Pathways to a Diagnosis of Autism Spectrum Disorder

Zavaleta-Ramírez, Patricia; Rosetti, M.; Albores-Gallo, Lilia; Vargas–Soberanis, Manuel Alejandro; López, Omar Náfate; Medina‐Mora, María Elena

doi:10.1176/appi.ps.201900518

Cited by 11 publications

(13 citation statements)

References 29 publications

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“…Even though we have seen progress in timely recognition, diagnostic delay in countries with medium and low income persist (Montiel-Nava, Chacín, & González-Ávila, 2017;Tapia Guillen et al, 2019;Zavaleta-Ramírez et al, 2020). For example, in México, the prevalence in León, Guanajuato, was .87% (95% CI [.62, 1.1]) (Fombonne et al, 2016), consistent with other recent studies of prevalence (Pedersen et al, 2012).…”

Section: Introductionsupporting

confidence: 82%

Assessing autism with DSM-IV and DSM-5 criteria using the Childhood Autism Rating Scale (CARS)

Flores-Rodriguez¹,

Ceballos²,

Albores-Gallo

2022

Salud Ment

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Introduction. The Childhood Autism Rating Scale (CARS) is an observational instrument for assessing autism. It is the most widely used instrument for the diagnosis of autism in Mexico. Objective. To study the psychometric properties in the Mexican population using DSM-IV and DSM-5 criteria. Method. This is an observational, cross-sectional study. Participants (N = 137) were 78.8% male, with an age range between 2 and 18 years, mean 8.5. Parents completed the M-CHAT, the ABC, the ADI-R, and semi-structured clinical interviews with DSM-IV. We inferred DSM-5 criteria by selecting atypical sensory items from the ABC. Results. The internal consistency for the total CARS items was α = .88. The concurrent validity of the CARS and the DSM-IV criteria showed a Spearman coefficient of correlation of rs = .62. The convergent validity with the ADI-R showed moderate correlations, rs = .32 to .61, with the DSM-IV k = .33 and DSM-5 k = .36. The concordance with the DSM-IV and DSM-5 was 71% and 84.5%, sensitivity was 58.1% and 46-7%, and specificity 76.6% and 90.5%, respectively. The discriminant analysis showed that the CARS correctly classified 97% of children with autism, 70% with pervasive developmental disorders not otherwise specified (PDD-NOS), and 12.5% with Asperger’s syndrome. Discussion and conclusion. The Mexican version of the CARS is a valid and reliable instrument for diagnosing autism in Mexican children and adolescents.

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Section: Introductionsupporting

confidence: 82%

Assessing autism with DSM-IV and DSM-5 criteria using the Childhood Autism Rating Scale (CARS)

Flores-Rodriguez¹,

Ceballos²,

Albores-Gallo

2022

Salud Ment

Self Cite

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“…Kogan et al (2018) estimated that population rates of autism in the United States could be as high as 1 in 44 children. The process in Mexico to obtain a diagnosis, and the delay in such a process, is within the range reported for other countries (i.e., Spain, United Kingdom, United States; Zavaleta-Ramírez et al, 2020). It is estimated that families of children on the autism spectrum in Mexico need, on average, three professional contacts and up to 11 contacts with health care services with approximately 27 months of delay to receive the diagnosis confirmation (Zavaleta-Ramírez et al, 2020).…”

Section: Autism In Mexicosupporting

confidence: 61%

“…In Mexico, the healthcare system plays a vital role in identifying autism. The health care system in Mexico includes (a) the private sector, where families can pay out of pocket for health care and treatment for their child on the autism spectrum (approximately 5% of the population; Frenk, 2006), and (b) the public sector, which provides health care services to individuals with and without social security benefits (Zavaleta-Ramírez et al, 2020). Public health services are funded by the government and are limited to providing diagnostics and pharmacological treatment (Dirección General de Gestión de Servicios de Salud, 2019).…”

Section: Autism In Mexicomentioning

confidence: 99%

“…Yet, there is little guidance or regulation toward involving families in the intervention process, and information about what services families actually receive during the diagnostic process is limited (Bravo Oro et al, 2014). Taken together, there is a great challenge in addressing autism in Mexico due to: (a) a lack of coordination between professionals, (b) weakness in the referral system, (c) sociodemographic variables between families, (d) lack of infrastructure and resources in schools, (e) limited availability to specialized professionals, (f) poor professional development and training, (g) limited information accessible to the public, all together or individually, and (h) limited access to early and quality services for families with children on the autism spectrum (Fombonne et al, 2016; Zavaleta-Ramirez et al, 2020).…”

Section: Autism In Mexicomentioning

confidence: 99%

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“El camino por recorrer”: Parent Perspectives on Early Autism Intervention in Mexico

Hampton

Herrera-Carrillo²,

Londoño

et al. 2022

Topics in Early Childhood Special Education

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Parents of children on the autism spectrum are important members of their child’s early intervention team, yet there are multiple barriers to translating evidence-based parent-mediated interventions in Mexico. We examined early intervention needs in the Mexican population, and compared these needs to those of the Latinx Spanish-speaking population in the United States. A total of 242 parents in Mexico and the United States responded to our survey. Results indicate that few parents in Mexico receive parent training during early intervention, are less likely than Latinx parents in the United States to report speech-language services, and most parents across both groups reported that they wished that they had more tools to support development and challenging behavior. Responses to open-ended survey questions were coded qualitatively for themes and subthemes. We provide four recommendations for adapting early interventions in Mexico and discuss implications for future research and practice.

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“…They rely on preprocessing to identify groups of sequences and are therefore less useful in early exploratory stages of data analysis where one wants to see the actual data. Finally, a Sankey plot (Zovaleta‐Ramirez et al., 2020 ) uses arrows or arcs to show flow between states, with the width of the arcs proportional to flow rate. While visually appealing, large numbers of states or timepoints results may unintelligible figures.…”

Section: Introductionmentioning

confidence: 99%

Graphical methods for understanding changes in states: Understanding medication use pathways

Wise

Adams

Leoutsakos

2022

Int J Methods Psych Res

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Objectives: As epidemiological studies become longer and larger, the field needs novel graphical methods to visualize complex longitudinal data. The aim of this study was to present the Slinkyplot, a longitudinal crosstabulation, to illustrate patterns of antidepressant use in a large prospective cohort of older adults with mild cognitive impairment. Methods: Data from the National Alzheimer's Coordinating Center are used to track switches between different states and types of antidepressant use. A Slinkyplot is populated with rows representing the state of medication use at each timepoint and columns representing the state at each subsequent visit. Results: The constructed Slinkyplots display the common practice of switching on and off different antidepressants over time, with citalopram, sertraline, and bupropion most commonly used followed by switching to another SSRI or SNRI as second-line treatment. Conclusions: Slinkyplots are an innovative graphical means of visualizing complex patterns of transitions between different states over time for large longitudinal studies.

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Pathways to a Diagnosis of Autism Spectrum Disorder

Cited by 11 publications

References 29 publications

Assessing autism with DSM-IV and DSM-5 criteria using the Childhood Autism Rating Scale (CARS)

Assessing autism with DSM-IV and DSM-5 criteria using the Childhood Autism Rating Scale (CARS)

“El camino por recorrer”: Parent Perspectives on Early Autism Intervention in Mexico

Graphical methods for understanding changes in states: Understanding medication use pathways

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