early identification of autism spectrum disorders
Download
Skip this Video
Download Presentation
Early identification of Autism Spectrum Disorders

Loading in 2 Seconds...

play fullscreen
1 / 38

Early identification of - PowerPoint PPT Presentation


  • 205 Views
  • Uploaded on

Early identification of Autism Spectrum Disorders. Catherine Lord University of Michigan Autism and Communication Disorders Center (UMACC). Collaborators. Pamela C. DiLavore Susan Risi Cory Shulman Audrey Thurm Families and children in the Early Diagnosis project. Deborah Anderson

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Early identification of' - Renfred


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
early identification of autism spectrum disorders

Early identification of Autism Spectrum Disorders

Catherine Lord

University of Michigan Autism and Communication Disorders Center (UMACC)

slide2

Collaborators

  • Pamela C. DiLavore
  • Susan Risi
  • Cory Shulman
  • Audrey Thurm
  • Families and children in the Early Diagnosis project
  • Deborah Anderson
  • Rosalind Oti
  • Michael Rutter
  • Andrew Pickles
  • Rebecca Niehus
  • Rhiannon Luyster
slide4

Is there a reason to distinguish narrowly defined autism

from more broadly defined ASD in young children?

slide6
Autism as a developmental disorder:What is manifested as autism changes with developmentDevelopment is affected by having autism
slide7
Both positive (abnormal) behaviors, and negative (the absence of normal) behaviors are required to make a diagnosis of ASD.

This means that developmental level and contextual effects (in what kind of circumstances does the child or adult function?) can both have significant effects on diagnostic judgments.

information from earlier studies
Conflicting information from treatment versus epidemiological/longitudinal studies

Empirical studies of preschool children

Joint attention: response to/initiation

Looking at faces; gaze

Response to name

Pretending

Information from earlier studies
slide9
Canadian follow-up study (N = 30)
  • Clearest discriminators at age two from parent report (ADI)
    • Attention to voice
    • Child spontaneously directing other’s attention (in any way)
    • Understands no words out of context
slide10
Clearest discriminators at age three
    • Attention to voice
    • Pointing to express interest
    • Hand and finger mannerisms
    • Use of other’s body as a tool
    • Uses no meaningful words spontaneously
north carolina chicago early diagnosis study
North Carolina/Chicago Early Diagnosis Study
  • Multiple measures
  • Parent report and direct observations
  • Larger sample
  • Greater diversity
slide14

Percent of age two diagnostic combinations and best-estimate judgments accurately predicting diagnosis at 9

(Age 2 best-estimate autism prevalence based on N=214)

[Age 9 best-estimate autism prevalence based on N=172]

slide15

Best Estimate Diagnoses at

2 and 9 (NC and Chicago)

At 9 years

At 2 years

slide16

Using Best Estimate Diagnoses:

  • Overall diagnoses of autism were very stable from 2-9
    • Of children who had a diagnosis of autism at 2
    • 84% had autism diagnoses at 9
    • 15% had PDD-NOS dx at 9
    • 1% had nonspectrum dx
  • Of children who had a diagnosis of autism at 9
  • 71% had autism diagnoses at 2
  • 27% had PDD-NOS dx at 2
  • 2% had nonspectrum dx at 2
slide17

Is there a reason to distinguish narrowly defined autism

from more broadly defined ASD in young children?

slide18

Two Year-old Measures Predicting ASD at 9,

including Best Estimate Diagnosis

(est. R2 = .63; TPV = 92%)

slide19

Two Year-old Measures Predicting ASD at 9,

excluding Best Estimate Diagnosis

(est. R2 = .52; TPV = 89%)

slide20

PDD-NOS as a category was much less stable

    • Of children with PDD-NOS at 2
    • 61% autism at 9
    • 25% PDD-NOS at 9
    • 14% nonspectrum at 9
  • Of children with PDD-NOS at 9:
  • 39% autism at 2
  • 33% PDD-NOS at 9
  • 27% nonspectrum at 9
slide21

More diagnostic changes were between 2 and 5.

    • Between 2–5 21% more severe
    • 13% less severe
    • 65% same
  • Between 5–9 11% more severe
  • 8% less severe
  • 81% same
slide27

Patterns of Change in VIQ

From Age 2- to 9-Years

N=17

N=18

N=40

N=62

VIQ

N=36

N=78

N=93

Age in Months

Age in Months

slide28

Patterns of Change in NVIQ

From Age 2- to 9-Years

N=61

NVIQ

N=68

N=43

Age in Months

slide29

Patterns of Change in ADOS Algorithm Totals

From Age 2- to 9-Years

ADOS

TOT

N=91

N=91

N=19

N=46

N=28

N=35

N=34

Age in Months

Age in Months

mullen ratio iq 7 29 05 viq 55 nviq 95 younger sibling minimal intervention
Mullen Ratio IQ(7/29/05): VIQ – 55; NVIQ – 95Younger sibling; minimal intervention

ADOS

Social Scores

ADOS

Repetitive

Scores

Age (mos)

mullen ratio iq 5 26 05 viq 112 nviq 98 younger sibling intensive intervention verbal behavior
Mullen Ratio IQ(5/26/05): VIQ – 112; NVIQ – 98Younger sibling; intensive intervention (Verbal Behavior)

ADOS

Social Scores

ADOS

Repetitive

Scores

Age (mos)

what would you tell professionals about giving early diagnoses
At age 9

Don’t give too much information too soon

Don’t stress negative prognoses

Present all options

Provide writteninformation

What would you tell professionals about giving early diagnoses?
summary
Autism can be reliably diagnosed at 2 years.

Diagnoses of milder cases of ASD with less clinician certainty were less reliable over time.

Summary
slide34

Conclusions:

Most diagnostic change occurred before 5.

Most common outcome for children with PDD-NOS at 2 was autism, but there was great variation.

Little evidence of “complete” recovery (1).

A significant minority (1 in 6) is doing quite well.

slide35

Conclusions (cont):

Considerable improvement in verbal IQs from 2 to 5 and 5 to 9.

Repetitive behavior was not crucial for diagnosis at age 2, but was an important predictor of diagnosis at 9.

Small differences in development made large differences in prognosis.

ad