27 results on '"Wiggins, Lisa"'
Search Results
2. CDC's 'Learn the Signs. Act Early.': Developmental Milestone Resources to Improve Early Identification of Children with Developmental Delays, Disorders, and Disabilities
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Abercrombie, Julia, Wiggins, Lisa, and Green, Katie K.
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Approximately 1 in 6 children in the US has a developmental delay, disorder, or disability (DD). Early identification of DDs can help families access services that empower children and families, and it can improve child outcomes. The "Learn the Signs. Act Early." (LTSAE) Program at the Centers for Disease Control and Prevention (CDC) encourages parents and providers to monitor every child's early development and act when there is a concern. In February 2022, LTSAE released revised materials that include updated developmental milestone checklists to better support ongoing conversations between families and professionals. This article describes the purpose of the checklists and how early childhood professionals can use these free resources to engage families in developmental monitoring.
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- 2022
3. A Preliminary Epidemiologic Study of Social (Pragmatic) Communication Disorder Relative to Autism Spectrum Disorder and Developmental Disability without Social Communication Deficits
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Ellis Weismer, Susan, Rubenstein, Eric, Wiggins, Lisa, and Durkin, Maureen S.
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The goal of this preliminary investigation was to compare demographic and clinical characteristics in a sample of children with likely Social (Pragmatic) Communication Disorder (SCD) (N = 117) to those in children with possible (N = 118) and some (N = 126) SCD traits, other developmental delay (DD) (N = 91) and autism spectrum disorder (ASD) (N = 642). We used data from the Study to Explore Early Development (SEED), a multi-site case-control study. Items reflecting SCD DSM-5 criteria were selected from an autism diagnostic measure, with SCD categories identified by creating quartiles. Our results suggest that SCD may fall along a continuum involving elevated deficits (in comparison to DD with no SCD) in social communication and restricted and repetitive behavior that do not reach the clinical threshold for ASD.
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- 2021
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4. The Broader Autism Phenotype in Mothers is Associated with Increased Discordance between Maternal-Reported and Clinician-Observed Instruments That Measure Child Autism Spectrum Disorder
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Rubenstein, Eric, Edmondson Pretzel, Rebecca, Windham, Gayle C., Schieve, Laura A., Wiggins, Lisa D., DiGuiseppi, Carolyn, Olshan, Andrew F., Howard, Annie G., Pence, Brian W., Young, Lisa, and Daniels, Julie
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Autism spectrum disorder (ASD) diagnosis relies on parent-reported and clinician-observed instruments. Sometimes, results between these instruments disagree. The broader autism phenotype (BAP) in parent-reporters may be associated with discordance. Study to Explore Early Development data (N = 712) were used to address whether mothers with BAP and children with ASD or non-ASD developmental disabilities were more likely than mothers without BAP to "over-" or "under-report" child ASD on ASD screeners or interviews compared with clinician observation or overall impression. Maternal BAP was associated with a child meeting thresholds on a maternal-reported screener or maternal interview when clinician ASD instruments or impressions did not (risk ratios: 1.30 to 2.85). Evidence suggests acknowledging and accounting for reporting discordances may be important when diagnosing ASD.
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- 2017
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5. Brief Report: Prevalence of Self-Injurious Behaviors among Children with Autism Spectrum Disorder--A Population-Based Study
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Soke, Gnakub N., Rosenberg, Steven A., Hamman, Richard F., Fingerlin, Tasha, Robinson, Cordelia, Carpenter, Laura, Giarelli, Ellen, Lee, Li-Ching, Wiggins, Lisa D., Durkin, Maureen S., and DiGuiseppi, Carolyn
- Abstract
Self-injurious behaviors (SIB) have been reported in more than 30% of children with an autism spectrum disorder (ASD) in clinic-based studies. This study estimated the prevalence of SIB in a large population-based sample of children with ASD in the United States. A total of 8,065 children who met the surveillance case definition for ASD in the Autism and Developmental Disabilities Monitoring (ADDM) Network during the 2000, 2006, and 2008 surveillance years were included. The presence of SIB was reported from available health and/or educational records by an expert clinician in ADDM Network. SIB prevalence averaged 27.7% across all sites and surveillance years, with some variation between sites. Clinicians should inquire about SIB during assessments of children with ASD.
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- 2016
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6. Evaluation of a Records-Review Surveillance System Used to Determine the Prevalence of Autism Spectrum Disorders
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Avchen, Rachel Nonkin, Wiggins, Lisa D., and Devine, Owen
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We conducted the first study that estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a population-based autism spectrum disorders (ASD) surveillance system developed at the Centers for Disease Control and Prevention. The system employs a records-review methodology that yields ASD classification (case versus non-ASD case) and was compared with classification based on clinical examination. The study enrolled 177 children. Estimated specificity (0.96, [CI 0.95 = 0.94, 0.99]), PPV (0.79 [CI 0.95 = 0.66, 0.93]), and NPV (0.91 [CI 0.95 = 0.87, 0.96]) were high. Sensitivity was lower (0.60 [CI .95 = 0.45, 0.75]). Given diagnostic heterogeneity, and the broad array of ASD in the population, identifying children with ASD is challenging. Records-based surveillance yields a population-based estimate of ASD that is likely conservative.
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- 2011
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7. Developmental Regression in Children with an Autism Spectrum Disorder Identified by a Population-Based Surveillance System
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Wiggins, Lisa D., Rice, Catherine E., and Baio, Jon
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This study evaluated the phenomenon of autistic regression using population-based data. The sample comprised 285 children who met the autism spectrum disorder (ASD) case definition within an ongoing surveillance program. Results indicated that children with a previously documented ASD diagnosis had higher rates of autistic regression than children who met the ASD surveillance definition but did not have a clearly documented ASD diagnosis in their records (17-26 percent of surveillance cases). Most children regressed around 24 months of age and boys were more likely to have documented regression than girls. Half of the children with regression had developmental concerns noted prior to the loss of skills. Moreover, children with autistic regression were more likely to show certain associated features, including cognitive impairment.These data indicate that some children with ASD experience a loss of skills in the first few years of life and may have a unique symptom profile. (Contains 2 tables.)
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- 2009
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8. Differential Performance of Social Communication Questionnaire Items in African American/Black vs. White Children.
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Dahl, Ethan, Moody, Eric J., Barger, Brian, Rosenberg, Steven, DiGuiseppi, Carolyn, Fallin, M. Daniele, Lee, Li-Ching, and Wiggins, Lisa
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DIAGNOSIS of autism ,DIFFERENTIAL item functioning (Research bias) ,AFRICAN Americans ,RESEARCH funding ,INTERVIEWING ,SAMPLE size (Statistics) ,QUESTIONNAIRES ,LOGISTIC regression analysis ,WHITE people ,CHI-squared test ,DESCRIPTIVE statistics ,RACE ,ODDS ratio ,SOCIAL skills ,COMMUNICATION ,PSYCHOMETRICS ,MEDICAL screening ,DELAYED diagnosis ,CONFIDENCE intervals ,DATA analysis software ,SENSITIVITY & specificity (Statistics) ,CHILDREN - Abstract
Screening for autism spectrum disorder (ASD) is an essential early step in the identification process and inaccurate screening may lead to significant delays in the onset of treatment. Past research has highlighted discrepancies in the performance of ASD screening tools such as the Social Communication Questionnaire (SCQ) among certain racial and ethnic groups. The current study explored the functioning of the SCQ among African American/Black and White respondents based on item level performance on the measure. Differential Item Functioning (DIF) analyses showed that 16 (41%) items of the SCQ functioned differently for African American/Black respondents when compared to White respondents. Implications, such as the potential for delayed diagnosis and treatment, and the influence on downstream outcomes, are discussed. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Using adaptive behavior scores to convey level of functioning in children with autism spectrum disorder: Evidence from the Study to Explore Early Development.
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Furnier, Sarah M, Ellis Weismer, Susan, Rubenstein, Eric, Gangnon, Ronald, Rosenberg, Steven, Nadler, Cy, Wiggins, Lisa D, and Durkin, Maureen S
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MOTOR ability ,COGNITIVE testing ,RESEARCH funding ,AUTISM ,FUNCTIONAL assessment ,PSYCHOLOGICAL adaptation ,SEVERITY of illness index ,DESCRIPTIVE statistics ,INTELLECTUAL disabilities ,CHILD development ,CHILD behavior ,SOCIALIZATION ,EVALUATION ,CHILDREN - Abstract
We examined relationships between measures of adaptive behavior, cognitive ability, and autism symptom severity in 1458 preschool-aged children with autism from the Study to Explore Early Development. While publications commonly describe autistic children as "low-" or "high-functioning" based on cognitive ability, relying solely on cognitive scores may obscure meaningful variation in functioning. We found significant heterogeneity in adaptive behavior scores of children with cognitive scores both above and below the threshold of two or more standard deviations below the population mean specified in the diagnostic criteria for intellectual disability (ID). Although cognitive and adaptive behavior scores were strongly associated in our sample, considerable variation in overall adaptive behavior and more than half in socialization and motor skills was unaccounted for by cognitive ability, autism symptom severity, and other covariates. Among children who could be designated "low-functioning" based on cognitive scores, 39.7% had composite adaptive behavior scores indicating no significant delays, while among those who might be designated "high-functioning," 9.0% had significant delays in overall adaptive behavior and 22.2% in socialization. These results suggest adaptive behavior scores capture variations in the autism phenotype not accounted for by other measures we considered. Autistic people are often described as "low-" or "high-functioning" based on their scores on cognitive tests. These terms are common in publications and in everyday communication. However, recent research and feedback from the autistic community suggests that relying on cognitive ability alone to describe functioning may miss meaningful differences in the abilities of autistic children and adults and in the kinds of support they may need. Additional methods are needed to describe "functioning" in autistic children. We examined whether scores from a test measuring adaptive behaviors would provide information on the functional abilities of children with autism that is different from cognitive ability and autism symptom severity. Adaptive behaviors include age-appropriate skills that allow people to function in their everyday lives and social interactions. We found that a large amount of the variation in adaptive behavior scores was not explained by cognitive development, autism symptom severity, and behavioral and emotional problems. In addition, there was a wide range of adaptive ability levels in children with autism in our study, including in those with low, average, or high cognitive scores. Our results suggest that adaptive behavior scores could provide useful information about the strengths and support needs of autistic children above and beyond measures of cognitive ability and autism symptom severity. Adaptive behavior scores provide important information on the needs of autistic people. [ABSTRACT FROM AUTHOR]
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- 2024
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10. The Prevalence and Characteristics of Children With Profound Autism, 15 Sites, United States, 2000-2016.
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Hughes, Michelle M., Shaw, Kelly A., DiRienzo, Monica, Durkin, Maureen S., Esler, Amy, Hall-Lande, Jennifer, Wiggins, Lisa, Zahorodny, Walter, Singer, Alison, and Maenner, Matthew J.
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PUBLIC health surveillance ,CONFIDENCE intervals ,AGE distribution ,PUBLIC health ,RACE ,ACQUISITION of data ,AUTISM ,SOCIAL classes ,MEDICAL records ,RESEARCH funding ,NEEDS assessment ,SOCIODEMOGRAPHIC factors ,LOGISTIC regression analysis ,LANGUAGE disorders in children ,DISEASE complications ,CHILDREN - Abstract
Objectives: Autism spectrum disorder (autism) is a heterogeneous condition that poses challenges in describing the needs of individuals with autism and making prognoses about future outcomes. We applied a newly proposed definition of profound autism to surveillance data to estimate the percentage of children with autism who have profound autism and describe their sociodemographic and clinical characteristics. Methods: We analyzed population-based surveillance data from the Autism and Developmental Disabilities Monitoring Network for 20 135 children aged 8 years with autism during 2000-2016. Children were classified as having profound autism if they were nonverbal, were minimally verbal, or had an intelligence quotient <50. Results: The percentage of 8-year-old children with profound autism among those with autism was 26.7%. Compared with children with non–profound autism, children with profound autism were more likely to be female, from racial and ethnic minority groups, of low socioeconomic status, born preterm or with low birth weight; have self-injurious behaviors; have seizure disorders; and have lower adaptive scores. In 2016, the prevalence of profound autism was 4.6 per 1000 8-year-olds. The prevalence ratio (PR) of profound autism was higher among non-Hispanic Asian/Native Hawaiian/Other Pacific Islander (PR = 1.55; 95 CI, 1.38-1.73), non-Hispanic Black (PR = 1.76; 95% CI, 1.67-1.86), and Hispanic (PR = 1.50; 95% CI, 0.88-1.26) children than among non-Hispanic White children. Conclusions: As the population of children with autism continues to change, describing and quantifying the population with profound autism is important for planning. Policies and programs could consider the needs of people with profound autism across the life span to ensure their needs are met. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Sensory features in autism: Findings from a large population‐based surveillance system.
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Kirby, Anne V., Bilder, Deborah A., Wiggins, Lisa D., Hughes, Michelle M., Davis, John, Hall‐Lande, Jennifer A., Lee, Li‐Ching, McMahon, William M., and Bakian, Amanda V.
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Sensory features (i.e., atypical responses to sensory stimuli) are included in the current diagnostic criteria for autism spectrum disorder. Yet, large population‐based studies have not examined these features. This study aimed to determine the prevalence of sensory features among autistic children, and examine associations between sensory features, demographics, and co‐occurring problems in other areas. Analysis for this study included a sample comprised of 25,627 four‐ or eight‐year‐old autistic children identified through the multistate Autism and Developmental Disabilities Monitoring Network (2006–2014). We calculated the prevalence of sensory features and applied multilevel logistic regression modeling. The majority (74%; 95% confidence interval: 73.5%–74.5%) of the children studied had documented sensory features. In a multivariable model, children who were male and those whose mothers had more years of education had higher odds of documented sensory features. Children from several racial and ethnic minority groups had lower odds of documented sensory features than White, non‐Hispanic children. Cognitive problems were not significantly related to sensory features. Problems related to adaptive behavior, emotional states, aggression, attention, fear, motor development, eating, and sleeping were associated with higher odds of having documented sensory features. Results from a large, population‐based sample indicate a high prevalence of sensory features in autistic children, as well as relationships between sensory features and co‐occurring problems. This study also pointed to potential disparities in the identification of sensory features, which should be examined in future research. Disparities should also be considered clinically to avoid reduced access to supports for sensory features and related functional problems. Lay Summary: In a large, population‐based sample of 25,627 autistic children, 74% had documented differences in how they respond to sensation. We also identified significant associations of sensory features with adaptive behavior and problems in other domains. Sensory features were less common among girls, children of color, and children of mothers with fewer years of education, suggesting potential disparities in identification. [ABSTRACT FROM AUTHOR]
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- 2022
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12. Gastrointestinal Symptoms in 2- to 5-Year-Old Children in the Study to Explore Early Development.
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Reynolds, Ann M., Soke, Gnakub N., Sabourin, Katherine R., Croen, Lisa A., Daniels, Julie L., Fallin, M. Daniele, Kral, Tanja V. E., Lee, Li- Ching, Newschaffer, Craig J., Pinto-Martin, Jennifer A., Schieve, Laura A., Sims, Amy, Wiggins, Lisa, and Levy, Susan E.
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RESEARCH ,CHILD development ,GASTROINTESTINAL diseases ,CHILDREN with disabilities ,MEDICAL cooperation ,NEURAL development ,BEHAVIOR disorders in children ,SLEEP disorders in children ,SEVERITY of illness index ,AUTISM in children ,DISEASE prevalence ,CHILD development deviations ,PHENOTYPES ,PARENTS ,SYMPTOMS ,CHILDREN - Abstract
Gastrointestinal symptoms (GIS) are commonly reported in children with autism spectrum disorder (ASD). This multi-site study evaluated the prevalence of GIS in preschool-aged children with ASD/(n = 672), with other developmental delays (DD)/(n = 938), and children in the general population (POP)/(n = 851). After adjusting for covariates, children in the ASD group were over 3 times more likely to have parent-reported GIS than the POP group, and almost 2 times more likely than the DD group. Children with GIS from all groups had more behavioral and sleep problems. Within the ASD group, children with developmental regression had more GIS than those without; however, there were no differences in autism severity scores between children with and without GIS. These findings have implications for clinical management. [ABSTRACT FROM AUTHOR]
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- 2021
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13. Brief Report: The ADOS Calibrated Severity Score Best Measures Autism Diagnostic Symptom Severity in Pre-School Children.
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Wiggins, Lisa D., Barger, Brian, Moody, Eric, Soke, Gnakub, Pandey, Juhi, and Levy, Susan
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DIAGNOSIS of autism , *ATTITUDE (Psychology) , *CHILDREN'S health , *MEDICAL personnel , *SEVERITY of illness index , *EVALUATION , *CHILDREN - Abstract
The severity of autism spectrum disorder (ASD) is often measured by co-occurring conditions, such as intellectual disability or language delay, rather than deficits in social interaction, and restricted interests and repetitive behaviors. The Autism Diagnostic Observation Schedule calibrated severity score (ADOS CSS) was created to facilitate comparison of the diagnostic features of ASD independent of related conditions over time. We examined the relationship between the ADOS CSS, ADOS total score, and clinician rated degree of impairment (DOI) in the Study to Explore Early Development. Like others, we confirmed that, among the measures we evaluated, the ADOS CSS was least influenced by developmental functioning and demographic factors and is therefore the best measure of core features of ASD in pre-school children. [ABSTRACT FROM AUTHOR]
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- 2019
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14. ASD Screening with the Child Behavior Checklist/1.5-5 in the Study to Explore Early Development.
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Levy, Susan E., Rescorla, Leslie A., Chittams, Jesse L., Kral, Tanja J., Moody, Eric J., Pandey, Juhi, Pinto-Martin, Jennifer A., Pomykacz, Alison T., Ramirez, AnnJosette, Reyes, Nuri, Rosenberg, Cordelia Robinson, Schieve, Laura, Thompson, Aleda, Young, Lisa, Zhang, Jing, and Wiggins, Lisa
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DIAGNOSIS of autism ,CHILD Behavior Checklist ,CHILD behavior ,MEDICAL screening ,CLASSIFICATION of mental disorders ,PSYCHOLOGY of children with disabilities ,SOCIAL support ,CASE-control method ,PERVASIVE child development disorders ,ONE-way analysis of variance ,CHILDREN - Abstract
We analyzed CBCL/1½-5 Pervasive Developmental Problems (DSM-PDP) scores in 3- to 5-year-olds from the Study to Explore Early Development (SEED), a multi-site case control study, with the objective to discriminate children with ASD (N = 656) from children with Developmental Delay (DD) (N = 646), children with Developmental Delay (DD) plus ASD features (DD-AF) (N = 284), and population controls (POP) (N = 827). ASD diagnosis was confirmed with the ADOS and ADI-R. With a cut-point of T ≥ 65, sensitivity was 80% for ASD, with specificity varying across groups: POP (0.93), DD-noAF (0.85), and DD-AF (0.50). One-way ANOVA yielded a large group effect (η
2 = 0.50). Our results support the CBCL/1½-5's as a time-efficient ASD screener for identifying preschoolers needing further evaluation. [ABSTRACT FROM AUTHOR]- Published
- 2019
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15. Comparison of autism spectrum disorder surveillance status based on two different diagnostic schemes: Findings from the Metropolitan Atlanta Developmental Disabilities Surveillance Program, 2012.
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Wiggins, Lisa, Christensen, Deborah, Van Naarden Braun, Kim, Martin, Lisa, and Baio, Jon
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AUTISM spectrum disorders , *HEALTH programs , *INTELLECTUAL disabilities , *HEALTH education - Abstract
For the first time, the Autism and Developmental Disabilities Monitoring Network (ADDM) at the Centers for Disease Control and Prevention (CDC) reported prevalence estimates based on two different diagnostic schemes in the 2014 surveillance period. Results found substantial agreement between surveillance case status based on Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition–Text Revision (DSM-IV-TR) criteria and DSM-5 criteria ASD (kappa = 0.85). No study has replicated this agreement in another independent sample of surveillance records. The objectives of this study were to (1) replicate agreement between surveillance status based on DSM-IV-TR criteria and DSM-5 criteria for ASD, (2) quantify the number of children who met surveillance status based on only DSM-IV-TR criteria and only DSM-5 criteria for ASD, and (3) evaluate differences in characteristics of these latter two groups of children. The study sample was 8-year-old children who had health and education records reviewed for ASD surveillance in metropolitan Atlanta, GA in the 2012 surveillance year. Results found substantial agreement between child’s surveillance status using DSM-IV-TR criteria and DSM-5 criteria for ASD (kappa = 0.80). There were no differences in child race/ethnicity, child sex, or intellectual disability between surveillance status defined by DSM-IV-TR criteria and that defined by DSM-5 criteria. Children who met surveillance status based on DSM-IV-TR criteria, but not DSM-5 criteria, were more likely to have developmental concerns and evaluations in the first three years. Children who met surveillance status based on DSM-5 criteria, but not DSM-IV-TR criteria, were more likely to have been receiving autism-related services or previously diagnosed with ASD. These results suggest that surveillance status of ASD based on DSM-5 criteria is largely comparable to that based on DSM-IV-TR criteria, and identifies children with similar demographic and intellectual characteristics. [ABSTRACT FROM AUTHOR]
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- 2018
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16. Screening for Autism with the SRS and SCQ: Variations across Demographic, Developmental and Behavioral Factors in Preschool Children.
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Moody, Eric, Reyes, Nuri, Ledbetter, Caroline, Wiggins, Lisa, DiGuiseppi, Carolyn, Alexander, Amira, Jackson, Shardel, Lee, Li-Ching, Levy, Susan, and Rosenberg, Steven
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EDUCATION of mothers ,AUTISM ,CHILD development ,CHILD behavior ,DIAGNOSTIC errors ,MEDICAL screening ,QUESTIONNAIRES ,CHILDREN - Abstract
The Social Communication Questionnaire (SCQ) and the Social Responsiveness Scales (SRS) are commonly used screeners for autism spectrum disorder (ASD). Data from the Study to Explore Early Development were used to examine variations in the performance of these instruments by child characteristics and family demographics. For both instruments, specificity decreased as maternal education and family income decreased. Specificity was decreased with lower developmental functioning and higher behavior problems. This suggests that the false positive rates of the SRS and the SCQ are associated with child characteristics and family demographic factors. There is a need for ASD screeners that perform well across socioeconomic and child characteristics. Clinicians should be mindful of differential performance of these instruments in various groups of children. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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17. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years -- Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016.
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Maenner, Matthew J., Shaw, Kelly A., Baio, Jon, Washington, Anita, Patrick, Mary, DiRienzo, Monica, Christensen, Deborah L., Wiggins, Lisa D., Pettygrove, Sydney, Andrews, Jennifer G., Lopez, Maya, Hudson, Allison, Baroud, Thaer, Schwenk, Yvette, White, Tiffany, Rosenberg, Cordelia Robinson, Li-Ching Lee, Harrington, Rebecca A., Huston, Margaret, and Hewitt, Amy
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AUTISM ,BLACK people ,CONFIDENCE intervals ,STATISTICAL correlation ,HISPANIC Americans ,CLASSIFICATION of mental disorders ,PEOPLE with intellectual disabilities ,PROBABILITY theory ,PUBLIC health surveillance ,WHITE people ,COMORBIDITY ,HEALTH equity ,DISEASE incidence ,DISEASE prevalence ,DATA analysis software ,DESCRIPTIVE statistics ,CHILDREN - Abstract
Description of System: The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance program that provides estimates of the prevalence of ASD among children aged 8 years whose parents or guardians live in 11 ADDM Network sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin). Surveillance is conducted in two phases. The first phase involves review and abstraction of comprehensive evaluations that were completed by medical and educational service providers in the community. In the second phase, experienced clinicians who systematically review all abstracted information determine ASD case status. The case definition is based on ASD criteria described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Results: For 2016, across all 11 sites, ASD prevalence was 18.5 per 1,000 (one in 54) children aged 8 years, and ASD was 4.3 times as prevalent among boys as among girls. ASD prevalence varied by site, ranging from 13.1 (Colorado) to 31.4 (New Jersey). Prevalence estimates were approximately identical for non-Hispanic white (white), non-Hispanic black (black), and Asian/Pacific Islander children (18.5, 18.3, and 17.9, respectively) but lower for Hispanic children (15.4). Among children with ASD for whom data on intellectual or cognitive functioning were available, 33% were classified as having intellectual disability (intelligence quotient [IQ] ≤70); this percentage was higher among girls than boys (40% versus 32%) and among black and Hispanic than white children (47%, 36%, and 27%, respectively). Black children with ASD were less likely to have a first evaluation by age 36 months than were white children with ASD (40% versus 45%). The overall median age at earliest known ASD diagnosis (51 months) was similar by sex and racial and ethnic groups; however, black children with IQ ≤70 had a later median age at ASD diagnosis than white children with IQ ≤70 (48 months versus 42 months). Interpretation: The prevalence of ASD varied considerably across sites and was higher than previous estimates since 2014. Although no overall difference in ASD prevalence between black and white children aged 8 years was observed, the disparities for black children persisted in early evaluation and diagnosis of ASD. Hispanic children also continue to be identified as having ASD less frequently than white or black children. Public Health Action: These findings highlight the variability in the evaluation and detection of ASD across communities and between sociodemographic groups. Continued efforts are needed for early and equitable identification of ASD and timely enrollment in services. [ABSTRACT FROM AUTHOR]
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- 2020
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18. Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years -- Early Autism and Developmental Disabilities Monitoring Network, Six Sites, United States, 2016.
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Shaw, Kelly A., Maenner, Matthew J., Baio, Jon, Washington, Anita, Christensen, Deborah L., Wiggins, Lisa D., Pettygrove, Sydney, Andrews, Jennifer G., White, Tiffany, Rosenberg, Cordelia Robinson, Constantino, John N., Fitzgerald, Robert T., Zahorodny, Walter, Shenouda, Josephine, Daniels, Julie L., Salinas, Angelica, Durkin, Maureen S., and Dietz, Patricia M.
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DIAGNOSIS of autism ,AUTISM ,CONFIDENCE intervals ,CLASSIFICATION of mental disorders ,PEOPLE with intellectual disabilities ,PUBLIC health surveillance ,COMORBIDITY ,DISEASE incidence ,DISEASE prevalence ,EARLY diagnosis ,DESCRIPTIVE statistics ,CHILDREN - Abstract
Description of System: The Early Autism and Developmental Disabilities Monitoring (Early ADDM) Network, a subset of the overall ADDM Network, is an active surveillance program that estimates ASD prevalence and monitors early identification of ASD among children aged 4 years. Children included in surveillance year 2016 were born in 2012 and had a parent or guardian who lived in the surveillance area in Arizona, Colorado, Missouri, New Jersey, North Carolina, or Wisconsin, at any time during 2016. Children were identified from records of community sources including general pediatric health clinics, special education programs, and early intervention programs. Data from comprehensive evaluations performed by community professionals were abstracted and reviewed by trained clinicians using a standardized ASD surveillance case definition with criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Results: In 2016, the overall ASD prevalence was 15.6 per 1,000 (one in 64) children aged 4 years for Early ADDM Network sites. Prevalence varied from 8.8 per 1,000 in Missouri to 25.3 per 1,000 in New Jersey. At every site, prevalence was higher among boys than among girls, with an overall male-to-female prevalence ratio of 3.5 (95% confidence interval [CI] = 3.1--4.1). Prevalence of ASD between non-Hispanic white (white) and non-Hispanic black (black) children was similar at each site (overall prevalence ratio: 0.9; 95% CI = 0.8--1.1). The prevalence of ASD using DSM-5 criteria was lower than the prevalence using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria at one of four sites that used criteria from both editions. Among sites where ≥60% of children aged 4 years had information about intellectual disability (intelligence quotient ≤70 or examiner's statement of intellectual disability documented in an evaluation), 53% of children with ASD had co-occurring intellectual disability. Of all children aged 4 years with ASD, 84% had a first evaluation at age ≤36 months and 71% of children who met the surveillance case definition had a previous ASD diagnosis from a community provider. Median age at first evaluation and diagnosis for this age group was 26 months and 33 months, respectively. Cumulative incidence of autism diagnoses received by age 48 months was higher for children aged 4 years than for those aged 8 years identified in Early ADDM Network surveillance areas in 2016. Interpretation: In 2016, the overall prevalence of ASD in the Early ADDM Network using DSM-5 criteria (15.6 per 1,000 children aged 4 years) was higher than the 2014 estimate using DSM-5 criteria (14.1 per 1,000). Children born in 2012 had a higher cumulative incidence of ASD diagnoses by age 48 months compared with children born in 2008, which indicates more early identification of ASD in the younger group. The disparity in ASD prevalence has decreased between white and black children. Prevalence of co-occurring intellectual disability was higher than in 2014, suggesting children with intellectual disability continue to be identified at younger ages. More children received evaluations by age 36 months in 2016 than in 2014, which is consistent with Healthy People 2020 goals. Median age at earliest ASD diagnosis has not changed considerably since 2014. Public Health Action: More children aged 4 years with ASD are being evaluated by age 36 months and diagnosed by age 48 months, but there is still room for improvement in early identification. Timely evaluation of children by community providers as soon as developmental concerns have been identified might result in earlier ASD diagnoses, earlier receipt of evidence-based interventions, and improved developmental outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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19. Using Standardized Diagnostic Instruments to Classify Children with Autism in the Study to Explore Early Development.
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Wiggins, Lisa, Reynolds, Ann, Rice, Catherine, Moody, Eric, Bernal, Pilar, Blaskey, Lisa, Rosenberg, Steven, Lee, Li-Ching, and Levy, Susan
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DIAGNOSIS of autism , *ALGORITHMS , *AUTISM , *CHILD development , *RESEARCH methodology , *MEDICAL cooperation , *PSYCHOLOGICAL tests , *PSYCHOMETRICS , *QUESTIONNAIRES , *RESEARCH , *PHENOTYPES , *CASE-control method , *DATA analysis software , *DESCRIPTIVE statistics , *CHILDREN , *CLASSIFICATION - Abstract
The Study to Explore Early Development (SEED) is a multi-site case-control study designed to explore the relationship between autism spectrum disorder (ASD) phenotypes and etiologies. The goals of this paper are to (1) describe the SEED algorithm that uses the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) to classify children with ASD, (2) examine psychometric properties of different ASD classification methods, including the SEED method that incorporates rules for resolving ADI-R and ADOS discordance, and (3) determine whether restricted interests and repetitive behaviors were noted for children who had instrument discordance resolved using ADI-R social and communication scores. Results support the utility of SEED criteria when well-defined groups of children are an important clinical or research outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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20. Comparison of a broad-based screen versus disorder-specific screen in detecting young children with an autism spectrum disorder.
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Wiggins, Lisa D, Piazza, Vivian, and Robins, Diana L
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INFANTS , *CHILDREN , *DIAGNOSIS of autism , *MEDICAL screening , *RESEARCH funding , *DATA analysis software , *DESCRIPTIVE statistics - Abstract
The goals of our study were to (a) compare agreement between autism spectrum disorder diagnosis and outcome of the Modified Checklist for Autism in Toddlers and Parents Evaluation of Developmental Status in a sample of toddlers and (b) examine specific concerns noted for toddlers who screened negative on the Modified Checklist for Autism in Toddlers or Parents Evaluation of Developmental Status but were later diagnosed with autism spectrum disorder. Participants were administered the Modified Checklist for Autism in Toddlers and Parents Evaluation of Developmental Status during well-child visits. Families were invited for a clinical evaluation if autism spectrum disorder symptoms were noted on the Modified Checklist for Autism in Toddlers and Modified Checklist for Autism in Toddlers Follow-Up Interview or if autism spectrum disorder concerns were noted by the pediatrician. Fifty-two children completed the Modified Checklist for Autism in Toddlers, Parents Evaluation of Developmental Status, and a clinical evaluation, and 30 of these children were diagnosed with an autism spectrum disorder. Modified Checklist for Autism in Toddlers results showed higher agreement with autism spectrum disorder diagnosis than any individual Parents Evaluation of Developmental Status screen result, although the latter detected many children with other developmental concerns. Children who screened negative on the Modified Checklist for Autism in Toddlers or Parents Evaluation of Developmental Status but were diagnosed with autism spectrum disorder had concerns noted in sensory response and proto-declarative pointing that can be considered in the context of screen results. In sum, our findings support universal autism spectrum disorder–specific screening in addition to general developmental screening and offer considerations to encourage early identification of toddlers with autism spectrum disorder. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
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21. Short report: Improving record–review surveillance of young children with an autism spectrum disorder.
- Author
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Wiggins, Lisa D, Robins, Diana L, and Yeargin-Allsopp, Marshalyn
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DIAGNOSIS of autism , *AUTISM , *EXPERIMENTAL design , *INTERVIEWING , *RESEARCH methodology , *PSYCHOLOGICAL tests , *RESEARCH funding , *PILOT projects , *PARENT attitudes , *DISEASE prevalence , *EARLY diagnosis , *DESCRIPTIVE statistics , *CHILDREN - Abstract
The article discusses a study which investigated the ability of the U.S. Centers for Disease Control and Prevention surveillance to identify younger children with autism spectrum disorder. Involved in the study were 31 families who screened positive for autism spectrum disorder and received a clinical evaluation at Georgia State University. It was found that 4 of the 10 children were diagnosed with the disorder after the George State University evaluation.
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- 2013
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22. Support for a Dimensional View of Autism Spectrum Disorders in Toddlers.
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Wiggins, Lisa, Robins, Diana, Adamson, Lauren, Bakeman, Roger, and Henrich, Christopher
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DIAGNOSIS of autism , *AUTISM , *ASPERGER'S syndrome , *AUTISM spectrum disorders , *ANALYSIS of variance , *CHILD development , *CLUSTER analysis (Statistics) , *EPIDEMIOLOGY , *INTERVIEWING , *RESEARCH methodology , *SCALE analysis (Psychology) , *SCALES (Weighing instruments) , *STATISTICS , *LOGISTIC regression analysis , *DATA analysis , *EARLY diagnosis , *DESCRIPTIVE statistics , *CHILDREN , *DIAGNOSIS - Abstract
We examined whether clinically distinct subgroups can be derived from a sample of toddlers ( n = 186) who failed the Modified Checklist for Autism in Toddlers, received a comprehensive clinical evaluation, and were diagnosed with an autism spectrum disorder (ASD). Three subgroups emerged from cluster analysis distinguished by (a) social, communication, and intellectual skills and (b) the rate and intensity of repetitive behaviors and abnormal sensory response. Preoccupations, compulsions, and rituals did not distinguish resultant subgroups. These results support a dimensional diagnostic view of ASDs in toddlers since subgroup differences were based on symptom severity rather than different symptom profiles. Results also identify specific types and levels of behavioral deficit relevant to toddler populations. Implications for early diagnosis are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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23. Evaluation of a Records-Review Surveillance System Used to Determine the Prevalence of Autism Spectrum Disorders.
- Author
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Nonkin Avchen, Rachel, Wiggins, Lisa D., Devine, Owen, Van Naarden Braun, Kim, Rice, Catherine, Hobson, Nancy C., Schendel, Diana, and Yeargin-Allsopp, Marshalyn
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AUTISM , *SECONDARY analysis , *DISEASE prevalence , *EVALUATION , *CHILDREN - Abstract
We conducted the first study that estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a population-based autism spectrum disorders (ASD) surveillance system developed at the Centers for Disease Control and Prevention. The system employs a records-review methodology that yields ASD classification (case versus non-ASD case) and was compared with classification based on clinical examination. The study enrolled 177 children. Estimated specificity (0.96, [CI = 0.94, 0.99]), PPV (0.79 [CI = 0.66, 0.93]), and NPV (0.91 [CI = 0.87, 0.96]) were high. Sensitivity was lower (0.60 [CI = 0.45, 0.75]). Given diagnostic heterogeneity, and the broad array of ASD in the population, identifying children with ASD is challenging. Records-based surveillance yields a population-based estimate of ASD that is likely conservative. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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24. Sex differences in the evaluation and diagnosis of autism spectrum disorders among children.
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Giarelli, Ellen, Wiggins, Lisa D., Rice, Catherine E., Levy, Susan E., Kirby, Russell S., Pinto-Martin, Jennifer, and Mandell, David
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SEX factors in disease ,DIAGNOSIS of autism in children ,DISEASE prevalence ,DEVELOPMENTAL disabilities ,ASPERGER'S syndrome in children ,COGNITION disorders ,CONFIDENCE intervals - Abstract
Abstract: Background: One of the most consistent features of the autism spectrum disorders (ASDs) is the predominance among males, with approximately four males to every female. We sought to examine sex differences among children who met case definition for ASD in a large, population-based cohort with respect to age at first developmental evaluation, age of diagnosis, influence of cognitive impairment on these outcomes, and sex-specific behavioral characteristics. Methods: We conducted a secondary analysis of data collected for a population-based study of the prevalence of ASD. The sample comprised 2,568 children born in 1994 who met the case definition of ASD as established by the Autism and Developmental Disabilities Monitoring (ADDM) Network for ASD surveillance. Children who had a history of developmental disability and behavioral features consistent with the DSM-IV-TR criteria for autistic disorder, Asperger''s disorder, and Pervasive Developmental Disorder–Not Otherwise Specified in existing evaluation records were classified as ASD cases via two paths: streamlined and nonstreamlined. Streamlined reviews were conducted if there was an ASD diagnosis documented in the records. Data were collected in 13 sites across the United States through the ADDM Network, funded by the Centers for Disease Control and Prevention. Results: Males constituted 81% of the sample. There were no differences by sex in average age at first evaluation or average age of diagnosis among those with an existing documented chart diagnosis of an ASD. Girls were less likely than boys to have a documented diagnosis (odds ratio [OR] = 0.76, p = .004). This analysis was adjusted for cognitive impairment status. In the logistic model, with the interaction term for sex and cognitive impairment, girls with IQ of 70 or less were less likely than boys with IQ of 70 or less to have a documented diagnosis (OR = 0.70, 95% confidence interval [CI] = 0.50-0.97, p = .035). Boys with IQ greater than 70 were less likely than boys with IQ of 70 or less to have a documented diagnosis (OR = 0.60, 95% CI = 0.49-0.74, p < .001). This finding (less likely to have a documented diagnosis) was also true for girls with IQ greater than 70 (OR = 0.45, 95% CI = 0.32-0.66, p < .001). Girls were more likely to have notations of seizure-like behavior (p < .001). Boys were more likely to have notations of hyperactivity or a short attention span and aggressive behavior (p < .01). Conclusions: Girls, especially those without cognitive impairment, may be formally identified at a later age than boys. This may delay referral for early intervention. Community education efforts should alert clinicians and parents to the potential of ASDs in boys and girls. [Copyright &y& Elsevier]
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- 2010
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25. Evaluation of sex differences in preschool children with and without autism spectrum disorder enrolled in the study to explore early development.
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Wiggins, Lisa D., Rubenstein, Eric, Windham, Gayle, Barger, Brian, Croen, Lisa, Dowling, Nicole, Giarelli, Ellen, Levy, Susan, Moody, Eric, Soke, Gnakub, Fields, Victoria, and Schieve, Laura
- Subjects
- *
CHILDREN with autism spectrum disorders , *PRESCHOOL children , *SCHOOL children , *AUTISM spectrum disorders - Abstract
Background and Aims: Research in school-aged children, adolescents, and adults with autism spectrum disorder (ASD) has found sex-based differences in behavioral, developmental, and diagnostic outcomes. These findings have not been consistently replicated in preschool-aged children. We examined sex-based differences in a large sample of 2-5-year-old children with ASD symptoms in a multi-site community-based study.Methods and Procedures: Based on a comprehensive evaluation, children were classified as having ASD (n = 1480, 81.55 % male) or subthreshold ASD characteristics (n = 593, 70.15 % male). Outcomes were behavior problems, developmental abilities, performance on ASD screening and diagnostic tests, and parent-reported developmental conditions diagnosed before study enrollment.Outcomes and Results: We found no statistically significant sex differences in behavioral functioning, developmental functioning, performance on an ASD screening test, and developmental conditions diagnosed before study enrollment among children with ASD or subthreshold ASD characteristics. Males in both study groups had more parent reported restricted interests and repetitive behaviors than females, but these differences were small in magnitude and not clinically meaningful.Conclusions and Implications: Preschool males and females who showed risk for ASD were more similar than different in the outcomes assessed in our study. Future research could examine sex-based differences in ASD phenotypes as children age. [ABSTRACT FROM AUTHOR]- Published
- 2021
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26. Pica, Autism, and Other Disabilities.
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Fields, Victoria L., Soke, Gnakub N., Reynolds, Ann, Tian, Lin H., Wiggins, Lisa, Maenner, Matthew, DiGuiseppi, Carolyn, Kral, Tanja V. E., Hightshoe, Kristina, and Schieve, Laura A.
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AUTISM , *DEVELOPMENTAL disabilities , *PEOPLE with intellectual disabilities , *PICA (Pathology) , *QUESTIONNAIRES , *RESEARCH , *SOCIOECONOMIC factors , *DISEASE prevalence , *CASE-control method , *DESCRIPTIVE statistics , *CHILDREN - Abstract
BACKGROUND AND OBJECTIVES: Pica, the repeated ingestion of nonfood items, can be life-threatening. Although case reports describe pica in children with autism spectrum disorder (ASD) or intellectual disability (ID), there has been little systematic study of pica prevalence. We assessed pica in children 30 to 68 months of age (median = 55.4 months) with and without ASD. METHODS: Our sample from the Study to Explore Early Development, a multisite case-control study, included children with ASD (n = 1426), children with other developmental disabilities (DDs) (n = 1735), and general population-based controls (POPs) (n = 1578). We subdivided the ASD group according to whether children had ID and the DD group according to whether they had ID and/or some ASD characteristics. Standardized developmental assessments and/or questionnaires were used to define final study groups, subgroups, and pica. We examined pica prevalence in each group and compared ASD and DD groups and subgroups to the POP group using prevalence ratios adjusted for sociodemographic factors. RESULTS: Compared with the prevalence of pica among POPs (3.5%), pica was higher in children with ASD (23.2%) and DD (8.4%), and in the following subgroups: ASD with ID (28.1%), ASD without ID (14.0%), DD with ID (9.7%), DD with ASD characteristics (12.0%), and DD with both ID and ASD characteristics (26.3%); however, pica prevalence was not elevated in children with DD with neither ID nor ASD characteristics (3.2%). Between-group differences remained after adjustment (adjusted prevalence ratio range 1.9-8.0, all P <.05). CONCLUSIONS: Pica may be common in young children with ASD, ASD characteristics, and ID. These findings inform the specialized health care needs of these children. [ABSTRACT FROM AUTHOR]
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- 2021
- Full Text
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27. Sleep Problems in 2- to 5-Year-Olds With Autism Spectrum Disorder and Other Developmental Delays.
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Reynolds, Ann M., Soke, Gnakub N., Sabourin, Katherine R., Hepburn, Susan, Katz, Terry, Wiggins, Lisa D., Schieve, Laura A., and Levy, Susan E.
- Subjects
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SLEEP disorder diagnosis , *AUTISM , *CONFIDENCE intervals , *DEVELOPMENTAL disabilities , *MEDICAL screening , *MULTIVARIATE analysis , *PARENT-child relationships , *QUESTIONNAIRES , *LOGISTIC regression analysis , *CASE-control method , *ODDS ratio , *CHILDREN - Abstract
BACKGROUND: Sleep problems can impact daytime behavior, quality of life, and overall health. We compared sleep habits in young children with autism spectrum disorder (ASD) and other developmental delays and disorders and in children from the general population (POP). METHODS: We included 2- to 5-year-old children whose parent completed all items on the Children's Sleep Habits Questionnaire (CSHQ) in a multisite case-control study: 522 children with ASD; 228 children with other developmental delays and disorders with autism spectrum disorder characteristics (DD w/ASD); 534 children with other developmental delays and disorders without autism spectrum disorder characteristics (DD w/o ASD); and 703 POP. Multivariable analysis of variance compared CSHQ mean total score (TS) and subscale scores between groups. Logistic regression analysis examined group differences by using TS cutoffs of 41 and 48. Analyses were adjusted for covariates. RESULTS: Mean CSHQ TS for children in each group: ASD (48.5); DD w/ASD (50.4); DD w/o ASD (44.4); and POP (43.3). Differences between children with ASD and both children with DD w/o ASD and POP were statistically significant. Using a TS cutoff of 48, the proportion of children with sleep problems was significantly higher in children in the ASD group versus DD w/o ASD and POP groups (adjusted odds ratios [95% confidence intervals]: 2.12 [1.57 to 2.87] and 2.37 [1.75 to 3.22], respectively). CONCLUSIONS: Sleep problems are more than twice as common in young children with ASD and DD w/ASD. Screening for sleep problems is important in young children to facilitate provision of appropriate interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
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