Lag Time between Parental First Concerns about Development and Entry into Early Intervention: Impact of Child/Family Factors, First Concerns, and Symptom Presentation

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impacts an individual’s ability to relate to and communicate with others. Although children often do not receive a diagnosis until age 4-5 years (Centers for Disease Control and Prevention, 2014), parents typically recognize developmental problems by age 2 years (Chawarska et al., 2007), and often in the first year of life (Kishore & Basu, 2011). However, these early concerns do not always translate into appropriate or timely steps to access care. Few studies have examined factors relating to the time lag that exists between early concerns and action. Because early intervention for ASD is critical for best outcomes, it is important to understand factors that can delay access to treatment. The current study included 4,215 toddlers between the ages of 16-37 months who were evaluated for an IDEA, Part C early intervention program in Louisiana. It closely examined child and family factors (i.e., the age of the child when parents first note concerns, gender, ethnicity, birth order, presence of a family member with ASD), the nature of early parental concerns, and symptom presentation to determine how these factors impact the time lag between parental first concern and entry into an early intervention program. Ethnicity was found to be a significant predictor of lag time such that minority families experienced a longer lag. The disparity was present across all functioning levels, although the difference was most pronounced for toddlers with functional impairments. Longer lags when parents reported general rather than specific concerns about their child’s development were also noted. Additional findings, their implications, and future directions for research relating to lag time were discussed

An investigation of self-injurious behaviors in adults with severe intellectual disabilities

Self-injurious behavior (SIB) is commonly observed among individuals with intellectual disability (ID) living in state-run supports and services centers. Specific examples of SIB include poking oneself in the eye; harming oneself by hitting, scratching, or pinching; and pica (i.e., swallowing objects causing bodily harm). Previous research has focused on SIB in individuals with ID more generally without focusing on specific levels of ID or taking into account other important personal variables. This study examined 45 adults with severe ID living in two large state-run facilities in the Southeastern United States who were separated into groups for comparison (ASD and non ASD; verbal and nonverbal). Data was collected on the presence of SIB using the Autism Spectrum Disorder-Problem Behavior Adult Version (ASD-PBA). A two-way analysis of variance (ANOVA) was conducted to determine if there were significant differences between groups on rates of SIB. Individuals with ID and ASD exhibited significantly higher rates of SIB than individuals with only ID, F (1,43)=50.84, p\u3c0.05. Furthermore, verbal individuals had significantly higher rates of SIB than nonverbal individuals, F (1,43)=57.612, p\u3c0.05. There was a significant interaction between the effects of ASD diagnosis and verbal ability on rates of SIB, F (1,43)=50.84, p\u3c0.05. The implications of these findings in the context of other research on ID, ASD, SIB, and verbal abilities are discussed

Autism spectrum disorder severity as a predictor of Battelle Developmental Inventory - second edition (BDI-2) scores in toddlers

OBJECTIVE: The study aimed to evaluate the relationship between the severity of autism spectrum disorder (ASD) symptomology and scores on the Battelle Developmental Inventory, Second Edition (BDI-2) in toddlers (n = 325). METHODS: Total scores on the BDI-2 and individual domain scores were examined to explore the relationship between severity of ASD and developmental quotient, impairment in personal-social skills, adaptive functioning, cognition, and communication. RESULTS: Regression analyses controlled for the impact of age and IQ on results, indicating that higher autism severity scores were associated with overall greater impairment and in the total scores and the individual domains of the BDI-2. The domains were found to be differentially affected by severity of ASD. CONCLUSION: These findings suggest severity of ASD may influence symptom presentation. Clinical implications of study findings are discussed

Food selectivity in children with and without an autism spectrum disorder: Investigation of diagnosis and age

Feeding problems are common in children with autism spectrum disorders (ASDs), with food selectivity being the most frequently reported. Selectivity based on type and/or texture of food is of concern in those with ASD. Variations in symptom presentation of food selectivity in children with different autism spectrum diagnoses across childhood have not often been investigated. Parent-report of food selectivity was examined in 525 children age 2-18 years diagnosed with autistic disorder, PDD-NOS, Asperger\u27s disorder, atypical development, and typical development using information garnered from the Autism Spectrum Disorder-Comorbidity for Children (ASD-CC), a tool to assess emotional issues and comorbid psychopathology. Individuals with an ASD were reported to have significantly more food selectivity than both the atypically developing group and the typically developing group. In addition, the ASD groups, when looked at together, showed a decrease in food selectivity across childhood with significant decrease in the Asperger\u27s disorder group

Food selectivity in children with and without an autism spectrum disorder: investigation of diagnosis and age

Feeding problems are common in children with autism spectrum disorders (ASDs), with food selectivity being the most frequently reported. Selectivity based on type and/or texture of food is of concern in those with ASD. Variations in symptom presentation of food selectivity in children with different autism spectrum diagnoses across childhood have not often been investigated. Parent-report of food selectivity was examined in 525 children age 2-18 years diagnosed with autistic disorder, PDD-NOS, Asperger\u27s disorder, atypical development, and typical development using information garnered from the Autism Spectrum Disorder-Comorbidity for Children (ASD-CC), a tool to assess emotional issues and comorbid psychopathology. Individuals with an ASD were reported to have significantly more food selectivity than both the atypically developing group and the typically developing group. In addition, the ASD groups, when looked at together, showed a decrease in food selectivity across childhood with significant decrease in the Asperger\u27s disorder group

Comparing challenging behavior in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5

OBJECTIVE: The aim of the current study is to investigate challenging behavior in children who may no longer meet criteria for an autism spectrum disorder (ASD) diagnosis according to the proposed fifth edition of the Diagnostic and Statistical Manual (DSM-5). METHOD: Children and adolescents (n = 459) were separated into three groups including those who met criteria for ASD according to the DSM-5 criteria (n = 219); those who will no longer qualify for an ASD diagnosis according to the DSM-5 but met criteria according to the DSM-IV-TR (n = 109); and a control group (n = 131). Scores on the Autism Spectrum Disorders - Problem Behaviors for Children (ASD-PB-C) were compared among groups. RESULTS: The DSM-5 captured a slightly more impaired population in terms of problem behavior. CONCLUSION: Implications regarding access to treatment for those no longer meeting criteria need to be taken into consideration in the coming months