ABSTRACT
While advances in intensive neonatal care have greatly improved survival rates among preterm infants, incidence of neurodevelopmental disorders in this group is still high, with autism spectrum disorder (ASD) being one of the most frequent. To this end, we conducted a social-communication intervention aimed at investigating efficacy in social-communicative skills. Eighteen children (preterm and full-term with ASD and preterm children) aged 18 through 20 months participated in the study. Our findings indicate that most participants in the intervention groups registered significant improvements in terms of socio-communicative skills, cognitive development, and language. Accordingly, these pilot data underscore the need for further research and implementation of early interventions in young preterm children with ASD.
Subject(s)
Autism Spectrum Disorder , Adolescent , Autism Spectrum Disorder/psychology , Autism Spectrum Disorder/therapy , Child , Communication , Early Intervention, Educational , Humans , Infant , Infant, Newborn , Infant, Premature , Pilot ProjectsABSTRACT
Investigation into the earliest signs of autism in infants has become a significant sub-field of autism research. This work invokes specific ethical concerns such as use of 'at-risk' language, communicating study findings to parents and the future perspective of enrolled infants when they reach adulthood. This study aimed to ground this research field in an understanding of the perspectives of members of the autism community. Following focus groups to identify topics, an online survey was distributed to autistic adults, parents of children with autism and practitioners in health and education settings across 11 European countries. Survey respondents (n = 2317) were positively disposed towards early autism research, and there was significant overlap in their priorities for the field and preferred language to describe infant research participants. However, there were also differences including overall less favourable endorsement of early autism research by autistic adults relative to other groups and a dislike of the phrase 'at-risk' to describe infant participants, in all groups except healthcare practitioners. The findings overall indicate that the autism community in Europe is supportive of early autism research. Researchers should endeavour to maintain this by continuing to take community perspectives into account.
Subject(s)
Attitude to Health , Autistic Disorder/psychology , Biomedical Research , Adult , Female , Focus Groups , Humans , Infant , Male , Parents/psychologyABSTRACT
Introducción. La intervención temprana en los niños con un trastorno del espectro autista (TEA) depende de una detección precoz y fiable. Aunque de manera general se habla de un diagnóstico estable, se ha evidenciado la necesidad de profundizar más en los factores que influyen en dicha estabilidad. Pacientes y métodos. Los participantes de la muestra fueron 142 menores con TEA (118 varones y 24 mujeres), con una mediana de 33 meses y un recorrido intercuartílico de 12 en la primera evaluación, y con una mediana de 47 meses y un recorrido intercuartílico de 29 en el seguimiento. Los diagnósticos se realizaron con las siguientes pruebas: escala Merrill Palmer revisada, escala de Leiter revisada, escala de inteligencia de Wechsler para preescolar y primaria III y escala de inteligencia de Wechsler para niños revisada y IV; además de la escala Vineland y la escala de observación diagnóstica del autismo genérica (ADOS-G), basándose el diagnóstico clínico en los criterios diagnósticos del Manual diagnóstico y estadístico de los trastornos mentales, cuarta edición, texto revisado (DSM-IV-TR), y quinta edición (DSM-5). Para la evaluación de la estabilidad diagnóstica, se realizaron tablas de contingencia para las valoraciones del diagnóstico en función del juicio clínico y los resultados de la ADOS-G. Resultados. El diagnóstico clínico basado en los criterios del DSM-IV-TR, el DSM-5 y el juicio clínico se mantiene estable a través del tiempo en un 96% de los casos. Si se valora la estabilidad diagnóstica teniendo en cuenta los resultados del ADOS-G (n = 30), el 87% de los casos mantiene el diagnóstico. El ANOVA muestra diferencias estadísticamente significativas para las medidas del factor intrasujeto del cociente intelectual y la edad social global, pero no para el diagnóstico. Conclusiones. La estabilidad diagnóstica se beneficia de un uso informado del criterio clínico y de la participación de un equipo multidisciplinar (AU)
Introduction. Early intervention for children with an autism spectrum disorder (ASD) depends on early and reliable detection. In general, diagnosis is stable, but evidence shows the need to go deeper into the factors that influence this stability. Patients and methods. A sample of 142 children with ASD (118 boys and 24 girls) with a median of 33 months of age and an interquartile range of 12 in the first evaluation. In the follow-up the median was 47 months and an interquartile range of 29. The following tests were applied to evaluate the children: Merrill-Palmer Scale-R, Leitter-R, WIPPSI-III, WISC-R and WISC-IV; as well as Vineland Scale and ADOS-G, based on clinical diagnosis to DSM-IV-R and DSM-5. For the evaluation of the diagnostic stability, contingency tables were performed for diagnostic assessments based on clinical judgment and the results of the ADOS-G. Repeated measures ANOVA was used to analyze the differences between measures of cognitive functioning, adaptive behavior and diagnosis. Results. The clinical diagnosis based on DSM-IV-TR, DSM-5 and clinical judgment remains stable over time in 96% of cases. If the diagnostic stability is measured based on the results of ADOS-G (n = 30), 87% of cases diagnosed maintained the diagnosis. The ANOVA showed statistically significant differences for measures of within-subject factors and global social age, but not for diagnosis. Conclusion. The diagnostic stability can be improved by utilizing clinical judgment and the participation of a multidisciplinary team (AU)
