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Parent Report on K-SADS: Children Meeting Diagnostic Criteria by Disorder (n = 42)
Source publication
This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of youth with ASD and anxiety (ages 8–14) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version). Youth o...
Contexts in source publication
Context 1
... addition to the K-SADS-PL, the Child Information Sheet (Wehner, 1999) was used to examine potential child and family characteristics that might be associated with comorbidity of psychiatric conditions as well as the family's experience with interventions. Table 2 provides a summary of the screening results and final diagnostic classifications (past and current) determined by the KSADS-PL interview. Only parents of children who screened positively for a condition participated in a full interview regarding that condition. ...
Context 2
... pertaining to the proportion of children who screened positively for a disorder are presented in Table 2. We did not formally assess the util- ity of the screening component of the K-SADS (e.g., we did not administer sections of the interview if the child did not screen positively for that par- ticular disorder), so we cannot comment on the false negative rate of the K-SADS screening questions. ...
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Citations
... Esiste secondo alcuni autori una piccola evidenza di base, attualmente ancora in via di sviluppo, che stabilisce tratti comportamentali e linguistici comuni ad entrambi autismo e deficit visivi (Butchart et al., 2017). Gli studiosi hanno posto l'accento sull'importanza che i professionisti non cadano in casi di "adombramento diagnostico" dati dal considerare tutti i tratti simili a quelli autistici (come la comunicazione deficitaria e le stereotipie) nelle persone come relati necessariamente alla diagnosi d'autismo senza considerare la coincidenza di un compresente deficit visivo (Hepburn et al. 2014;NICE 2012). Deficit visivi non diagnosticati impattano gravemente la qualità della vita ed è necessario che i professionisti che lavorano con l'autismo siano formati a riconoscere la presenza di deficit visivi e la necessità di inviare i pazienti a controlli oftalmologici se necessario, inoltre anche che vi siano adeguamenti degli ambienti in cui si offre servizio alle persone con deficit visivi e che si offrano attività di supporto mirate (Butchart et al., 2017). ...
... Esiste secondo alcuni autori una piccola evidenza di base, attualmente ancora in via di sviluppo, che stabilisce tratti comportamentali e linguistici comuni ad entrambi autismo e deficit visivi (Butchart et al., 2017). Gli studiosi hanno posto l'accento sull'importanza che i professionisti non cadano in casi di "adombramento diagnostico" dati dal considerare tutti i tratti simili a quelli autistici (come la comunicazione deficitaria e le stereotipie) nelle persone come relati necessariamente alla diagnosi d'autismo senza considerare la coincidenza di un compresente deficit visivo (Hepburn et al. 2014;NICE 2012). Deficit visivi non diagnosticati impattano gravemente la qualità della vita ed è necessario che i professionisti che lavorano con l'autismo siano formati a riconoscere la presenza di deficit visivi e la necessità di inviare i pazienti a controlli oftalmologici se necessario, inoltre anche che vi siano adeguamenti degli ambienti in cui si offre servizio alle persone con deficit visivi e che si offrano attività di supporto mirate (Butchart et al., 2017). ...
Relationship between autism and visual impairments.
... Esiste secondo alcuni autori una piccola evidenza di base, attualmente ancora in via di sviluppo, che stabilisce tratti comportamentali e linguistici comuni ad entrambi autismo e deficit visivi (Butchart et al., 2017). Gli studiosi hanno posto l'accento sull'importanza che i professionisti non cadano in casi di "adombramento diagnostico" dati dal considerare tutti i tratti simili a quelli autistici (come la comunicazione deficitaria e le stereotipie) nelle persone come relati necessariamente alla diagnosi d'autismo senza considerare la coincidenza di un compresente deficit visivo (Hepburn et al. 2014;NICE 2012). Deficit visivi non diagnosticati impattano gravemente la qualità della vita ed è necessario che i professionisti che lavorano con l'autismo siano formati a riconoscere la presenza di deficit visivi e la necessità di inviare i pazienti a controlli oftalmologici se necessario, inoltre anche che vi siano adeguamenti degli ambienti in cui si offre servizio alle persone con deficit visivi e che si offrano attività di supporto mirate (Butchart et al., 2017). ...
Theoric and psychometric issues in the relationship between autism and visual impairments
... ECT is a well-established treatment of suicidal ideation, mood disorders, and psychosis in NT individuals. (Bahji et al., 2019;Espinoza & Kellner, 2022;Hedley & Uljarević, 2018;Horowitz et al., 2018;Luccarelli et al., 2020aLuccarelli et al., , 2021aLuccarelli et al., , 2021bTørring et al., 2017) This is a point of consideration as individuals with ASD and ID are at an elevated risk for mood disorders, psychosis, selfinjury, and suicidal behaviors; (Dodd et al., 2016;Hedley & Uljarević, 2018;Hepburn et al., 2014;Horowitz et al., 2018;Ludi et al., 2012;O'Halloran et al., 2022;Oakley et al., 2021;Schwartzman et al., 2021;Segers & Rawana, 2014) yet no clear treatment options are well researched, especially in cases of ASD+ID. We also found that bitemporal electrode placement and brief pulse duration was the most commonly used ECT parameter across all groups. ...
Autism spectrum disorder (ASD) and intellectual disability (ID) are heterogenous and prevalent conditions which may occur in isolation or as a co-morbidity. Psychiatric co-morbidity is common with limited treatment options. Preliminary research into electroconvulsive therapy (ECT) for these conditions has been encouraging. Thus, further research in this patient population is warranted. We conducted a 10-year retrospective review of the electronic medical record and identified intellectually capable individuals with ASD (IC-ASD), and those with ASD+ID or ID who received at least three ECT treatments. 32 patients were identified of which 30 (94%) experienced positive clinical response, defined as a clinical global impression-improvement (CGI-I) score of 3 or less. The average retrospective CGI-I score across all groups was 1.97, and results of a t-test performed on CGI-I scores indicated improvement across all groups [t = − 16.54, df = 31, p < 0.001, 95% CI = (1.72, 2.22)]. No significant adverse events were identified based on clinical documentation. Our findings further support previous ECT research in this patient population.
... Children and young people with Autism Spectrum Disorder (ASD), a life-long neurodevelopmental condition affecting approximately 1.2% of the population (Diallo et al. 2018), have an increased risk of developing mental health problems including anxiety and depression (Hepburn et al. 2014, Ratcliffe et al. 2015, Simonoff et al. 2008, Weiss 2014. Population-based studies suggest that up to 40-50% of children with ASD have emotional and behavioural problems at a level of clinical concern (Totsika et al. 2011). ...
Emotional and behavioural problems occur more commonly in children with Autism Spectrum Disorder (ASD) compared to other children. Few studies have focused on these problems in children with ASD attending mainstream schools. We assessed via parent report the emotional and behavioural problems in 160 children aged 4-17 years with ASD attending mainstream schools and investigated differences between the primary and secondary aged children. Children with ASD had higher levels of problems across all domains of the Strengths and Difficulties Questionnaire (SDQ) compared to UK norms. Within the ASD sample, SDQ scores were associated with male sex, living in a household with more children, more severe autism symptoms and fewer adaptive skills, and higher levels of family socio-economic risk. No robust primary-secondary school differences were found. Implications for future research and the support of children with ASD in mainstream school settings are discussed.
... Psychiatric comorbidity is the rule rather than the exception among youth with high functioning autism spectrum disorder (ASD) [1]. 1 Approximately 70-90% of youth with ASD meet diagnostic criteria for at least one psychiatric disorder [2][3][4][5][6], with 41% [2] meeting criteria for two or more disorders. Anxiety disorders and obsessive-compulsive disorder (OCD) are among the most common co-occurring disorders, with prevalence estimates reported as high as 56% [3,[7][8][9]. ...
... Additional psychiatric comorbidity, beyond the required primary anxiety and ASD diagnoses, was found in nearly all cases, with youth on average meeting diagnostic criteria for three comorbid disorders. Similarly, Hepburn, Stern, Blakeley-Smith, Kimel and Reaven [5] found an average of four psychiatric disorders in youth with ASD and anxiety symptoms. The most common comorbid disorder, after accounting for the primary anxiety/ OCD diagnosis and ASD diagnosis, was ADHD (61%), followed by GAD (51%), and SP (48%). ...
The impact of externalizing comorbidity on treatment outcome was examined in 104 youth ages 7–16 (M = 11.09 years) with autism spectrum disorder and primary anxiety/obsessive compulsive disorder who completed modular cognitive behavioral therapy (CBT) for anxiety/OCD. Three comorbidity profiles were utilized for group comparisons: participants with oppositional defiant or conduct disorder with attention-deficit hyperactivity disorder (ODD; CD; ADHD; group EXT, n = 25); those without ODD/CD and only ADHD (group ADHD, n = 46); and those without externalizing comorbidity (NO-EXT, n = 33). Post-treatment outcomes were measured continuously (Pediatric Anxiety Rating Scale, Clinical Global Impression-Severity) and categorically (treatment response, remission). The ADHD group was four times more likely of being a treatment responder compared to NO-EXT (OR 4.05). Comorbidity group did not impact remission. After controlling for pre-treatment scores, there was a significantly greater reduction of the CGI-S for ADHD versus NO-EXT and EXT versus NO-EXT, but results did not significantly differ for the PARS. Results suggest that a modular CBT approach yields positive impact for treatment outcomes in youth with comorbid externalizing problems, particularly among those with comorbid ADHD.
... Whereas there are multiple studies which show clear correlation betwen anxiety and Autism Spectrum Disorders, there are little longitudinal studies which demonstrate the impact of autism on depression. Prospective studies indicate that social interaction deficit predicts a high risk of social phobia [6]. The inability to represent one's intentions and the low level of adaptive functions enhance stress and unpleasant scenarios for adolescents with Asperger' s Syndrome, who may eventually experiment social withdrawal and an avoidant attitude towards people. ...
Autism spectrum disorders occupy a special place in the neurodevelopmental disorders due to its high prevalence in the contemporary world. Autism is known as a "spectrum" disorder because there is wide variation in the type and severity of symptoms people experience. First epidemiological studies were reported in 1967, when the frequency was about 4.5 in 10.000 children. Nowadays, about 1 in 54 children is identified with an autism spectrum disorder (ASD), according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM) Network. Althought more and more parents are becoming concerned about the severity of the longtime consequences, Applied Behavioral Analysis (ABA) Therapy showed significant improvement regarding social communication and expressive behaviour. Therefore, one can recover lost aquisitions if therapeutic approaches are implemented as soon as possible. The American Academy of Pediatrics recocommends that all children should be screened for autism.
... Different comorbidities occur often along with the core symptoms [7], such as gastrointestinal disorders, auditory disorders and infections, or psychiatric disorders that may severely affect daily normal functioning [8]. Among the latter, symptoms of anxiety or depressive disorders are consistently described in three quarters of affected children [9]. The correlations between GI symptoms and ASD behavioral phenotype carefully revised in a very systematical meta-analysis seem to relate to alterations of gut microbiota composition [10]. ...
Background and objectives: The hormone oxytocin (OXT) has already been reported in both human and animal studies for its promising therapeutic potential in autism spectrum disorder (ASD), but the comparative effectiveness of various administration routes, whether central or peripheral has been insufficiently studied. In the present study, we examined the effects of intranasal (IN) vs. intraperitoneal (IP) oxytocin in a valproic-acid (VPA) autistic rat model, focusing on cognitive and mood behavioral disturbances, gastrointestinal transit and central oxidative stress status. Materials and Methods: VPA prenatally-exposed rats (500 mg/kg; age 90 days) in small groups of 5 (n = 20 total) were given OXT by IP injection (10 mg/kg) for 8 days consecutively or by an adapted IN pipetting protocol (12 IU/kg, 20 μL/day) for 4 consecutive days. Behavioral tests were performed during the last three days of OXT treatment, and OXT was administrated 20 minutes before each behavioral testing for each rat. Biochemical determination of oxidative stress markers in the temporal area included superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA). A brief quantitative assessment of fecal discharge over a period of 24 hours was performed at the end of the OXT treatment to determine differences in intestinal transit. Results: OXT improved behavioral and oxidative stress status in both routes of administration, but IN treatment had significantly better outcome in improving short-term memory, alleviating depressive manifestations and mitigating lipid peroxidation in the temporal lobes. Significant correlations were also found between behavioral parameters and oxidative stress status in rats after OXT administration. The quantitative evaluation of the gastrointestinal (GI) transit indicated lower fecal pellet counts in the VPA group and homogenous average values for the control and both OXT treated groups. Conclusions: The data from the present study suggest OXT IN administration to be more efficient than IP injections in alleviating autistic cognitive and mood dysfunctions in a VPA-induced rat model. OXT effects on the cognitive and mood behavior of autistic rats may be associated with its effects on oxidative stress. Additionally, present results provide preliminary evidence that OXT may have a balancing effect on gastrointestinal motility.
... Mental health difficulties have been widely reported in individuals with ASD (de Bruin, Ferdinand, Meester, de Nijs, & Verheij, 2007;Hepburn, Stern, Blakeley-Smith, Kimel, & Reaven, 2014;Leyfer et al., 2006;van Steensel, Bögels, & de Bruin, 2013). For ...
Individuals with autism spectrum disorder (ASD) tend to experience difficulties with emotion regulation (ER). Treatments designed to address ER difficulties in individuals with ASD are emerging. The authors review cognitive-behavioral therapy (CBT) and mindfulness-based treatments that have focused on ER difficulties in youth and young adults with ASD. In general, these treatments addressing ER skills have included awareness of emotions/psychoeducation about emotions, frustration tolerance, and ER skills, as well as practice and use of these skills during group therapy that sometimes includes caregivers. The results from these interventions are encouraging for individuals with high-functioning ASD because ER skills tend to improve following treatment. The inclusion of ER in other ASD treatments is discussed.
... It is widely accepted that co-occurring psychiatric disorders are common in autistic adolescents and adults. One in two people on the spectrum is affected by a co-occurring anxiety or depressive disorder [2][3][4]. Among people with ASD who do not also have intellectual disability, anxiety and depression are among the most common co-occurring mental health problems. ...
Purpose of Review
This synthesis of treatment research related to anxiety and depression in adolescents and adults with autism spectrum disorder (ASD) focuses on the scientific support for various forms of psychosocial interventions, useful adaptations to standard interventions, and engagement of candidate therapeutic mechanisms.
Recent Findings
There is considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) to treat co-occurring problems with anxiety, but there has been relatively little research on treatment of co-occurring depression. Multiple mechanisms of treatment effect have been proposed, but there has been little demonstration of target engagement via experimental therapeutics.
Summary
Comorbidity between ASD and anxiety and/or mood problems is common. Although there is evidence for the use of CBT for anxiety, little work has addressed how to effectively treat depression. There is emerging support for alternative treatment approaches, such as mindfulness-based interventions. We encourage rigorous, collaborative approaches to identify and manipulate putative mechanisms of change.
