Early Diagnostic Assessment

Kuriakose, Sarah; Shalev, Rebecca A.

doi:10.1007/978-3-319-30925-5_2

“…Increasing professionals’ awareness of children and families who are most at‐risk of delays to recognition and identification (e.g. low SES, ethnic minority groups, female gender) may also improve EI access (Kuriakose & Shalev, 2016). Exploration of research into the recognition or identification of developmental disabilities in middle‐late childhood or adulthood may also be important for understanding and addressing these barriers earlier (e.g.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review

Sapiets

¹

,

Totsika

²

,

Hastings

³

2020

Research Intellect Disabil

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Access to early intervention (EI) has been identified as a priority for global research in developmental disability (Collins et al., 2017;Tomlinson et al., 2014). As a term, developmental disability refers to several developmental conditions but especially developmental delay, intellectual disability and autism spectrum disorder (ASD) 1 .The onset of developmental disabilities takes place during early development and lasts throughout an individual's lifetime (Patel & Merrick, 2011). Whilst the individual needs of children with developmental disabilities are unique, general delays in cognitive and adaptive skills are present by definition (American Psychiatric Association, 2013;Carulla et al., 2011;McDonald et al., 2006). A range of other adverse outcomes are associated with developmental disabilities, such as poorer mental health, poorer physical health and social inequalities (Emerson, 2003;Emerson & Hatton, 2007;Gurney et al., 2006;Vasilopoulou & Nisbet, 2016). For example, an increased risk for behaviour problems is present in children with developmental disabilities as young as 3-5 years old (Totsika et al., 2011), and this increased risk persists into adolescence and adulthood (Gray 1 While autism spectrum disorder (ASD) is predominately used in the current paper in line with the Diagnostic and Statistical Manual of Mental Disorders-5, other autism diagnostic labels (Asperger syndrome, autism, Pervasive Developmental Disorder Not Otherwise Specified, Rett syndrome, autistic traits) are used to describe studies completed in the context prior to the widespread use of ASD as an all-encompassing autism diagnosis in instances where autism diagnostic label is pertinent to the findings.

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“…Thus, autism is now represented as a dimensional rather than categorical disorder. For example, it is assumed that those with high functioning autism (previously Asperger's disorder) differ only in severity from those with a greater degree of impairment rather than having a distinct disorder (Kamp-Becker et al, 2010;Kuriakose & Shalev, 2016).…”

Section: Diagnostic Criteria and Defining Characteristicsmentioning

confidence: 99%

Evaluation of low-intensity therapy and parent training for young children with autism based on the early start Denver model

Waddington¹

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<p>Autism spectrum disorder (ASD) is a pervasive developmental disorder that is characterised by deficits in social communication and restricted and repetitive behaviours, interests and activities. Recent developments in identification techniques mean that many children can be reliably diagnosed with ASD before the age of 2. Early identification creates the opportunity for early intervention. In fact, some research suggests that the earlier a child with ASD receives intervention, the greater the progress he or she is likely to make. Naturalistic developmental behavioural interventions are a relatively recent method of early intervention for children with ASD, which combine elements of previous intervention approaches (behavioural, naturalistic behavioural, and developmental/relationship-focused intervention). One such naturalistic developmental behavioural intervention is the early start Denver model (ESDM), which is designed for children with or at risk for ASD between the ages of 12 and 60 months (5 years). Research suggests that ESDM intervention may improve a range of child outcomes when delivered for at least 15 hours per week over at least 10 months. However, many families may not be able to access or afford such intensive intervention. Therefore, the two studies in this thesis evaluated the effectiveness of two ESDM delivery approaches that required relatively few hours of professional input per week. Specifically, low-intensity therapist delivered ESDM intervention, and ESDM parent training. Study 1 used a multiple probe across participants design to evaluate the effectiveness of 3 hours per week of home-based ESDM therapy for 12 weeks for improving imitation, communication, and engagement for four young children with ASD. It also examined whether children showed increases in these outcomes with their mothers following the intervention. The results of this study suggest that, following the intervention, all four children increased their imitation skills and their engagement with the therapist. In addition three of the children had more functional utterances and one child increased his use of intentional vocalisations. These results were maintained four weeks after intervention and generalised to a lesser degree to each child’s mother. This suggests that low-intensity therapist delivered ESDM intervention may improve outcomes for children with ASD. The results of Studies 1 and 2 suggest that both low-intensity therapist delivered ESDM intervention and ESDM parent training may be promising intervention approaches for young children with ASD. This is particularly encouraging as both approaches involved relatively few hours of professional input per week. In theory, this could increase the number of families who are able to access such intervention. More research is needed to identify the most effective low-intensity ESDM intervention method, or combination of methods.</p>

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“…Barbaro, & Dissanayake, 2010;Baron-Cohen, Allen, & Gillberg, 1992;Robins, Fein, Barton, & Green, 2001, Rutter, Bailey, & Lord, 2003Schopler, Van Bourgondien, Wellman, & Love, 2010). There are two levels of screening tools: level one screeners, which are designed to screen the entire population for ASD and can be quickly administered, and level two screeners which are typically used with children who may be "atrisk" for ASD, such as high-risk siblings (Kuriakose & Shalev, 2016). Level one screeners generally have high sensitivity, meaning that they accurately identify the majority of children who are at risk for ASD, but lower specificity, meaning that they do not always exclude children who are not at risk for ASD.…”

Section: Early Identificationmentioning

confidence: 99%

“…It is a 20-min play-based observational assessment which evaluates the infant 's social, affective, communication, visual, and motor responses to presses from a trained administrator. The AOSI is not currently recommended for clinical or diagnostic use due to low sensitivity but it has provided valuable information about the early behavioural markers of children who will later receive a diagnosis of ASD (Kuriakose & Shalev, 2016).…”

Section: Early Identificationmentioning

confidence: 99%

“…There are several factors which may affect the age of diagnosis (Kuriakose & Shalev, 2016). Research suggests that children are likely to be diagnosed later than average if: (a) they are female (Shattuck et al, 2009), (b) they have less severe autism symptoms (Mandell, Novak, & Zubritsky, 2005), (c) they belong to an ethnic minority (Mandell, Listerud, Levy, & Pinto-Martin, 2002), (d) their family is near the poverty level (Mandell et al, 2005), or (e) they live rurally (Mandell et al, 2005).…”

Section: Early Identificationmentioning

confidence: 99%

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Evaluation of low-intensity therapy and parent training for young children with autism based on the early start Denver model

Waddington¹

0

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<p>Autism spectrum disorder (ASD) is a pervasive developmental disorder that is characterised by deficits in social communication and restricted and repetitive behaviours, interests and activities. Recent developments in identification techniques mean that many children can be reliably diagnosed with ASD before the age of 2. Early identification creates the opportunity for early intervention. In fact, some research suggests that the earlier a child with ASD receives intervention, the greater the progress he or she is likely to make. Naturalistic developmental behavioural interventions are a relatively recent method of early intervention for children with ASD, which combine elements of previous intervention approaches (behavioural, naturalistic behavioural, and developmental/relationship-focused intervention). One such naturalistic developmental behavioural intervention is the early start Denver model (ESDM), which is designed for children with or at risk for ASD between the ages of 12 and 60 months (5 years). Research suggests that ESDM intervention may improve a range of child outcomes when delivered for at least 15 hours per week over at least 10 months. However, many families may not be able to access or afford such intensive intervention. Therefore, the two studies in this thesis evaluated the effectiveness of two ESDM delivery approaches that required relatively few hours of professional input per week. Specifically, low-intensity therapist delivered ESDM intervention, and ESDM parent training. Study 1 used a multiple probe across participants design to evaluate the effectiveness of 3 hours per week of home-based ESDM therapy for 12 weeks for improving imitation, communication, and engagement for four young children with ASD. It also examined whether children showed increases in these outcomes with their mothers following the intervention. The results of this study suggest that, following the intervention, all four children increased their imitation skills and their engagement with the therapist. In addition three of the children had more functional utterances and one child increased his use of intentional vocalisations. These results were maintained four weeks after intervention and generalised to a lesser degree to each child’s mother. This suggests that low-intensity therapist delivered ESDM intervention may improve outcomes for children with ASD. The results of Studies 1 and 2 suggest that both low-intensity therapist delivered ESDM intervention and ESDM parent training may be promising intervention approaches for young children with ASD. This is particularly encouraging as both approaches involved relatively few hours of professional input per week. In theory, this could increase the number of families who are able to access such intervention. More research is needed to identify the most effective low-intensity ESDM intervention method, or combination of methods.</p>

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Early Diagnostic Assessment

Cited by 4 publications

References 125 publications

Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review

Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review

Evaluation of low-intensity therapy and parent training for young children with autism based on the early start Denver model

Evaluation of low-intensity therapy and parent training for young children with autism based on the early start Denver model

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