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2. Sensory Abnormality and Quantitative Autism Traits in Children with and without Autism Spectrum Disorder in an Epidemiological Population

Author

Jussila, K., Junttila, M., Kielinen, M., Ebeling, H., Joskitt, L., Moilanen, I., and Mattila, M.-L

Abstract

Sensory abnormalities (SAs) are recognized features in Autism Spectrum Disorder (ASD), and a relationship between SAs and ASD traits is also suggested in general population. Our aims were to estimate the prevalence of SAs in three different settings, and to study the association between SAs and quantitative autism traits (QAT) using the Autism Spectrum Screening Questionnaire (ASSQ) and a parental questionnaire. In an epidemiological population of 8-year-old children (n = 4397), the prevalence of SAs was 8.3%, in an ASD sample (n = 28), 53.6%, and in a non-ASD sample (n = 4369), 8.0%, respectively. Tactile and auditory hypersensitivity predicted an ASD diagnosis. The ASSQ was able to differentiate children with and without SA. In conclusion, QAT level and SAs were associated in all study samples.

Published
2020
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4. Developing agency through music and movement

Author

Sutela, K. (Katja), Ojala, J. (Juha), Kielinen, M. (Marko), Sutela, K. (Katja), Ojala, J. (Juha), and Kielinen, M. (Marko)

Abstract

This ethnographic study examines the development of agency in students with special needs during an experiment of classroom music teaching in a special school. The experiment took place from August 2015 to March 2016 and was based on Emile Jaques-Dalcroze’s ideas of music and movement as a means of developing competencies, skills and understanding in music and life in general. The lessons included activities, such as quick reaction and follow exercises, singing with movement, body percussion exercises, dancing, movement improvisation, and relaxation exercises. The data consisted of video recordings of the lessons, and interviews with students, teachers, and teaching assistants. The data were analyzed using qualitative analysis software and thematic analysis. The analysis of the ethnographic data of this practitioner research showed that music-and-movement activities support the development of students’ agency by fostering (a) students’ own decision-making, (b) interaction with others, (c) expression of emotions and initiative, and (d) being recognized by others as active and able musicians. Consequently, this study encourages educators to advocate music and movement as a tool to support individual agency and active participation inside and outside the classroom.

Published
2021

5. Puheenvuoroja kieli- ja kulttuuritietoisesta varhaiskasvatuksesta

Author

Kess, R. (Riikka) and Kielinen, M. (Marko)

Subjects
moninaisuus, varhaiskasvatus, kielellinen kehitys, early childhood education, language awareness, linguistic development, kulttuuritietoisuus, cultural awareness, kielitietoisuus, diversity
Abstract

Tiivistelmä Tämä julkaisu on syntynyt osana Hyvään alkuun varhiksessa -hanketta. Hanke on toteutunut Oulun yliopiston, Kasvatustieteiden tiedekunnan koordinoimana vuosien 2018–2020 aikana ja hankkeen on rahoittanut Opetus- ja kulttuuriministeriö. Hanke on tähdännyt kielellisten valmiuksien arvioinnin ja tukemisen kehittämiseen sekä kieli- ja kulttuuritietoisen työotteen lisäämiseen päiväkodeissa varhaiskasvatuksen henkilöstölle suunnattujen täydennyskoulutusten avulla pohjoisessa Suomessa. Hankkeessa on suunniteltu kaksi eri laajuista täydennyskoulutuskokonaisuutta, jotka on toteutettu vuosina 2018–2019 Oulussa ja saamelaisalueella, Inarissa. Hankkeessa toteutettujen täydennyskoulutusten suunnittelussa ja toteutuksessa on tehty tiivistä yhteistyötä Oulun kaupungin ja Saamelaisalueen koulutuskeskuksen kanssa (SAKK). Tämä julkaisu on rakentunut Oulussa järjestetyn, 15 opintopisteen laajuisen täydennyskoulutuksen pohjalta ja artikkelit liittyvät täydennyskoulutuksen keskeisiin sisältöalueisiin: kielellisten valmiuksien arvioinnin kehittäminen, kielen moninaisuus ja yhdenvertaisuus varhaiskasvatuksessa sekä mentorointi yhteisten käytänteiden jalkauttamisessa. Julkaisussa kirjoittavat täydennyskoulutuksessa luennoitsijoina toimineet asiantuntijat. Mukana on myös yksi varhaiskasvatuksen kentän asiantuntijan puheenvuoro. Ajankohtaiset artikkelit käsittelevät varhaisten kuuntelutaitojen merkitystä lapsen kielenkehitykselle, moninaisuutta sukupuolen näkökulmasta varhaiskasvatuksessa, saamelaisten arvojen merkitystä saamelaisessa kasvatuksessa, ohjattua vertaisryhmätyöskentelyä käytänteiden kehittämisen tukena sekä kieli- ja kulttuuritietoisuutta varhaiskasvatuksen arjessa. Lisäksi julkaisun johdantoluvussa kuvataan hanketta ja toteutuneita täydennyskoulutuksia. Julkaisu on suunnattu varhaiskasvatuksen henkilöstölle sekä varhaiskasvatuksen oppimateriaaliksi kieli- ja kulttuuritietoisuutta käsitteleville opintojaksoille eri koulutusasteilla. Abstract This publication is part of the project “Good Start in the Early Childhood Education”, during the project period 2018–2020. The University of Oulu, Faculty of Education, is coordinating the project. The project is funded by the Finnish Ministry of Education and Culture. The project goals are to develop the evaluation and supporting of linguistic skills, and language- and culture-conscious work approach in preschools through continuing education for early childhood educators in Northern Finland. The project planned and executed two continuing education courses of separate scopes. The courses were implemented during 2018–2019 in Oulu region and in Sámi region, Inari. The project cooperated closely with the City of Oulu and with the Sámi Education Institute (SAKK) in the planning and implementation of the continuing education courses. This publication is based on the 15 ECTS course organized in Oulu. The articles relate to the key content areas of this continuing education course: development of language skills evaluation, language diversity and equality in early childhood education, and mentoring in the implementation of common practices. The articles of this publication are written by experts who acted as lecturers in this continuing education. There is also one article by an expert from the field of early childhood education. The articles deal with the importance of listening skills in child’s language development, diversity from gender perspective in early childhood education, the importance of values in the Sámi early childhood education, supervised peer group working in supporting practice development, and also language and cultural awareness of early childhood education in everyday life. The introductory chapter of the publication describes the project and the completed continuing education courses. The publication is aimed at early childhood educators and as an educational material for early childhood education courses dealing with language and cultural awareness at different levels of education.

Published
2020

6. Opettajat ammatillisina toimijoina inkluusiota edistämässä

Author

Takala, M. (Marjatta), Kielinen, M. (Marko), Sirkko, R. (Riikka), Takala, M. (Marjatta), Kielinen, M. (Marko), and Sirkko, R. (Riikka)

Abstract

Since the 1990s, the Finnish education policy has been committed to promoting inclusion and inclusive values. Inclusive education aims to promote the presence, learning and participation of all pupils in educational settings. One inclusive education method is co-teaching, where teachers plan, teach and evaluate students together. Collaboration between teachers requires professional agency, which in this dissertation summary section is understood as an ability that prepares employees for new learning, as well as a process that manifests when employees make choices about their work under different workplace conditions. This article dissertation examines inclusive education through three sub-studies to answer two research questions: 1) What does a teacher’s professional agency look like in co-teaching practices?; and 2) How can teachers support the realization of inclusion? The data for sub-studies I and II were collected using an electronic questionnaire and analyzed via qualitative content analysis. Sub-study III, meanwhile, consisted of photographs taken by students and discussions alongside them, which were analyzed using a phenomenological approach. The research results showed that the definition of inclusion is unclear for teachers, even when their workplace has used an element of inclusive education. Furthermore, some pedagogical methods even featured practices that categorize and exclude students. In their work, several teachers implemented co-teaching in a way that deviated from the traditional definition of co-teaching, broadening its definition. The teachers also described that co-teaching had increased learning at work. Co-teaching, in which professional development, interactions between teachers, trust in one another and a similar perception of teaching are realized, can be described as a situation where co-teachers have reached a level of collective agency. At that point, teachers have a common vision of their work and its purpose, and a desire t, Tiivistelmä Suomalainen koulutuspolitiikka on 1990-luvulta saakka sitoutunut edistämään inkluusiota ja sen arvoja. Inklusiivisella kasvatuksella pyritään edistämään kaikkien oppilaiden läsnäoloa, oppimista ja osallisuutta kasvatusympäristöissä. Yksi inklusiivisen opetuksen keino on yhteisopettajuus, jolla tarkoitetaan useamman opettajan toteuttamaa yhteistä opetuksen suunnittelua, toteutusta ja arviointia. Opettajien välinen yhteistyö edellyttää opettajilta ammatillista toimijuutta, joka käsitetään tämän väitöstutkimuksen yhteenveto-osassa kyvyksi, joka valmistaa työntekijöitä uuden oppimiseen sekä prosessiksi, joka ilmenee työntekijöiden tehdessä työtään koskevia valintoja työpaikan erilaisissa olosuhteissa. Tässä artikkeliväitöskirjassa tarkastellaan seuraavia tutkimuskysymyksiä kolmen osatutkimuksen kautta: 1) Millaiselta näyttää opettajan ammatillinen toimijuus yhteisopetuksen käytänteissä? ja 2) Kuinka opettajat voivat tukea inkluusion toteutumista? Osatutkimusten I ja II aineisto on koottu sähköisellä kyselylomakkeella ja aineisto on analysoitu sisällönanalyysillä. Osatutkimus III koostuu oppilaiden ottamista valokuvista ja keskusteluista niiden äärellä ja analyysissa on käytetty fenomenologista lähestymistapaa. Väitöstutkimuksen tulokset osoittavat, että inkluusio määritelmänä oli vielä epäselvä, vaikka työssä toteutettiin inklusiivisen opetuksen elementtejä. Joissakin pedagogisissa menetelmissä oli kuitenkin havaittavissa oppilaita kategorisoivia ja poissulkevia toimintatapoja. Useat opettajat olivat työssään toteuttaneet yhteisopetusta perinteisestä yhteisopetuksen määritelmästä poikkeavalla tavalla laajentaen yhteisopetuksen määritelmää. Opettajat kuvasivat yhteisopettajuuden lisänneen työssä oppimista. Yhteisopettajuutta, jossa toteutuivat ammatillinen kehittyminen, opettajien välinen vuorovaikutus, luottamus toiseen sekä samanlainen käsitys opettajuudesta, voidaan kuvata tilanteeksi, jossa yhteisopettajat ovat saavuttaneet kollektiivisen toimijuuden taso

Published
2020

7. Sensory abnormality and quantitative autism traits in children with and without autism spectrum disorder in an epidemiological population

Author

Jussila, K. (K.), Junttila, M. (M.), Kielinen, M. (M.), Ebeling, H. (H.), Joskitt, L. (L.), Moilanen, I. (I.), Mattila, M.-L. (M.-L.), Jussila, K. (K.), Junttila, M. (M.), Kielinen, M. (M.), Ebeling, H. (H.), Joskitt, L. (L.), Moilanen, I. (I.), and Mattila, M.-L. (M.-L.)

Abstract

Sensory abnormalities (SAs) are recognized features in Autism Spectrum Disorder (ASD), and a relationship between SAs and ASD traits is also suggested in general population. Our aims were to estimate the prevalence of SAs in three different settings, and to study the association between SAs and quantitative autism traits (QAT) using the Autism Spectrum Screening Questionnaire (ASSQ) and a parental questionnaire. In an epidemiological population of 8-year-old children (n = 4397), the prevalence of SAs was 8.3%, in an ASD sample (n = 28), 53.6%, and in a non-ASD sample (n = 4369), 8.0%, respectively. Tactile and auditory hypersensitivity predicted an ASD diagnosis. The ASSQ was able to differentiate children with and without SA. In conclusion, QAT level and SAs were associated in all study samples.

Published
2020

12. Autism in Northern Finland:a prevalence, follow-up and descriptive study of children and adolescents with autistic disorder

Author

Kielinen, M. (Marko)

Subjects
comorbidity, treatment, prevalence, outcome, autism, autistic spectrum
Abstract

The aims of this study were to estimate the prevalence of autism in Northern Finland and to assess retrospectively the associations of autistic disorder with identified medical conditions and additional disabilities in this defined population of children and adolescents with autistic disorder. In order to find out the factors influencing the outcome, the methods of treatment/habilitation and the interventions used were studied in detail. The last aim was to elicit reliable information for decision-makers as well as ideas for giving support and, because of the presumed better outcome, saving resources in the long run. The data were collected from hospital records and the records of the central institutions for the intellectually disabled in the Provinces of Oulu and Lapland in 1996–1997. The age-specific prevalences obtained in this study showed the prevalence to be lowest, i.e. 6.1 per 10 000, in the oldest age group of 15- to 18-year-old adolescents and highest, i.e. 20.7 per 10 000, in the age group of 5- to 7-year-old children, when the criteria of ICD-10 and DSM-IV were used. In this study, almost 50% of the autistic cases had a tested IQ above 70. Associated medical disorders or associated disorders of known or suspected genetic origin were diagnosed in 12.3%. Other associated medical disorders were epilepsy, hydrocephalus, fetal alcohol syndrome and cerebral palsy. Severe impairment of vision was evident in 3.7%. The most common therapies were physiotherapy and speech, occupational and music therapy. 43.9% of the children and adolescents with autism received specific training according to the TEACCH (Treatment and Education of Autistic and related Communication-Handicapped Children), 10.2% according to the Lovaas and 30.5% according to the Portage program. Antiepileptic medication had been prescribed to 23.9% and psychopharmacals to 14.9% of the individuals with autistic disorder (AD). About three- to fourfold prevalence of AD in Northern Finland was found when compared to 16 years ago. Early, effective and regular interventions in autism have a good impact and should be provided as early as possible to children with autism. Based on the poorer prognosis of those without any early intervention, it can be anticipated that these methods will save resources in the long run.

Published
2005

14. Opettajat ammatillisina toimijoina inkluusiota edistämässä

Author

Sirkko, R. (Riikka), Takala, M. (Marjatta), and Kielinen, M. (Marko)

Subjects
school development, ekskluusio, inclusion, professional agency, co-teaching, ammatillinen toimijuus, yhteisopettajuus, koulun kehittäminen, exclusion, inkluusio
Abstract

Since the 1990s, the Finnish education policy has been committed to promoting inclusion and inclusive values. Inclusive education aims to promote the presence, learning and participation of all pupils in educational settings. One inclusive education method is co-teaching, where teachers plan, teach and evaluate students together. Collaboration between teachers requires professional agency, which in this dissertation summary section is understood as an ability that prepares employees for new learning, as well as a process that manifests when employees make choices about their work under different workplace conditions. This article dissertation examines inclusive education through three sub-studies to answer two research questions: 1) What does a teacher’s professional agency look like in co-teaching practices?; and 2) How can teachers support the realization of inclusion? The data for sub-studies I and II were collected using an electronic questionnaire and analyzed via qualitative content analysis. Sub-study III, meanwhile, consisted of photographs taken by students and discussions alongside them, which were analyzed using a phenomenological approach. The research results showed that the definition of inclusion is unclear for teachers, even when their workplace has used an element of inclusive education. Furthermore, some pedagogical methods even featured practices that categorize and exclude students. In their work, several teachers implemented co-teaching in a way that deviated from the traditional definition of co-teaching, broadening its definition. The teachers also described that co-teaching had increased learning at work. Co-teaching, in which professional development, interactions between teachers, trust in one another and a similar perception of teaching are realized, can be described as a situation where co-teachers have reached a level of collective agency. At that point, teachers have a common vision of their work and its purpose, and a desire to reflect on their work together. Tiivistelmä Suomalainen koulutuspolitiikka on 1990-luvulta saakka sitoutunut edistämään inkluusiota ja sen arvoja. Inklusiivisella kasvatuksella pyritään edistämään kaikkien oppilaiden läsnäoloa, oppimista ja osallisuutta kasvatusympäristöissä. Yksi inklusiivisen opetuksen keino on yhteisopettajuus, jolla tarkoitetaan useamman opettajan toteuttamaa yhteistä opetuksen suunnittelua, toteutusta ja arviointia. Opettajien välinen yhteistyö edellyttää opettajilta ammatillista toimijuutta, joka käsitetään tämän väitöstutkimuksen yhteenveto-osassa kyvyksi, joka valmistaa työntekijöitä uuden oppimiseen sekä prosessiksi, joka ilmenee työntekijöiden tehdessä työtään koskevia valintoja työpaikan erilaisissa olosuhteissa. Tässä artikkeliväitöskirjassa tarkastellaan seuraavia tutkimuskysymyksiä kolmen osatutkimuksen kautta: 1) Millaiselta näyttää opettajan ammatillinen toimijuus yhteisopetuksen käytänteissä? ja 2) Kuinka opettajat voivat tukea inkluusion toteutumista? Osatutkimusten I ja II aineisto on koottu sähköisellä kyselylomakkeella ja aineisto on analysoitu sisällönanalyysillä. Osatutkimus III koostuu oppilaiden ottamista valokuvista ja keskusteluista niiden äärellä ja analyysissa on käytetty fenomenologista lähestymistapaa. Väitöstutkimuksen tulokset osoittavat, että inkluusio määritelmänä oli vielä epäselvä, vaikka työssä toteutettiin inklusiivisen opetuksen elementtejä. Joissakin pedagogisissa menetelmissä oli kuitenkin havaittavissa oppilaita kategorisoivia ja poissulkevia toimintatapoja. Useat opettajat olivat työssään toteuttaneet yhteisopetusta perinteisestä yhteisopetuksen määritelmästä poikkeavalla tavalla laajentaen yhteisopetuksen määritelmää. Opettajat kuvasivat yhteisopettajuuden lisänneen työssä oppimista. Yhteisopettajuutta, jossa toteutuivat ammatillinen kehittyminen, opettajien välinen vuorovaikutus, luottamus toiseen sekä samanlainen käsitys opettajuudesta, voidaan kuvata tilanteeksi, jossa yhteisopettajat ovat saavuttaneet kollektiivisen toimijuuden tason. Kollektiivisen toimijuuden tasolla opettajilla on yhteinen näkemys työstä ja sen tarkoituksesta sekä halua yhteiseen työn reflektointiin.

Published
2020

15. Factor analysis of the autism spectrum screening questionnaire in a population-based child sample.

Author

Junttila M, Jussila K, Joskitt L, Ebeling H, Kielinen M, Loukusa S, Miettunen J, Mäntymaa M, and Mattila ML

Subjects
Humans, Child, Surveys and Questionnaires, Psychometrics, Factor Analysis, Statistical, Reproducibility of Results, Mass Screening, Autistic Disorder diagnosis, Autistic Disorder epidemiology, Child Development Disorders, Pervasive diagnosis, Autism Spectrum Disorder diagnosis, Autism Spectrum Disorder epidemiology
Abstract

Purpose: The aim of this study was to investigate several possible factor structures of the Autism Spectrum Screening Questionnaire (ASSQ)., Materials and Methods: We used the 27-item screening tool for school-aged children in a general population of 8-year-old children ( n  = 3,538) and compared the occurring solutions to previously published factor models., Results: A one-factor solution and a four-factor solution were identified in Exploratory Factor Analysis (EFA) and confirmed with Confirmatory Factor Analysis (CFA), while two-, three-, five- and six-factor solutions were rejected. In CFA, our four-factor solution showed the best goodness-of-fit indexes when compared with factor models previously presented by Posserud et al. and Ehlers et al., Conclusions: The results indicate a strong underlying connection between all ASSQ items which is elicited by the one-factor solution. Although as a screening tool, ASSQ is functioning with the unifactorial solution, the four factors can help to identify certain clusters of autism spectrum traits.

Published
2023
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16. Validation of the Finnish Autism Spectrum Screening Questionnaire (ASSQ) for clinical settings and total population screening.

Author

Mattila ML, Jussila K, Linna SL, Kielinen M, Bloigu R, Kuusikko-Gauffin S, Joskitt L, Ebeling H, Hurtig T, and Moilanen I

Subjects
Child, Diagnostic and Statistical Manual of Mental Disorders, Female, Finland, Humans, Male, Psychometrics, Schools, Child Development Disorders, Pervasive diagnosis, Mass Screening, Surveys and Questionnaires
Abstract

We assessed the validity and determined cut-off scores for the Finnish Autism Spectrum Screening Questionnaire (ASSQ). A population sample of 8-year-old children (n = 4,408) was rated via the ASSQ by parents and/or teachers, and a subgroup of 104 children was examined via structured interview, semi-structured observation, IQ measurement, school observation, and medical records. Autism spectrum disorders (ASDs) were diagnosed following DSM-IV-TR criteria. A search for hospital-registered ASDs was performed. For Finnish higher-functioning primary school-aged, 7- to 12-year-olds, the optimal cut-off score was 30 in clinical settings and 28 in total population screening using summed ASSQ scores of parents' and teachers' ratings. Determining appropriate cut-off scores in ASD screening in different languages and in different cultures is of utmost importance.

Published
2012
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17. [Autism spectrum disorders in children and adolescents].

Author

Moilanen I, Mattila ML, Loukusa S, and Kielinen M

Subjects
Adolescent, Child, Child Development Disorders, Pervasive epidemiology, Comorbidity, Humans, Mass Screening, Prevalence, Prognosis, Child Development Disorders, Pervasive diagnosis, Child Development Disorders, Pervasive physiopathology, Child Development Disorders, Pervasive rehabilitation
Abstract

Childhood autism, Asperger's syndrome and atypical autism together make up autism spectrum disorders (ASDs) with a prevalence of 0.6-0.7%. These disorders are defined by qualitative impairments in social interaction, qualitative abnormalities in communication, and by restricted, stereotyped, repetitive patterns of behaviour, interests and activities. Many children or adolescents with ASDs have sensory abnormalities, neurological disorders and additional disabilities of vision, hearing or ambulation. Psychiatric co-morbidity is common. Diagnostics and rehabilitation are implemented in multi-professional collaboration. Early recognition makes up the basis for early intervention that improves the prognosis. Screening of these disorders in well-baby clinics is being developed.

Published
2012

18. Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: a community- and clinic-based study.

Author

Mattila ML, Hurtig T, Haapsamo H, Jussila K, Kuusikko-Gauffin S, Kielinen M, Linna SL, Ebeling H, Bloigu R, Joskitt L, Pauls DL, and Moilanen I

Subjects
Adolescent, Anxiety Disorders complications, Anxiety Disorders diagnosis, Anxiety Disorders psychology, Asperger Syndrome psychology, Attention Deficit and Disruptive Behavior Disorders complications, Attention Deficit and Disruptive Behavior Disorders diagnosis, Attention Deficit and Disruptive Behavior Disorders psychology, Child, Depressive Disorder, Major complications, Depressive Disorder, Major diagnosis, Depressive Disorder, Major psychology, Female, Humans, Male, Mental Disorders diagnosis, Mental Disorders psychology, Psychiatric Status Rating Scales, Sex Factors, Tic Disorders complications, Tic Disorders diagnosis, Tic Disorders psychology, Asperger Syndrome complications, Mental Disorders complications
Abstract

The present study identifies the prevalence and types of comorbid psychiatric disorders associated with Asperger syndrome (AS)/high-functioning autism (HFA) in a combined community- and clinic-based sample of fifty 9- to 16-year-old subjects using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version. The level of functioning was estimated using the Children's Global Assessment Scale. The results support common (prevalence 74%) and often multiple comorbid psychiatric disorders in AS/HFA; behavioral disorders were shown in 44%, anxiety disorders in 42% and tic disorders in 26%. Oppositional defiant disorder, major depressive disorder and anxiety disorders as comorbid conditions indicated significantly lower levels of functioning. To target interventions, routine evaluation of psychiatric comorbidity in subjects with AS/HFA is emphasized.

Published
2010
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19. When does the Autism Spectrum Screening Questionnaire (ASSQ) predict autism spectrum disorders in primary school-aged children?

Author

Mattila ML, Jussila K, Kuusikko S, Kielinen M, Linna SL, Ebeling H, Bloigu R, Joskitt L, Pauls D, and Moilanen I

Subjects
Child, Faculty, Female, Health Surveys, Humans, Male, Parents, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results, Schools, Statistics, Nonparametric, Child Development Disorders, Pervasive diagnosis, Surveys and Questionnaires
Abstract

The aims of this study were, firstly, to study the association between parents' and teachers' ratings for the Finnish version of the Autism Spectrum Screening Questionnaire (ASSQ), secondly, to find out whether the original cut-off scores of the ASSQ identify primary school-aged children with Asperger syndrome (AS) or autism by using the Finnish ASSQ, and thirdly, to evaluate the validity of the ASSQ. Parents and/or teachers of higher-functioning (full-scale intelligence quotient > or = 50) 8-year-old total population school children (n = 4,408) and 7-12-year-old outpatients with AS/autism (n = 47) completed the Finnish version of the ASSQ. Agreement between informants was slight. In the whole total population, low positive correlation was found between parents' and teachers' ratings, while in the sample of high-scoring children the correlation turned out to be negative. A cut-off of 30 for parents' and teacher's summed score and 22 for teachers' single score is recommended. A valid cut-off for parents' single score could not been estimated. The clinicians are reminded that the ASSQ is a screening instrument, not a diagnosing instrument. The importance of using both parents' and teachers' ratings for screening in clinical settings is underlined.

Published
2009
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20. An epidemiological and diagnostic study of Asperger syndrome according to four sets of diagnostic criteria.

Author

Mattila ML, Kielinen M, Jussila K, Linna SL, Bloigu R, Ebeling H, and Moilanen I

Subjects
Adolescent, Child, Diagnosis, Differential, Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, International Classification of Diseases, Male, Prevalence, Surveys and Questionnaires, Asperger Syndrome diagnosis, Asperger Syndrome epidemiology
Abstract

Objective: This study evaluated the diagnostic process and prevalence rates of Asperger syndrome (AS) according to the DSM-IV, ICD-10, and criteria developed by Gillberg and Gillberg and by Szatmari and colleagues and clarified confusion about AS., Method: An epidemiological study of 5,484 eight-year-old children in Finland, 4,422 (80.6%) of whom rated on the high-functioning Autism Spectrum Screening Questionnaire by parents and/or teacher, 125 of them screened and 110 examined by using structured interview, semistructured observation, IQ measurement, school day observation, and patient records. Diagnoses were performed by following the DSM-IV, ICD-10, and criteria developed by Gillberg and Gillberg and by Szatmari and colleagues in detail., Results: The prevalence rates per 1,000 were 2.5 according to the DSM-IV, 2.9 to ICD-10, 2.7 to Gillberg and Gillberg's criteria, and 1.6 to the criteria of Szatmari et al., Conclusions: The results emphasize the need to reconsider the diagnostic criteria of AS. The importance of multi-informant sources came up, and the need of several informants was highlighted, especially when diagnosing the broader pervasive developmental disorders.

Published
2007
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21. Intervention,treatmentand care in autistic disorder. Challenging case reports from northern Finland.

Author

Kielinen M, Hjelmquist E, Moilanen I, and Syrjälä L

Subjects
Adolescent, Autistic Disorder epidemiology, Behavior Therapy methods, Child, Combined Modality Therapy, Female, Finland epidemiology, Humans, Intelligence Tests, Male, Prognosis, Psychiatric Status Rating Scales, Retrospective Studies, Risk Assessment, Sampling Studies, Severity of Illness Index, Treatment Outcome, Autistic Disorder diagnosis, Autistic Disorder therapy, Psychotherapy methods, Psychotropic Drugs therapeutic use
Abstract

Objectives: Autism produces characteristic patterns of behaviour, and individuals with autistic disorder (AD) have a lot in common in terms of behaviour and mannerisms. Individuals with autism, however, also have their own overall personalities, which both underlie and interact with their autism. This article focuses on challenges of identifying AD and delivering appropriate services in face of long distances and limited resources., Study Design: This study is a retrospective descriptive chart review and cases series. Hospital records and data on the treatment/habilitation status of 187 children and adolescents with autistic disorder aged 3-18 years were evaluated from Northern Finland., Methods: Nine subjects, representing the age group of 9- to 17-year-olds, did not show any improvement on the Childhood Autism Rating Scale (CARS) and in the clinical examination during the follow-up period 1990--97. In this study, these children and adolescents with AD were evaluated more carefully., Results: The treatment programs and therapies varied, depending on the availability of trained staff. There were various reasons for the absence of the most suitable treatment, or habilitation, at the individual level. The difficulties also varied over time and between individuals. In addition, after the follow-up period, four of the nine (55.6%) individuals showed more positive outcome when the level of autism had been taken into account in the planning of the intervention for, treatment and care of AD., Conclusion: The possible reasons for poor outcome included the level of mental disability, impairments of speech and communication, lack of knowledge of autism at the municipal level, long distance to services, severe epilepsy, additional medical diagnosis, parental acceptance of the child's autism and late start of the intervention for, or habilitation of autism.

Published
2005
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22. Associated medical disorders and disabilities in children with autistic disorder: a population-based study.

Author

Kielinen M, Rantala H, Timonen E, Linna SL, and Moilanen I

Subjects
Adolescent, Cerebral Palsy epidemiology, Child, Child, Preschool, Chromosome Aberrations, Epilepsy epidemiology, Female, Finland, Health Surveys, Hearing Disorders epidemiology, Humans, Hydrocephalus epidemiology, Incidence, Male, Tuberous Sclerosis epidemiology, Autistic Disorder complications, Disabled Children
Abstract

A population-based survey was conducted among 152,732 Finnish children and adolescents aged under 16 years and living in northern Finland. Diagnoses and associated medical conditions were derived from the hospital and institutional records of this area. One hundred and eighty-seven children with DSM-IV autistic disorder were identified. Associated medical disorders or associated disorders of known or suspected genetic origin were found in 12.3 percent, including tuberous sclerosis, Down syndrome, fragile X syndrome, Klinefelter syndrome, XYY syndrome, chromosome 17 deletion, chromosome 46, XX, dup(8) (p) and mitochondriopathy. Other associated medical disorders identified were epilepsy, hydrocephalus, foetal alcohol syndrome and cerebral palsy. Hearing impairments were found in 8.6 percent and severe impairment of vision in 3.7 percent of the individuals with autistic disorder. Medical disorders seem to have a special impact on the genesis of autistic disorder and need to be thoroughly examined in each child with autistic disorder.

Published
2004
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23. Deficient auditory processing in children with Asperger Syndrome, as indexed by event-related potentials.

Author

Jansson-Verkasalo E, Ceponiene R, Kielinen M, Suominen K, Jäntti V, Linna SL, Moilanen I, and Näätänen R

Subjects
Acoustic Stimulation, Asperger Syndrome complications, Auditory Perceptual Disorders etiology, Child, Electroencephalography, Female, Humans, Male, Asperger Syndrome physiopathology, Auditory Perception physiology, Auditory Perceptual Disorders physiopathology, Evoked Potentials, Auditory physiology
Abstract

Asperger Syndrome (AS) is characterized by normal language development but deficient understanding and use of the intonation and prosody of speech. While individuals with AS report difficulties in auditory perception, there are no studies addressing auditory processing at the sensory level. In this study, event-related potentials (ERP) were recorded for syllables and tones in children with AS and in their control counterparts. Children with AS displayed abnormalities in transient sound-feature encoding, as indexed by the obligatory ERPs, and in sound discrimination, as indexed by the mismatch negativity. These deficits were more severe for the tone stimuli than for the syllables. These results indicate that auditory sensory processing is deficient in children with AS, and that these deficits might be implicated in the perceptual problems encountered by children with AS.

Published
2003
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24. Some aspects of treatment and habilitation of children and adolescents with autistic disorder in Northern-Finland.

Author

Kielinen M, Linna SL, and Moilanen I

Subjects
Adolescent, Anticonvulsants therapeutic use, Autistic Disorder classification, Autistic Disorder complications, Autistic Disorder drug therapy, Child, Child, Preschool, Epilepsy complications, Epilepsy drug therapy, Female, Finland, Humans, Male, Patient Education as Topic, Perception, Treatment Outcome, Autistic Disorder rehabilitation, Autistic Disorder therapy
Abstract

Hospital records and data on the treatment/habilitation status of 187 children with autism aged 3-18 years were gathered from Northern Finland. The treatment programs and therapies varied, depending on the trained staff available. One-hundred and fifty-two (82.9%) children and adolescents with autism received more than one therapeutic intervention or specific training program. The most common therapies were physiotherapy as well as speech, occupational and music therapy. 43.9% of the children and adolescents with autism received specific training according to TEACCH (Treatment and Education of Autistic and related Communication-Handicapped Children), 10.2% according to Lovaas and 30.5% according to the Portage program. Antiepileptic medication had been prescribed to 23.9% and psychopharmacological interventions to 14.9% of the individuals with autistic disorder (AD). One hundred and seventy-eight subjects out of 187 showed some improvement on the Childhood Autism Rating Scale (CARS), even if no statistically significant difference was found between the outcome of the available habilitation methods.

Published
2002
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