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1 – 10 of 69Sarah Talari, Kanmani Balaji and Alison Jane Stansfield
The diagnosis of autism in adults often involves the use of tools recommended by NICE guidance but which are validated in children. The purpose of the paper is to establish the…
Abstract
Purpose
The diagnosis of autism in adults often involves the use of tools recommended by NICE guidance but which are validated in children. The purpose of the paper is to establish the strength of the association between the Autism Diagnostic Interview-Revised (ADI-R) scores and the final clinical outcome in an all intellectual quotients adult autism diagnostic service and to establish if this in any way relates with gender and intellectual ability.
Design/methodology/approach
The sample includes referrals to Leeds Autism Diagnostic Service in 2015 that received a clinical outcome. Sensitivity, specificity and positive and negative predictive values were calculated to evaluate ADI-R and final clinical outcomes. Logistic regression model was used to predict the effect of the scores in all the domains of ADI-R and the two-way interactions with gender and intellectual ability.
Findings
ADI-R has a high sensitivity and low specificity and is useful to rule out the presence of autism, but if used alone, it can over diagnose. Restricted stereotyped behaviours are the strongest predictor for autism and suggests that the threshold should be increased to enhance its specificity.
Research limitations/implications
This is a single site study with small effect size, so results may not be replicable. It supports the combined use of ADI-R and Autism Diagnostic Observation Schedule and suggests increasing ADI-R cut-offs to increase the specificity.
Practical implications
The clinical team may consider piloting a modified ADI-R as suggested by the results.
Originality/value
To the authors’ knowledge this is the only study of ADI-R in an adult population of all intellectual abilities.
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Saeid Bashirian, Ali Reza Soltanian, Mahdieh Seyedi, Salman Khazaei, Ensiyeh Jenabi, Katayoon Razjouyan, Hadi Zarafshan, Majid Barati and Maryam Afshari
The purpose of this paper is to assess the validity of the Autism Diagnostic Interview-Revised (ADI-R) in an Iranian population to determine its efficacy in identifying children…
Abstract
Purpose
The purpose of this paper is to assess the validity of the Autism Diagnostic Interview-Revised (ADI-R) in an Iranian population to determine its efficacy in identifying children with autism spectrum disorder (ASD) who parents have Persian-speaking parents.
Design/methodology/approach
A case–control study was performed in March until July 2020 in Hamadan city, Iran. The case group was children were examined by the clinicians used a coding scheme based on the DSM-IV criteria for ASD. The control group was all children in the family, including healthy siblings, were asked to participate in the study. The reliability, content and face validity were performed to assess the psychometric properties of the tool. Confirmatory factor analysis (CFA) was performed to evaluate the four-dimensional structure of the tool (Scores A, B, C and D). Statistical analysis was performed using AMOS for SPSS 21, and the statistical significant level was less than 0.05.
Findings
The quantitative content validity analysis revealed that the mean of content validity ratio (CVR) and content validity index (CVI) for all domains was 0.94 and 0.91, respectively. For CFA, four domains A, B, C and D were used and demonstrated a good fit (CFI = 0.92 and RMSEA = 0.06). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) in domains A, B (verbal), C and D were 100%. For domain B (non-verbal), the sensitivity, specificity, PPV and NPV were 86.7%, 100%, 100% and 88.2%, respectively.
Research limitations/implications
This study showed that ADI-R has sufficient ability to discriminate between children with ASD and those with no psychiatric diagnosis, and it is a reliable tool in Iran. The sensitivity and specificity for correctly diagnosing ASD was high, regardless of the age and cognitive level of the examiner.
Originality/value
To the best of the authors’ knowledge, this is the first paper on psychometric properties of ADI-R in children with ASD.
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According to current estimates, the prevalence of autism spectrum disorders (ASDs) ranges from 1 in 500 children to 1 in 150 children (Centers for Disease Control and…
Abstract
According to current estimates, the prevalence of autism spectrum disorders (ASDs) ranges from 1 in 500 children to 1 in 150 children (Centers for Disease Control and Prevention/CDC, 2007; Desmon, 2007). In the past such disorders usually were not identified until a child was school-aged, but these disorders are now more likely to be diagnosed in affected individuals during the preschool years (McConachie, Le Couteur, & Honey, 2005; Rutter, 2006). For example, Mandell, Novak, and Zubritsky (2005) surveyed over 900 caregivers of children with ASDs and learned that on an average, children with autistic disorder were diagnosed at 3.1 years of age. These researchers also reported that children who exhibited such characteristics as severe language impairment, toe walking, hand flapping, and sustained unusual play behaviors were diagnosed earlier than children without these features.
Lucia Parisi, Teresa Di Filippo and Michele Roccella
Cornelia de Lange syndrome (CdLS) is a congenital disorder characterized by distinctive facial features, growth retardation, limb abnormalities, intellectual disability, and…
Abstract
Cornelia de Lange syndrome (CdLS) is a congenital disorder characterized by distinctive facial features, growth retardation, limb abnormalities, intellectual disability, and behavioral problems. Cornelia de Lange syndrome is associated with abnormalities on chromosomes 5, 10 and X. Heterozygous point mutations in three genes (NIPBL, SMC3 and SMC1A), are responsible for approximately 50-60% of CdLS cases. CdLS is characterized by autistic features, notably excessive repetitive behaviors and expressive language deficits. The prevalence of autism spectrum disorder (ASD) symptomatology is comparatively high in CdLS. However, the profile and developmental trajectories of these ASD characteristics are potentially different to those observed in individuals with idiopathic ASD. A significantly higher prevalence of self-injury are evident in CdLS. Self-injury was associated with repetitive and impulsive behavior. This study describes the behavioral phenotype of four children with Cornelia de Lange syndrome and ASDs and rehabilitative intervention that must be implemented.
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Lisa Underwood, Jane McCarthy, Eddie Chaplin, Andrew Forrester, Richard Mills and Declan Murphy
The purpose of this paper is to determine the extent of autism spectrum disorder (ASD) traits among prisoners. The authors tested the hypotheses that ASD traits would: be…
Abstract
Purpose
The purpose of this paper is to determine the extent of autism spectrum disorder (ASD) traits among prisoners. The authors tested the hypotheses that ASD traits would: be continuously distributed among prisoners; be unrecognised by prison staff; and predict whether a prisoner met diagnostic criteria for ASD.
Design/methodology/approach
ASD traits were measured among 240 prisoners in a male prison in London, UK using the 20-item Autism Quotient (AQ-20). Further diagnostic assessment was carried out using the Autism Diagnostic Observation Schedule. Results were compared with ASD data from the 2007 Psychiatric Morbidity Survey.
Findings
There were 39 participants with an AQ-20 score=10; indicating significant autistic traits. The distribution of ASD traits among participants appeared to be normal and was not significantly higher than the rate found in a population-based sample from England.
Originality/value
Few studies have explored ASD traits among prisoners. The authors identified high levels of unrecognised ASD traits among a group of male prisoners, many of whom went on to meet diagnostic criteria for ASD. The study highlights the need for specialist assessment within the criminal justice system for individuals with neurodevelopmental disorders including ASD. The authors discuss the process of carrying out an ASD assessment project in a prison.
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Francois A.M. Jean, Ali Jouni, Manuel P. Bouvard, Guillaume Camelot, Anita Beggiato, Isabelle Scheid, Alexandru Gaman, Celine Bouquet, Myryam Ly-Le Moal, Josselin Houenou, Richard Delorme, Marion Leboyer and Anouck Amestoy
This study aims to explore the overlap between symptoms of depression, anxiety, irritability and aggressiveness in autism spectrum disorder (ASD), to measure specific and…
Abstract
Purpose
This study aims to explore the overlap between symptoms of depression, anxiety, irritability and aggressiveness in autism spectrum disorder (ASD), to measure specific and idiosyncratic emotional responses.
Design/methodology/approach
A total of 42 high functioning adolescents and adults, between 12 and 39 years old, meeting the diagnostic and statistical manual of mental disorders – 5 criteria for ASD were selected from the InFoR Autism cohort. Data were analyzed in an exploratory way using Hill and Smith and K-medoids cluster analysis.
Findings
The authors found an aggregation of anxiety, depression, aggressive behaviors and irritability. Cluster analysis was maximized for two groups with 17 and 25 participants, respectively. The first group was characterized by high levels of symptoms of irritability, aggressiveness, hyperactivity and intermediate levels of anxiety and depression. In the first group, participants had significantly higher levels of autistic symptoms considering the social responsiveness scale and repetitive behavior scale-revised scales (relatives’ reports) suggesting that a particular group of subjects with a high level of ASD specific symptoms may express anxiety and depression in a specific way based on externalizing behaviors in addition to the common mood and anxiety symptoms.
Research limitations/implications
Improved understanding of the aggregation of externalized symptoms with symptoms of anxiety and mood disorders in ASD should lead to a better understanding of the underlying mechanisms related to emotion dysregulation in ASD.
Practical implications
Improved knowledge of the symptoms could lead to enhanced detection of psychiatric comorbidities in ASD.
Originality/value
The study was based on a transdiagnostic approach of psychiatric symptoms in individuals with ASD. Aggregation and clustering analysis was used to explore naive patterns of these psychiatric symptoms.
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This paper aims to describe the way in which autism spectrum disorder (ASD) is identified, defined and diagnosed; and how changes in the conceptualisation and understanding of…
Abstract
Purpose
This paper aims to describe the way in which autism spectrum disorder (ASD) is identified, defined and diagnosed; and how changes in the conceptualisation and understanding of autism have impacted on clinical practice and research findings. Specific issues relating to the nature of Asperger syndrome and the profile of females with ASD are discussed. Finally, the apparent increase over time in the incidence of autism is considered.
Design/methodology/approach
The paper is a non‐systematic review of the current literature relating to the diagnosis and epidemiology of autism.
Findings
Despite its diverse presentation and complex aetiology, the autism spectrum is increasingly well understood amongst professionals and the general public. Diagnostic criteria are revised periodically and new versions of the formal definitions are due to be published soon. The prevalence of ASD appears to be in the region of 1 per cent. There is a clear perception that the true incidence of autism is on the increase and, despite several well‐conducted epidemiological studies, it remains impossible to confirm or refute this notion.
Practical implications
Diagnosis in clinical practice should involve some reference to the formal criteria, the use of standardised diagnostic instruments and should ideally take place within a multi‐disciplinary team setting.
Originality/value
This paper provides an up‐to‐date review of current diagnostic practice for all professionals working with children and adults with ASD.
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Anastasios Galanopoulos, Dene Robertson and Emma Woodhouse
The purpose of this paper is to explore and highlight the main elements of an autism spectrum disorder assessment in adults. It features significant challenges for the clinical…
Abstract
Purpose
The purpose of this paper is to explore and highlight the main elements of an autism spectrum disorder assessment in adults. It features significant challenges for the clinical teams responsible to undertake the assessment. This paper aims to explain the importance of the wider needs assessment in accordance to the Autism Act and Autism Strategy.
Design/methodology/approach
The paper describes the main symptom domains for an ASD diagnosis, according to the two basic diagnostic manuals. It provides compendious summary of the available diagnostic tools and the significant comorbidities people with ASD present with including other neurodevelopmental disorders, mental or physical health problems, challenging behaviour and risk issues.
Findings
The paper proposes that all National Health System professionals should be able to recognise possible signs of ASD and accordingly refer individuals for a comprehensive assessment to secondary services. It highlights the importance of a wider needs assessment as part of a broader approach to addressing the needs of those with suspected ASD.
Practical implications
The paper aims to improve the gaps which remain in the referral and diagnostic process of people affected by ASD.
Social implications
Through a comprehensive assessment the paper aims to improve the educational, social and personal functioning of people with ASD as well as the quality of life of their parents and carers.
Originality/value
The paper assembles a wide range of relevant considerations in regards to potential ASD in one place, and can be used to inform a comprehensive understanding of the assessment/diagnosis process.
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Estimates of the prevalence of AS in children throughout the entire population of the United States are highly limited and greatly variable. Ozonoff, Dawson, and McPartland (2002)…
Abstract
Estimates of the prevalence of AS in children throughout the entire population of the United States are highly limited and greatly variable. Ozonoff, Dawson, and McPartland (2002) stated that estimates of AS range from 0.2 to 0.5% (or 2–5 individuals in 1,000), while Volkmar and Klin (2000) cited studies reporting rates of 36 in 1,000 to approximately 1 in 10,000. The Diagnostic and Statistical Manual of the American Psychiatric Association (2000), fourth edition (DSM-IV-TR), states that “definitive data about the prevalence of Asperger Syndrome does not exist.”
This chapter is a comprehensive discussion of autism spectrum disorder (ASD) across the globe (e.g., United States, China, Brazil, Japan and Turkey). Topics that are discussed…
Abstract
This chapter is a comprehensive discussion of autism spectrum disorder (ASD) across the globe (e.g., United States, China, Brazil, Japan and Turkey). Topics that are discussed include the following: diagnostic criteria and approaches; international perspectives of ASD; western and eastern assessment practices; cultural considerations of assessment of ASD; educational and medical interventions; behavioral and emotional interventions; complementary and alternative medical interventions; variations in educational services among countries; early intervention practices; adult services; national and international resources; and current needs and future directions.