Autism spectrum disorders (ASD) often go undetected in toddlers. The Modified Checklist for Autism in Toddlers (M-CHAT) was used to screen 3,793 children aged 16-30 months from lowand high-risk sources; screen positive cases were diagnostically evaluated. Re-screening was performed on 1,416 children aged 42-54 months. Time 1 Positive Predictive Value (PPV) was .36 for the initial screening and .74 for the screening plus follow-up telephone interview; values were similar for Time 2 PPV. When separating referral sources, PPV was low for the low-risk sample but acceptable with the follow-up telephone interview. Children with ASD from the low-risk and high-risk samples were highly similar. Results indicate that the M-CHAT continues to be a promising instrument for the early detection of ASD.
Autism Spectrum Disorders (ASD) diagnosis in very young children may be delayed due to doubts about validity. In this study, 77 children received a diagnostic and developmental evaluation between 16 and 35 months and also between 42 and 82 months. Diagnoses based on clinical judgment, Childhood Autism Rating Scale, and the Autism Diagnostic Observation Schedule were stable over time. Diagnoses made using the Autism Diagnostic Interview were slightly less stable. According to clinical judgment, 15 children (19%) moved off the autism spectrum by the second evaluation; none moved onto the spectrum. Results indicate diagnostic stability at acceptable levels for diagnoses made at age 2. Movement off the spectrum may reflect true improvement based on maturation, intervention, or over-diagnosis at age 2.
Individuals with autism spectrum disorders (ASDs) have significant visuomotor processing deficits, atypical motoric behavior, and often substantial problems connecting socially. We suggest that the perceptual, attentional, and adaptive timing deficiencies associated with autism might directly impact the ability to become a socially connected unit with others. Using a rocking chair paradigm previously employed with typical adults, we demonstrate that typically-developing (TD) children exhibit spontaneous social rocking with their caregivers. In contrast, children diagnosed with ASD do not demonstrate a tendency to rock in a symmetrical state with their parents. We argue that the movement of our bodies is one of the fundamental ways by which we connect with our environment and, especially, ground ourselves in social environments. Deficiencies in perceiving and responding to the rhythms of the world may have serious consequences for the ability to become adequately embedded in a social context.
The Modified Checklist for Autism in Toddlers (M-CHAT) was used to screen younger (16-23 months) versus older (24-30 months) high- and low-risk toddlers. Refusal rates for follow-up interview showed no group differences, but parents of younger/low-risk children were more likely to refuse evaluation than parents of high-risk children. PPP for an ASD diagnosis was: younger/high-risk 0.79, older/high-risk 0.74, younger/low-risk 0.28, and older/low-risk 0.61, with PPP differing by age within the low-risk group. Most of the children in all groups, however, were diagnosed with a developmental disorder. Symptom severity generally did not differ among groups. Cognitive and adaptive measures showed minimal group differences. Therefore, older and younger toddlers had similar symptomatology and developmental delays; PPP for ASD is better at 24 than 18 months for low-risk children; however, these children are still highly likely to show a developmental disorder. Clinical decision making should balance early identification against the lower specificity of M-CHAT screening for the younger/low-risk group.
People with Williams syndrome are extremely sociable, empathic, and expressive in communication. Some researchers suggest they may be especially sensitive to perceiving emotional expressions. We administered the Faces and Paralanguage subtests of the Diagnostic Analysis of Nonverbal Accuracy Scale (DANVA2), a standardized measure of emotion recognition for basic emotions to three groups: adolescents and adults with Williams syndrome, age and IQ-matched participants with learning/intellectual disability, and age-matched nonimpaired controls. The Williams syndrome and learning/intellectual disability groups performed significantly worse than the typically developing controls on both subtests, especially on negative emotions. Error analysis indicated the same general pattern of performance across versions and subtests of the DANVA2 for all groups. These findings suggest that emotion recognition is not spared in Williams syndrome.
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