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This study aims to examine the impact that diagnostic factors such as duration of diagnostic period, number of professionals consulted and perceived social support have on parental stress during the diagnostic process of autism spectrum disorder (ASD).

Forty parents of 2–18 year-old children/adolescents with a formal ASD diagnosis recruited from five specialized private clinics in Lisbon completed a survey which included diagnostic questionnaire, parental stress scale and social support scale from April to December 2022.

Data analysis indicated that the mean age of the diagnosis was 5.6 years with a delay of 3.95 years from first concern until final diagnosis. On average, parents consulted a mean of 3.62 professionals. Other findings indicated that as age of parents increased, levels of parental stress decreased. Parents with higher levels of social support had lower levels of parental stress. Furthermore, higher age of child at first concern predicted higher affective social support.

This study reflects on the experience of obtaining the ASD diagnosis in Portugal, raising awareness on the importance of providing early detection and social support for distressed parents.

People with Down's syndrome are at increased risk of developing early onset Alzheimer's disease. It has been recommended that all adults with Down's syndrome receive baseline neuropsychological testing for dementia. In certain areas prospective screening of people with Down's syndrome takes place to ensure the early diagnosis of the condition. However, little has been published on the value of this type of screening. The purpose of this paper is to report on a prospective screening programme and asks whether the programme is effective in identifying dementia-related changes in people with Down's syndrome and whether the current screening intervals are appropriate.

All adults with Down's syndrome in Plymouth (UK) are identified and offered a comprehensive test battery at baseline at the age of 20 and then have testing biennially from 40 to 50 and annually after 50. All individuals diagnosed with dementia between 2001 and 2013 were identified and their case notes examined. The symptoms at the time of diagnosis were identified and whether these symptoms had been identified through the screening programme or by other routes were recorded. Prevalence data and age at diagnosis were also recorded.

In total, 26 people were diagnosed with dementia during the study period. Of these, the diagnosis of dementia followed concerns being identified during the routine screening programme in 54 per cent of cases. In the younger age group (age 40-49) 63 per cent of people were identified through the screening programme. At the time of diagnosis a mean of 5.5 areas of concern were in evidence.

Limited by small sample size, however service development not original research. Implications for the use of prospective dementia screening in people with Down's syndrome.

Implications for how services choose to run their Down's syndrome and dementia screening programmes, including the frequency of screening.

The paper adds to a growing evidence base around the value of prospective dementia screening in people with Down's syndrome. It is also one of a few studies exploring the frequency of screening. Additionally, it adds further data about prevalence of dementia in people with Down's syndrome.

Research about the prevalence of dementia among older adults in the incarceration system is currently lacking, and further investigation is warranted. Considering the high level of healthcare needs, unique behavioural issues and difficulty to rehabilitate within the system due to its punitive approach and lack of effective rehabilitation programs, further investigation is warranted to characterize and determine the number of incarcerated older adults with dementia. The purpose of this study is to estimate the prevalence of individuals with dementia in the prison system while also describing the incarceration, demographic and offence-related characteristics of this unique population.

South Carolina (SC) Alzheimer’s Disease and Related Dementias Registry (1992–2016) and South Carolina Department of Corrections (SCDC) data (Fiscal years 1992–2019) were cross-referenced. The prevalence of Alzheimer’s disease and related dementias (ADRD) cases in the corrections system was calculated using South Carolina Alzheimer's Disease (SC AD) SC ADRD Registry and SCDC data. Pearson’s correlation coefficients were calculated to determine strength and direction of relationships between year of incarceration and frequency of ADRD cases both prior to and after incarcerations, respectively. Significant differences by age group, race, gender and dementia type were determined using a two-tailed pooled t-test and Bonferroni approach where appropriate. Count data for types of crimes committed are also presented.

The linkage showed that there were 2,171 individuals within the SC AD Registry who have been in the corrections system, about 1% of those in the Registry. Of these individuals, 1,930 cases were diagnosed with ADRD after incarceration and 241 prior to incarceration. In 2016, 317 individuals with ADRD were incarcerated. For ages 55 and above in South Carolina, the prevalence of ADRD is 6.7% in the general, non-incarcerated population compared to 14.4% in the incarcerated population. Additional results showed that those diagnosed with ADRD between 55 and 65 years of age had a significantly lower mean age at first incarceration (34.6 years of age) than those diagnosed between 66 and 74 years of age (55.9 years of age), indicating that those incarcerated earlier in life had an earlier dementia diagnosis. Additionally, African Americans had a significantly lower mean age at first incarceration (43.4 years of age) than Whites (46.2 years of age) and females had significantly lower mean age at first incarceration (42.9 years of age) than males (45 years of age). When investigating trends, results showed a significant positive linear association between year and frequency of ADRD diagnoses (p-value < 0.05) for those with ADRD diagnosis prior to incarceration and a significant decreasing linear association (p-value < 0.0001) in the number of individuals with an ADRD diagnosis after corrections. Findings also showed that a large percentage of older adults with ADRD in prison did not commit a violence offence.

This study links a population-based Alzheimer’s disease registry and state-wide corrections data to estimate the prevalence of individuals with dementia in the prison system. This linkage presents an opportunity to fill in significant gaps and contribute to the body of literature on dementia among people in prison in the USA.

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.

This paper presents three case studies that were completed at a free community ASD screening clinic in Southern California.

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.

Conclusions from these three cases cannot generalize to all children being seen in clinics for neurodevelopmental concerns.

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.

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.

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).

This study aims to develop a clinical prediction rule for the diagnosis of autistic spectrum disorder (ASD) in children.

This population-based study was carried out in children aged 2 to 5 years who were suspected of having ASD. Data regarding demographics, risk factors, histories taken from caregivers and clinical observation of ASD symptoms were recorded before specialists assessed patients using standardized diagnostic tools. The predictors were analyzed by multivariate logistic regression analysis and developed into a predictive model.

An ASD diagnosis was rendered in 74.8 per cent of 139 participants. The clinical prediction rule consisted of five predictors, namely, delayed speech for their age, history of rarely making eye contact or looking at faces, history of not showing off toys or favorite things, not following clinician’s eye direction and low frequency of social interaction with the clinician or the caregiver. At four or more predictors, sensitivity was 100 per cent for predicting a diagnosis of ASD, with a positive likelihood ratio of 16.62.

This practical clinical prediction rule would help general practitioners to initially diagnose ASD in routine clinical practice.

The purpose of this paper is to describe the characteristics of adult male autistic spectrum disorder (ASD) patients admitted to low secure services and to compare them with non‐ASD patients.

Case‐control study of admissions to two ASD units and one non‐ASD unit at a tertiary referral centre. Subjects were compared on demographic, personal, clinical and offending behaviour variables.

In total, 51 ASD and 43 controls were studied. Median age at diagnosis of ASD was 21 years (range 6‐56). The ASD group were younger (median age 27 vs 33 years) and more likely to be single than controls. Their age at first contact with psychiatric services was lower and proportionally more were admitted from prison and courts. Almost three‐quarters had psychiatric comorbidity, most commonly schizophrenia, but unlike controls, personality disorder and drug and alcohol disorders were uncommon. Lifetime sexually inappropriate behaviour and physical violence were less common, as was non‐compliance with medication. However, 78 per cent had a lifetime history of physical violence and a third had a conviction for GBH or homicide. Offending behaviour was sometimes atypical in nature and some had convictions for unusual offences such as harassment and stalking.

The age difference between cases and controls is likely to have confounded the results. Findings cannot be generalised to the NHS.

This group of ASD patients in low security differed in several important respects from their non‐ASD counterparts, which highlights their differing treatment needs, strengths and weaknesses.

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.

The paper is a non‐systematic review of the current literature relating to the diagnosis and epidemiology of autism.

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.

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.

This paper provides an up‐to‐date review of current diagnostic practice for all professionals working with children and adults with ASD.

This paper describes a service improvement project with two aims: to identify and screen all adults with Down's syndrome aged over 30 years in a defined locality using a standardised instrument to establish functional baselines; and to set up a database to facilitate early diagnosis of dementia in this population.

An assistant psychologist used a standardised instrument to screen participants who were identified through contact with health, social, and third sector, and housing services.

Eligible people were identified and screened using an informant‐based measure. Three groups were identified: group 1 showed no significant change; group 2 showed significant change but no signs of dementia; and group 3 showed significant change plus signs of dementia. People with suspected dementia were referred on for further investigation/assessment and supportive services.

Terminology is important in engaging families in a screening project, as is the opportunity to provide information. A proactive screening project can be established by employing working partnerships between intellectual disability and older adult services to aid diagnosis.

Adults with Down's syndrome aged over 30 years in a defined locality can be identified through contact with health, social, and third sector, and housing services. Those identified can be screened using a standardised instrument and a database of screening results established in order to establish baselines against which future re‐screening can be conducted. Partnership working between older adult mental health services and intellectual disability services can improve the diagnostic service to adults with Down's syndrome.

The purpose of this paper is to examine the prevalence of posttraumatic stress symptoms (PTSS) in adults and children who were exposed to applied behavior analysis (ABA) autism early childhood intervention. Using an online questionnaire to survey autistic adults and caregivers of autistic children, the author collected data from 460 respondents on demographics, intervention types, and current pathological behaviors with symptom severity scales. This study noted PTSS in nearly half of ABA-exposed participants, while non-exposed controls had a 72 percent chance of being asymptomatic. ABA satisfaction ratings for caregivers averaged neutral or mild satisfaction. In contrast, adult satisfaction with ABA was lower on average and also tended to take on either extremely low or extremely high ratings. Exposure to ABA predicted a higher rate and more severe PTSS in participants, but the duration of exposure did not affect satisfaction with the intervention in caregivers.

Participants were recruited for an online survey through social media networks, adult gatherings, social skills groups, and autism support groups nationwide. Adult inclusion criteria consisted of autism – diagnosed or self-diagnosed – and an age of 18 or older. A total of 460 respondents, consisting of autistic adults and caregivers of autistic children, completed an online survey. The caregiver entries (n=217) concerned 79 percent male children, 21 percent female children (male to female 3.80:1), and one MtF transgender child, ages 1-38, with an average age at diagnosis of 4.69 years. The adult entries (n=243) concerned 30 percent males, 55 percent females (male to female 0.55:1), and 14 percent other gender, ages 18-73, with an average age at diagnosis of 25.38 years.

Nearly half (46 percent) of the ABA-exposed respondents met the diagnostic threshold for PTSD, and extreme levels of severity were recorded in 47 percent of the affected subgroup. Respondents of all ages who were exposed to ABA were 86 percent more likely to meet the PTSD criteria than respondents who were not exposed to ABA. Adults and children both had increased chances (41 and 130 percent, respectively) of meeting the PTSD criteria if they were exposed to ABA. Both adults and children without ABA exposure had a 72 percent chance of reporting no PTSS (see Figure 1). At the time of the study, 41 percent of the caregivers reported using ABA-based interventions.

The majority of adult respondents were female, raising questions about the population of online autistic survey respondents. Further, the high numbers of reported gender other than male or female in the adult respondents, as well as at least on MtF child from the caregiver respondents indicates that future studies should consider these intersections. These accompanied significant discrepancies in reporting bias between caregivers and ABA-exposed individuals, which highlight the need for the inclusion of the adult autistic voice in future intervention design. Based on the findings, the author predicts that nearly half of ABA-exposed autistic children will be expected to meet the PTSD criteria four weeks after commencing the intervention; if ABA intervention persists, there will tend to be an increase in parent satisfaction despite no decrease in PTSS severity.

The aims of this paper are to: briefly review the long‐term or late effects of cancer diagnosis and treatment on children and youth; examine the implications of these effects on the educational needs of the child or youth; explore the implications of childhood cancer survivorship on the school, particularly for female students. Over the last 25 years, treatments for childhood cancers have increased survival rates by 45 per cent, to nearly 77 per cent. It is estimated that one in 900 people aged 15‐44 years in the USA is a childhood cancer survivor; 80 per cent of children diagnosed with cancer in 1990 will survive into adulthood.

A comprehensive literature review of studies relevant to female childhood cancer survivorship and education over the past ten years was conducted, having been collected through searches of MEDLINE, CINAHL, PSYCINFO, and EMBASE.

Long‐term and late effects of cancer have been observed in neurocognition, cardiopulmonary symptoms, second cancers, reproductive organs, and hearing loss. Other health effects, such as impaired growth, osteopenia, hepatitis C infection, oral and dental malformations, and behavioral risk factors such as fatigue, obesity, and smoking have also been reported among childhood cancer survivors. These longer‐term treatment sequelae, particularly on neurological systems, have implications for changed student educational needs, including the provision of specialized instruction, classroom adaptations, as well as ancillary health services.

Based on the ecologic model, a research agenda is proposed for better integrating the increasing numbers of childhood cancer survivors into the educational environment.

Practical interventions for survivors who are experiencing difficulties in school are listed.

To the best of one's knowledge, this is the first comprehensive review on the implications of childhood cancer survivors in schools.