Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting / Rebecca MCNALLY KEEHN in Autism, 29-4 (April 2025)  

Public ISBD [article]  inAutism > 29-4 (April 2025) . - p.945-957 Titre : Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting Type de document : Texte imprimé et/ou numérique Auteurs : Rebecca MCNALLY KEEHN, Auteur ; Noha F. MINSHAWI, Auteur ; Qing TANG, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Ann Marie MARTIN, Auteur ; Angela PAXTON, Auteur ; Patrick O. MONAHAN, Auteur ; Mary CICCARELLI, Auteur ; Brandon KEEHN, Auteur Article en page(s) : p.945-957 Langues : Anglais (eng) Mots-clés : autism  diagnosis  primary care Index. décimale : PER Périodiques Résumé : Feasible and accurate assessment tools developed for non-specialists are needed to scale community-based models of autism evaluation. The purpose of this study was to evaluate use of the Screening Tool for Autism in Toddlers and Young Children (STAT) when used by primary care practitioners (n = 10) across a statewide system of early diagnosis set within seven United States primary care practices. Specifically, for 130, 14- to 48-month-old children, we examined (1) agreement between STAT classification and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) outcome and expert diagnosis of autism, (2) characteristics of children with inaccurate STAT classifications, (3) consistency between STAT classification and primary care practitioner diagnosis, and (4) the relationship between STAT/primary care practitioner classification and expert diagnosis. The STAT demonstrated good concurrent validity with the ADOS-2 (77% agreement). Concordance between specialty trained primary care practitioners with expert diagnosis was 80%-87% across three age-based subgroups of children. Children misclassified by the STAT were older, had higher developmental and adaptive skills, and lower autism symptoms. Primary care practitioner diagnosis aligned with STAT categorical risk classification in 86% of cases, and 73% of consistent classifications between STAT and primary care practitioner diagnosis matched expert diagnosis. Overall, the STAT demonstrates good accuracy when used by non-specialists as part of a diagnostic evaluation.Lay summary Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation. En ligne : https://dx.doi.org/10.1177/13623613241292850 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=552 [article] Accuracy of the Screening Tool for Autism in Toddlers and Young Children in the primary care setting [Texte imprimé et/ou numérique] / Rebecca MCNALLY KEEHN, Auteur ; Noha F. MINSHAWI, Auteur ; Qing TANG, Auteur ; Brett ENNEKING, Auteur ; Tybytha RYAN, Auteur ; Ann Marie MARTIN, Auteur ; Angela PAXTON, Auteur ; Patrick O. MONAHAN, Auteur ; Mary CICCARELLI, Auteur ; Brandon KEEHN, Auteur . - p.945-957. Langues : Anglais (eng) in Autism > 29-4 (April 2025) . - p.945-957 Mots-clés : autism  diagnosis  primary care Index. décimale : PER Périodiques Résumé : Feasible and accurate assessment tools developed for non-specialists are needed to scale community-based models of autism evaluation. The purpose of this study was to evaluate use of the Screening Tool for Autism in Toddlers and Young Children (STAT) when used by primary care practitioners (n = 10) across a statewide system of early diagnosis set within seven United States primary care practices. Specifically, for 130, 14- to 48-month-old children, we examined (1) agreement between STAT classification and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) outcome and expert diagnosis of autism, (2) characteristics of children with inaccurate STAT classifications, (3) consistency between STAT classification and primary care practitioner diagnosis, and (4) the relationship between STAT/primary care practitioner classification and expert diagnosis. The STAT demonstrated good concurrent validity with the ADOS-2 (77% agreement). Concordance between specialty trained primary care practitioners with expert diagnosis was 80%-87% across three age-based subgroups of children. Children misclassified by the STAT were older, had higher developmental and adaptive skills, and lower autism symptoms. Primary care practitioner diagnosis aligned with STAT categorical risk classification in 86% of cases, and 73% of consistent classifications between STAT and primary care practitioner diagnosis matched expert diagnosis. Overall, the STAT demonstrates good accuracy when used by non-specialists as part of a diagnostic evaluation.Lay summary Specialists conduct autism evaluations using tools that are expensive and difficult to get trained on. Families often wait a long time and travel far to get a diagnosis for their child. To help with this problem, primary care practitioners can be trained to provide evaluations in local communities. However, usable and accurate tools developed for non-specialists are needed. The Screening Tool for Autism in Toddlers and Young Children (STAT) was created for this purpose, but limited research has been done on accuracy of the tool in community primary care. This study tested the STAT when used by primary care practitioners as part of a diagnostic evaluation in 130, 14- to 48-month-old children. We tested (1) STAT agreement with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and diagnosis based on an expert research evaluation, and (2) the relationship between STAT classification, primary care practitioner diagnosis, and expert diagnosis. STAT classification matched the ADOS-2 in 77% of cases and expert diagnosis in 78% of cases. Autistic children incorrectly classified by the STAT were older, had higher developmental and adaptive skills, and fewer autism symptoms. In 86% of cases, the STAT classification agreed with primary care practitioner diagnosis. STAT classification, primary care practitioner diagnosis, and expert diagnosis agreed in 73% of cases. Overall, the STAT shows good accuracy when used by primary care practitioners as part of a community primary care autism evaluation. En ligne : https://dx.doi.org/10.1177/13623613241292850 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=552

Attentional networks in children and adolescents with autism spectrum disorder / Brandon KEEHN in Journal of Child Psychology and Psychiatry, 51-11 (November 2010)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 51-11 (November 2010) . - p.1251-1259 Titre : Attentional networks in children and adolescents with autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Brandon KEEHN, Auteur ; Alan J. LINCOLN, Auteur ; Ralph-Axel MULLER, Auteur ; Jeanne TOWNSEND, Auteur Année de publication : 2010 Article en page(s) : p.1251-1259 Langues : Anglais (eng) Mots-clés : Autism reaction-time visual-attention alerting orienting executive-control Index. décimale : PER Périodiques Résumé : Background:  Individuals diagnosed with autism spectrum disorder (ASD) exhibit lifelong abnormalities in the adaptive allocation of visual attention. The ubiquitous nature of attentional impairments in ASD has led some authors to hypothesize that atypical attentional modulation may be a factor in the development of higher-level sociocommunicative deficits. Method:  Participants were 20 children with ASD and 20 age- and Nonverbal IQ-matched typically developing (TD) children. We used the Attention Network Test (ANT) to investigate the efficiency and independence of three discrete attentional networks: alerting, orienting, and executive control. Additionally, we sought to investigate the relationship between each attentional network and measures of sociocommunicative symptom severity in children with ASD. Results:  Results indicate that the orienting, but not alerting or executive control, networks may be impaired in children with ASD. In contrast to TD children, correlational analyses suggest that the alerting and executive control networks may not function as independently in children with ASD. Additionally, an association was found between the alerting network and social impairment and between the executive control network and IQ in children with ASD. Conclusions:  The results provide further evidence of an impairment in the visuospatial orienting network in ASD and suggest that there may be greater interdependence of alerting and executive control networks in ASD. Furthermore, decreased ability to efficiently modulate levels of alertness was related to increased sociocommunicative deficits, suggesting that domain-general attentional function may be associated with ASD symptomatology. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2010.02257.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=110 [article] Attentional networks in children and adolescents with autism spectrum disorder [Texte imprimé et/ou numérique] / Brandon KEEHN, Auteur ; Alan J. LINCOLN, Auteur ; Ralph-Axel MULLER, Auteur ; Jeanne TOWNSEND, Auteur . - 2010 . - p.1251-1259. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 51-11 (November 2010) . - p.1251-1259 Mots-clés : Autism reaction-time visual-attention alerting orienting executive-control Index. décimale : PER Périodiques Résumé : Background:  Individuals diagnosed with autism spectrum disorder (ASD) exhibit lifelong abnormalities in the adaptive allocation of visual attention. The ubiquitous nature of attentional impairments in ASD has led some authors to hypothesize that atypical attentional modulation may be a factor in the development of higher-level sociocommunicative deficits. Method:  Participants were 20 children with ASD and 20 age- and Nonverbal IQ-matched typically developing (TD) children. We used the Attention Network Test (ANT) to investigate the efficiency and independence of three discrete attentional networks: alerting, orienting, and executive control. Additionally, we sought to investigate the relationship between each attentional network and measures of sociocommunicative symptom severity in children with ASD. Results:  Results indicate that the orienting, but not alerting or executive control, networks may be impaired in children with ASD. In contrast to TD children, correlational analyses suggest that the alerting and executive control networks may not function as independently in children with ASD. Additionally, an association was found between the alerting network and social impairment and between the executive control network and IQ in children with ASD. Conclusions:  The results provide further evidence of an impairment in the visuospatial orienting network in ASD and suggest that there may be greater interdependence of alerting and executive control networks in ASD. Furthermore, decreased ability to efficiently modulate levels of alertness was related to increased sociocommunicative deficits, suggesting that domain-general attentional function may be associated with ASD symptomatology. En ligne : http://dx.doi.org/10.1111/j.1469-7610.2010.02257.x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=110

Atypical Hemispheric Specialization for Faces in Infants at Risk for Autism Spectrum Disorder / Brandon KEEHN in Autism Research, 8-2 (April 2015)  

Public ISBD [article]  inAutism Research > 8-2 (April 2015) . - p.187-198 Titre : Atypical Hemispheric Specialization for Faces in Infants at Risk for Autism Spectrum Disorder Type de document : Texte imprimé et/ou numérique Auteurs : Brandon KEEHN, Auteur ; Vanessa VOGEL-FARLEY, Auteur ; Helen TAGER-FLUSBERG, Auteur ; Charles A. NELSON, Auteur Article en page(s) : p.187-198 Langues : Anglais (eng) Mots-clés : autism  EEG coherence  face processing  hemispheric specialization  endophenotype  gamma  infancy Index. décimale : PER Périodiques Résumé : Among the many experimental findings that tend to distinguish those with and without autism spectrum disorder (ASD) are face processing deficits, reduced hemispheric specialization, and atypical neurostructural and functional connectivity. To investigate the earliest manifestations of these features, we examined lateralization of event-related gamma-band coherence to faces during the first year of life in infants at high risk for autism (HRA; defined as having an older sibling with ASD) who were compared with low-risk comparison (LRC) infants, defined as having no family history of ASD. Participants included 49 HRA and 46 LRC infants who contributed a total of 127 data sets at 6 and 12 months. Electroencephalography was recorded while infants viewed images of familiar/unfamiliar faces. Event-related gamma-band (30–50?Hz) phase coherence between anterior–posterior electrode pairs for left and right hemispheres was computed. Developmental trajectories for lateralization of intra-hemispheric coherence were significantly different in HRA and LRC infants: by 12 months, HRA infants showed significantly greater leftward lateralization compared with LRC infants who showed rightward lateralization. Preliminary results indicate that infants who later met criteria for ASD were those that showed the greatest leftward lateralization. HRA infants demonstrate an aberrant pattern of leftward lateralization of intra-hemispheric coherence by the end of the first year of life, suggesting that the network specialized for face processing may develop atypically. Further, infants with the greatest leftward asymmetry at 12 months where those that later met criteria for ASD, providing support to the growing body of evidence that atypical hemispheric specialization may be an early neurobiological marker for ASD. En ligne : http://dx.doi.org/10.1002/aur.1438 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=256 [article] Atypical Hemispheric Specialization for Faces in Infants at Risk for Autism Spectrum Disorder [Texte imprimé et/ou numérique] / Brandon KEEHN, Auteur ; Vanessa VOGEL-FARLEY, Auteur ; Helen TAGER-FLUSBERG, Auteur ; Charles A. NELSON, Auteur . - p.187-198. Langues : Anglais (eng) in Autism Research > 8-2 (April 2015) . - p.187-198 Mots-clés : autism  EEG coherence  face processing  hemispheric specialization  endophenotype  gamma  infancy Index. décimale : PER Périodiques Résumé : Among the many experimental findings that tend to distinguish those with and without autism spectrum disorder (ASD) are face processing deficits, reduced hemispheric specialization, and atypical neurostructural and functional connectivity. To investigate the earliest manifestations of these features, we examined lateralization of event-related gamma-band coherence to faces during the first year of life in infants at high risk for autism (HRA; defined as having an older sibling with ASD) who were compared with low-risk comparison (LRC) infants, defined as having no family history of ASD. Participants included 49 HRA and 46 LRC infants who contributed a total of 127 data sets at 6 and 12 months. Electroencephalography was recorded while infants viewed images of familiar/unfamiliar faces. Event-related gamma-band (30–50?Hz) phase coherence between anterior–posterior electrode pairs for left and right hemispheres was computed. Developmental trajectories for lateralization of intra-hemispheric coherence were significantly different in HRA and LRC infants: by 12 months, HRA infants showed significantly greater leftward lateralization compared with LRC infants who showed rightward lateralization. Preliminary results indicate that infants who later met criteria for ASD were those that showed the greatest leftward lateralization. HRA infants demonstrate an aberrant pattern of leftward lateralization of intra-hemispheric coherence by the end of the first year of life, suggesting that the network specialized for face processing may develop atypically. Further, infants with the greatest leftward asymmetry at 12 months where those that later met criteria for ASD, providing support to the growing body of evidence that atypical hemispheric specialization may be an early neurobiological marker for ASD. En ligne : http://dx.doi.org/10.1002/aur.1438 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=256

Brief Report: Eye-Movement Patterns During an Embedded Figures Test in Children with ASD / Brandon KEEHN in Journal of Autism and Developmental Disorders, 39-2 (February 2009)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 39-2 (February 2009) . - p.383-387 Titre : Brief Report: Eye-Movement Patterns During an Embedded Figures Test in Children with ASD Type de document : Texte imprimé et/ou numérique Auteurs : Brandon KEEHN, Auteur ; Alan J. LINCOLN, Auteur ; Laurie A. BRENNER, Auteur ; Ralph-Axel MULLER, Auteur ; Aurora I. RAMOS, Auteur ; Sandra P. MARSHALL, Auteur Année de publication : 2009 Article en page(s) : p.383-387 Langues : Anglais (eng) Mots-clés : Autism Reaction-time Visual-attention Visual-perception Eye-movement Eye-fixation Index. décimale : PER Périodiques Résumé : The present study examined fixation frequency and duration during an Embedded Figures Test (EFT) in an effort to better understand the attentional and perceptual processes by which individuals with autism spectrum disorder (ASD) achieve accelerated EFT performance. In particular, we aimed to elucidate differences in the patterns of eye-movement in ASD and typically developing (TD) children, thus providing evidence relevant to the competing theories of weak central coherence (WCC) and enhanced perceptual functioning. Consistent with prior EFT studies, we found accelerated response time (RT) in children with ASD. No group differences were seen for fixation frequency, but the ASD group made significantly shorter fixations compared to the TD group. Eye-movement results indicate that RT advantage in ASD is related to both WCC and enhanced perceptual functioning. En ligne : http://dx.doi.org/10.1007/s10803-008-0608-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=684 [article] Brief Report: Eye-Movement Patterns During an Embedded Figures Test in Children with ASD [Texte imprimé et/ou numérique] / Brandon KEEHN, Auteur ; Alan J. LINCOLN, Auteur ; Laurie A. BRENNER, Auteur ; Ralph-Axel MULLER, Auteur ; Aurora I. RAMOS, Auteur ; Sandra P. MARSHALL, Auteur . - 2009 . - p.383-387. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 39-2 (February 2009) . - p.383-387 Mots-clés : Autism Reaction-time Visual-attention Visual-perception Eye-movement Eye-fixation Index. décimale : PER Périodiques Résumé : The present study examined fixation frequency and duration during an Embedded Figures Test (EFT) in an effort to better understand the attentional and perceptual processes by which individuals with autism spectrum disorder (ASD) achieve accelerated EFT performance. In particular, we aimed to elucidate differences in the patterns of eye-movement in ASD and typically developing (TD) children, thus providing evidence relevant to the competing theories of weak central coherence (WCC) and enhanced perceptual functioning. Consistent with prior EFT studies, we found accelerated response time (RT) in children with ASD. No group differences were seen for fixation frequency, but the ASD group made significantly shorter fixations compared to the TD group. Eye-movement results indicate that RT advantage in ASD is related to both WCC and enhanced perceptual functioning. En ligne : http://dx.doi.org/10.1007/s10803-008-0608-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=684

Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder / Catharine LORY in Journal of Autism and Developmental Disorders, 50-11 (November 2020)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 50-11 (November 2020) . - p.4183-4190 Titre : Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder Type de document : Texte imprimé et/ou numérique Auteurs : Catharine LORY, Auteur ; Girija KADLASKAR, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Alexander L FRANCIS, Auteur ; Brandon KEEHN, Auteur Article en page(s) : p.4183-4190 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Autonomic arousal  Ecg  Heart rate variability Index. décimale : PER Périodiques Résumé : Dysregulation of the autonomic nervous system (ANS), which can be indexed by heart rate variability (HRV), has been posited to contribute to core features of autism spectrum disorder (ASD). However, the relationship between ASD and HRV remains uncertain. We assessed tonic and phasic HRV of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children and examined (1) group differences in HRV and (2) associations between HRV and ASD symptomatology. Children with ASD showed significantly lower tonic HRV, but similar phasic HRV compared to TD children. Additionally, reduced tonic HRV was associated with atypical attentional responsivity in ASD. Our findings suggest ANS dysregulation is present in ASD and may contribute to atypical attentional responses to sensory stimulation. En ligne : http://dx.doi.org/10.1007/s10803-020-04458-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432 [article] Brief Report: Reduced Heart Rate Variability in Children with Autism Spectrum Disorder [Texte imprimé et/ou numérique] / Catharine LORY, Auteur ; Girija KADLASKAR, Auteur ; Rebecca MCNALLY KEEHN, Auteur ; Alexander L FRANCIS, Auteur ; Brandon KEEHN, Auteur . - p.4183-4190. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 50-11 (November 2020) . - p.4183-4190 Mots-clés : Autism spectrum disorder  Autonomic arousal  Ecg  Heart rate variability Index. décimale : PER Périodiques Résumé : Dysregulation of the autonomic nervous system (ANS), which can be indexed by heart rate variability (HRV), has been posited to contribute to core features of autism spectrum disorder (ASD). However, the relationship between ASD and HRV remains uncertain. We assessed tonic and phasic HRV of 21 children with ASD and 21 age- and IQ-matched typically developing (TD) children and examined (1) group differences in HRV and (2) associations between HRV and ASD symptomatology. Children with ASD showed significantly lower tonic HRV, but similar phasic HRV compared to TD children. Additionally, reduced tonic HRV was associated with atypical attentional responsivity in ASD. Our findings suggest ANS dysregulation is present in ASD and may contribute to atypical attentional responses to sensory stimulation. En ligne : http://dx.doi.org/10.1007/s10803-020-04458-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432

Caregiver Touch-Speech Communication and Infant Responses in 12-Month-Olds at High Risk for Autism Spectrum Disorder / Girija KADLASKAR in Journal of Autism and Developmental Disorders, 50-3 (March 2020)  

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Exploring What’s Missing: What Do Target Absent Trials Reveal About Autism Search Superiority? / Brandon KEEHN in Journal of Autism and Developmental Disorders, 46-5 (May 2016)  

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Impaired downregulation of visual cortex during auditory processing is associated with autism symptomatology in children and adolescents with autism spectrum disorder / R. Joanne JAO KEEHN in Autism Research, 10-1 (January 2017)  

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Impaired prioritization of novel onset stimuli in autism spectrum disorder / Brandon KEEHN in Journal of Child Psychology and Psychiatry, 49-12 (December 2008)  

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A Magnetic Resonance Spectroscopy Study of Superior Visual Search Abilities in Children with Autism Spectrum Disorder / David A. EDMONDSON in Autism Research, 13-4 (April 2020)  

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Measures of tonic and phasic activity of the locus coeruleus-norepinephrine system in children with autism spectrum disorder: An event-related potential and pupillometry study / Yesol KIM in Autism Research, 15-12 (December 2022)  

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Patterns of Visual Attention to Faces and Objects in Autism Spectrum Disorder / James C. MCPARTLAND in Journal of Autism and Developmental Disorders, 41-2 (February 2011)  

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Sensory Symptoms and Processing of Nonverbal Auditory and Visual Stimuli in Children with Autism Spectrum Disorder / Claire R. STEWART in Journal of Autism and Developmental Disorders, 46-5 (May 2016)  

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Slowed Search in the Context of Unimpaired Grouping in Autism: Evidence from Multiple Conjunction Search / Brandon KEEHN in Autism Research, 9-3 (March 2016)  

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Tract-specific analyses of diffusion tensor imaging show widespread white matter compromise in autism spectrum disorder / Dinesh K. SHUKLA in Journal of Child Psychology and Psychiatry, 52-3 (March 2011)  

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