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Autistic Spectrum Conditions
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Assessment and diagnosis are complex. There are many diagnostic instruments including: Autism Diagnostic Interview (ADI), a detailed, lengthy, semi-structured interview administered to parents or carers by trained professionals, taking around three hours.Autism Diagnostic Observation Schedule (ADOS): often complements the above and is equally exhaustive.Diagnostic Interview for Social and Communication Disorders (DISCO), a semi-structured questionnaire completed collaboratively by parents/carers and professionals. It takes a clinically orientated dimensional approach, covers the entire intellectual ability range, provides coverage of commonly associated challenges and diagnoses and includes algorithms allowing ascertainment of a range of diagnoses. It is completed in conjunction with behavioural observations and interactions with the child in both structured and unstructured settings. Supporting information from important sources, such as school, is necessary.The computerised 3Di interview is another valid and reliable diagnostic tool.
Developmental Social Neuroscience and the Autism Spectrum of Disorders
Published in Christopher J. Nicholls, Neurodevelopmental Disorders in Children and Adolescents, 2018
The CDC notes that no single tool should be used as the basis of the diagnosis of ASD and requires at least two sources of information, including parent or caregiver report as well as direct child observation. Examples of tools that could be utilized to specify symptoms of ASD include the Autism Diagnostic Inventory-Revised (ADI-R) (Lord, Rutter, & Le Couteur, 1994); the Autism Diagnostic Observation Schedule-Generic (ADOS) (Lord, Rutter, DiLavore, Risi, Gotham, & Bishop, 2012); the Childhood Autism Rating Scale (Schopler & Van Bourgondien, 2010); and the Gilliam Autism Rating Scale, 2nd Edition (Gilliam, 2014) among others. These types of tools tend to include diagnostic algorithms or suggested “cutoff” scores, which clinicians can utilize to decide whether the individual “meets” the number and level of symptoms required by the diagnosis. Other tools developed from these strategies take a similar approach, such as the Social Communication Questionnaire (Rutter, Bailey, Berument, Lord, & Pickles, 2003), which asks caregivers to rate a relatively smaller sample of behavior by severity and offers a cutoff score that is thought to have sufficient sensitivity and specificity to warrant its use in diagnosis.
The Ethics of Prodromal and Preclinical Disease Stages
Published in L. Syd M Johnson, Karen S. Rommelfanger, The Routledge Handbook of Neuroethics, 2017
Jalayne J. Arias, Jennifer C. Sarrett, Rosa Gonzalez, Elaine F. Walker
ASD is typically diagnosed in early childhood using behavioral observation and parental interview. Best practices suggest the use of a multidisciplinary team that combines diagnostic tools with clinical judgment (Woolfenden et al., 2012). There are a host of diagnostic tools and practices, but Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R) are two of the most frequently used tools available. A recent meta-analysis of diagnostic tools found that, when used together, the ADOS and ADI-R have a correct classification rate of autism at 0.88 for children under 3 years old (0.84 for older children) and 0.80 for an autism spectrum disorder (Falkmer et al., 2013). Despite recommendations by the American Academy of Pediatrics ( Johnson et al., 2007) and the CDC (Centers for Disease Control and Prevention, 2016) for screening all children at 18- and 24-month checkups, studies report mean ages at diagnosis to be anywhere from 38 to 120 months (Daniels and Mandell, 2014). The CDC reports an average age of 4 years for ASD diagnoses (Christensen et al., 2016). Factors involved in diagnostic age include the number and intensity of autistic traits present and socioeconomic and geographic circumstances (Daniels and Mandell, 2014).
A cluster analysis of daily living skills in school aged children with autism spectrum disorder
Published in International Journal of Developmental Disabilities, 2023
Amie Duncan, Melissa Liddle, Ryan Adams
The Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2; Lord et al.2012) is the ‘gold standard’ clinician-administered assessment for evaluating autism symptomatology and was used as one measure to evaluate symptoms and characteristics associated with a diagnosis of autism spectrum disorder. All participants had a documented ADOS Module 1, 2, or 3 administered by staff at one of the ATN sites. Only 22% of children in the current study had data on cognitive abilities (i.e. full scale IQ, nonverbal IQ, and/or verbal IQ), and 5% of children in the current study had data on language abilities (i.e. receptive language, expressive language, and/or overall language). Thus, the ADOS was utilized as a measure of functioning level. Specifically, children who received an ADOS Module 1 or 2 were classified as being in the Low Language group (i.e. were nonverbal or used primarily single words [Module 1] or used simple or flexible phrase speech [Module 2]). It is expected that children receiving a Module 2 on the ADOS-2 would have expressive language skills similar to that of a 24 to 48-month-old child. Children who received an ADOS Module 3 were classified as being in the High Language group (i.e. were able to use spontaneous and flexible complex sentences to communicate). It is expected that children receiving a Module 3 on the ADOS-2 would have expressive language skills similar to those of a child who is 4 years of age or older.
Developmental Functioning of Toddlers At-Risk for Autism With and Without Down Syndrome
Published in Developmental Neurorehabilitation, 2023
Celeste Tevis, Johnny L. Matson, Megan Callahan
In the Motor subdomain, the toddlers in the ASD+ (M = 92.46) group had significantly higher motor skills than the toddlers in the DS- (M = 72.28) and DS+ (M = 66.15) groups. The toddlers in the DS- (M = 72.28) group also had significantly higher motor skills than those in the DS+ (M = 66.15). Children with DS typically exhibit delays in motor skills, such as poor balance, hypotonia (i.e., poor muscle tone), and ligament laxity (i.e., ligament looseness that accounts for increased joint flexibility). Motor skill difficulties are not a core diagnostic feature of ASD, though children with ASD can be delayed in reaching motor milestones, like crawling and walking.44 Both of the groups of toddlers with diagnoses of DS had lower motor skill abilities than those at risk for ASD, suggesting that the DS diagnosis is related to lower motor functioning. The co-occurrence of risk for ASD and DS resulted in more difficulties with motor functioning beyond that which was accounted for the DS diagnosis only. As previously mentioned, no prior studies comparing motor functioning between children with DS and ASD have been conducted. The motor skill difficulties among those with DS at risk for ASD are particularly concerning given that the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), a commonly used standardized tool for ASD assessment, requires that individuals participating in the assessment have no sensory or motor impairments. This may further delay identification of ASD in toddlers and young children with DS.
Inhibitory Control in Male and Female Adolescents with Autism Spectrum Disorder (ASD)
Published in Developmental Neuropsychology, 2022
Mackenzie N. Cissne, Katherine R. Bellesheim, Shawn E. Christ
Participants were patients receiving clinical services at an interdisciplinary academic medical center specializing in diagnosis and treatment of ASD. Diagnostic interviews, caregiver questionnaires, the Autism Diagnostic Observation Schedule (ADOS-G and ADOS-2; Lord et al., 2012), and observation focusing on DSM–5 criteria (American Psychiatric Association, 2013) were used for the initial diagnosis of ASD in these individuals. Participants were 4–12 years of age at the time of diagnosis. ADOS scores were unavailable for one participant; however, it was noted in their medical records that they met cutoffs for ASD. To characterize participant’s current level of symptomatology, the Social Responsiveness Scale (SRS; Constantino et al., 2003) and Social Communication Questionnaire (SCQ; Rutter, Bailey, & Lord, 2003) were collected at the time of study participation and are also included in Table 1. Non-ASD participants were recruited from the local community.