Practice Patterns for Early Screening and Evaluation for Autism Spectrum Disorder Diagnosis in Bulgaria

Искров, Георги; Vasilev, Georgi; Mitev, Martin; Nikolova, Ralitsa; Stoykova, Maria; Стефанов, Румен

doi:10.1007/s10803-019-04170-2

Cited by 7 publications

(9 citation statements)

References 38 publications

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“…In 94 children examined after 1 August 2016, a structured ASD questionnaire based on DSM-5 was filled in with information of the objective examination and history [ 16 ] ( Table 3 ). The average age of filling this form was 44.3 months (18 to 120 months).…”

Section: Resultsmentioning

confidence: 99%

“…The dissociation between parental opinion about child’s problems and objective status is common in ASD [ 33 ]. Parental collaboration in the diagnostic evaluation is rated by Bulgarian physicians as moderate—3, 2–3, 4 in a 1 to 5 scale [ 16 ]. Delay in language development was the most common (or even the only symptom in half of the cases) that raised parental concerns and urged them to seek medical help.…”

Section: Discussionmentioning

confidence: 99%

“…In Bulgaria, awareness on ASD is in constant rise in the last 10 years, leading to increased referral for diagnostic evaluation, but still there is no universal screening implemented [ 15 ]. A study based on interviews of medical professionals in Bulgaria disclosed some potential barriers in the diagnostic process including lack of pediatric psychiatrists [ 16 ]. Some instruments, like Modified Checklist for Autism in Toddlers (M-CHAT) and Childhood Autism Rating Scale (CARS) are validated, but still not widely used.…”

Section: Introductionmentioning

confidence: 99%

“…Some instruments, like Modified Checklist for Autism in Toddlers (M-CHAT) and Childhood Autism Rating Scale (CARS) are validated, but still not widely used. Autism Diagnostic Observation Schedule (ADOS) and Social Communication Questionnaire (SCQ) are also used by some psychiatrists [ 16 ]. According to that study the mean delay from first ASD symptoms to diagnosis is 14 months [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Autism Diagnostic Observation Schedule (ADOS) and Social Communication Questionnaire (SCQ) are also used by some psychiatrists [ 16 ]. According to that study the mean delay from first ASD symptoms to diagnosis is 14 months [ 16 ]. To our knowledge, there is no clinical study that estimated directly the route from first symptoms to diagnosis in pediatric practice, so that to evaluate the gap between intention (the before mentioned questionnaire data) and practice.…”

Section: Introductionmentioning

confidence: 99%

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The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria

et al. 2021

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Diagnosis of autism spectrum disorder (ASD) before the age of three years is a challenge. Analyzing the present practice may help reaching that goal. Aim: To investigate developmental abnormalities and diagnostic pathway of ASD patients in pediatric practice. Methods: Retrospective cross-sectional study of 192 children aged 13 months to 17 years 11 months (average 4 years 9 months), investigated in an outpatient and hospital setting from January 2015 to June 2018 by a semi-structured history and clinical examination, and diagnosed with ASD by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Results: Behavioral peculiarities were detected in the history of the first two years of life in 74.8% of the subjects. The first developmental abnormalities were noticed by the parents at ages from 8 to 36 months (mean 15.6 months) and were predominantly in speech (in 94.6%) and non-verbal communication (11.3%). Developmental regression was reported in 42.1% of the patients occurring between the ages of 6 and 50 months (mean 17.9 months), affecting most commonly speech (88.4% of cases), non-verbal communication (29.2%), and behavior (12.8%). By history, the first manifestations of ASD were noticed at ages from 8 months to 84 months (mean 18.5 months), and were disorders of expressive speech (in 66.7% of cases), receptive speech (in 45.8%), non-verbal communication (35.4%), behavior (27.6%), play (8.9%), socialization (5.7%), and joint attention (2.1%). The most common motive for specialized consultation was delay in language development—in 84.6% of children. The age of ASD diagnosis varied between 12 and 132 months (mean 39.7 months), and the time period between first ASD manifestations and diagnosis was in the range of 0 to 79 months (mean 23.3 months). Many symptoms of abnormal social communication, unnoticed by parents, were detected objectively in more than 95% of the cases—absent or rare spontaneous or reciprocal smile; lack of sharing of interest or affect; abnormal eye contact; lack of finger pointing; lack of gaze to a pointed object; poor facial expressions; lack of imaginary play, etc. Conclusions: Almost two years are needed for diagnosing abnormal development in other domains besides speech in ASD patients. Diagnosis before the age of three years can be achieved by focusing parents’ and pediatricians’ attention on social communication and behavior in patients with speech delay or developmental regression.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria

et al. 2021

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Methods for Diagnosing ASD in Young Children

Callahan

Matson

Brown

2022

Handbook of Autism and Pervasive Developmental Disorder

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Editorial S.I: Early Identification in Autism Spectrum Disorders: The Present and Future, and Advances in Early Identification

Øien

Vivanti

Robins

2021

J Autism Dev Disord

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Early identification of autism spectrum disorder (ASD) is considered by most scholars and clinicians to be a feasible and useful step for improving the wellbeing of individuals on the autism spectrum and their families. Arguments supporting early detection efforts include the benefit of earlier access to services providing autism-specific evidence-based interventions (Vivanti et al., Journal of Autism and Developmental Disorders, 46(7), 2441–2449, 2016; Zwaigenbaum et al., Pediatrics, 136(Suppl), S10–S40, 2015), and its potential to mitigate or even prevent the challenges associated with ASD symptoms, reduce care costs, and improve the quality of life and productivity of individuals with ASD (Constantino et al., Pediatrics, 146(3), e20193629, 2020; Jacobson et al., Behavioral Interventions, 13(4), 201–226, 1998; Jacobson and Mulick, Journal of Autism and Developmental Disorders, 30(6), 585–593, 2000). Nevertheless, controversies and challenges in this field exist.

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Practice Patterns for Early Screening and Evaluation for Autism Spectrum Disorder Diagnosis in Bulgaria

Cited by 7 publications

References 38 publications

The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria

The Route to Autism Spectrum Diagnosis in Pediatric Practice in Bulgaria

Methods for Diagnosing ASD in Young Children

Editorial S.I: Early Identification in Autism Spectrum Disorders: The Present and Future, and Advances in Early Identification

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