Review Journal of Autism and Developmental Disorders最新文献

The Autism Observation Scale for Infants (AOSI) is being applied to non infant sibling populations. Assessment of the tool’s utility across increased likelihood (IL) populations is therefore needed. A systematic review and meta-analysis was conducted on 17 studies identified from six databases. The AOSI has been used in four IL contexts: infant siblings, infants with Fragile X Syndrome, Tuberous Sclerosis Complex, and Down Syndrome. There were three main findings: (1) five studies report classification data though no consistent approach was used; (2) group differences between IL-ASD, IL non-ASD, and controls started at 12-months; and (3) large effect sizes between IL-ASD and control samples was identified. Utility of the AOSI to identify early signs of ASD in IL populations was demonstrated.

Research on the prevalence of anxiety in children and adolescents with autism remains fragmented due to a reliance on help-seeking populations and differences in anxiety assessment. We present the pooled findings from 15 community studies (N = 4459) sourced from the Embase, PubMed, and PsycINFO databases (1970–2023). Equally high rates of anxiety symptoms and disorders were identified via self-report (33%, CI = 25 to 40%) and diagnostic interview (19%, CI = 7 to 40%). Higher IQ and male gender were identified as significant covariates, although these results may reflect sampling biases. The findings highlight the need for routine screening, with multiple informants, and improved sampling methods. Protocol was registered on Open Science Framework (https://osf.io/7mtca/).

Abstract

This article provides a systematic review of the prevalence and risk factors associated with interpersonal violence reported by autistic adults. A systematic search of electronic data bases for peer-reviewed journal articles in English was conducted. The search identified 16 studies that addressed rates and/or risk factors for interpersonal violence. There was wide variation in prevalence rates which was attributed to differences in types of violence being investigated, definitions and measures used, age range and gender of participants and time-frame covered. Overall results indicated that rates may be higher than in the general population. Twelve studies reported on possible risk factors with both individual and broader social factors identified. Further research utilising longitudinal design and validated measures is needed.

Background

Individuals with autism are more likely to suffer from various physical and mental health problems and experience disparities in effectively accessing healthcare services. This review aims to identify studies that report on the experiences of autistic children, their parents/carers, and the healthcare professionals treating them; to develop an understanding of the facilitators and barriers to healthcare access in order to inform policies and practice to improve access to healthcare for autistic children in the UK.

Methods

A total of 3069 records were screened, and 24 studies were included; six quantitative, four qualitative, and fourteen mixed-methodology studies.

Results

Professional and parental knowledge about autism, sensory issues, challenging behaviour, system-level barriers, patient-provider-parent communication issues, lack of person-centred care, stigma, and culture emerged as significant barriers to accessing healthcare for autistic children.

Conclusions

Families of autistic children experience several barriers to accessing healthcare. Recommendations for those planning services and clinicians are discussed.

Although first described in 1944 (the year the description of infantile autism), Asperger’s syndrome attracted little attention until the publication by Lorna Wing in early 1980. Over time, different views of the definition of Asperger’s syndrome developed. By the time of the Third Edition of the American Psychiatric Association’s Diagnostic and Statistical Manual and the Tenth Edition of the World Health Organization’s International Classification of Disease, enough information had accumulated to include the condition within the broader autism category. Asperger’s syndrome remained a focus of research interest and debate until its exclusion in the DSM-5 in 2013. We argue that the decision to remove Asperger’s syndrome 10 years ago as a distinct condition was premature. A discussion of the tensions around defining Asperger’s and concerns now arising due to the lack of this diagnostic category for new cases is provided.

Little is known about how policy—laws, regulations, procedures, administrative actions, incentives, or voluntary practices of governments or other institutions—shapes access to early autism services including diagnosis before age three. Early diagnosis and treatment are considered critical to improve outcomes. Understanding how policy influences such services could have substantial impact on outcomes for autistic children. We conducted a narrative literature review to determine what is known on how policy impacts early autism diagnosis and treatment. We found 17 articles that describe policy factors promoting early diagnosis and seven articles that identify policy factors affecting variability in autism services. We identified the following themes: (1) state policy factors influence access to diagnosis and other autism services, (2) innovative screening models affect early diagnosis, (3) provider training programs increase autism screening and diagnosis, (4) insurance policy influences autism services variability, and (5) resource availability affects geographic variability in autism services. Although common themes exist, more robust investigation is needed on policy impacting early autism services—beyond insurance and early intervention—and utilizing more rigorous designs.

Interventions based on the principles of applied behavior analysis (ABA) have been determined to be evidenced-based practices and are widely used with individuals with autism spectrum disorders (ASD) across the world. Originally developed in the USA, implementation of these interventions has become widespread in the last decade in Turkey. Given the significance of culture in guiding ABA practices, this meta-analysis investigated the prevalence and the magnitude effects of ABA-based interventions and whether specific participant and intervention characteristics moderated such effects in Turkey. Seventy-one ABA-based intervention studies were assessed based on What Works Clearinghouse (WWC, Kratochwill et al., Remedial and Special Education, 34(1), 26–38, 2013) design standards (DSs) including (a) systematic manipulation of independent variables, (b) interrater reliability, (c) three demonstrations of the intervention effect, and (d) adequate number of data points collected for each condition. Forty-three studies that met WWC (Kratochwill et al., Remedial and Special Education, 34(1), 26–38, 2013) DSs were analyzed and calculated with baseline-corrected tau (Tarlow, Behavior Modification, 41(4), 427–467, 2017). Furthermore, performance-criteria-based effect size values (PCES; Aydin and Tanious, Journal of Applied Behavior Analysis, 2021) were calculated for 27 studies that had mastery criteria. While the overall tau appeared to be large 0.71 (p = 0.072, se = 0.254), the overall effect size for PCES revealed a small effect of 0.73. The comparisons of all sub-categories’ effect sizes of moderator variables were not statistically significant based on Kruskal Wallis or Mann Whitney U tests. Additionally, findings revealed that studies were predominantly implemented by highly trained researchers in segregated one-on-one settings, and did not include adults with ASD nor challenging behavior. Overall, there has been significant growth in ABA-based interventions in Turkey that show promise in improving the lives of individuals with ASD. However, further research and cultural considerations are essential for a comprehensive understanding of their impact in the Turkish context. Findings from two different effect size analyses and recommendations for future studies are discussed.

Social communication, like all inter-human behaviors, are highly affected by an individual’s intersectional identities and memberships of diverse communities. The current systematic literature review investigated the reporting practices of participant demographics and the extent to which under-represented autistic groups were included in social communication intervention studies in the 2020 National Clearinghouse on Autism Evidence and Practice report. Results show inconsistencies and gaps in reporting participant variables as well as a general lack of representation of diverse autistic communities in social communication intervention research. The results highlight the limitations of current racial categories and considerations for complex intersectional identities. Recommendations for future researchers are also discussed.

Reflecting the significant delays in autism assessments globally, studies have explored whether autism assessments conducted via telehealth are feasible and accurate. This systematic review investigated the psychometric properties of autism assessment tools for children administered via telehealth and examined the diagnostic accuracy of telehealth assessment procedures compared to care-as-usual in-person assessments. Relevant databases (MEDLINE, Embase and PsycInfo) were searched for eligible studies (PROSPERO: CRD42022332500). In total, 18 studies were included, collectively assessing 1593 children for autism. Telehealth assessments for autism were largely comparable to in-person assessments, with a diagnostic agreement of 80–88.2%. Individual behavioral observation tools, diagnostic interviews, and clinician-administered screening tools demonstrated acceptable validity. For many children, diagnostic decision-making can be expedited without loss of validity using telehealth.

We conducted a network meta-analysis to assess and rank the efficacy of different physical activities on motor function, social function, communication, and stereotyped behavior in children with autism spectrum disorder. PubMed, EBSCO, Cochrane Library, and Web of Science databases were searched through May 25, 2023. A total of 37 studies involving 1200 participants and 17 interventions were included in our study. Based on the ranking probabilities, Tai Chi Chuan and fundamental motor skill intervention were ranked as possibly the most effective intervention for motor function and communication, respectively. Kata techniques had the highest probability of being best for stereotyped behavior and social function. This review provides valuable information that physical activity can be a useful strategy in the management of autism spectrum disorder.