Differential Diagnosis in Children with Autistic Symptoms and Subthreshold ADOS Total Score: An Observational Study

Abstract

Background: Children with autism spectrum disorder (ASD) share some symptoms with children with other neurodevelopmental disorders (ie, intellectual disability or communication disorders or language disorders). These similarities can make difficult to obtain an accurate diagnosis, which is essential to give targeted treatments to the patients. We aim to verify in our study if children with autistic traits who undergo to Autism Diagnostic Observation Schedule had specific clinical diagnosis. Patients and Methods: We selected 73 children tested with ADOS-G or ADOS-2, for the presence of autistic symptoms. The whole sample did not reach the cut-off of ADOS and did not receive the ASD diagnosis, according to DSM-5. Results: Results of this study showed that in order of frequency and early diagnosis, communication disorders (CD), mild intellectual disability (mID) and the attention deficit hyperactivity disorders (ADHD) represent the most common final clinical diagnosis in children with autistic traits. Conclusion:Our results showed as the CD was the common diagnosis of these children and that often associated with younger age. Moreover, analyses of ADOS domains and the difference of individual items between groups did not show the capacity to differentiate between different neurodevelopmental disorders in terms of differential diagnosis, and this confirms the need for integrating multiple sources of information during the diagnostic process.

Identifying Autistic-Like Symptoms in Children with ADHD: A Comparative Study Using ADOS-2

“…Ranging from 1 to 10, CSS offers an evaluation of autism symptoms that is unaffected by age or language proficiency, making it better suited than ADOS-2 scores for assessing the severity of ASD. 25 …”

“…This method facilitated a direct comparison of the occurrence of atypical behaviors among different groups, employing a technique akin to approaches used in other studies on neurodevelopmental disorders. 25 , 29–31 Items from different ADOS modules, as recommended by Lord et al 32 and outlined in Table 1 , were combined for comparison. The proportions of scores indicating atypical behavior (1) and the absence of abnormality (0) in children with ADHD for each combined item were evaluated and compared with the frequency in the ASD groups, utilizing chi-square analysis to assess the distribution of atypical behavior.…”

Epigenetic Modulation to perturb theSYNGAP1Intellectual Disability (ID) that ameliorates synaptic and behavioural deficits

“…Neurodevelopmental disorders (NDD) such as ID and ASD are characterized by poor cognitive, social, emotional, and adaptive functions ( 1, 2 ). While the precise neurophysiological and neurobiological causes underlying these impairments are understood to an extent, the consensus is that they are a consequence of disrupted neuronal network connections that prevent proper information processing capabilities, particularly during the early stages of development ( 3, 4 ).…”