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1.
Psychol Med ; 53(16): 7707-7719, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37381780

RESUMEN

BACKGROUND: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.


Asunto(s)
Trastorno Autístico , Problema de Conducta , Preescolar , Humanos , Niño , Masculino , Femenino , Emociones , Padres , Atención
2.
Mol Autism ; 13(1): 28, 2022 06 27.
Artículo en Inglés | MEDLINE | ID: mdl-35761377

RESUMEN

BACKGROUND: Canonical babbling-producing syllables with a mature consonant, full vowel, and smooth transition-is an important developmental milestone that typically occurs in the first year of life. Some studies indicate delayed or reduced canonical babbling in infants at high familial likelihood for autism spectrum disorder (ASD) or who later receive an ASD diagnosis, but evidence is mixed. More refined characterization of babbling in the first year of life in infants with high likelihood for ASD is needed. METHODS: Vocalizations produced at 6 and 12 months by infants (n = 267) taking part in a longitudinal study were coded for canonical and non-canonical syllables. Infants were categorized as low familial likelihood (LL), high familial likelihood diagnosed with ASD at 24 months (HL-ASD) or not diagnosed (HL-Neg). Language delay was assessed based on 24-month expressive and receptive language scores. Canonical babble ratio (CBR) was calculated by dividing the number of canonical syllables by the number of total syllables. Generalized linear (mixed) models were used to assess the relationship between group membership and CBR, controlling for site, sex, and maternal education. Logistic regression was used to assess whether canonical babbling ratios at 6 and 12 months predict 24-month diagnostic outcome. RESULTS: No diagnostic group differences in CBR were detected at 6 months, but HL-ASD infants produced significantly lower CBR than both the HL-Neg and LL groups at 12 months. HL-Neg infants with language delay also showed reduced CBR at 12 months. Neither 6- nor 12-month CBR was significant predictors of 24-month diagnostic outcome (ASD versus no ASD) in logistic regression. LIMITATIONS: Small numbers of vocalizations produced by infants at 6 months may limit the reliability of CBR estimates. It is not known if results generalize to infants who are not at high familial likelihood, or infants from more diverse racial and socioeconomic backgrounds. CONCLUSIONS: Lower canonical babbling ratios are apparent by the end of the first year of life in ASD regardless of later language delay, but are also observed for infants with later language delay without ASD. Canonical babbling may lack specificity as an early marker when used on its own.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Trastornos del Desarrollo del Lenguaje , Trastorno del Espectro Autista/diagnóstico , Humanos , Lactante , Trastornos del Desarrollo del Lenguaje/diagnóstico , Estudios Longitudinales , Reproducibilidad de los Resultados
3.
Mol Autism ; 12(1): 57, 2021 08 14.
Artículo en Inglés | MEDLINE | ID: mdl-34391468

RESUMEN

BACKGROUND: Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. METHODS: The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years. RESULTS: The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age. LIMITATIONS: The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children. CONCLUSIONS: These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.


Asunto(s)
Trastorno del Espectro Autista , Trastorno Autístico , Trastorno del Espectro Autista/diagnóstico , Niño , Cognición , Humanos , Pruebas de Inteligencia , Estudios Longitudinales
4.
Nat Commun ; 10(1): 5519, 2019 12 05.
Artículo en Inglés | MEDLINE | ID: mdl-31801954

RESUMEN

Identification of genetic biomarkers associated with autism spectrum disorders (ASDs) could improve recurrence prediction for families with a child with ASD. Here, we describe clinical microarray findings for 253 longitudinally phenotyped ASD families from the Baby Siblings Research Consortium (BSRC), encompassing 288 infant siblings. By age 3, 103 siblings (35.8%) were diagnosed with ASD and 54 (18.8%) were developing atypically. Thirteen siblings have copy number variants (CNVs) involving ASD-relevant genes: 6 with ASD, 5 atypically developing, and 2 typically developing. Within these families, an ASD-related CNV in a sibling has a positive predictive value (PPV) for ASD or atypical development of 0.83; the Simons Simplex Collection of ASD families shows similar PPVs. Polygenic risk analyses suggest that common genetic variants may also contribute to ASD. CNV findings would have been pre-symptomatically predictive of ASD or atypical development in 11 (7%) of the 157 BSRC siblings who were eventually diagnosed clinically.


Asunto(s)
Trastorno del Espectro Autista/genética , Variaciones en el Número de Copia de ADN , Predisposición Genética a la Enfermedad/genética , Genoma Humano/genética , Genómica/métodos , Hermanos , Trastorno del Espectro Autista/diagnóstico , Preescolar , Salud de la Familia , Femenino , Humanos , Masculino , Linaje , Fenotipo , Factores de Riesgo
5.
J Autism Dev Disord ; 49(11): 4390-4399, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31372802

RESUMEN

Preschool children with autism spectrum disorder (ASD) experience slower development of daily living skills (DLS) that are essential for independent functioning compared to typically developing children. Few studies have examined the trajectories of DLS in preschoolers with ASD and the existing literature has reported conflicting results. This study examined DLS trajectories and potential covariates for preschoolers with ASD from a multi-site longitudinal study following children from diagnosis to the end of grade 1. Multi-level modeling was conducted with DLS domain scores from the Vineland Adaptive Behavior Scales-2. The results demonstrated a positive trajectory of increasing scores over time, associations of age of diagnosis, developmental level, stereotypy, and language skills with the mean score at T4 or age 6 years, whereas rate of change was only associated with ASD symptom severity, such that an improvement in DLS trajectory was associated with lower and improving ASD symptom severity.


Asunto(s)
Actividades Cotidianas/psicología , Trastorno del Espectro Autista/psicología , Niño , Desarrollo Infantil , Lenguaje Infantil , Preescolar , Femenino , Humanos , Estudios Longitudinales , Masculino , Análisis Multinivel , Índice de Severidad de la Enfermedad , Factores de Tiempo
6.
J Abnorm Child Psychol ; 47(5): 907-920, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30146674

RESUMEN

Initiation of joint attention is a critical developmental function related to further social communicative development in infancy. Joint attention appears to be impaired very early in life for children with autism spectrum disorder (ASD), well before a formal diagnosis is established. To observe the early development of joint attention, we prospectively followed infant siblings at high risk for ASD (HR) and low-risk (LR) infants. Initiations of joint attention behaviors were coded with respect to frequency, quality, and variety from videos taken during the administration of the Autism Observation Schedule for Infants. Participants were further stratified based on the presence of ASD (n = 17) or language delay (n = 19) at 3 years of age. Our results revealed that initiations of joint attention are impaired from 12 months of age in both children with ASD and those with language delay, especially for use of gestures (i.e., showing and pointing). At 18 months, fewer initiations of joint attention in all three dimensions distinguished infants with ASD, compared to infants with language delay and HR and LR infants without a diagnosis. Beyond the definition of initiation of joint attention as an early sign for ASD, clinical implications of these results concern the importance of intervening on frequency, quality, and variety of joint attention as early as possible in infants at heightened risk for ASD.


Asunto(s)
Atención/fisiología , Trastorno del Espectro Autista/fisiopatología , Desarrollo Infantil/fisiología , Gestos , Trastornos del Desarrollo del Lenguaje/fisiopatología , Conducta Social , Preescolar , Femenino , Humanos , Lactante , Masculino , Riesgo , Hermanos
7.
J Neurodev Disord ; 10(1): 29, 2018 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-30348077

RESUMEN

BACKGROUND: Language delay is extremely common in children with autism spectrum disorder (ASD), yet it is unclear whether measurable variation in early language is associated with genetic liability for ASD. Assessment of language development in unaffected siblings of children with ASD can inform whether decreased early language ability aggregates with inherited risk for ASD and serves as an ASD endophenotype. METHODS: We implemented two approaches: (1) a meta-analysis of studies comparing language delay, a categorical indicator of language function, and language scores, a continuous metric, in unaffected toddlers at high and low familial risk for ASD, and (2) a parallel analysis of 350 unaffected 24-month-olds in the Infant Brain Imaging Study (IBIS), a prospective study of infants at high and low familial risk for ASD. An advantage of the former was its detection of group differences from pooled data across unique samples; an advantage of the latter was its sensitivity in quantifying early manifestations of language delay while accounting for covariates within a single large sample. RESULTS: Meta-analysis showed that high-risk siblings without ASD (HR-noASD) were three to four times more likely to exhibit language delay versus low-risk siblings without ASD (LR-noASD) and had lower mean receptive and expressive language scores. Analyses of IBIS data corroborated that language delay, specifically receptive language delay, was more frequent in the HR-noASD (n = 235) versus LR-noASD group (n = 115). IBIS language scores were continuously and unimodally distributed, with a pathological shift towards decreased language function in HR-noASD siblings. The elevated inherited risk for ASD was associated with lower receptive and expressive language scores when controlling for sociodemographic factors. For receptive but not expressive language, the effect of risk group remained significant even when controlling for nonverbal cognition. CONCLUSIONS: Greater frequency of language delay and a lower distribution of language scores in high-risk, unaffected toddler-aged siblings support decreased early language ability as an endophenotype for ASD, with a more pronounced effect for receptive versus expressive language. Further characterization of language development is warranted to refine genetic investigations of ASD and to elucidate factors influencing the progression of core autistic traits and related symptoms.


Asunto(s)
Trastorno del Espectro Autista/complicaciones , Trastorno del Espectro Autista/genética , Endofenotipos , Trastornos del Desarrollo del Lenguaje/complicaciones , Trastornos del Desarrollo del Lenguaje/genética , Hermanos/psicología , Trastorno del Espectro Autista/fisiopatología , Trastorno del Espectro Autista/psicología , Encéfalo/fisiopatología , Preescolar , Femenino , Predisposición Genética a la Enfermedad , Humanos , Lactante , Trastornos del Desarrollo del Lenguaje/fisiopatología , Masculino , Estudios Prospectivos
8.
J Autism Dev Disord ; 48(10): 3417-3431, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29767824

RESUMEN

Early communication impairment is among the most-reported first concerns in parents of young children with autism spectrum disorder (ASD). Using a parent-report questionnaire, we derived trajectory groups for early language and gesture acquisition in siblings at high risk for ASD and in children at low risk, during their first 2 years of life. Developmental skills at 6 months were associated with trajectory group membership representing growth in receptive language and gestures. Behavioral symptoms also predicted gesture development. All communication measures were strongly related to clinical and developmental outcomes. Trajectory groups further indicated slowest language/gesture acquisition in infants with later ASD diagnoses, in particular when associated with language delay. Overall, our results confirm considerable variability in communication development in high-risk infants.


Asunto(s)
Trastorno del Espectro Autista/diagnóstico , Gestos , Desarrollo del Lenguaje , Trastorno del Espectro Autista/epidemiología , Preescolar , Femenino , Humanos , Lactante , Masculino
9.
Brain Res ; 1685: 79-90, 2018 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-29453959

RESUMEN

The purpose of the current study was to examine how repetitive behaviour in Autism Spectrum Disorder (ASD) is related to intrinsic functional connectivity patterns in a number of large-scale, neural networks. Resting-state fMRI scans from thirty subjects with ASD and thirty-two age-matched, typically developing control subjects were analysed. Seed-to-voxel and ROI-to-ROI functional connectivity analyses were used to examine resting-state connectivity in a number of cortical and subcortical neural networks. Bivariate correlation analysis was performed to examine the relationship between repetitive behaviour scores from the Repetitive Behaviour Scale - Revised and intrinsic functional connectivity in ASD subjects. Compared to control subjects, ASD subjects displayed marked over-connectivity of the thalamus with several cortical sensory processing areas, as well as over-connectivity of the basal ganglia with somatosensory and motor cortices. Within the ASD group, significant correlations were found between functional connectivity patterns and total RBS-R scores as well as one principal component analysis-derived score from the RBS-R. These results suggest that thalamocortical resting-state connectivity is altered in individuals with ASD, and that resting-state functional connectivity is associated with ASD symptomatology.


Asunto(s)
Trastorno del Espectro Autista/fisiopatología , Conducta/fisiología , Encéfalo/fisiopatología , Red Nerviosa/fisiopatología , Vías Nerviosas/fisiopatología , Adolescente , Cognición/fisiología , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Análisis de Componente Principal/métodos , Descanso/fisiología
10.
Biol Psychiatry ; 82(3): 186-193, 2017 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-28392081

RESUMEN

BACKGROUND: We previously reported that infants who developed autism spectrum disorder (ASD) had increased cerebrospinal fluid (CSF) in the subarachnoid space (i.e., extra-axial CSF) from 6 to 24 months of age. We attempted to confirm and extend this finding in a larger independent sample. METHODS: A longitudinal magnetic resonance imaging study of infants at risk for ASD was carried out on 343 infants, who underwent neuroimaging at 6, 12, and 24 months. Of these infants, 221 were at high risk for ASD because of an older sibling with ASD, and 122 were at low risk with no family history of ASD. A total of 47 infants were diagnosed with ASD at 24 months and were compared with 174 high-risk and 122 low-risk infants without ASD. RESULTS: Infants who developed ASD had significantly greater extra-axial CSF volume at 6 months compared with both comparison groups without ASD (18% greater than high-risk infants without ASD; Cohen's d = 0.54). Extra-axial CSF volume remained elevated through 24 months (d = 0.46). Infants with more severe autism symptoms had an even greater volume of extra-axial CSF from 6 to 24 months (24% greater at 6 months, d = 0.70; 15% greater at 24 months, d = 0.70). Extra-axial CSF volume at 6 months predicted which high-risk infants would be diagnosed with ASD at 24 months with an overall accuracy of 69% and corresponding 66% sensitivity and 68% specificity, which was fully cross-validated in a separate sample. CONCLUSIONS: This study confirms and extends previous findings that increased extra-axial CSF is detectable at 6 months in high-risk infants who develop ASD. Future studies will address whether this anomaly is a contributing factor to the etiology of ASD or an early risk marker for ASD.


Asunto(s)
Trastorno del Espectro Autista/líquido cefalorraquídeo , Trastorno del Espectro Autista/diagnóstico por imagen , Líquido Cefalorraquídeo/diagnóstico por imagen , Trastorno del Espectro Autista/genética , Vértebra Cervical Axis , Ventrículos Cerebrales/diagnóstico por imagen , Preescolar , Femenino , Predisposición Genética a la Enfermedad , Humanos , Procesamiento de Imagen Asistido por Computador , Lactante , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Destreza Motora , Tamaño de los Órganos , Reconocimiento de Normas Patrones Automatizadas , Síntomas Prodrómicos , Pronóstico , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Hermanos , Espacio Subaracnoideo
11.
Child Care Health Dev ; 43(1): 18-30, 2017 01.
Artículo en Inglés | MEDLINE | ID: mdl-27620870

RESUMEN

BACKGROUND: Families with a child diagnosed with autism spectrum disorder (ASD) often utilize a variety of professional services. The provision of these services has many potential benefits for families; however, these services also place demands on parents, particularly mothers, to access, navigate and participate. Little is known about how involvement with these services and service systems influences the psychological wellbeing of mothers of children diagnosed with ASD. We examined the relationship between professional services and psychological wellbeing for mothers of children diagnosed with ASD. METHODS: Mothers (n = 119) of children (mean child age 10.1 years; range 2-24 years) diagnosed with ASD anonymously completed a comprehensive survey. The survey included data related to maternal psychological wellbeing, professional services received and perceptions of these services, and child, mother and household characteristics. RESULTS: Regression analyses revealed that maternal psychological wellbeing was positively associated with the perceived continuity of services, and negatively associated with the number of professionals involved. Child and maternal age, and household income were also statistically significant predictors of maternal psychological wellbeing. CONCLUSIONS: The study findings draw attention to the potentially negative impact of systems-level challenges, especially fragmentation of services, on maternal psychological wellbeing, despite positive front-line services. In particular, our data suggest that psychological wellbeing among mothers of children with ASD may vary more as a function of service system variables than practitioner-level or child-level variables.


Asunto(s)
Actitud Frente a la Salud , Trastorno del Espectro Autista/terapia , Servicios de Salud del Niño/organización & administración , Salud Materna/estadística & datos numéricos , Madres/psicología , Adolescente , Adulto , Alberta , Niño , Preescolar , Continuidad de la Atención al Paciente , Atención a la Salud/organización & administración , Femenino , Humanos , Lactante , Masculino , Bienestar Materno , Salud Mental , Servicios de Salud Mental/organización & administración , Persona de Mediana Edad , Responsabilidad Parental/psicología , Relaciones Profesional-Familia , Factores Socioeconómicos , Adulto Joven
12.
Paediatr Child Health ; 20(8): e43-7, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26744563

RESUMEN

OBJECTIVE: To describe services received by preschool children diagnosed with autism spectrum disorder (ASD) during the five-year period following their diagnosis. METHOD: An inception cohort of preschoolers diagnosed with ASD from Halifax (Nova Scotia), Montreal (Quebec), Hamilton (Ontario), Edmonton (Alberta) and Vancouver (British Columbia) were invited to participate. Parents/caregivers (n=414) described the services provided to their children at four time points: baseline (T1; within four months of diagnosis; mean age three years); six months later (T2); 12 months later (T3); and at school entry (T4). Data were first coded into 11 service types and subsequently combined into four broader categories (no services, behavioural, developmental and general) for analysis. RESULTS: More than 80% of children at T1, and almost 95% at T4 received some type of service, with a significant number receiving >1 type of service at each assessment point. At T1, the most common service was developmental (eg, speech-language therapy). Subsequently, the most common services were a combination of behavioural and developmental (eg, intensive therapy based on applied behaviour analysis and speech-language therapy). Service provision varied across provinces and over time. DISCUSSION: Although most preschool children with ASD residing in urban centres were able to access specialized services shortly after diagnosis, marked variation in services across provinces remains a concern.


OBJECTIF: Décrire les services qu'ont reçus des enfants d'âge préscolaire ayant un trouble du spectre autistique (TSA) pendant la période de cinq ans suivant leur diagnostic. MÉTHODOLOGIE: Une cohorte initiale d'enfants d'âge préscolaire ayant un TSA diagnostiqué et qui provenaient de Halifax (Nouvelle-Écosse), de Montréal (Québec), de Hamilton (Ontario), d'Edmonton (Alberta) ou de Vancouver (Colombie-Britannique) a été invitée à participer à l'étude. Les parents et les tuteurs (n=414) ont décrit les services fournis à leur enfant à quatre moments : au début (T1; dans les quatre mois suivant le diagnostic, âge moyen de trois ans); six mois plus tard (T2); 12 mois plus tard (T3) et à l'entrée à l'école (T4). Les chercheurs ont d'abord codé les données en 11 types de services, pour ensuite les regrouper en quatre catégories plus vastes (absence de services, comportementaux, développementaux et généraux) en vue de leur analyse. RÉSULTATS: Plus de 80 % des enfants ont reçu certains services à T1, et près de 95 % à T4, et un nombre significatif a reçu plus d'un type de services à chaque évaluation. À T1, le service le plus courant était de type développemental (p. ex., orthophonie). Par la suite, les services les plus courants étaient un mélange de services comportementaux et développementaux (p. ex., thérapie intensive selon l'analyse de comportement appliquée et orthophonie). La prestation des services variait selon les provinces et au fil du temps. EXPOSÉ: Même si la plupart des enfants d'âge préscolaire ayant un TSA qui habitaient dans un centre urbain avaient accès à des services spécialisés peu après le diagnostic, les variations marquées des services entre les provinces demeurent préoccupantes.

13.
Transl Psychiatry ; 4: e388, 2014 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-24802306

RESUMEN

Autism spectrum disorder (ASD) is a developmental disorder defined by behavioral symptoms that emerge during the first years of life. Associated with these symptoms are differences in the structure of a wide array of brain regions, and in the connectivity between these regions. However, the use of cohorts with large age variability and participants past the generally recognized age of onset of the defining behaviors means that many of the reported abnormalities may be a result of cascade effects of developmentally earlier deviations. This study assessed differences in connectivity in ASD at the age at which the defining behaviors first become clear. There were 113 24-month-old participants at high risk for ASD, 31 of whom were classified as ASD, and 23 typically developing 24-month-old participants at low risk for ASD. Utilizing diffusion data to obtain measures of the length and strength of connections between anatomical regions, we performed an analysis of network efficiency. Our results showed significantly decreased local and global efficiency over temporal, parietal and occipital lobes in high-risk infants classified as ASD, relative to both low- and high-risk infants not classified as ASD. The frontal lobes showed only a reduction in global efficiency in Broca's area. In addition, these same regions showed an inverse relation between efficiency and symptom severity across the high-risk infants. The results suggest delay or deficits in infants with ASD in the optimization of both local and global aspects of network structure in regions involved in processing auditory and visual stimuli, language and nonlinguistic social stimuli.


Asunto(s)
Corteza Cerebral/fisiopatología , Trastornos Generalizados del Desarrollo Infantil/fisiopatología , Red Nerviosa/fisiopatología , Preescolar , Imagen de Difusión Tensora , Femenino , Humanos , Masculino , Riesgo , Índice de Severidad de la Enfermedad
14.
J Autism Dev Disord ; 44(11): 2797-808, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24865586

RESUMEN

Children with autism spectrum disorder (ASD) and structural language impairment (LI) may be at risk of more adverse social-developmental outcomes. We examined trajectories of early social competence (using the Vineland-II) in 330 children aged 2-4 years recently diagnosed with ASD, and compared 3 subgroups classified by: language impairment (ASD/LI); intellectual disability (ASD/ID) and ASD without LI or ID (ASD/alone). Children with ASD/LI were significantly more socially impaired at baseline than the ASD/alone subgroup, and less impaired than those with ASD/ID. Growth in social competence was significantly slower for the ASD/ID group. Many preschool-aged children with ASD/LI at time of diagnosis resembled "late talkers" who appeared to catch up linguistically. Children with ASD/ID were more severely impaired and continued to lag further behind.


Asunto(s)
Trastornos Generalizados del Desarrollo Infantil/diagnóstico , Trastornos del Desarrollo del Lenguaje/diagnóstico , Lenguaje , Habilidades Sociales , Trastornos Generalizados del Desarrollo Infantil/psicología , Preescolar , Femenino , Humanos , Trastornos del Desarrollo del Lenguaje/psicología , Masculino , Índice de Severidad de la Enfermedad
15.
Child Care Health Dev ; 38(6): 817-28, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21916929

RESUMEN

BACKGROUND: Much is known about the hardships associated with parenting a child with a disability, but few studies have examined the broader contributions of the child to family life or society. METHODS: The study involved qualitative analysis of interviews with 16 families of children with autism spectrum disorder or Down syndrome at critical transition periods (entry to elementary or high school), targeting their perceptions of benefits. RESULTS: Parents discussed a wide range of benefits beyond the personal level, including parental, family and societal benefits. Exploratory group comparisons indicated that parents of high school-aged children were more likely to mention family-level and societal benefits. CONCLUSIONS: The findings suggest that raising a child with a disability can trigger role-related decisions that lead to a series of resiliency-related processes and cascading benefits. The findings inform practitioners about the nature of potential positive experiences that can be shared with families starting out on their journey, allowing parents to recognize the positive dimensions of raising a child with a disability in addition to the hardships.


Asunto(s)
Trastornos Generalizados del Desarrollo Infantil , Niños con Discapacidad , Síndrome de Down , Relaciones Padres-Hijo , Padres/psicología , Percepción Social , Adolescente , Conducta del Adolescente , Niño , Protección a la Infancia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Psicometría , Investigación Cualitativa , Discriminación Social , Grabación en Cinta
16.
Chronic Dis Can ; 30(4): 125-34, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20946713

RESUMEN

OBJECTIVE: To determine whether certain maternal characteristics and obstetric complications are associated with increased risk of autism spectrum disorders (ASD) in children. METHODS: Provincial delivery records identified the cohort of 218 890 singleton live births in Alberta, Canada,between January 1, 1998, and December 31, 2004. These were followed-up for ASD via ICD-9 diagnostic codes assigned by physician billing until March 31, 2008. Maternal and obstetric risk factors were also extracted from PDR. RESULTS: Prevalence and incidence of ASD in Alberta are in line with those reported elsewhere and suggest recent increases in rate of diagnosis and/or incidence. Boys have 5-fold higher prevalence than girls. The peak age of diagnosis occurs at age 3 years. Relative risk modelling indicates that the risk of ASD is elevated among children of older mothers and those who experience specific pregnancy and birth complications. CONCLUSION: Certain maternal characteristics and obstetric complications are associated with ASD in children. We identified lower rates of ASD and later age at diagnosis among children of Aboriginal mothers that requires further research.


Asunto(s)
Trastornos Generalizados del Desarrollo Infantil/epidemiología , Trastornos Generalizados del Desarrollo Infantil/etiología , Edad Materna , Complicaciones del Trabajo de Parto , Complicaciones del Embarazo , Adulto , Distribución por Edad , Alberta/epidemiología , Niño , Preescolar , Femenino , Humanos , Incidencia , Modelos Logísticos , Masculino , Registros Médicos , Embarazo , Prevalencia , Adulto Joven
17.
Autism ; 12(5): 433-56, 2008 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-18805941

RESUMEN

Earlier intervention improves outcomes for children with autism spectrum disorders (ASDs), but existing identification tools are at the limits of standardization with 18-month-olds. We assessed potential behavioural markers of ASD at 18 months in a high-risk cohort of infant siblings of children with ASD. Prospective data were collected using the Autism Diagnostic Observation Schedule (ADOS) and Autism Observation Scale for Infants (AOSI) on 155 infant siblings and 73 low-risk controls at 18 months. Infants were classified into three groups (ASD sibs, non-ASD sibs, controls) based on blind best-estimate diagnosis at age 3. Fisher's exact tests, followed by discriminant function analyses, revealed that the majority of informative ADOS items came from the social and behavioural domains, and AOSI items measuring behavioural reactivity and motor control contributed additional information. Findings highlight the importance of considering not only social-communication deficits, but also basic dimensions of temperament including state regulation and motor control when assessing toddlers with suspected ASD.


Asunto(s)
Trastorno Autístico/diagnóstico , Análisis Discriminante , Femenino , Humanos , Lactante , Masculino , Factores de Riesgo , Índice de Severidad de la Enfermedad
18.
Rev. Síndr. Down ; 23(89): 51-58, jun. 2006.
Artículo en Es | IBECS | ID: ibc-72073

RESUMEN

Es escasa la información de que disponemos sobre la visión del mundo, los valores y las prioridades que tienen las familias de niños con autismo o con síndrome de Down, a pesar de que se considera que los sistemas de convicción o de valores de la familias se encuentran entre los factores más importantes que afectan a su adaptación y a su capacidad de resistencia y flexibilidad. El trabajo recoge las opiniones libremente expresadas en grupos por parte de 19 personas altamente comprometidas con la discapacidad (15 padres y 4 profesionales). Las reuniones fueron grabadas en video y analizadas por métodos cualitativos. Los temas expuestos indicaron que criar a un hijo con discapacidad es una experiencia que cambia la vida y obliga a las familias a reanalizar sus sistemas de creencias y valores. Se llega a conseguir un sentido de coherencia y de control a través del cambio en su visión del papel como padres y el papel de la familia. Con el tiempo se asumen adaptaciones positivas, y se aprecian las contribuciones positivas que los hijos con discapacidad hacen a la familia y a la sociedad en su conjunto. Las experiencias de los padres resaltan la importancia de la esperanza y de discernir las posibilidades futuras (AU)


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Niño , Trastorno Autístico , Síndrome de Down , Valores Sociales , Relaciones Familiares , Ajuste Social , Conocimientos, Actitudes y Práctica en Salud
19.
Child Care Health Dev ; 32(3): 353-69, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16634980

RESUMEN

BACKGROUND: There have been few reports of the world views, values and priorities of families of children with autism or Down syndrome, despite the fact that family belief systems are considered to be among the most important factors affecting the adaptation and resilience of families. METHODS: Transcripts from three focus groups involving 19 key informants (15 parents of children with autism or Down syndrome, and 4 service providers) were analysed using qualitative methods. RESULTS: The themes indicated that raising a child with a disability can be a life-changing experience that spurs families to examine their belief systems. Parents can come to gain a sense of coherence and control through changes in their world views, values and priorities that involve different ways of thinking about their child, their parenting role, and the role of the family. Although parents may grapple with lost dreams, over time positive adaptations can occur in the form of changed world views concerning life and disability, and an appreciation of the positive contributions made by children to family members and society as a whole. Parents' experiences indicate the importance of hope and of seeing possibilities that lie ahead. CONCLUSIONS: The information from this study may be used to provide families with an advance understanding of the changes in beliefs that they might undergo, and assists service providers in providing individualized and family-centred services and supports to families.


Asunto(s)
Trastorno Autístico/psicología , Cultura , Síndrome de Down/psicología , Familia/psicología , Adaptación Psicológica , Actitud Frente a la Salud , Trastorno Autístico/rehabilitación , Niño , Discapacidades del Desarrollo/psicología , Discapacidades del Desarrollo/rehabilitación , Síndrome de Down/rehabilitación , Femenino , Humanos , Aprendizaje , Masculino , Relaciones Padres-Hijo , Responsabilidad Parental/psicología , Padres/psicología , Valores Sociales
20.
J Autism Dev Disord ; 35(3): 393-9, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16119480

RESUMEN

We report a 4-year-old girl with a de novo, apparently balanced complex chromosome rearrangement. She initially presented for assessment of velopharyngeal insufficiency due to hypernasal speech. She has distinctive facial features (long face, broad nasal bridge, and protuberant ears with simplified helices), bifid uvula, strabismus, and joint laxity. She is developmentally delayed, with language and cognitive skills approximately 2 SD below the mean expected for her age, and meets ADI, ADOS, and DSM-IV criteria for pervasive developmental disorder. She has poor eye contact, atypical communication and social interaction, repetitive behaviours and significant difficulties with processing sensory input. Her karyotype is characterized by the presence of two derivative chromosomes; 46,XX, der(8)(10pter- >10pl2.32::8p12- >8qter), der(l0)(8pter- >8p21.3::10p12.32- >10p11.23::8p21.3- > 8p12::10p11.23- >l0qter). The der(8) is a result of translocation of the segment 10p12.32-pter onto 8p12. The der(l0) has two 8p segments collectively from 8p12-pter in that the segment 8p21.3-pter is translocated onto 10p12.32 and the segment 8p12-p21.3 is inserted at 10p11.23. FISH analysis showed no microdeletion of the major locus at 22q11.2 nor for the minor locus at 10p13p14. This case suggests that aberrations at 8p12, 8p21.3, 10p11.23 and/or 10p12.32 may result in pervasive developmental disorder, associated with mild cognitive delay and specific facial anomalies.


Asunto(s)
Trastornos Generalizados del Desarrollo Infantil/genética , Cromosomas Humanos Par 10/genética , Cromosomas Humanos Par 8/genética , Reordenamiento Génico/genética , Translocación Genética/genética , Preescolar , Femenino , Humanos , Cariotipificación
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