Claire O. Burns

Factors related to parental age of first concern in toddlers with autism spectrum disorder.

ABSTRACT Purpose: The age of first concern (AOC) of parents of children with autism spectrum disorders (ASD) has substantial implications for early diagnosis and intervention. The current study sought to determine the average AOC, what types of first concerns are most common, and what factors predict earlier AOC in toddlers with ASD. Methods: This study analyzed the predictive influence of the type of concern, symptom severity, medical diagnoses, and other independent variables on AOC among toddlers with ASD using multiple regressions. Results: The mean AOC was found to be 13.97 months (SD = 7.86). The most commonly reported first concern was speech/language. First concerns related to communication, speech/language predicted later AOC, while motor concerns predicted earlier AOC. Conclusions: Concerns that are more closely related to social communication deficits characteristic of ASD predicted later AOC. The implications of these findings on screening/assessment and intervention are discussed.

Normal Developmental Milestones of Toileting

The age at which children should begin toilet training is a question that concerns many parents. Although there is no universally accepted timeline for toileting skills, researchers have suggested general age ranges during which these abilities are likely to emerge. The current chapter discusses normal toileting milestones and when they tend to occur in typically developing children. Necessary developmental precursors, such as physiological and psychological maturity, are described. This chapter also considers factors that influence age at successful toileting, such as gender and cultural differences. Finally, the authors attempt to dispel some of the common misconceptions regarding toilet training. There has been a great deal of media attention surrounding certain trends in toileting practices, and these methods often deviate from those recommended by researchers and clinicians. The elimination communication method in particular has gained popularity in the United States in recent years, and the implications and feasibility of this method are explored.

An evaluation of the clinical application of the DSM-5 for the diagnosis of autism spectrum disorder

ABSTRACT Introduction: The changes to the diagnostic criteria for autism spectrum disorder (ASD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were met with much controversy by researchers, clinicians, and families of individuals with ASD. The goal of this paper is to review the literature on the impact of these changes. Areas covered: This paper reviews the major changes to diagnostic criteria from DSM-IV-TR to DSM-5. It emphasizes how these changes are hypothesized to impact prevalence rates, as well as trends in characteristics of individuals who would have met previous criteria for ASD but no longer qualify for a diagnosis under DSM-5. Policy issues such as access to services and research considerations are also briefly reviewed. Expert commentary: Researchers have found that the DSM-5 diagnostic criteria for ASD may significantly impact which children receive diagnoses, which in turn affects access to services that address impairments characteristic of this disorder. Despite the fact that the DSM-5 has now been in use for four years, fewer recent studies were identified than was expected. Future research should continue to focus on the impact of changes in criteria, as well as on translational scientific advances across disciplines.

Assessing Bipolar Disorder and Major Depression

Pediatric bipolar disorder and major depression are topics which have received a marked increase in attention by the mental health community in recent years. This group of disorders, when present, is very serious and debilitating. Also, symptoms can wax and wane for many years. Thus, identification and treatment are very important. One of the greatest concerns regarding this mental health condition is misidentification, often through the application of symptoms that do not truly represent pediatric mood disorders . A variety of symptoms have been reported in the literature. A brief review of the behaviors which have been described in the literature to characterize pediatric mood disorders follows. This section is followed by relevant topics in diagnosis and methods used to identify major depression and bipolar disorder.

The Assessment of ADHD in Persons with Developmental Disabilities

Attention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder diagnosed in childhood. Significant educational, psychological, and medical resources are expended in the assessment and treatment of persons with ADHD. Even the most seasoned clinician will face challenges when assessing ADHD in children with developmental disabilities. The core symptoms of ADHD can combine in thousands of ways to render the diagnosis and comorbid conditions abound. The clinician must understand a child’s unique experience with the identified developmental disability before attempting to assess for ADHD. This chapter provides detailed guidance on the assessment of ADHD in persons with developmental disabilities.

Differences in Developmental Concerns of Young Children with Autism Spectrum Disorder Across Racial/Ethnic Groups

ABSTRACT Purpose: Parents/caregivers of children with autism spectrum disorder (ASD) have varying types of initial concerns regarding their child’s development, which may be culturally bound to parents’ perceptions of their child’s development. This study investigated differences in the types of initial developmental concerns reported by parents or caregivers of different racial/ethnic groups with children in an early intervention program. Method: This study examined the frequency of endorsement of different types of concerns in African American, Caucasian, and Hispanic families. Results: No significant differences between racial/ethnic groups were found in the endorsement of concerns related to communication, language/speech, motor, problem behavior, sensory, feeding, prematurity, attention, adaptive functioning, and medical conditions. Racial/ethnic groups differed significantly in their endorsement for social concerns. Conclusion: Racial/ethnic group differences were confirmed regarding initial developmental concerns related to social behavior, which may be due to cultural beliefs. The implications of these findings on early identification are discussed.

An investigation of the association between seizures, autism symptomology, and developmental functioning in young children

ABSTRACT Objective: The aim of the present study was to explore whether a history of seizures was associated with autism symptom severity and developmental functioning in young children. Methods: Autism symptom severity and developmental functioning were compared between children with and without a history or seizures who either had atypical development or met criteria for autism spectrum disorder (ASD) based on review of records by a licensed clinical psychologist. Results: Parents of children who met criteria for ASD reported lower levels of autism symptomology when the child had a history of seizures, while the opposite trend was found for children with atypical development. Participants without ASD or seizures had greater developmental functioning than the other groups. Conclusion: The present study emphasizes the need for early identification and diagnosis of both ASD and seizure disorders, as timely intervention for these two conditions may be related to improved outcomes for young children.

Ethical Considerations Regarding Treatment

Treatment efficacy is very important. However, establishing ethical guidelines that examine the intrusiveness, cost, time commitment, and side effect(s) is critical. These factors are essential in determining the most humane way to provide care. The variables noted above also factor into treatments parents choose as well as interventions persons with autism spectrum disorder prefer. This chapter reviews these and related issues in the broad context of ethical treatment.

Diet and Supplementation Targeted for Autism Spectrum Disorder

This chapter explores various diet- and nutrition-based treatments for children diagnosed with autism spectrum disorder (ASD) as well as their appeal. While little evidence of efficacy has appeared, these approaches continue to be widely popular among parents and many clinicians. The prevalence of diet-based treatments remains high, even in cases where diet-based treatment can be dangerous for children with ASD. This chapter discusses the current status of research and recommendations for future research and current use.

History of Social Skills

The development of modern approaches to social skills training dates to the 1970s (McFall & Twentyman, 1973). Initially, research was carried out using discrete behaviors considered to be components of appropriate assertiveness training. These early papers largely focused on typically developing adults (McFall & Lillesaud, 1971). These efforts helped to establish a methodology for training and to demonstrate the efficacy of learning-based methods to improve these skills.