Search

Daytime activity, in terms of engagement in an occupation or education, is highly important for individuals with autism spectrum disorder (ASD), regardless of their level of functioning. In this nationwide survey, the parents of young adults diagnosed with ASD in childhood (n = 1266) provided information about the current daytime activity of their child, as well as behavioral characteristics, comorbidity, history of schooling during primary and secondary school, and availability of support. The young adults without a regular daytime activity constituted approximately one-fifth of the sample and had more behavioral difficulties and comorbidities than young adults with a daytime activity. Intellectual disability, part-time job, history of schooling, including type of school, and availability of support were found to be associated with daytime activity.

Objectives: This qualitative study aims to examine parental experiences of feasibility and relational changes from participating in the Paediatric Autism Communication Therapy (PACT) intervention. Methods: Thirteen parents of children diagnosed with autism spectrum disorder (mean age 3.89 years) participated in semi-structured interviews. Thematic analysis was performed, inspired by an abductive approach informed by the theories of the attachment system, the caregiving system and mentalisation. Results: Three overarching themes were identified: the struggle of fitting PACT into everyday life, the fruit of relational connection and the cascading relational effects of PACT. Parents were challenged regarding finding time for the intervention but adapted PACT to their individual needs and possibilities. All parents experienced relational improvement, and a cycle of positive relational change through PACT was identified. Conclusions: This study has several clinical implications. Therapists and clinics offering PACT interventions should encourage and support parents in their individual journey of implementing PACT into their everyday lives. Some of the parents described improvements in parental mentalisation, child attachment and mutual enjoyment in the parent–child relationship. Children with autism could benefit from parents increasing their sensitivity when caregiving, and clinicians may through interventions such as PACT facilitate this development. [ABSTRACT FROM AUTHOR]

This is the fourth international preparatory study designed to develop International Classification of Functioning, Disability and Health (ICF, and Children and Youth version, ICF-CY) Core Sets for Autism Spectrum Disorder (ASD). Examine functioning of individuals diagnosed with ASD as documented by the ICF-CY in a variety of clinical settings. A cross-sectional study was conducted, involving 11 units from 10 countries. Clinical investigators assessed functioning of 122 individuals with ASD using the ICF-CY checklist. In total, 139 ICF-CY categories were identified: 64 activities and participation, 40 body functions and 35 environmental factors. The study results reinforce the heterogeneity of ASD, as evidenced by the many functional and contextual domains impacting on ASD from a clinical perspective.

A nationwide survey of children diagnosed with autism spectrum disorders (ASD) was conducted with the aim of exploring outcomes in adolescence and adulthood. The purpose of this article is to evaluate the representativeness of the study population and to describe the study population. In total, 1,734 parents and 933 individuals with ASD returned the questionnaire, which included information from individuals with ASD and their parents. The study population was found to be representative of individuals diagnosed with ASD in childhood at Danish psychiatric hospitals. Compared to other ASD populations, lower rates of intellectual disability, psychiatric comorbidity, language difficulties, and epilepsy were found.

Little is known about use of early interventions for autism spectrum disorder in Europe. Parents of children with autism spectrum disorder aged 7?years or younger (N?=?1680) were recruited through parent organisations in 18 European countries and completed an online survey about the interventions their child received. There was considerable variation in use of interventions, and in some countries more than 20% of children received no intervention at all. The most frequently reported interventions were speech and language therapy (64%) and behavioural, developmental and relationship-based interventions (55%). In some parts of Europe, use of behavioural, developmental and relationship-based interventions was associated with higher parental educational level and time passed since diagnosis, rather than with child characteristics. These findings highlight the need to monitor use of intervention for children with autism spectrum disorder in Europe in order to contrast inequalities.

This study investigated time trends and associated factors of incidence rates of diagnosed autism spectrum disorders (ASD) across the lifespan from 1995 to 2010, using data from the Danish Psychiatric Central Research Registry. First time diagnosis of childhood autism, atypical autism, Asperger's syndrome, or pervasive developmental disorder-unspecified (PDD-NOS) were identified, incidence rates were calculated, and data were fitted using non-linear least squares methods. A total of 14.997 patients were identified and incidence rates for ASD increased from 9.0 to 38.6 per 100,000 person years during the 16-year period. The increases were most pronounced in females, adolescents, adults, and patients with Asperger's syndrome and PDD-NOS.

The etiology of autism spectrum disorders (ASD) is for the majority of cases unknown and more studies of risk factors are needed. Geographic variation in ASD occurrence has been observed, and urban residence has been suggested to serve as a proxy for etiologic and identification factors in ASD. We examined the association between urbanicity level and ASD at birth and during childhood. The study used a Danish register-based cohort of more than 800,000 children of which nearly 4,000 children were diagnosed with ASD. We found a dose-response association with greater level of urbanicity and risk of ASD. This association was found for residence at birth as well as residence during childhood. Further, we found an increased risk of ASD in children who moved to a higher level of urbanicity after birth. Also, earlier age of ASD diagnosis in urban areas was observed. While we could not directly examine the specific reasons behind these associations, our results demonstrating particularly strong associations between ASD diagnosis and post-birth migration suggest the influence of identification-related factors such as access to services might have a substantive role on the ASD differentials we observed.

The International Collaboration for Autism Registry Epidemiology (iCARE) is the first multinational research consortium (Australia, Denmark, Finland, Israel, Norway, Sweden, USA) to promote research in autism geographical and temporal heterogeneity, phenotype, family and life course patterns, and etiology. iCARE devised solutions to challenges in multinational collaboration concerning data access security, confidentiality and management. Data are obtained by integrating existing national or state-wide, population-based, individual-level data systems and undergo rigorous harmonization and quality control processes. Analyses are performed using database federation via a computational infrastructure with a secure, web-based, interface. iCARE provides a unique, unprecedented resource in autism research that will significantly enhance the ability to detect environmental and genetic contributions to the causes and life course of autism.

To identify possible early signs of autism spectrum disorder (ASD) within the Danish National Birth Cohort, we studied prospectively collected interviews from 76,441 mothers about their children's development and behaviour at 6 and 18 months. In Danish national registries, 720 children with ASD and 231 children with intellectual disability (ID) were identified. At 6 months, associations between early signs and ASD or ID were found only in few areas. At 18 months social, language, and motor skills were delayed, and suspicion of vision and hearing problems were increased for both groups. Signs distinguishing ASD from ID were unclear, and the positive predictive values regarding ASD were below 10 % for individual predictors and aggregated risk scores.

The aim of this study was to study patterns of contact with hospital for children with autism spectrum disorder (ASD) using Danish population based register data. We included all children born in Denmark from 1994 through 2002. We found that children diagnosed with ASD had an increased rate of contact with hospital, almost regardless of the cause for the hospital contact. Given the overall association between hospital contact for various causes and ASD observed in these data, hospital data should be used cautiously in future studies searching for associations between a specific disease and ASD. If the increased rate of hospital contact overall for children with ASD is not considered, then misleading over interpretations might be made of observed associations between specific diseases and ASD.

The purpose of this study was to assess the validity of the diagnosis of childhood autism in the Danish Psychiatric Central Register (DPCR) by reviewing medical records from 499 of 504 total children with childhood autism born 1990-1999. Based on review of abstracted behaviors recorded in case records from child psychiatric hospitals, case status determination was performed using a standardized coding scheme. In 499 children diagnosed with childhood autism in the DPCR, the diagnosis could be confirmed in 469 children (94%). Of the 30 non-confirmed cases, five were classified by the reviewers as non-autistic cases and the remaining 25 cases were either classified with another ASD diagnosis or the specific diagnosis was not possible to determine.

Background: The etiology of autism is unknown. A strong genetic component has been detected but non-genetic factors may also be involved in the etiology. Methods: We used data from the Danish Psychiatric Central Register and the Danish Civil Registration System to study some risk factors of autism, including place of birth, parental place of birth, parental age, family history of psychiatric disorders, and paternal identity. Results: A total of 943,664 children younger than ten years were followed from 1994 to 2001; of those, 818 children developed autism. The highest risks of autism were found in siblings of children with autism, or Asperger's syndrome and other pervasive developmental disorders (PDDs), with relative risks of 22 and 13, respectively. The relative risk of autism in the child was about twice as high if the mother had been diagnosed with a psychiatric disorder. The risk of autism was associated with increasing degree of urbanisation of the child's place of birth and with increasing paternal, but not maternal, age. An increased relative risk of 1.4 was found if the mother was born outside Europe, and in children of parents who were born in different countries. Conclusions: The highest risk of autism was found in families with a history of autism, or Asperger's syndrome and other PDDs in siblings, supporting the commonly accepted knowledge that genetic factors are involved in the etiology of autism.

Background: High rejection rates for referrals to child and adolescent mental health services (CAMHS) are common. The most cited reasons for rejection are that the child does not have a clinical need for assessment and poor quality of the referrals. However, studies of interventions aimed at improving appropriateness of referrals are sparse. Methods: In this randomized feasibility trial, we tested if the Development and Well-Being Assessment (DAWBA) as an adjunct to referral letters could improve accuracy of referral decisions made by CAMHS. The primary outcome of the study was the proportion of "correct" referral decisions. Results: The study included 160 children referred to CAMHS. Almost all (95.6%) participants fulfilled criteria for a mental disorder and 82.1% also reported high impact of symptoms. Compared to the group who did not complete the DAWBA, referral decisions for the DAWBA group showed higher sensitivity (0.63 vs. 0.83), specificity (0.30 vs. 0.42), and negative predictive value (0.14 vs. 0.36) as well as slightly higher positive predictive value (0.81 vs. 0.86). Conclusions: The use of the DAWBA as an adjunct to standard referral letters could lead to more correct referral decisions and reduce the proportion of wrongful rejection referrals to CAMHS. [ABSTRACT FROM AUTHOR]