Advances in Autism – 8-2
1. Heyman M, Ledoux Galligan M, Salinas GB, Baker E, Blacher J, Stavropoulos K. Differential diagnosis of autism spectrum disorder, intellectual disability and attention-deficit hyperactivity disorder (ADHD). Advances in Autism;2022;8(2):89-103.
Purpose Professionals working with community populations are often presented with complicated cases where it is difficult to determine which diagnosis or diagnoses are appropriate. Differentiating among neurodevelopmental disorders such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder and intellectual disability can be a complex process, especially, as these disorders have some overlapping symptoms and often co-occur in young children. This series of case studies aims to present commonly overlapping symptoms in children who present to clinics with developmental concerns. Design/methodology/approach This paper presents three case studies that were completed at a free community ASD screening clinic in Southern California. Findings The case studies have common presenting behaviors and symptoms (e.g. social communication difficulties) that often co-occur across diagnoses; explanations for the final diagnoses are given in each case. Research limitations/implications Conclusions from these three cases cannot generalize to all children being seen in clinics for neurodevelopmental concerns. Practical implications This series of case studies highlights commonly overlapping symptoms in children who present for differential diagnosis with social and/or behavioral concerns. Implications for educational placement and intervention are discussed. Social implications These cases highlight the challenges involved in the differential and dual diagnostic process for young children with developmental concerns. Diagnostic considerations can affect later educational placement and opportunities for socialization. Originality/value This series of case studies provide practical information for clinicians about how to effectively differentiate between commonly occurring neurodevelopmental disorders, particularly given recent changes to the Diagnostic and Statistical Manual, 5th edition (DSM-5).
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2. Hillier A, Poto N, Schena Ii D, Buckingham A, Frye A. An individualized life-skills coaching program for adults with autism. Advances in Autism;2022;8(2):104-116.
Purpose The lack of services for adults on the autism spectrum is of growing concern. Given the huge variation in how autism impacts people, individualized approaches might be particularly effective. The purpose of this paper is to present an overview of a community-based life-skills coaching program for adults with autism “LifeMAP.” Design/methodology/approach LifeMAP is structured around individualized meetings between a client and their coach where they identify, prioritize and make progress toward self-selected goals. LifeMAP was established in 2008 and has since served around 2,600 clients. This paper provides an outline of the LifeMAP program, how sessions with clients are structured, goals that adults with autism prioritize and preliminary data on progress toward goal attainment. Findings Findings indicated that the LifeMAP program model was effective in supporting progress toward goals, increasing confidence toward goals and reducing anxiety. Originality/value Given the scope of the LifeMAP program, this overview is unique in providing pertinent information to others looking for effective and authentic strategies to support autistic adults and those transitioning from high school. This study provides a realistic perspective on how programs are applied in community-based settings, outside a structured, formal lab setting. It is concluded that individualized intervention approaches might be key to successful outcomes for adults with autism.
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3. Shatananda S, Oyedokun A, Odiyoor M, Jaydeokar S, Shahzad S. Usefulness of current autism diagnostic or screening assessment tools in adults with intellectual disability (ID): systematic review of literature. Advances in Autism;2022;8(2):117-131.
Purpose The purpose of the study is to identify and ascertain if there were any validated tools for diagnosing or screening autism spectrum disorder in adults with ID. The estimated prevalence of intellectual disability (ID) in the general population is about 10.37/1,000 population (Maulik et al., 2011). In total, 1 out of 4 individuals with ID suffers from an autism spectrum disorder (ASD) (Sappok et al., 2010). Early diagnosis and support for ASD is key to having a good quality of life. The diagnosis of ASD in people with an ID presents its own challenges and it is likely under-identification of ASD amongst adults with ID by about 20% to 30% (Emerson and Baines, 2010). Design/methodology/approach Studies were selected based on the following criteria: studies that reported either screening or diagnostic tools for ASD, participants had an ID i.e. a mean IQ of <70, adults i.e. participants were >18 years of age at the time of entry to the study and articles reported either sensitivity, specificity or area under the curve. Relevant studies that were published up to January 2020 were identified from EMBASE, PsychINFO, CINAHL and PubMed. In total, 75 papers were identified of which 15 papers met the criteria. Findings The screening or diagnostic tools currently in use is dependant on the degree of ID. A number of the tools had good psychometric properties and utility when used in people with specific degrees of ID or when used in combination with another screening or diagnostic tool. The authors could not identify a diagnostic tool that could be used across all levels of severity of ID unless used in combination. Hence, concluded that there is a need for a diagnostic tool with good psychometric properties for the assessment of ASD in adults with all degree of ID within a reasonable time period without the need for an additional tool to be used in conjunction. Originality/value Currently, the “gold standard” for diagnosing ASD is a lengthy and time-consuming process carried out by trained multi-disciplinary team members who assess historical, behavioural and parent/carer report to arrive at a diagnosis. There are a number of tools that have been developed to aid diagnosis. However, it is important to identify the tools that can optimise the procedures and are also time-efficient.
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4. Vasilevska Petrovska I, Giannakopoulou AC, Tsecoura V, Winstanley A, Miletto R, Roşca GC, Ivanova B, Kaisa V, Trajkovski V. Parental perspectives on support needs and availability of autism services in South and South-Eastern Europe. Advances in Autism;2022;8(2):132-146.
Purpose Amid the expanding demand on the autism service delivery system, little knowledge is accumulated regarding access and availability of support and services in the region of Southern and South-Eastern Europe – critical for improvement of individual outcomes, as well as family quality of life. The purpose of this paper is to explore how service delivery systems are responding to the specific needs of autistic individuals with autism, as perceived by parents. Design/methodology/approach A qualitative exploratory descriptive method was used. Thematic analysis was used as a pragmatic method to report on the experiences of parents (92% mothers, n = 55) of children, youth and young autistic adults (76% male) across six South and South-Eastern European counties that participated in a survey involving a combination of qualitative and quantitative data collection. Findings Thematic analysis revealed three broad themes: challenging pathways to service utilization, insufficient service options and providers’ competences and lack of continuous and meaningful support across life span. Originality/value The findings from this study add to the small body of literature specific to South and South-Eastern Europe, by exposing problems related to meeting the needs of autistic children and youth and potential ways to strengthen services, as perceived by parents. The findings have potential policy ramifications for the region in which the research was conducted.
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5. Kissi-Abrokwah B, Kodua-Ntim K. The concept of autism spectrum disorder: a study on knowledge sharing protocol among parents with autistic children in Ghana. Advances in Autism;2022;8(2):147-162.
Purpose The purpose of this paper is to identify knowledge sharing practices used among parents with children diagnosed with autism spectrum disorder (ASD). Design/methodology/approach The study was based on qualitative philosophical foundations, where phenomenological case study design was used to make an in-depth understanding of how parents whose children are diagnosed with ASD shared knowledge among themselves. The population for this research consists of parents whose children have been diagnosed with ASD in Ghana. The study sampled for the study was 12 parents and was selected from 4 autism awareness centres in Ghana to obtain data through the use of focus group discussion and analysed with the aid of thematic analysis. Findings The study showed that the dimensions of knowledge sharing practices used by parents with autistic children were after-action review/lesson learnt, brainstorming, mentoring, coaching system, discussion forum, face-to-face meeting, documentation, peer assistance and storytelling. Finally, the study also revealed that knowledge sharing practices used by parents with autistic children help them in their daily engagement. Social implications An aspect of the training of social workers should focus on how to assist parents, family and neighbours of children with ASD. The government through the needed ministries and agencies should create a social support system to assist parents and families with children with ASD. Counsellors should avail their services to parents with children with ASD as early as possible to avoid or ameliorate some of the emotional and psychological challenges of these parents. Originality/value The paper offers a comprehensive overview on how knowledge sharing transforms the individual to learn and accept autistic condition in Ghana.
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6. Berry V, Sharma CB. Case study: impact of interdisciplinary interventions in a 9-year-old male child with autism spectrum disorder. Advances in Autism;2022;8(2):163-177.
Purpose This study aims to highlight the need for an interdisciplinary intervention approach to bring noteworthy changes in children with an autism spectrum disorder. It proposes to study how holistic individualized therapeutic plans can promote functionality even in the adolescent age. This study aims to channelize the restricted abilities in a positive manner and make it, a strength for the child. Social-emotional development along with academic goals is also proposed. Design/methodology/approach The paper is based on an exploratory study where participant observation was the main tool. Unstructured interviews with the therapists were conducted and the background history was taken. Documents and assessments related to the case were referred. Findings The paper provides empirical insight into the impact of an interdisciplinary intervention on autism spectrum disorder. It suggests that speech therapy, occupational therapy, special education and counseling taken up as a holistic approach and modified as per the needs and competence of the child prove to be effective. It also becomes evident that intervention can help the child to become functional and meaningful even if the intervention is started a little late in life. Consistency and intensity of interventions along with compassion play a very positive role in the life of children with autism. Research limitations/implications As the approach taken describes one case in depth, there is less probability of generalization of results. Therefore, it suggests a wide scope of testing the proposed propositions further. Practical implications This paper includes implications for the children with autism spectrum disorder, who: are not able to get early intervention for some reason and the ones who have special restricted abilities. It also is an inspiration for the service providers to develop comprehensive and interdisciplinary plans of intervention. Social implications This will help parents who somehow miss providing interventions at an early age to be hopeful and to seek help. The results are encouraging so as to make children with autism spectrum disorder more functional and acceptable in their lives. Originality/value This paper worked on the identified needs of children with autism but found that their restricted abilities that are commonly found can be used and channelized positively to become a strength. There is a scope and hope to guide these children toward a functional life where they can connect with others around them and are accepted and included in society. Individualized and interdisciplinary interventions prove to make these children happier and confident.
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7. Álvarez-Couto M, García-Villamisar D, Sáez-Suanes GP, d’Orey Roquete M. Variables predicting the association between autistic traits and externalizing symptoms among young adults. Advances in Autism;2022;8(2):178-189.
Purpose Considering the high comorbidity of autism spectrum disorder (ASD) with externalizing disorders and that ASD is considered as a continuum, which implies the identification of it features in the whole population, the purpose of this paper is to know the characteristics of the association of externalizing symptoms in the population with ASD traits. Design/methodology/approach One hundred and seventeen postsecondary students participated in the study, providing responses to a battery of self-reported tests. Findings The existence of a significant association between ASD and attention deficit hyperactivity disorder (ADHD) (0.519; p < 0.01) was proved. Regression analyses showed that problems in executive functioning, working memory deficits and difficulties in the use of emotion regulation strategies predicted the presence of ADHD traits (F = 36.757, R2 = 62.3%, p < 0. 01) and impulsivity behavior (F = 18.249, R2 = 45.1%, p < 0.01). Research limitations/implications Externalizing symptomatology in people with higher ASD traits is extended to the general population. Future research should study other problematic behaviors, such as aggression or self-harm, to continue generating appropriate interventions. Originality/value The results reported reinforce the study of ASD as a dimensional disorder, in line with the latest advances in the classification of psychopathology. Considering which variables are behind the problematic behaviors allows interventions to be focused on these factors, contributing to their reduction and to the improvement of professional practices.
