Sex differences in autism screening: An examination of the Childhood Autism Spectrum Test-Hebrew version.

LAY ABSTRACT: Autism is a neurodevelopmental condition, characterized by social communication alterations and restricted, repetitive behaviors. Typically diagnosed in early childhood, screening and diagnosis at a later age can be challenging, particularly in girls who exhibit a wider range of behaviors and characteristics. Our study set out to examine the effectiveness of the Hebrew translation of the Childhood Autism Spectrum Test, a parent report questionnaire, in identifying these diverse characteristics of autism within an Israeli sample of boys and girls. We examined parent reports on 403 (211 autistic, 192 non-autistic) children, aged 4-12 years. Results revealed the Childhood Autism Spectrum Test-Hebrew version was a valuable tool in differentiating between autistic and typically developing children, correctly identifying 93% of children with autism and 82% of typically developing children. In addition, specific items of the Childhood Autism Spectrum Test-Hebrew version were particularly useful in differentiating between autistic and non-autistic boys and autistic and non-autistic girls. Using these items, in addition to the overall score of the questionnaire, increased the correct identification of children as autistic or typically developing, especially in girls. The Childhood Autism Spectrum Test-Hebrew version test results corresponded well with the Autism Diagnostic Interview-Revised, which relies on parental input, but not with the clinician-administered Autism Diagnostic Observation Schedule-2. Our findings highlight the potential benefits of gender-specific tools to better support correct identification of autism in boys and in girls. More research is recommended to further explore these gender differences and to validate our findings with a larger, diverse group.

The Autism-Spectrum Quotient-Hebrew version: Psychometric properties of a full and a short form, adapted for DSM-5.

LAY ABSTRACT: Despite the attempt to diagnose autism at an early age, there are still many individuals who would only get an autism diagnosis in adulthood. For these adults, a questionnaire that could assist in highlighting their need to seek diagnostic assessment is needed. The Autism-Spectrum Quotient is a self-report scale used to assess autistic traits. It was tested cross-culturally, and a short version was recommended to help identify adults who should be referred for an autism assessment. However, its relevance for the up-to-date diagnostic criteria, according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), has not been tested. This study aimed to examine the psychometric properties of the Hebrew version of the Autism-Spectrum Quotient and to create a short version of the Hebrew Autism-Spectrum Quotient, based on items which map on to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. Ninety-three autistic adults (24 females), aged 18-51, clinically diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.), and 147 comparable controls (34 females) filled out the Hebrew version of the Autism-Spectrum Quotient. Ten clinicians who specialize in diagnosing autism in adults classified the Autism-Spectrum Quotient's items according to Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. The short version of the Hebrew Autism-Spectrum Quotient comprised items that best differentiated between adults with and without autism, five items representing each of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnostic domains. The overall probability for participants to be correctly classified as autistic or neurotypical was 86% for the Hebrew version of the Autism-Spectrum Quotient and 88% for the short version of the Hebrew Autism-Spectrum Quotient. We conclude that both versions are reliable and sensitive instruments that can help referring adults for autism assessment.

A randomized controlled trial evaluating the Hebrew adaptation of the PEERS® intervention: Behavioral and questionnaire-based outcomes.

Social interaction deficits form a core characteristic of ASD that is commonly targeted through social-skill groups. The Program for the Education and Enrichment of Relational Skills (PEERS® ) is a well-established parent-assisted intervention for adolescents, which addresses key areas of social functioning. PEERS® has been mainly studied in North-America and its evaluations were mostly questionnaire based. The aim of the current study was to test the effectiveness of the adapted and translated Hebrew version of the PEERS® intervention in a randomized controlled trial, using behavioral measures of peer interaction, in addition to self, parent, and teacher reports. Forty-one participants with ASD and no intellectual impairment, aged 12-17 years, were randomly assigned to an immediate intervention or a delayed-intervention group. All participants were assessed before and after the immediate intervention, and again at follow up, after the delayed intervention took place. Results revealed intervention-related behavioral improvements on adolescents' engagement, question-asking, and physical arousal. Parental reports indicated improved social skills, and reduced ASD symptoms. Adolescents reported on more social encounters, greater empathy, and scored higher on social-skill knowledge. Most of these effects maintained at a 16-week follow-up. Teacher reports' yielded effects only on pre-post intervention analysis. Adolescents' improvement on behavioral engagement predicted parent-reported social skills improvement. Our findings support the effectiveness of the adapted Hebrew version of PEERS® for adolescents with ASD, through significant behavioral and questionnaire-based outcomes, which maintained at follow-up. Autism Res 2018, 11: 1187-1200. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Social-skills groups, which facilitate key social deficits characteristic of ASD, are a popular intervention for adolescents with ASD. Indeed, many treatment protocols have been published, and some have also been research validated. However, there have been inconsistent findings regarding the effectiveness of different protocols, in addition to limited findings of improvement beyond questionnaire reports. This study evaluated the Hebrew adaptation of the PEERS® intervention, a 16-weeks long program, which involves the parents as their adolescents' social coaches. Following the intervention, adolescents improved their social-skills, participated more in social encounters, reported greater empathy, and demonstrated higher social-skill knowledge. A live play-role assessment with an unfamiliar peer indicated that adolescents showed greater involvement, asked more questions and were more physically relaxed during the conversation. Improvements maintained 16 weeks after the intervention was completed.