting brief telehealth sessions, with expert diagnosis from in-person gold-standard evaluations. Participants were toddlers (n = 32, age 12–36 months) referred for any developmental concerns by four primary care clinicians from one pediatric practice in the United States. Primary care clinicians indicated their diagnostic classification and families then completed telehealth evaluations and in-person evaluations with one of five autism diagnostic expert clinicians. When primary care clinicians classified a child as having definite autism (n = 11), they were 100% accurate, but only 57% accurate when they indicated a child definitely did not have autism. Experts providing classification after a telehealth evaluation accurately classified 72% of children and were confident in the diagnosis for 55% of cases. In high-confidence cases, telehealth diagnosis matched final diagnosis 88% of the time. These findings indicate that when primary care clinicians believe a toddler is autistic, or when autism experts indicate autism telehealth classification with confidence, the child should begin receiving autism-specific services and supports right away.Lay abstract There are long waitlists for autism evaluations, which greatly delay the start of interventions that are known to improve children’s outcomes. We tested the accuracy of primary care clinicians’ impressions of autism versus other developmental delays during well-child visits, and of experts during brief telemedicine visits, and found that more than half of the children were accurately identified through these streamlined methods. These findings support a tiered approach in which children identified through these more efficient methods begin autism intervention immediately; this approach also benefits children with more complex differentials by shortening waitlists for comprehensive evaluations for those who require them prior to treatment entry. En ligne : https://dx.doi.org/10.1177/13623613251355257 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=570

Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample / Andrea T. WIECKOWSKI in Autism Research, 13-8 (August 2020)  

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Identifying and Addressing the Missing Links Between Research, Policy, and Practice in Autism Research: Lessons From Early Autism Screening and Intervention Research / Anne M. ROUX ; Diana L. ROBINS ; Andrea Trubanova WIECKOWSKI ; Allison S. NAHMAIS ; Kaitlin H. KOFFER MILLER ; Lindsay L. SHEA in Autism Research, 18-6 (June 2025)  

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

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Measuring change in facial emotion recognition in individuals with autism spectrum disorder: A systematic review / Andrea Trubanova WIECKOWSKI in Autism, 24-7 (October 2020)  

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Reported Barriers and Facilitators for Autistic Individuals, Persons with Other Intellectual and Developmental Disabilities, and Their Caregivers to Receive the COVID-19 Vaccine: A Pilot Study / Annie W. RESNIKOFF in Journal of Autism and Developmental Disorders, 55-12 (December 2025)  

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Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) / Sherief Y ELDEEB in Autism, 27-7 (October 2023)  

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Social Anxiety Symptoms Predict Poorer Facial Emotion Recognition in Autistic Male Adolescents and Young Adults Without Intellectual Disability / Andrew VALDESPINO ; Andrea T. WIECKOWSKI ; Marika C. COFFMAN ; Corinne N. CARLTON ; Katelyn M. GARCIA ; Denis GRACANIN ; Susan W. WHITE ; John A. RICHEY in Journal of Autism and Developmental Disorders, 54-7 (July 2024)  

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Task Dependency When Evaluating Association Between Facial Emotion Recognition and Facial Emotion Expression in Children with ASD / Andrea T. WIECKOWSKI in Journal of Autism and Developmental Disorders, 49-2 (February 2019)  

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The first five minutes: Initial impressions during autism spectrum disorder diagnostic evaluations in young children / Andrea T. WIECKOWSKI in Autism Research, 14-9 (September 2021)  

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What About the Girls? Sex-Based Differences in Autistic Traits and Adaptive Skills / Allison B. RATTO in Journal of Autism and Developmental Disorders, 48-5 (May 2018)  

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