Une étude de validation de l'échelle LABIRINTO pour l'évaluation des "troubles du spectre de l'autisme" chez les enfants âgés de 2 à 4 ans

Aperçu: G.M.

Objectif :
Trouver des preuves du contenu, et de la validité des critères de l'échelle LABIRINTO pour le diagnostic des "troubles du spectre de l'autisme" (TSA) chez les enfants âgés de 24 à 59 mois. 

Méthodes :
L'échelle a été construite en quatre étapes : 

1. les éléments ont été définis sur la base d'un examen approfondi de la littérature et de discussions avec des spécialistes de l'autisme et du développement de l'enfant ; 
2. des spécialistes du développement de l'enfant ont évalué chaque élément ; 
3. une version préliminaire de l'échelle a été appliquée aux enfants diagnostiqués avec un TSA pour permettre les ajustements nécessaires ; 
4. l'échelle a ensuite été appliquée à 27 enfants avec un développement typique et sans trouble neurodéveloppemental et 48 enfants avec un diagnostic de TSA. Selon la 5e édition du Manuel diagnostique et statistique des troubles mentaux (DSM-5) et la Childhood Autism Rating Scale (CARS), le diagnostic clinique constitue l'étalon-or. 

Résultats :
Les indices psychométriques de l'échelle étaient appropriés pour la validité de construit, avec Kaiser-Meyer-Olkin = 0,94 et une erreur quadratique moyenne d'approximation = 0,000. Un seul facteur de l'échelle avait un alpha de Cronbach de 0,97. La courbe caractéristique de fonctionnement du récepteur indiquait un seuil de 12, avec une sensibilité de 100 % et une spécificité de 100 % pour distinguer les enfants ayant un développement autistique de ceux ayant un développement typique. 

Conclusion :
Cette étude a confirmé la validité de l'échelle LABIRINTO.

. 2021 Jun 15.  doi: 10.47626/2237-6089-2020-

A validation study of the LABIRINTO scale for the evaluation of autism spectrum disorder in children aged 2 to 4 years

Milena Pereira Pondé  ¹ , Daniele de Brito Wanderley  ² , Laise Dodô de Menezes  ³ , Fernanda Lima Gomes  ³ , Gustavo Marcelino Siquara  ¹

Affiliations

• PMID: 34139117
• DOI: 10.47626/2237-6089-2020-0141

Abstract

Objective: To find evidence of the content, construct, and criterion validity of the LABIRINTO scale for the diagnosis of autism spectrum disorder (ASD) in children aged 24-59 months.

Methods: The scale was constructed in four stages: 1) items were defined based on an extensive literature review and discussions with autism and child development specialists; 2) child development specialists evaluated each item; 3) a preliminary version of the scale was applied to children diagnosed with ASD to enable any necessary adjustments; 4) the scale was then applied to 27 children with typical development and no neurodevelopmental disorder and 48 children with ASD. According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Childhood Autism Rating Scale (CARS), clinical diagnosis constitutes the gold standard.

Results: The scale's psychometric indexes were appropriate for construct validity, with Kaiser-Meyer-Olkin = 0.94 and root mean square error of approximation = 0.000. Only one factor on the scale had a Cronbach alpha of 0.97. The receiver operating characteristic curve indicated a cutoff of 12, with a sensitivity of 100% and specificity of 100% for distinguishing children with ASD from those with typical development.

Conclusion: This study confirmed the validity of the LABIRINTO scale.

Keywords: Autism; diagnostic evaluation; psychometrics; validation.

Toujours laissés pour compte : les jeunes noirs d'âge scolaire reçoivent moins souvent un diagnostic de TSA par rapport aux jeunes blancs

Aperçu: G.M.

Des recherches antérieures suggèrent que les enfants noirs sont à risque de retards dans le diagnostic de l'autisme, mais les facteurs qui influencent le moment du diagnostic entre les groupes ethniques restent flous. 

Cette étude a analysé les données d'enfants noirs et blancs qui ont reçu un premier diagnostic d'autisme dans une clinique spécialisée. Les jeunes noirs étaient sous-représentés dans le groupe qui a reçu un premier diagnostic au milieu/à la fin de l'enfance (c'est-à-dire après l'âge de six ans). Recevoir un diagnostic plus tard dans l'enfance était lié à un QI plus élevé (niveau de tendance) et à plus de problèmes d'intériorisation pour les enfants blancs alors qu'il était lié à un QI plus faible (niveau de tendance) et à une intensité plus élevée des symptômes de TSA pour les enfants noirs. 

Les résultats suggèrent que les disparités ethniques dans l'identification précoce de l'autisme peuvent diminuer mais persistent chez les personnes diagnostiquées plus tard dans l'enfance.

. 2021 Jun 4.  doi: 10.1007/s10803-021-05118-1. 

Still Left Behind: Fewer Black School-Aged Youth Receive ASD Diagnoses Compared to White Youth

Serene Habayeb  ^{1   2} , Lauren Kenworthy  ³ , Andrea De La Torre  ^{3   4} , Allison Ratto  ³

Affiliations

• PMID: 34089141
• DOI: 10.1007/s10803-021-05118-1

Abstract

Prior research suggests that Black children are at risk for delays in diagnosis of autism, but factors that influence diagnostic timing across races remain unclear. This study analyzed data from Black and White children who received a first-time autism diagnosis at a specialty clinic. Black youth were under-represented in the group who received a first diagnosis in middle/late childhood (i.e., after age six). Receiving a diagnosis later in childhood was related to higher IQ (trend level) and more internalizing problems for White children whereas it was related to lower IQ (trend level) and higher ASD symptom intensity for Black children. Findings suggest racial disparities in early identification of autism may be diminishing but persist among those diagnosed later in childhood..

Keywords: Autism Spectrum Disorder; Diagnosis Delay; First Diagnosis; Race.

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Diagnostic d'autisme assisté par ordinateur basé sur des modèles d'attention visuelle utilisant le suivi oculaire

Aperçu: G.M. 

Un avantage de l'utilisation du suivi oculaire pour le diagnostic est qu'il est non invasif et peut être effectué chez des individus avec différents niveaux fonctionnels et âges. Le diagnostic assisté par ordinateur utilisant des données de suivi oculaire est généralement basé sur des points de fixation oculaire dans certaines régions d'intérêt (ROI) d'une image. Cependant, outre la nécessité de chaque démarcation de ceraines régions d'intérêt  dans chaque image ou trame vidéo utilisée dans l'expérience, la diversité des caractéristiques visuelles contenues dans chaque région d'intérêt  peut compromettre la caractérisation de l'attention visuelle dans chaque groupe (cas ou contrôle) et la précision du diagnostic qui en résulte. Bien que certaines approches utilisent des signaux de suivi oculaire pour faciliter le diagnostic, il est toujours difficile d'identifier les cadres d'intérêt lorsque les vidéos sont utilisées comme stimuli et de sélectionner les caractéristiques pertinentes extraites des vidéos. Ceci est principalement observé dans les applications pour le diagnostic des "troubles du spectre de l'autisme" (TSA). 

Pour résoudre ces problèmes, le présent article propose:
(1) une méthode de calcul, intégrant les concepts des techniques de modèle d'attention visuelle, de traitement d'image et d'intelligence artificielle pour apprendre un modèle pour chaque groupe (cas et contrôle) à l'aide de données de suivi oculaire, et
(2 ) un classificateur supervisé qui, à l'aide des modèles appris, effectue le diagnostic. 

Bien que cette approche ne soit pas spécifique au trouble, elle a été testée dans le cadre du diagnostic de TSA, obtenant une moyenne de précision, de rappel et de spécificité de 90%, 69% et 93%, respectivement.

. 2021 May 12;11(1):10131. doi: 10.1038/s41598-021-89023-8.

Computer-aided autism diagnosis based on visual attention models using eye tracking

Jessica S Oliveira  ¹ , Felipe O Franco  ^{2   3} , Mirian C Revers  ² , Andréia F Silva  ² , Joana Portolese  ² , Helena Brentani  ^{2   3} , Ariane Machado-Lima  ^{1   3} , Fátima L S Nunes  ⁴

Affiliations

• PMID: 33980874
• DOI: 10.1038/s41598-021-89023-8

Free article

Abstract

An advantage of using eye tracking for diagnosis is that it is non-invasive and can be performed in individuals with different functional levels and ages. Computer/aided diagnosis using eye tracking data is commonly based on eye fixation points in some regions of interest (ROI) in an image. However, besides the need for every ROI demarcation in each image or video frame used in the experiment, the diversity of visual features contained in each ROI may compromise the characterization of visual attention in each group (case or control) and consequent diagnosis accuracy. Although some approaches use eye tracking signals for aiding diagnosis, it is still a challenge to identify frames of interest when videos are used as stimuli and to select relevant characteristics extracted from the videos. This is mainly observed in applications for autism spectrum disorder (ASD) diagnosis. To address these issues, the present paper proposes: (1) a computational method, integrating concepts of Visual Attention Model, Image Processing and Artificial Intelligence techniques for learning a model for each group (case and control) using eye tracking data, and (2) a supervised classifier that, using the learned models, performs the diagnosis. Although this approach is not disorder-specific, it was tested in the context of ASD diagnosis, obtaining an average of precision, recall and specificity of 90%, 69% and 93%, respectively.

Observation précoce des drapeaux rouges chez les frères et sœurs de nourrissons de 12 mois diagnostiqués plus tard avec un trouble du spectre de l'autisme

Aperçu: G.M.

Objectif
Des outils de dépistage valides et fiables sont nécessaires pour améliorer la détection précoce et optimiser les résultats développementaux des tout-petits à risque de "trouble du spectre de l'autisme" (TSA). L'étude actuelle visait à évaluer l'utilité de l'observation systématique des drapeaux rouges (SORF) pour le TSA à 12 mois dans un échantillon de frères et sœurs à haut risque d'enfants avec un diagnostic de TSA. 

Méthode
Dans le cadre d'une étude prospective longitudinale, nous avons examiné la sensibilité et la spécificité du SORF à 12 mois pour prédire un diagnostic de TSA à 24 mois sur un échantillon de 122 nourrissons dont 31 diagnostiqués de TSA. 

Résultats
Le score seuil optimal SORF composite de 18 identifiait correctement 24 des 31 enfants de 12 mois qui avaient reçu un diagnostic de TSA, donnant une sensibilité de 0,77 et une spécificité de 0,76. Le score seuil optimal SORF Red Flags de 7 identifiait correctement 20 des 31 nourrissons, donnant une sensibilité de 0,65 et une spécificité de 0,75. 

Conclusion
Cette étude préliminaire démontre le potentiel du SORF en tant que mesure de dépistage observationnelle efficace pour les enfants de 12 mois à risque de TSA avec une bonne discrimination, sensibilité et spécificité.

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. 2021 May 14;1-10. doi: 10.1044/2020_AJSLP-20-00165. 

Early Observation of Red Flags in 12-Month-Old Infant Siblings Later Diagnosed With Autism Spectrum Disorder

Moira L Pileggi  ¹ , Natalie Brane  ¹ , Jessica Bradshaw  ² , Abigail Delehanty  ³ , Taylor Day  ⁴ , Courtney McCracken  ⁵ , Jennifer Stapel-Wax  ⁵ , Amy M Wetherby  ⁶

Affiliations

• PMID: 33989505
• DOI: 10.1044/2020_AJSLP-20-00165

Abstract

Purpose Valid and reliable screening tools are needed to improve early detection and optimize developmental outcomes for toddlers at risk for autism spectrum disorder (ASD). The current study aimed to evaluate the utility of the Systematic Observation of Red Flags (SORF) for ASD at 12 months of age in a sample of high-risk infant siblings of children with ASD. Method As part of a prospective, longitudinal study, we examined the sensitivity and specificity of the SORF at 12 months for predicting a diagnosis of ASD at 24 months in a sample of 122 infants, 31 of whom were diagnosed with ASD. Results The optimal SORF Composite cutoff score of 18 correctly identified 24 of the 31 twelve-month-olds who were diagnosed with ASD, yielding a sensitivity of .77 and a specificity of .76. The optimal SORF Red Flags cutoff score of 7 correctly identified 20 of the 31 infants, yielding a sensitivity of .65 and a specificity of .75. Conclusion This preliminary study demonstrates the potential of the SORF as an effective observational screening measure for 12-month-olds at risk for ASD with good discrimination, sensitivity, and specificity.

Relations entre le revenu du ménage et le comportement indépendant fonctionnel des enfants autistes

 Aperçu: G.M.

Les enfants des ménages à faible revenu sont moins susceptibles de recevoir un diagnostic de "trouble du spectre de l'autisme" (TSA) et le diagnostic est souvent retardé. L'absence ou le retard d'identification des TSA minimise la capacité d'un enfant à recevoir des services d'intervention précoce efficaces qui soutiennent le développement des compétences d'autonomie fonctionnelle.
La recherche n'a pas encore identifié les relations entre l'indépendance fonctionnelle et le revenu du ménage pour les enfants autistes.
Une enquête nationale transversale auprès de 231 soignants d'enfants autistes âgés de 2 à 12 ans a été menée. Les soignants ont répondu à un sondage de 90 minutes portant sur la démographie de la famille, les services d'intervention, la gravité des symptômes de l'autisme et les résultats comportementaux fonctionnels des enfants.
Des différences significatives dans les scores de comportement d'indépendance fonctionnelle ont été identifiées pour les enfants des catégories de revenu le plus élevé et le plus bas lors du contrôle de la gravité des symptômes de l'autisme, de l'âge du diagnostic et de la réception des services d'intervention. Cette étude fournit des preuves préliminaires à l'appui de l'association entre le revenu et le comportement fonctionnel indépendant des enfants autistes.

2021 May 6;15394492211012654.  doi: 10.1177/15394492211012654. 

Relationships Between Household Income and Functional Independent Behavior for Children With Autism

Brittany St John  ¹ , Karla Ausderau  ¹

Affiliations

• PMID: 33955293
• DOI: 10.1177/15394492211012654

Abstract

Children in lower income households are less likely to be diagnosed with autism spectrum disorder (ASD) and diagnosis is often delayed. Lack of or delayed identification of ASD minimizes a child's ability to receive effective early intervention services that support development of functional independence skills. Research has yet to identify relationships between functional independence and household income for children with ASD. A cross-sectional national survey with 231 caregivers of children with autism aged 2-12 years was conducted. Caregivers completed a 90-min survey examining family demographics, intervention services, autism symptom severity, and children's functional behavioral outcomes. Significant differences in functional independence behavior scores were identified for children from the highest and lowest income categories when controlling for autism symptom severity, age of diagnosis, and receipt of intervention services. This study provides preliminary evidence to support the association between income and functional independent behavior for children with ASD.

Keywords: activities of daily living; autism; children; functional outcomes.

Expériences des pères concernant le diagnostic de "trouble du spectre de l'autisme" de leur enfant: une revue narrative de la recherche internationale

Aperçu: G.M.

But et objectifs:
Le but de cette revue systématique était d'identifier les points de vue et les expériences des pères concernant le diagnostic de "trouble du spectre de l'autisme" de leur enfant. 

Contexte:
Le diagnostic de "trouble du spectre de l'autisme" d'un enfant peut être une expérience stressante, créant de l'incertitude pour les parents. Il y a eu une recherche limitée sur les points de vue et les expériences des pères en ce qui concerne le diagnostic de "trouble du spectre de l'autisme" de leur enfant. 

Conception:
Une revue systématique de la littérature des études de recherche quantitatives, qualitatives et de méthodes mixtes. Sources de données: Academic Search Complete, CINAHL, MEDLINE et PsycINFO. 

Méthodes:
D'août à octobre 2020, deux auteurs ont indépendamment procédé à une extraction systématique des données et évalué les études à l'aide d'un instrument reconnu. La liste de contrôle PRISMA a été utilisée dans l'examen. 

Résultats:
Neuf articles répondaient aux critères d'inclusion. Quatre thèmes ont émergé: (a) la reconnaissance graduelle du retard de développement, (b) un moment émotionnel, (c) faire face et adaptation et (d) les ajustements continus du rôle de père. 

Conclusions:
Les infirmières et autres professionnels doivent travailler en collaboration avec les pères pour améliorer leurs expériences et fournir du soutien au moment du diagnostic de "trouble du spectre de l'autisme".

. 2021 May 5. doi: 10.1111/jocn.15781. 

Experiences of fathers regarding the diagnosis of their child with autism spectrum disorder: A narrative review of the international research

Michael Brown  ¹ , Lynne Marsh  ¹ , Edward McCann  ²

Affiliations

• PMID: 33951251
• DOI: 10.1111/jocn.15781

Abstract

Aim and objectives: The aim of this systematic review was to identify the views and experiences of fathers regarding their child's Autism Spectrum Disorder diagnosis.

Background: The diagnosis of a child's Autism Spectrum Disorder may be a stressful experience, creating uncertainty for parents. There has been a limited research focus on the views and experiences of fathers in relation to the diagnosis of Autism Spectrum Disorder of their child.

Design: A systematic literature review of quantitative, qualitative and mixed-methods research studies.

Data sources: Academic Search Complete, CINAHL, MEDLINE and PsycINFO.

Methods: From August to October 2020, two authors independently performed a systematic data extraction and appraised the studies using a recognised instrument. The PRISMA checklist was used in the review.

Results: Nine papers met the inclusion criteria. Four themes emerged: (a) gradual recognition of developmental delay, (b) an emotional time, (c) coping and adaptation and (d) ongoing adjustments to the fathering role.

Conclusions: Nurses and other professionals need to work collaboratively with fathers to improve their experiences and provide supports at the time of Autism Spectrum Disorder diagnosis.

Keywords: ASD; autism spectrum disorder; diagnosis; fathers; nurses; support; systematic review.

© 2021 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.

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