Autism Spectrum Disorder

 Autism Spectrum Disorder

Carl Stuart

Stuart Medical Series

 Literature Review.

Ouellette-Kuntz, H. M., Coo, H., Larn, M., Yu, C. T., Breitenbach, M. M., Hennessey, P. E., & Crews, L. R. (2009). Age at diagnosis of autism spectrum disorders in four regions of Canada. Canadian Journal of Public Health, 100(4), 268-73.

The main objectives of this quantitative research was to investigate the earliest age at which a diagnosis of autism can be made in Canadian children, and to examine whether there exists any temporal or geographic variations; or if the observed differences are determined by the diagnostic subtype or gender. The research utilized data that was collected as part of the autism surveillance survey that was conducted in Manitoba, Prince Edward Island, Southeastern Ontario, and Newfoundland and Labrador. The research focused on autistic children whose diagnosis was made in period covering 1997 to 2005. The research studied a total of 769 subjects. The results showed that there were significant inter-regional variations with regards to the age at diagnosis with Southeastern Ontario having the highest median age at 55.0 months, and Newfoundland and Labrador the lowest at 39.0 months. The results also showed that there was an increase in the age at diagnosis in Southeastern Ontario. Diagnostic subtype showed a significant association with the age at diagnosis irrespective of the geographical location.

The findings of this research show that there exist geographical differences in the age at diagnosis. The research also showed that the Diagnostic subtype shows a significant association with the age at diagnosis.

The credibility of the authors of this quantitative research is assured by the fact that all the authors are affiliated to areas of work or university departments that are related to psychology, sociology, education and community health. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. Moreover, the research studied a large sample population thus lending further credibility to its findings. The main gap in the research was that it did not adequately identify the factors that contributed to the observed differences.

Huerta, M., Bishop, S. L., Duncan, A., Hus, V., & Lord, C. (2012). Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. American Journal of Psychiatry, 169(10), 1056-1064.

This study was necessitated by the fact that the DSM-IV criteria for ASDs (autism spectrum disorders) had undergone substantial and significant revisions in order to increase the criteria’s diagnostic specificity and sensitivity. The main objective of this study was to evaluate the diagnostic effectiveness of the DSM-V criteria for ASD in the diagnosis of ASD in autistic children previously diagnosed with PDDs (pervasive developmental disorders) and non-PDD disorders. A total of 5143 subjects were enrolled in this study. 4453 subjects were diagnosed with PDD using the DSM-IV criteria while the remaining 690 subjects had non-PDD diagnoses based on the DSM-IV criteria.  The information collected from these subjects was grouped into three data sets. The study utilized the Autism Diagnostic Observation Schedule, and Autism Diagnostic Interview–Revised to collect information which was later used to evaluate the clinical utility of DSM-IV criteria and DSM-V criteria in relation to ASDs. Moreover, the information was also used to evaluate the relative diagnostic specificity and sensitivity of DSM-IV criteria in relation to DSM-V criteria. The results showed that the DSM-V criterion was able to identify about 91% of all cases of clinical DSM-IV PDD. The sensitivity of both criteria was considerably high with no significant differences between the DSM-IV and DSM-V criteria. The results also showed that the DSM-V criterion was more specific than DSM-IV criteria with regards to the clinical diagnosis of ASDs. These results do demonstrate that the DSM-IV criterion is still eligible for clinical ASD-PDD diagnoses. The results also reveal that the specificity of DSM-V criteria enables it to diagnosis certain ASD disorders that could not have been diagnosed using DSM-IV criteria.

The authors of this study are all recognized psychiatrists, and as such their credibility is assured. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. Moreover, the research studied a large sample population thus lending further credibility to its findings. There was no discernible gap in this study.

Cassel, T. D., Messinger, D. S., Ibanez, L. V., Haltigan, J. D., Acosta, S. I., & Buchman, A. C. (2007). Early social and emotional communication in the infant siblings of children with autism spectrum disorders: An examination of the broad phenotype. Journal of Autism and Developmental Disorders, 37(1), 122-132.

This study was necessitated by the fact that infants whose older siblings are affected with ASD are at an increased risk of enduring socio-emotional difficulties. In this study, infants with normally or typically developing elder siblings (TD-sibs) were compared to infants with siblings diagnosed with ASD (ASD-sibs). A total of 31 subjects were enrolled in this study. The study utilized face-to-face/still-face (FFSF) protocols and Early Social Communication Scale (ESCS). The interactive FFSF protocols assess the quality and type of emotional expressivity in infants. In this study, it was administered at 6 months of age. On the other hand, the ESCS assesses the early communicative behaviors in children who have not yet developed their language skills. In this study, it was administered to children aged 8 months, 10 months, 12 months, 15 months and 18 months. The results showed that the number of ASD-sibs who smiled was significantly lower than the number of TD-sibs who smiled as assessed by the FFSF protocols. Moreover, the protocols showed that the AASD-sibs lacked the aspect of emotional continuity between the smiling episodes. Relative to the TD-sibs, the ASD-sibs demonstrated lower levels of engagement in the initiation of joint attention at the age of 15 months, and also exhibited less joint attention bids at the age of 18 months. The results also revealed that the ASD-sibs had few higher-level behavioral requests at the age of 12 months. The aforementioned results suggest that ASD-sibs have subtle but inconsistently multifaceted deficits in referential communication and emotional expression.

The authors of this study are recognized experts in their respective fields, and as such the information that they have published is deemed credible. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. However, the research studied a small sample population. No other gap was discernible in the study.

Weismer, S. E., Gernsbacher, M. A., Stronach, S., Karasinski, C., Eernisse, E. R., Venker, C. E., & Sindberg, H. (2011). Lexical and grammatical skills in toddlers on the autism spectrum compared to late talking toddlers. Journal of Autism and Developmental Disorders, 41(8), 1065-1075.

In this study, language development was compared in two toddler groups. A total of 80 subjects were enrolled in this study. Group A was made up of 25-months old late-talking children without ASD. Group A was made up of 40 subjects, 13 females and 27 males. Group B was comprised of 30-months old children with ASDs. Group A was made up of 40 subjects, 5 females and 35 males. These two groups were compared in terms of overall productive vocabulary. The nonverbal cognition component was controlled during the study. Several words - including some psychological state terms - were categorized into specific semantic categories. The information collected was used to assess and compare early lexical-grammatical relationships and the vocabulary-related language acquisition patterns. The results obtained in this result showed that the defined semantic word categories were acquired and used by children with ASDs at a rate equivalent to that of the children without ASDs. Moreover, the results also revealed that both groups had equivalent grammatical complexity. However, the late-talkers showed a stronger association between word combination and lexical-grammatical abilities as compared to the children with ASD. These results are consistent with the conventional dimensional accounts that state that the early and core linguistic capabilities do develop at the same rate in the different children population groups that have been affected by language delay.

The authors of this study are recognized experts in their respective fields, and as such the information that they have published is credible. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. Moreover, the research studied a large sample population thus lending further credibility to its findings. There was no discernible gap in this study.

Kim, Y. S., Leventhal, B. L., Koh, Y. J., Fombonne, E., Laska, E., Lim, E. C., & Grinker, R. R. (2011). Prevalence of autism spectrum disorders in a total population sample. American Journal of Psychiatry, 168(9), 904-912.

This study used a population-based sample of school-aged children to carry out an estimation of the prevalence rate of ASD in school-age children. Moreover, the study also investigated the clinical features of ASD in the same population group.  A total of 55, 266 subjects were enrolled in this study. The subjects were aged between 7 -12 years. The subjects were sampled from high probability groups and the general population. The high probability groups were found in disability registry centers and special education schools; while the general population was represented by the regular schools. The researchers used the ASSQ (Autism Spectrum Screening Questionnaire) and standardized diagnostic procedures to identify their subjects. The ASSQ is a systematic multi-informant screening tool used to identify individuals with ASD. The results showed that the estimated ASD prevalence rate was 2.64%. The prevalence rate in the general population was 1.89% while the prevalence rate in the high probability groups was 0.75%. The features of ASD differed in the groups studied with the affected female-to-male ratio being 1: 5.1 and 1:2.5 in the high probability groups and the general population samples respectively. The general population sample had a higher IQ (intelligence quotient) than the high probability groups. It can be inferred from these results that a majority of ASD cases remain undiagnosed in the school-going population. Thus, it can be concluded that this study shows that there is an urgent need for comprehensive screening programs for ASD among children.

The authors of this study are recognized experts in their respective fields, and as such the information that they have published is credible. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. Moreover, the research studied a large sample population thus lending further credibility to its findings. There was no discernible gap in this study.

Hellemans, H., Colson, K., Verbraeken, C., Vermeiren, R., & Deboutte, D. (2007). Sexual behavior in high-functioning male adolescents and young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(2), 260-269.

The aim of this study was to investigate the sexual behavior displayed by high-functioning males affected with ASD. In the study, 24 institutionalized males were interviewed using the guidelines set forth by the ISA (Interview Sexuality Autism). All the interviewees were exhibited features of high-functioning autism (HFA). HFA is a type of autism in which the affected individual shows a heightened concern about sexuality and physical relationships. The results showed that most of the interviewees had displayed over-sexualized patterns of behaviors. The results also showed that the interviewees tended to over-express their sexual interests. The results also showed that they had functionally-relevant knowledge concerning socio-sexual skills but the interviewees were unable or unwilling to put that knowledge into practical use. This is exemplified by the finding that most of the interviewees sought physical contact with other people. Half of them had been in a relationship while 3 interviewees had engaged in sexual intercourse.  The results also revealed an exceptionally high rate of bisexual orientation among the interviewees. Moreover, it was also documented that ritual-sexual utilization of ordinary objects for sexual fascination was present. Finally, the results also revealed that 8 interviewees needed psychiatric and medical interventions regarding their sexual behavior or abnormal development. It can thus be concluded that HFA-males are predisposed to hyper-sexualization and they tend to exhibit bizarre sexual behaviors.

The authors of this study are recognized experts in their respective fields, and as such the information that they have published is credible. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. However, the research studied a small sample population. No other gap was discernible in the study.

Bauminger, N., Solomon, M., Aviezer, A., Heung, K., Gazit, L., Brown, J., & Rogers, S. J. (2008). Children with autism and their friends: A multidimensional study of friendship in high-functioning autism spectrum disorder. Journal of Abnormal Child Psychology, 36(2), 135-150.

The aim of this study was to examine the characteristics and quality of friendships among preadolescent children affected by high-functioning ASD (HFASD). 82 subjects from Israel and the USA were enrolled in the study. The subjects were aged between 8-12 years. 44 subjects had HFASD while the remaining 38 subjects were the typically (or normally) developing children (TYP). The study examined there interactions with close friends. The subjects were allocated to groups which were matched on child age, receptive language vocabulary, socioeconomic status and gender. The multidimensional assessments were comprised of observation of child-friend interactions and the behaviors exhibited during such interactions; mother reported characteristics and the perception of the child about the quality of the friendship. The results showed that the children affected by HFASD did display significant differences on both dyadic and individual friendship measures. The results also revealed that both verbal capabilities and age did affect the friendship behaviors and the quality of friendships. Hoewever, the HFASD children and their friends who had the same disorder did perceive friendship qualities similarly, thereby suggesting that HFASD preadolescents were capable of perceiving interpersonal awareness. Moreover, the results also revealed that there was some degree of between-group similarities. Tit can thus be concluded that the developmental trajectory of ASD does allow an individual to enhance his or her social interaction skills.

The authors of this study are recognized experts in their respective fields, and as such the information that they have published is credible. The article does link its conclusions with the results. The strength of this research was not affected by any inconsistencies or flaws in the overall research or its methodology, and it can thus be inferred that this is a credible research. Moreover, the research studied a large sample population thus lending further credibility to its findings. There was no discernible gap in this study.