The Brief Observation of Symptoms of Autism (BOSA): Development of a New Adapted Assessment Measure for Remote Telehealth Administration through COVID-19 and Beyond

D, Dow; Holbrook, Alison; Toolan, Christina; McDonald, Nicole M.; Sterrett, Kyle; Rosen, Nicole E.; Sh, Kim; Lord, Cara

doi:10.1101/2021.11.01.21265761

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Although every site experienced a period of lower evaluation and identification among children aged 4 years, certain sites showed movement toward recovery to prepandemic levels. This could reflect increased use of telehealth approaches that enabled remote evaluation and identification of children with ASD (12)(13)(14)(15)(16). Sustained decreases also could reflect extended remote learning through the end of 2020 in certain sites such as in Minnesota, where many children are identified in schools (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020

Shaw¹,

Bilder²,

McArthur³

et al. 2023

MMWR Surveill. Summ.

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Problem/Condition Autism spectrum disorder (ASD). Period Covered 2020. Description of System The Autism and Developmental Disabilities Monitoring Network is an active surveillance program that estimates prevalence and characteristics of ASD and monitors timing of ASD identification among children aged 4 and 8 years. In 2020, a total of 11 sites (located in Arizona, Arkansas, California, Georgia, Maryland, Minnesota, Missouri, New Jersey, Tennessee, Utah, and Wisconsin) conducted surveillance of ASD among children aged 4 and 8 years and suspected ASD among children aged 4 years. Surveillance included children who lived in the surveillance area at any time during 2020. Children were classified as having ASD if they ever received 1) an ASD diagnostic statement in an evaluation, 2) a special education classification of autism (eligibility), or 3) an ASD International Classification of Diseases (ICD) code (revisions 9 or 10). Children aged 4 years were classified as having suspected ASD if they did not meet the case definition for ASD but had a documented qualified professional’s statement indicating a suspicion of ASD. This report focuses on children aged 4 years in 2020 compared with children aged 8 years in 2020. Results For 2020, ASD prevalence among children aged 4 years varied across sites, from 12.7 per 1,000 children in Utah to 46.4 in California. The overall prevalence was 21.5 and was higher among boys than girls at every site. Compared with non-Hispanic White children, ASD prevalence was 1.8 times as high among Hispanic, 1.6 times as high among non-Hispanic Black, 1.4 times as high among Asian or Pacific Islander, and 1.2 times as high among multiracial children. Among the 58.3% of children aged 4 years with ASD and information on intellectual ability, 48.5% had an IQ score of ≤70 on their most recent IQ test or an examiner’s statement of intellectual disability. Among children with a documented developmental evaluation, 78.0% were evaluated by age 36 months. Children aged 4 years had a higher cumulative incidence of ASD diagnosis or eligibility by age 48 months compared with children aged 8 years at all sites; risk ratios ranged from 1.3 in New Jersey and Utah to 2.0 in Tennessee. In the 6 months before the March 2020 COVID-19 pandemic declaration by the World Health Organization, there were 1,593 more evaluations and 1.89 more ASD identifications per 1,000 children aged 4 years than children aged 8 years received 4 years earlier. After the COVID-19 pandemic declaration, this pattern reversed: in the 6 months after pandemic onset, there were 217 fewer evaluations and 0.26 fewer identifications per 1,000 children aged 4 years than children aged 8 years received 4 years earlier. Patterns of evaluation and identification varied among sites, but there was not recovery to pre-COVID-19 pandemic levels by the end of 2020 at most sites or overall. For 2020, prevalence of suspected ASD...

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Section: Discussionmentioning

confidence: 99%

Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020

Shaw¹,

Bilder²,

McArthur³

et al. 2023

MMWR Surveill. Summ.

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“…The BOSA provides an accompanying sheet to recode ADOS‐2 items to a dichotomous system (i.e., presence [0] or absence of behaviors [1]) that maximizes sensitivity). An inital validation study determined the BOSA to be a promising instrument with high sensitivity and specificity that practitioners could use when direct assessments are not possible (Dow et al, 2021). Currently, online BOSA training is free, and most of the items needed to administer the assessment are included in the ADOS‐2 kit.…”

Section: Autism Spectrum Disorder (Asd)mentioning

confidence: 99%

Best practice assessments for autism spectrum disorders in schools

Christopher

Lord

2022

Psychology in the Schools

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The heterogeneous nature of Autism Spectrum Disorder (ASD) makes accurate diagnosis challenging. Best practice assessments in schools can open pathways to appropriate interventions and educational placements for those with ASD, as well as help identify a student's strengths. There are various tools used in school settings to assess autism. In this review, we briefly discuss those instruments with a specific focus on the use of the Autism Diagnostic Observation Schedule‐Second Edition (ADOS‐2), one of the most widely used and well‐researched assessment tools. We address special considerations that may impact the psychometric properties of the ADOS‐2 as well as outline practical implications and recommendations for practitioners in schools.

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“…8 There has been a proliferation of research on telehealth as a possible strategy to mitigate in-person service losses for children with autism. [9][10][11] Before the pandemic, feasibility and potential efficacy of telehealth interventions have been demonstrated for individuals with ASD in several systematic reviews. 12,13 A small telehealth occupation-based coaching intervention study conducted before COVID-19 found significant gains in parent efficacy, in various domains of child participation, and in parent-identified goals postintervention.…”

mentioning

confidence: 99%

“…15 However, intervention studies of telehealth models for autism care during COVID-19 have generally used small pilot samples with limited generalizability or have not been specific to therapies for autism (e.g., telerehabilitation physical therapy). [16][17][18] There are multiple studies of telehealth focused on screening, assessment, and diagnosis 9,10,19 but fewer studies that investigate more hands-on therapies such as applied behavior analysis for autism. Although these existing studies have promising results, parent and family views and preferences around a telehealth format for habilitative therapy specific to autism are not well understood, including whether these views can inform the use of telehealth in the future.…”

mentioning

confidence: 99%

Habilitative Teletherapy for Children with Autism Spectrum Disorder: A Survey of Parents

Choi

Becerra-Culqui

Tejada

et al. 2022

J Dev Behav Pediatr

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Objective: The purpose of this study was to investigate whether service losses during the coronavirus disease 2019 (COVID-19) pandemic were associated with worsened parent mental health or child behavioral health among families of children with autism spectrum disorder and to identify factors associated with favorable parent appraisals of habilitative teletherapy (applied behavior analysis; speech, occupational, physical therapy) for their child. Method: This web-based survey study was conducted from May to July 2021 with parents whose children were receiving habilitative therapy for autism from an integrated health system. A total of 322 parents responded to the survey (20% response rate). The outcome variables were pandemic-related parent mental health, pandemic-related child behavioral health, and appraisal of habilitative teletherapy. Predictors were COVID-19-related services changes in health care or child care, COVID-19 history (COVID-19 stress, testing positive for COVID-19), and child autism factors (autistic behaviors, caregiving strain). Results: Loss of regular child care was associated with higher odds of worsened parent mental health (odds ratio [OR] 5 2.7, 95% confidence interval [CI] 5 1.5-4.8); higher levels of caregiving strain were associated with worsened child behavioral health (OR 5 2.3, 95% CI 5 1.4-3.8). Higher levels of COVID-19 stress were associated with more favorable appraisals of telehealth (b 5 0.4, p < 0.01), whereas higher caregiving strain scores were associated with less favorable appraisals of telehealth (b 5 20.2, p < 0.01). Conclusion: During COVID-19, caregiving factors were associated with worsened parent mental health and worsened child behavioral health, and telehealth is not preferred by all families. Policy interventions to support caregivers, such as affordable, high-quality child care and paid family leave, are a high priority.

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The Brief Observation of Symptoms of Autism (BOSA): Development of a New Adapted Assessment Measure for Remote Telehealth Administration through COVID-19 and Beyond

Cited by 5 publications

References 20 publications

Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020

Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020

Best practice assessments for autism spectrum disorders in schools

Habilitative Teletherapy for Children with Autism Spectrum Disorder: A Survey of Parents

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