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Journal of Autism and Developmental Disorders

12-04-2024 | Original Article

Factors Associated with Confirmed and Unconfirmed Autism Spectrum Disorder Diagnosis in Children Volunteering for Research

Auteurs: Susanne W. Duvall, Rachel K. Greene, Randi Phelps, Tara M. Rutter, Sheila Markwardt, Julia Grieser Painter, Michaela Cordova, Beth Calame, Olivia Doyle, Joel T. Nigg, Eric Fombonne, Damien Fair

Gepubliceerd in: Journal of Autism and Developmental Disorders

Abstract

Purpose

Diagnostic accuracy of autism spectrum disorder (ASD) is crucial to track and characterize ASD, as well as to guide appropriate interventions at the individual level. However, under-diagnosis, over-diagnosis, and misdiagnosis of ASD are still prevalent.

Methods

We describe 232 children (M_Age = 10.71 years; 19% female) with community-based diagnoses of ASD referred for research participation. Extensive assessment procedures were employed to confirm ASD diagnosis before study inclusion. The sample was subsequently divided into two groups with either confirmed ASD diagnoses (ASD+) or unconfirmed/inaccurate diagnoses (ASD-). Clinical characteristics differentiating the groups were further analyzed.

Results

47% of children with community-based ASD diagnoses did not meet ASD criteria by expert consensus. ASD + and ASD- groups did not differ in age, gender, ethnicity, or racial make-up. The ASD + group was more likely to have a history of early language delays compared to the ASD- group; however, no group differences in current functional language use were reported by caregivers. The ASD + group scored significantly higher on ADI-R scores and on the ADOS-2 algorithm composite scores and calibrated severity scores (CSSs). The ASD- group attained higher estimated IQ scores and higher rates of psychiatric disorders, including anxiety disorder, disruptive behavior, and mood disorder diagnoses. Broadly, caregiver questionnaires (SRS-2, CCC-2) did not differentiate groups.

Conclusion

Increased reported psychiatric disorders in the ASD- group suggests psychiatric complexity may contribute to community misdiagnosis and possible overdiagnosis of ASD. Clinician-mediated tools (ADI-R, ADOS-2) differentiated ASD + versus ASD- groups, whereas caregiver-reported questionnaires did not.

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Titel: Factors Associated with Confirmed and Unconfirmed Autism Spectrum Disorder Diagnosis in Children Volunteering for Research
Auteurs: Susanne W. Duvall
Rachel K. Greene
Randi Phelps
Tara M. Rutter
Sheila Markwardt
Julia Grieser Painter
Michaela Cordova
Beth Calame
Olivia Doyle
Joel T. Nigg
Eric Fombonne
Damien Fair
Publicatiedatum: 12-04-2024
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-024-06329-y

Bohn Stafleu van Loghum

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Abstract

Purpose

Methods

Results

Conclusion

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