scholarly journals The Autism Phenome Project: Toward Identifying Clinically Meaningful Subgroups of Autism

2022 ◽  
Vol 15 ◽  
Author(s):  
Christine Wu Nordahl ◽  
Derek Sayre Andrews ◽  
Patrick Dwyer ◽  
Einat Waizbard-Bartov ◽  
Bibiana Restrepo ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Early Childhood ◽  
Clinical Characteristics ◽  
Developmental Trajectories ◽  
Autism Spectrum ◽  
Health Conditions ◽  
Targeted Interventions ◽  
Multidisciplinary Study ◽  
Wide Range

One of the most universally accepted facts about autism is that it is heterogenous. Individuals diagnosed with autism spectrum disorder have a wide range of behavioral presentations and a variety of co-occurring medical and mental health conditions. The identification of more homogenous subgroups is likely to lead to a better understanding of etiologies as well as more targeted interventions and treatments. In 2006, we initiated the UC Davis MIND Institute Autism Phenome Project (APP) with the overarching goal of identifying clinically meaningful subtypes of autism. This ongoing longitudinal multidisciplinary study now includes over 400 children and involves comprehensive medical, behavioral, and neuroimaging assessments from early childhood through adolescence (2–19 years of age). We have employed several strategies to identify sub-populations within autistic individuals: subgrouping by neural, biological, behavioral or clinical characteristics as well as by developmental trajectories. In this Mini Review, we summarize findings to date from the APP cohort and describe progress made toward identifying meaningful subgroups of autism.

scholarly journals Psychometric properties of questionnaires and diagnostic measures for autism spectrum disorders in adults: A systematic review

Autism ◽  
2018 ◽  
Vol 23 (2) ◽  
pp. 287-305 ◽  
Author(s):  
Sarah Wigham ◽  
Jacqui Rodgers ◽  
Tom Berney ◽  
Ann Le Couteur ◽  
Barry Ingham ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum Disorders ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Health Conditions ◽  
Cochrane Library ◽  
Mental Health Conditions ◽  
Diagnostic Measures ◽  
Spectrum Disorders

Accurately diagnosing autism spectrum disorders in adulthood can be challenging. Structured questionnaires and diagnostic measures are frequently used to assist case recognition and diagnosis. This study reviewed research evidence on structured questionnaires and diagnostic measures published since the National Institute for Health and Care Excellence evidence update. The Cochrane library, Medline, Embase and PsycINFO were searched. In all, 20 studies met inclusion criteria. Sensitivity and specificity of structured questionnaires were best for individuals with previously confirmed autism spectrum disorder diagnoses and reduced in participants referred for diagnostic assessments, with discrimination of autism spectrum disorder from mental health conditions especially limited. For adults with intellectual disability, diagnostic accuracy increased when a combination of structured questionnaires were used. Evidence suggests some utility of diagnostic measures in identifying autism spectrum disorder among clinic referrals, although specificity for diagnosis was relatively low. In mental health settings, the use of a single structured questionnaire is unlikely to accurately identify adults without autism spectrum disorder or differentiate autism spectrum disorder from mental health conditions. This is important as adults seeking an autism spectrum disorder diagnostic assessment are likely to have co-existing mental health conditions. Robust autism spectrum disorder assessment tools specifically for use in adult diagnostic health services in the presence of co-occurring mental health and neurodevelopmental disorders are a research priority.

School Nurses on the Front Lines of Health Care: How to Help Students With Autism Spectrum Disorder Navigate a Meltdown in School

2019 ◽  
Vol 35 (3) ◽  
pp. 143-146
Author(s):  
Christy Lucas ◽  
Kelly Mahler ◽  
Cheryl D. Tierney ◽  
Robert P. Olympia
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Pediatric Population ◽  
Autism Spectrum ◽  
School Nurses ◽  
Spectrum Disorder ◽  
Case Scenario ◽  
Wide Range ◽  
Physical Consequences ◽  
And Behavior

Through a presented case scenario, this article describes the assessment and management of behaviors associated with autism spectrum disorder (ASD) in the pediatric population, with mnemonics as a memory tool. Although students present mainly to the school nurses’ office with physical complaints, there are many mental health concerns in the school-age population with emotional and physical consequences, particularly among students with ASD. Typically considered a developmental disorder, ASD affects communication and behavior with a wide range of symptoms that can vary in severity from person to person. It is important to understand the presentation and management of common pediatric mental health issues at school to be on the front line of your students’ health.

scholarly journals Theoretical and practical approaches to the organization of psychopreventive care in early childhood

2020 ◽  
Vol 3 (2) ◽  
pp. 126-131
Author(s):  
G.V. Kozlovskaya ◽  
◽  
L.F. Kremneva ◽  
M.A. Kalinina ◽  
M.V. Ivanov ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Childhood ◽  
Mental Disorders ◽  
Inclusive Education ◽  
Genetic Disorders ◽  
Autism Spectrum ◽  
Health Conditions ◽  
Contributing Factors ◽  
Mental Health Conditions ◽  
Increased Risk

The growing prevalence of diagnosed mental health conditions in children is currently reported. Morbidity structure has changed over the last two decades as autism spectrum disorders including debilitating ones have come to the fore. Epidemiological study outcomes demonstrate an increased risk of mental disorders as compared with good mental health. Psychogenic factors are of crucial importance for the development of certain mental health conditions in children. Among them, the development of mother-child dyad is particularly important. This article reviews fundamental articles by domestic authors and describes in detail the development of optimal psychological component of gestational dominance that prepares a woman for maternity being one of the top priorities of early psychoprophylaxis. Toddlers who are at higher risk for mental disorders are categorized into groups depending on contributing factors, i.e., children with residual cerebral abnormalities due to the organic lesion of the central nervous system, children with manifestations of schizotypic diathesis or other genetic disorders, and deprived children. Major principles of the organization of primary, secondary, and corrective psychopreventive care in children are addressed. Specialized services for early psychopreventive care to support mental health and to reduce the prevalence of mental disorders and the severity of deprivation disorders in children are required. The paper also highlights the need for reopening of psychological medical social centers and harmonizing preschool and school education through the disaggregation of groups and classes. Finally, the authors declare that inclusive education is unreasonable.Keywords: mental disorders, early childhood, risk group, deprivation, schizotypic diathesis, psychoprophylaxis.For citation: Kozlovskaya G.V., Kremneva L.F., Kalinina M.A., Ivanov M.V. Theoretical and practical approaches to the organization of psychopreventive care in early childhood. Russian Journal of Woman and Child Health. 2020;3(2):126–131. DOI: 10.32364/2618-8430-2020-3-2-126-131.

Characterizing therapist delivery of evidence-based intervention strategies in publicly funded mental health services for children with autism spectrum disorder: Differentiating practice patterns in usual care and AIM HI delivery

Autism ◽  
2021 ◽  
pp. 136236132110016
Author(s):  
Eliana Hurwich-Reiss ◽  
Colby Chlebowski ◽  
Teresa Lind ◽  
Kassandra Martinez ◽  
Karin M Best ◽  
...  
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Usual Care ◽  
Teaching Strategies ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Intervention Strategies ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Active Teaching

This study identified patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder within publicly funded mental health services and compared patterns for therapists delivering usual care to those trained in AIM HI (“An Individualized Mental Health Intervention for ASD”). Data were drawn from a randomized community effectiveness trial and included a subsample of 159 therapists (86% female) providing outpatient or school-based psychotherapy. Therapist strategies were measured via observational coding of psychotherapy session recordings. Exploratory factor analysis used to examine patterns of strategy delivery showed that among therapists in the usual care condition, strategies loaded onto the single factor, General Strategies, whereas for therapists in the AIM HI training condition, strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies. Among usual care therapists, General Strategies were associated with an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were associated with reductions in child behavior problems over 18 months. Results support the effectiveness of training therapists in evidence-based interventions to increase the specificity of strategies delivered to children with autism spectrum disorder served in publicly funded mental health settings. Findings also support the use of active teaching strategies in reducing challenging behaviors. Lay abstract This study was conducted to identify patterns of therapist delivery of evidence-based intervention strategies with children with autism spectrum disorder receiving publicly funded mental health services and compare strategy use for therapists delivering usual care to those trained to deliver AIM HI (“An Individualized Mental Health Intervention for ASD”), an intervention designed to reduce challenging behaviors in children with autism spectrum disorder. For therapists trained in AIM HI, intervention strategies grouped onto two factors, Autism Engagement Strategies and Active Teaching Strategies, while strategies used by usual care therapists grouped onto a broader single factor, General Strategies. Among usual care therapists, General Strategies were related to an increase in child behavior problems, whereas for AIM HI therapists, Active Teaching Strategies were related with reductions in child behavior problems over 18 months. Findings support the use of active teaching strategies in reducing challenging behaviors in children with autism spectrum disorder and provide support for the effectiveness of training therapists in evidence-based interventions to promote the delivery of targeted, specific intervention strategies to children with autism spectrum disorder in mental health services.

Mental health correlates and potential childhood predictors for the wish to be of the opposite sex in young autistic adults

Autism ◽  
2021 ◽  
pp. 136236132110240
Author(s):  
Jung-Chi Chang ◽  
Meng-Chuan Lai ◽  
Yueh-Ming Tai ◽  
Susan Shur-Fen Gau
Keyword(s):  
Mental Health ◽  
Autism Spectrum Disorder ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Typically Developing ◽  
Item Endorsement ◽  
Opposite Sex ◽  
Autistic Adults

Cross-sectional research has demonstrated the overrepresentation of gender dysphoria in children and adults with autism spectrum disorder. However, the predictors and underlying mechanisms of this co-occurrence remain unclear. This follow-up study aimed to explore baseline (childhood/adolescence) predictors for the follow-up (adulthood) self-reported wish to be of the opposite sex and to investigate its mental health correlates in a sample of 88 autistic individuals as compared with 42 typically developing controls. An item on the Adult Self-Report Inventory-4, “I wish I was the opposite sex,” was used. We compared mental health symptoms between adults with and without this item endorsement. We used prediction models to explore family and autism-related predictors in childhood/adolescence to endorse this item in adulthood. There were more adults endorsing the item in the autism spectrum disorder group compared with the typically developing group. Autistic adults who endorsed the item experienced more mental health challenges, more bullying victimization, more suicidal ideations, and worse quality of life. Lower parent-reported family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. It is necessary to raise more attention to gender development and related mental health impact in autistic individuals. Lay abstract Autistic people/people with autism spectrum disorder are more likely to experience gender dysphoria. However, the possible longitudinal predictors and underlying mechanisms of this co-occurrence are unclear. To fill this knowledge gap, we assessed 88 people with autism spectrum disorder and 42 typically developing individuals at their average ages of 13.0 (baseline, childhood/adolescence) and 20.2 years old (follow-up, adulthood). At follow-up, their endorsement on the item “I wish I was the opposite sex” was used to evaluate gender dysphoric symptoms. We compared mental health symptoms between adults with and without this item endorsement at the follow-up assessment. We explored parent-reported family and autism characteristics-related predictors in childhood/adolescence to this item endorsement in adulthood. We found that more autistic adults reported the wish to be of the opposite sex than did typically developing individuals. Autistic adults who endorsed this item experienced more mental health challenges, more school bullying and cyberbullying, more suicidal ideation, and worse quality of life. Moreover, parent-reported lower family support and more stereotyped/repetitive behaviors during childhood/adolescence predicted the self-reported wish to be of the opposite sex in adulthood in autistic individuals. More attention and support should be provided to autistic people regarding gender development and related mental health and quality of life impact, especially during the transition period to young adulthood.

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