scholarly journals Diagnosis despite clinical ambiguity: physicians’ perspectives on the rise in Autism Spectrum disorder incidence

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael Davidovitch ◽  
Dorit Shmueli ◽  
Ran Shmuel Rotem ◽  
Aviva Mimouni Bloch
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Mental Illnesses ◽  
Spectrum Disorder ◽  
Medical Community ◽  
Categorical Variables ◽  
Diagnostic Process ◽  
Child Neurology ◽  
Chi Square ◽  
Child Psychiatrists

Abstract Background To provide insight on physicians’ perspectives concerning recent changes in the incidence and diagnostic process of Autism Spectrum Disorder (ASD) compared to other mental and neurodevelopmental disorders. Method A questionnaire was sent to 191 specialists in child neurology and child development, and 200 child psychiatrists in Israel. Information was collected on professional background, as well as on physicians’ opinions concerning the accuracy and rate of ASD diagnosis compared to that of cerebral palsy (CP), mental illness, and Attention Deficit Hyperactivity Disorder (ADHD). For each closed-ended question, a global chi-square test for categorical variables was performed. Results 115 (60.2%) of specialists in child neurology and development, and 59 (29.5%) of child psychiatrists responded. Most physicians (67.2%) indicated that there was a moderate/significant increase in the incidence of ASD, which was higher than similar responses provided for CP (2.9%, p < 0.01) and mental illnesses (14.4%, p < 0.01), and similar to responses provided for ADHD (70.1%, p = 0.56). 52.8% of physicians believed that in more than 10% of clinical assessments, an ASD diagnosis was given despite an inconclusive evaluation (CP: 8.6%, p < 0.01; mental illnesses: 25.8%, p = 0.03; ADHD: 68.4%, p = 0.03). Conclusion The clinicians perceive both ASD and ADHD as over-diagnosed disorders. The shared symptomology between ASD and other disorders, coupled with heightened awareness and public de-stigmatization of ASD and with the availability of ASD-specific services that are not accessible to children diagnosed with other conditions, might lead clinicians to over-diagnose ASD. It is advisable to adopt an approach in which eligibility for treatments is conditional on function, rather than solely on a diagnosis. The medical community should strive for accurate diagnoses and a continuous review of diagnostic criteria.

scholarly journals Parental evaluation of a revised autism spectrum disorder diagnostic process for children under 36 months of age

2021 ◽  
Author(s):  
Jean-François Lemay ◽  
Shauna Langenberger ◽  
Scott McLeod
Keyword(s):  
Autism Spectrum Disorder ◽  
Early Intervention ◽  
Parent Education ◽  
Positive Impact ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
High Level

Abstract Background The Alberta Children’s Hospital-Autism Spectrum Disorder Diagnostic Clinic (ACH-ASDC) was restructured due to long wait times and unsustainable clinic workflow. Major changes included the initiation of pre- and post-ASD parent education sessions and distinct ASD screening appointments before the ASD diagnostic appointment. Methods We conducted a parental program evaluation in summer 2018 of the ACH-ASDC. We used a cross-sectional survey to evaluate key outcomes including parental satisfaction, and the percentage of families obtaining access to government supports and early intervention programs. Results For the 101 eligible patients diagnosed with ASD under 36 months of age 70 (69.3%) parents agreed to participate. The mean diagnostic age of the children diagnosed with ASD was 30.6 months (SD=4.1 months). There were no statistically significant age differences between biological sexes. Ninety-three per cent of parents felt that ASD educational sessions were useful, and 92% of parents were satisfied to very satisfied with the overall ASD diagnostic process. Ninety per cent of parents had access to at least one of the key resources available for ASD early intervention in our province following diagnosis. Parents reported a positive impact on intervention provided to their child in the areas of communication, social interaction, and behaviour. Conclusion Parents of children diagnosed with ASD expressed a high level of satisfaction with the restructured ACH-ASDC process. Implementing parent education sessions was well received and met parents’ needs. Parents were able to access intervention services following diagnosis and reported positive impacts for their child. Re-envisioning program approaches to incorporate novel strategies to support families should be encouraged.

scholarly journals The earlier, the better? Diagnostic experiences of parents in a community-based early intervention system for preschool children with autism

2019 ◽  
Vol 4 ◽  
pp. 239694151984520
Author(s):  
Mitsuaki Iwasa ◽  
Yasuo Shimizu ◽  
Ikuko Hara ◽  
Miho Imai ◽  
Hideo Honda
Keyword(s):  
Autism Spectrum Disorder ◽  
Preschool Children ◽  
Early Intervention ◽  
Individual Case ◽  
Autism Spectrum ◽  
Parental Satisfaction ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Diagnostic Disclosure ◽  
The Individual

Background and aims In many countries, early detection and diagnosis of autism spectrum disorder is largely dependent on parents’ initial concern with early symptoms of autism spectrum disorder. Previous research on parental perceptions of the autism spectrum disorder diagnostic process indicates that parental satisfaction may be due to either the timing of the diagnostic notification or the provision of post-diagnostic support. The objective of this research is to study the diagnostic notification process and its impact on parents who are informed of their young child’s diagnosis before they notice a problem and whose child undergoes early intervention therapy. Methods Eighty parents of preschool children diagnosed and undergoing early intervention for autism were surveyed to examine their experience of the diagnostic disclosure process. Results Of 68 respondents, 39 (58.2%) approved of the timing of diagnostic notification, while 10 of 13 dissatisfied respondents indicated that the diagnosis was communicated too late. However, there was no correlation between a higher degree of parental satisfaction with the diagnostic notification process and earlier timing of notification. Conclusions Although it is preferable to communicate a diagnosis of childhood autism as soon as possible, findings suggest that a highly individualized approach, allowing a degree of latitude in the timing of notification, may be permissible, depending on the individual case and parental readiness to receive the diagnosis. Implications Findings have clinical implications related to the concept of optimality of diagnostic disclosure as related to the diagnostic notification process, though later notification tends to lead to more dissatisfaction.

Generosity of state insurance mandates and growth in the workforce for autism spectrum disorder

Autism ◽  
2020 ◽  
pp. 136236132097674
Author(s):  
Ryan K McBain ◽  
Jonathan H Cantor ◽  
Aaron Kofner ◽  
Timothy Callaghan ◽  
Bradley D Stein ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Health Workforce ◽  
Behavioral Therapy ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Access To Health Services ◽  
Us States ◽  
Insurance Mandates ◽  
Child Psychiatrists

All 50 US states have enacted mandates requiring insurers to cover autism-related services. We assessed whether and to what extent variation in generosity of state insurance mandates has been associated with rate of growth in the health workforce for children with autism spectrum disorder: including board-certified behavioral analysts, child psychiatrists, and pediatricians. Drawing data from the National Conference of State Legislatures and Area Health Resource Files, we evaluated eight mandate policy features, utilizing a fixed-effect longitudinal regression framework to examine their relationships with workforce growth during a 15-year period (2003–2017) over which 44 states enacted a mandate. Aspects of mandate generosity included ages covered, spending caps, and types of services covered. We found that mandate generosity was closely associated with the magnitude of increase in supply of board-certified behavioral analysts and—to a lesser extent—child psychiatrists. States with the most generous mandates would be expected to have 39% more board-certified behavioral analysts and 17% more child psychiatrists in 2017, compared to states with least generous mandates. We found no association between mandate generosity and supply of pediatricians. Collectively, our results suggest that the degree of generosity afforded by mandates may be as important as the passage of mandate legislation itself for encouraging workforce growth. Lay abstract To improve access to health services for children with autism spectrum disorder, US states have passed laws requiring health insurers to cover autism-related care, commonly known as state insurance mandates. However, the features of mandates differ across states, with some state laws containing very generous provisions and others containing very restrictive provisions such as whether the mandates include children aged above 12 years, whether there is a limit on spending, and whether there are restrictions on the types of services covered. This study examined the relationship between generosity of mandates and growth in the health workforce between 2003 and 2017, a period during which 44 states passed mandates. We found that states that enacted more generous mandates experienced significantly more growth in board-certified behavioral analysts who provide behavioral therapy as well as more growth in child psychiatrists. We did not find differences in the growth of pediatricians, which is a less specialized segment of the workforce. Our findings were consistent across eight different mandate features and suggest that the content of legislation may be as important as whether or not legislation has been passed in terms of encouraging growth in the supply of services for children with autism spectrum disorder.

scholarly journals Sociocultural Barriers to Early Diagnosis of Autism Spectrum Disorder

2020 ◽  
Vol 1 (4) ◽  
pp. 6
Author(s):  
Anum Farooq ◽  
Shoaib Ahmed
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Early Diagnosis ◽  
Health Care System ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Educational Outreach ◽  
Diagnostic Process ◽  
Pathway To Care ◽  
Care System

Objective: To qualitatively explore community, family, and health care system barriers to early diagnosis of autism spectrum disorder (ASD) in children. Study Design: A phenomenological qualitative approach was used to explore mothers' experiences of receiving ASD diagnosis for their children. Place and Duration of Study: The study was conducted at Autism Resource Centre Islamabad, from March 2018 to August 2018. Materials and Methods: In-depth qualitative interviews of eight mothers of children diagnosed with ASD, who were above 36 months of age. Results: Using thematic analysis, three major themes were identified as barriers in reaching ASD diagnosis i.e. parent's lack of knowledge and misperceptions of ASD; health care system issues like undefined pathway to care, dissatisfaction with medical or associated professionals, delays due to structural and process barriers; and family factors such as stigma around mental health and disability, family denial and financial constraints. Conclusion: Additional educational outreach to families, de-stigmatization of ASD, streamlining the ASD diagnostic process, and providing additional support to parents of at-risk children may decrease delays in ASD diagnosis among children.

scholarly journals Exploring the Potential Use of Telehealth Technology to Improve the Diagnostic Process of Autism Spectrum Disorder (ASD) in Wales, United Kingdom

2021 ◽  
Author(s):  
◽  
Manahil M. Alfuraydan
Keyword(s):  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Diagnostic Assessment ◽  
Diagnostic Process ◽  
Successful Implementation ◽  
Online Questionnaire ◽  
Parental Experience ◽  
Use Of Technology ◽  
Willingness To Use

There is a significant delay between parents initially seeking help and receiving a diagnosis of Autism Spectrum Disorder (ASD). Telehealth has the potential to accelerate the ASD diagnostic pathway. However, user acceptance is essential for the successful implementation of telehealth technology. This thesis therefore aims to examine whether telehealth can be used to increase access to ASD diagnostic services in Wales and reduce the time taken to receive a diagnosis. To achieve this, a multimethod approach was adopted, comprising of three studies. Initially, a scoping review (Study1) was conducted examining the use of telehealth in ASD diagnostic assessment. This identified two methods: (a) Real-Time (b) Store-and-Forward, particularly the Naturalistic Observation Diagnostic Assessment (NODA) system. Results also suggest that telehealth is feasible and acceptable to the families. However, findings indicate that no study had thus far examined the factors of telehealth acceptance, based on theoretical foundation. Therefore, Studies two and three were conducted, to explore the parental experience of the diagnostic process, and investigate the predictors of their acceptance to use NODA for ASD diagnostic assessment, using the Unified Theory of Acceptance and Use of Technology model. Data for both studies was collected via an online questionnaire, targeting parents of children with ASD in Wales. Descriptive and inferential statistics were applied to the closed-ended questions, and thematic analysis was used for open-ended questions. Study 2 findings revealed that the majority of parents were dissatisfied with the diagnostic process, with the time taken to obtain a diagnosis being a predictor of their satisfaction. Study 3 found that the majority of parents felt positively towards the NODA, with their willingness to use the system being predicted by their age, performance expectancy, social influence and comfort with using laptop and smartphone devices. Implications and recommendations are further discussed at the end of the thesis.

scholarly journals A Protocol for the Diagnosis of Autism Spectrum Disorder Structured in Machine Learning and Verbal Decision Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Evandro Andrade ◽  
Samuel Portela ◽  
Plácido Rogério Pinheiro ◽  
Luciano Comin Nunes ◽  
Marum Simão Filho ◽  
...  
Keyword(s):  
Machine Learning ◽  
Autism Spectrum Disorder ◽  
Decision Analysis ◽  
Autism Spectrum ◽  
Machine Learning Algorithms ◽  
Spectrum Disorder ◽  
World Health ◽  
Diagnostic Process ◽  
Icd 10 ◽  
Verbal Decision Analysis

Autism Spectrum Disorder is a mental disorder that afflicts millions of people worldwide. It is estimated that one in 160 children has traces of autism, with five times the higher prevalence in boys. The protocols for detecting symptoms are diverse. However, the following are among the most used: the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), of the American Psychiatric Association; the Revised Autistic Diagnostic Observation Schedule (ADOS-R); the Autistic Diagnostic Interview (ADI); and the International Classification of Diseases, 10th edition (ICD-10), published by the World Health Organization (WHO) and adopted in Brazil by the Unified Health System (SUS). The application of machine learning models helps make the diagnostic process of Autism Spectrum Disorder more precise, reducing, in many cases, the number of criteria necessary for evaluation, denoting a form of attribute engineering (feature engineering) efficiency. This work proposes a hybrid approach based on machine learning algorithms’ composition to discover knowledge and concepts associated with the multicriteria method of decision support based on Verbal Decision Analysis to refine the results. Therefore, the study has the general objective of evaluating how the mentioned hybrid methodology proposal can make the protocol derived from ICD-10 more efficient, providing agility to diagnosing Autism Spectrum Disorder by observing a minor symptom. The study database covers thousands of cases of people who, once diagnosed, obtained government assistance in Brazil.

Order out of chaos? Autism spectrum disorder coordinators’ impact on service delivery in New Zealand

2021 ◽  
pp. 103985622110092
Author(s):  
Matthew Eggleston ◽  
Katherine Eggleston ◽  
Hiran Thabrew ◽  
Shannon Hennig ◽  
Christopher Frampton
Keyword(s):  
Autism Spectrum Disorder ◽  
New Zealand ◽  
Support Groups ◽  
Parent Satisfaction ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Diagnostic Process ◽  
Care Plans ◽  
Key Aspects ◽  
The Impact

Objective: To evaluate the impact of autism spectrum disorder (ASD) coordinators (ASDCs) on key aspects of the experience of obtaining an ASD diagnosis and post-diagnostic supports in New Zealand. Method: Members of New Zealand ASD parent support groups were surveyed. Results: Of 516 parents, 41.3% had seen an ASDC. The majority were satisfied. Parents who saw ASDCs pre-diagnosis were more likely to be satisfied with the diagnostic process ( p = .04) and saw fewer professionals before receiving a diagnosis ( p = .04). Parents who had seen ASDCs post-diagnosis were more likely to be satisfied with post-diagnostic supports ( p < .001) and their coordination ( p < .001). Conclusions: ASDCs are well regarded by parents and improve key aspects of the process of obtaining an ASD diagnosis and post-diagnostic supports. Given the particularly low rates of parent satisfaction with post-diagnostic supports (23%) and their coordination (19%), ASDCs may be of most value when employed post-diagnosis to assist parents in navigating key supports and co-developing comprehensive individualised care plans.

scholarly journals Perception of Special Teachers on the Evidence based Intervention Strategies for Children with Autism Spectrum Disorder

2019 ◽  
Vol 8 (3S2) ◽  
pp. 427-434
Keyword(s):  
Autism Spectrum Disorder ◽  
Developmental Disorders ◽  
Neurodevelopmental Disorder ◽  
Autism Spectrum ◽  
Intervention Strategies ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Graduate Degree ◽  
Chi Square ◽  
Children With Asd

Autism Spectrum Disorder (ASD) is one of five developmental disorders, it is a complex neurodevelopmental disorder affecting the ability of the person to socialize, communicate along with stereotype behaviours. ASD can affect any person irrespective of the gender, caste, creed or religion. Intervention means doing something, taking action or using a treatment to try to improve a particular condition or a problem. When it comes to ASD, there are many kinds of interventions offered. Depending on the type, they can involve the child, the parent or both. They might be one-off events or involve many sessions spread over years. Interventions are based on different theories about what causes ASD. The current study which is a part of the PhD tries to study the perception of special teachers on the current Intervention strategies for children with ASD. The study was conducted by circulating the questionnaire developed to the special teachers (n=40) working for ASD in the country. The participants consisted of special teachers having Diploma, Degree) and Post Graduate degree in the field of ASD (n=40). Descriptive statistics; frequency, percentages, and chi square tests were done using SPSS. The results indicated that teachers accepted the need for evidence based intervention strategies for training children with ASD.

Sign in / Sign up

Export Citation Format

Share Document