The assessment of autism spectrum disorders in adults

2016 ◽  
Vol 2 (1) ◽  
pp. 31-40
Author(s):  
Anastasios Galanopoulos ◽  
Dene Robertson ◽  
Emma Woodhouse
Keyword(s):  
Needs Assessment ◽  
National Health System ◽  
Autism Spectrum ◽  
Comprehensive Assessment ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Content Type ◽  
Wide Range ◽  
Physical Health Problems ◽  
Personal Functioning

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.

Characteristics of referrals and admissions to a medium secure ASD unit

2014 ◽  
Vol 5 (3) ◽  
pp. 138-146
Author(s):  
Therese O' Donoghue ◽  
John Shine ◽  
Olufunto Orimalade
Keyword(s):  
Autism Spectrum ◽  
Response To Treatment ◽  
Diagnostic Tools ◽  
Treatment Pathway ◽  
Content Type ◽  
Therapeutic Engagement ◽  
Starting Point ◽  
Wide Range ◽  
History Of

Purpose – The purpose of this paper is to present preliminary data on a cohort of patients referred to a specialist forensic medium-secure autism spectrum disorder (ASD) service during its first two years of opening and to identify variables associated with admission to the service. Design/methodology/approach – Data on all referrals to the service (n=40) was obtained from clinical files on demographics, offending history, psychiatric history and levels of therapeutic engagement. The sample was divided into two groups: referred and admitted (n=23) and referred and not admitted (n=17). Statistical analysis compared the two groups on all variables. Findings – Totally, 94 per cent of all individuals assessed had a diagnosis of autism, however, structured diagnostic tools for ASD were used in a small minority of cases. About half the sample had a learning disability, almost four-fifths had at least one additional mental disorder and almost three-quarters had a history of prior supervision failure or non-compliance with treatment. The sample had a wide range of previous offences. No significant differences were found between the groups on any of the variables included in the study. Research limitations/implications – The present study presents a starting point to follow up in terms of response to treatment and characteristics associated with treatment outcome. Practical implications – The sample had a wide range of clinical and risk-related needs. Both groups shared many similarities. Originality/value – This highlights the need for comprehensive assessment looking at risk-related needs so that individuals are referred to an optimal treatment pathway.

scholarly journals Resources, Problems and Challenges of Autism Spectrum Disorder Diagnosis and Support System in Poland

2021 ◽  
Author(s):  
Anna Lenart ◽  
Jacek Pasternak
Keyword(s):  
Autism Spectrum Disorder ◽  
Support System ◽  
Autism Spectrum ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Autism Diagnosis ◽  
Autism Spectrum Disorder Diagnosis ◽  
Effective System ◽  
Diagnostic Standards ◽  
And Control

AbstractThe article refers to resources, problems and challenges of autism diagnosis and support system in Poland. The resources include: the increasing number of specialists, diagnostic and therapeutic centres, well-established course of education for people working with youths, standardised and normalised diagnostic tools. The diagnostic process is not without some areas in need of our focus: the tendency of some specialists to make unauthorised diagnosis, overshadowing; underestimation of comorbidity of ASD with other disorders. The challenges refer to introducing an effective system of monitoring the services provided in form of certification and control in order to prevent their abuse, initiating category of temporary diagnosis; paying more attention on individual’s resources, better cooperation among specialists, teachers and families, developing and unifying diagnostic standards.

Autism spectrum mixed neurodevelopmental disorder associated with 6q27 deletion and multiple copies within 20q11.23: a case study

2014 ◽  
Vol 8 (3) ◽  
pp. 210-215
Author(s):  
Stephen Hopkins ◽  
Jeremy Turk ◽  
Adeniyi Daramola ◽  
Marinos Kyriakopoulos
Keyword(s):  
Neurodevelopmental Disorder ◽  
Autism Spectrum ◽  
Copy Number Variations ◽  
Comparative Genomic Hybridisation ◽  
Comparative Genomic ◽  
Content Type ◽  
Effective Strategies ◽  
Wide Range ◽  
Multiple Copies

Purpose – Copy Number Variations (CNVs) are not infrequently observed in aberrant neurodevelopment. CNVs can alter gene expression and have been linked to a wide range of neuropsychiatric disorders. The purpose of this case study is to report the association of CNVs with a mixed neurodevelopmental disorder. Design/methodology/approach – Array-Comparative Genomic Hybridisation analysis was carried out in a case of an eight-year-old boy presenting with a mixed neurodevelopmental disorder including autism spectrum disorder, intellectual disability, tic disorder, anxiety and severe aggression. The child's parents also underwent the same investigation. Findings – A 6q27 deletion and multiple copies within 20q11.23 were identified. The boy's father shared the 6q27 deletion and his mother also had multiple copies within 20q11.23. Originality/value – This is the first report linking the combination of 6p27 and 20q11 CNVs with a mixed neurodevelopmental presentation. Identifying CNVs that may underlie aberrant neurodevelopment is likely to assist in unravelling the aetiology of neurodevelopmental and psychiatric disorders and lead to more effective strategies for their characterisation and management.

Autism and virtual reality head-mounted displays: a state of the art systematic review

2018 ◽  
Vol 12 (3) ◽  
pp. 101-113 ◽  
Author(s):  
Ryan Bradley ◽  
Nigel Newbutt
Keyword(s):  
Virtual Reality ◽  
Empirical Studies ◽  
Skills Training ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Application Technology ◽  
Content Type ◽  
Wide Range ◽  
Head Mounted Displays ◽  
Autistic Population

Purpose The use of virtual reality (VR) technologies in the education of autistic children has been a focus of research for over two decades. It is argued that this form of technology can provide authentic “real world” contexts that target social and life skills training in safe, controllable and repeatable virtual environments. The development of affordable VR head-mounted displays (HMD), such as Google cardboard and Oculus Rift, has seen a renewed interest in their use for a wide range of applications, including the education of autistic individuals. The paper aims to discuss these issues. Design/methodology/approach A systematic search of electronic databases focussing on empirical studies on the use of VR-HMD for children and adults on the autism spectrum was undertaken. Findings A review of the literature identified a limited number of studies in this field characterised by differences in the type of application, technology used and participant characteristics. Research limitations/implications Whilst there are some grounds for optimism, more research is needed on the use of this technology within educational settings to ensure robust recommendations can be made on the implementation, use and sustainability of this approach. Originality/value This paper is the first to consider the evidence base for the use of VR-HMD technology to support the needs of the autistic population.

Diagnosing psychiatric disorders in people with intellectual disabilities: issues and achievements

2015 ◽  
Vol 9 (5) ◽  
pp. 230-242 ◽  
Author(s):  
Marco O. Bertelli ◽  
Michele Rossi ◽  
Daniela Scuticchio ◽  
Annamaria Bianco
Keyword(s):  
Psychiatric Disorders ◽  
Psychiatric Symptoms ◽  
Evidence Base ◽  
Current Status ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Content Type ◽  
People With Intellectual Disabilities ◽  
Assessment Procedures ◽  
Source Of Information

Purpose – Diagnosing psychiatric disorders (PD) in adults with Intellectual Disability (ID) presents several issues and need specific skills and tools. The purpose of this paper is to provide a detailed description of the current status of art through a systematic mapping of the literature. Design/methodology/approach – The authors reviewed the international literature on the basis of the following questions: what are the issues in the psychiatric diagnostic process for adults with ID? What methods and procedures have been used for psychiatric assessment in ID? To date, is it possible to identify some most effective procedures? Findings – The analysis of the literature indicates that main issues of the psychiatric diagnostic process in adults with ID are the following: identification of psychiatric symptoms, behavioural equivalents, diagnostic criteria, setting, source of information, screening, and diagnostic tools. The evidence base is only emerging and although many relevant achievements have been reached in the last two decades, no definitive guideline has been produced. Most recent acquisition also allowed to identify some assessment procedures that are currently considered the most effective. Individualised assessment remains the best way to meet the needs of this heterogeneous and variable patient group. Originality/value – This paper offers a comprehensive and updated description of current achievements and issues towards the assessment of PD in people with ID.

scholarly journals Novel Diagnosis of Lyme Disease: Potential for CAM Intervention

2009 ◽  
Vol 6 (3) ◽  
pp. 283-295 ◽  
Author(s):  
Aristo Vojdani ◽  
Frank Hebroni ◽  
Yaniv Raphael ◽  
Jonathan Erde ◽  
Bernard Raxlen
Keyword(s):  
Lyme Disease ◽  
Herbal Medicines ◽  
Clinical Diagnostics ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Clinical Diagnostic ◽  
Wide Range ◽  
Tick Borne Disease

Lyme disease (LD) is the most common tick-borne disease in the northern hemisphere, producing a wide range of disabling effects on multiple human targets, including the skin, the nervous system, the joints and the heart. Insufficient clinical diagnostic methods, the necessity for prompt antibiotic treatment along with the pervasive nature of infection impel the development and establishment of new clinical diagnostic tools with increased accuracy, sensitivity and specificity. The goal of this article is 4-fold: (i) to detail LD infection and pathology, (ii) to review prevalent diagnostic methods, emphasizing inherent problems, (iii) to introduce the usage ofin vivoinduced antigen technology (IVIAT) in clinical diagnostics and (iv) to underscore the relevance of a novel comprehensive LD diagnostic approach to practitioners of Complementary and Alternative Medicine (CAM). Utilization of this analytical method will increase the accuracy of the diagnostic process and abridge the time to treatment, with antibiotics, herbal medicines and nutritional supplements, resulting in improved quality of care and disease prognosis.

scholarly journals Phylogeny and Population Structure of Brown Rot- and Moko Disease-Causing Strains of Ralstonia solanacearum Phylotype II

2012 ◽  
Vol 78 (7) ◽  
pp. 2367-2375 ◽  
Author(s):  
G. Cellier ◽  
B. Remenant ◽  
F. Chiroleu ◽  
P. Lefeuvre ◽  
P. Prior
Keyword(s):  
Population Structure ◽  
Ralstonia Solanacearum ◽  
Brown Rot ◽  
Phylogeographic Structure ◽  
Diagnostic Tools ◽  
Comparative Genomic ◽  
Content Type ◽  
Pathogenic Variants ◽  
Group I ◽  
Wide Range

ABSTRACTThe ancient soilborne plant vascular pathogenRalstonia solanacearumhas evolved and adapted to cause severe damage in an unusually wide range of plants. In order to better describe and understand these adaptations, strains with very similar lifestyles and host specializations are grouped into ecotypes. We used comparative genomic hybridization (CGH) to investigate three particular ecotypes in the American phylotype II group: (i) brown rot strains from phylotypes IIB-1 and IIB-2, historically known as race 3 biovar 2 and clonal; (ii) new pathogenic variants from phylotype IIB-4NPB that lack pathogenicity for banana but can infect many other plant species; and (iii) Moko disease-causing strains from phylotypes IIB-3, IIB-4, and IIA-6, historically known as race 2, that cause wilt on banana, plantain, andHeliconiaspp. We compared the genomes of 72R. solanacearumstrains, mainly from the three major ecotypes of phylotype II, using a newly developed pangenomic microarray to decipher their population structure and gain clues about the epidemiology of these ecotypes. Strain phylogeny and population structure were reconstructed. The results revealed a phylogeographic structure within brown rot strains, allowing us to distinguish European outbreak strains of Andean and African origins. The pangenomic CGH data also demonstrated that Moko ecotype IIB-4 is phylogenetically distinct from the emerging IIB-4NPB strains. These findings improved our understanding of the epidemiology of important ecotypes in phylotype II and will be useful for evolutionary analyses and the development of new DNA-based diagnostic tools.

Catatonia in individuals with Autism Spectrum Disorder and intellectual disability: a discussion of four cases

2019 ◽  
Vol 13 (5) ◽  
pp. 182-193
Author(s):  
Huw Morgan Dunstall ◽  
Catherine Walton ◽  
Lance Vincent Watkins ◽  
Andrew Bhasker Isaac ◽  
Mohamed El Tahir
Keyword(s):  
Autism Spectrum Disorder ◽  
Intellectual Disability ◽  
Rating Scales ◽  
Autism Spectrum ◽  
Stressful Events ◽  
Spectrum Disorder ◽  
Response To Treatment ◽  
Diagnostic Tools ◽  
Content Type ◽  
High Index Of Suspicion

Purpose Catatonia is increasingly recognised as a comorbid syndrome of Autism Spectrum Disorder (ASDs). The assessment and management of individuals with comorbid ASD and intellectual disability (ID) adds a further dimension to this already complex presentation, with few cases identified in the literature. The paper aims to discuss these issues. Design/methodology/approach This paper presents four cases of catatonia in individuals with comorbid ASD and ID. The diagnostic challenges, response to treatment and prognosis are discussed whilst comparing with the existing literature. Findings A high index of suspicion is required to recognise the subtle catatonic features seen in patients with ASD and ID. Clinicians should be particularly vigilant following stressful events in young adults. The assessment of catatonia in ASDs and ID requires a pragmatic approach given the lack of suitable diagnostic tools and difficulties completing investigations. Caution is advised when using rating scales as they are not validated in ID. The mainstay of treatment is lorazepam, although responses vary. Originality/value The discussion of these four cases strengthens the existing literature, and highlights the implications a comorbid diagnosis of ID has on the assessment and management of catatonia in ASDs.

A comprehensive assessment process for children with autism spectrum disorders

2019 ◽  
Vol 6 (2) ◽  
pp. 95-108
Author(s):  
Magda Di Renzo ◽  
Viviana Guerriero ◽  
Massimiliano Petrillo ◽  
Lidia Racinaro ◽  
Elena Vanadia ◽  
...  
Keyword(s):  
Autism Spectrum Disorders ◽  
Autism Spectrum ◽  
Comprehensive Assessment ◽  
Sensory Profile ◽  
Assessment Process ◽  
Content Type ◽  
Development Trajectory ◽  
Detailed Assessment ◽  
Spectrum Disorders ◽  
Definition Of

Purpose The assessment of Autism Spectrum Disorders (ASD) in childhood has two essential aspects: the identification of the risk (under 30 months of age) and the definition of a diagnosis that takes into account its core areas as well as further non-specific aspects. The purpose of this paper is to present an approach that considers the combination of clinical evaluation with the use of tools that analyse the various levels of the child’s functioning as fundamental. Design/methodology/approach The comprehensive assessment at the Institute of Ortofonologia in Rome provides the ADOS-2 and the Leiter-R for the evaluation of the symptomatology, the severity level, the non-verbal cognitive functioning and the fluid reasoning; the TCE and the UOI are used to identify, respectively, the child’s emotional skills and the ability to understand the intentions of others, as precursors of the theory of mind. Within this assessment, the Brief-P, the Short Sensory Profile and the RBS are also included for the evaluation of executive functions, sensory pattern and of restricted and repetitive behaviours, as observed by parents. Findings How to define a reliable development profile, which allows to plan a specific intervention calibrated on the potential of the child and on his development trajectory, is described. Two clinical cases are also presented. Originality/value The entire process is aimed both at a detailed assessment of the child’s functioning and at identifying a specific therapeutic project and predictive factors for achieving an optimal outcome.

Differential diagnosis of autism spectrum disorder and early onset schizophrenia: two clinical cases

2020 ◽  
Vol 6 (2) ◽  
pp. 139-151
Author(s):  
Ann Marie Martin ◽  
Katherine Stavropoulos ◽  
Jan Blacher
Keyword(s):  
Autism Spectrum Disorder ◽  
Differential Diagnosis ◽  
Early Stage ◽  
Autism Spectrum ◽  
Repetitive Behaviors ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Content Type ◽  
Restricted And Repetitive Behaviors ◽  
Clinical Cases

Purpose Historically, children with autism spectrum disorder (ASD) were sometimes diagnosed with schizophrenia or major psychosis. Although significant advancements in the process of differential diagnosis have been made since 1950s, there still exists a problematic delay in diagnosis due to overlap of symptoms. Negative symptoms of schizophrenia can mimic the social difficulties and stereotyped behaviors characteristic of ASD, whereas positive symptoms of schizophrenia can be perceived as restricted and repetitive behaviors, complicating the diagnostic process. The purpose of this paper is to present two clinical cases that highlight the complexities in differential diagnosis of early psychosis, schizophrenia and ASD. Design/methodology/approach Two females, 14 and 16 years of age, were referred to a free screening clinic in Southern California to be assessed for possible ASD. Both females were referred because of the presentation of restricted and repetitive behaviors and social communication difficulties. Both females and their families were administered a battery of measures to ascertain the youths’ cognitive functioning, adaptive living skills and severity of autism-related behaviors. Findings The 14-year-old presented with early-stage (prodromal or at-risk mental state) psychosis; 16-year-old met criteria for schizophrenia. Both were referred to clinics specializing in treatment for psychosis and/or schizophrenia. Neither met criteria for ASD. Originality/value More published studies are needed on the overlap of symptoms between ASD and schizophrenia to help prevent diagnostic overshadowing of autistic symptoms and promote treatment during the early stages of psychosis. This is particularly important given the strong evidence that early treatment for psychosis improves social, cognitive and functional outcomes.

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