Search

Symptoms of autism spectrum disorder and attention-deficit/hyperactivity disorder often co-occur, challenging timely, and accurate diagnosis. We assessed the performance of three parent-report measures in discriminating autism spectrum disorder from attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD) in school-age verbally fluent children. We examined the Autism Symptom Interview – School-Age and two widely used parent questionnaires: Social Responsiveness Scale – 2nd Edition and Social Communication Questionnaire – Lifetime. Receiver operating characteristic curves assessed each instrument’s performance against the best-estimate clinician Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnosis of autism spectrum disorder or of ADHDw/oASD ( n = 74, n = 102, respectively; 6–11 years). These yielded moderate accuracies: area under the curve = 0.85, 0.79, and 0.78 for Social Communication Questionnaire – Lifetime, Autism Symptom Interview, and Social Responsiveness Scale – 2nd Edition, respectively. Area under the curve pairwise comparisons reached our statistical significance ( p w/oASD. Lay abstract We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview – School-Age, the Social Responsiveness Scale – 2nd Edition, and the Social Communication Questionnaire – Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire – Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.

Children with autism spectrum disorder (ASD) have varying degrees of language impairment across multiple domains, which may include deficits in syntactic, pragmatic, and/or semantic skills. The heterogeneity of language profiles within ASD, coupled with the limited scope of existing standardized language measures, makes a comprehensive assessment of language impairments in ASD challenging. The Observation of Spontaneous Expressive Language (OSEL) is a new measure developed to capture children's spontaneous use of language in a naturalistic setting. The current study used the OSEL to examine the patterns of spontaneous expressive language abilities of 87 clinically ascertained children with ASD from 2 to 12 years. As expected, children with ASD were significantly more impaired in their spontaneous use of language compared to typically developing peers. Syntax and narrative skills continued to increase with age from toddler to elementary school years in cross-sectional comparisons. Pragmatic skills improved form toddler to preschool years but remained stable from preschool to elementary school years. Preliminary data also demonstrated significant improvements in OSEL syntax scores over time for a subset of children followed longitudinally (n = 8). Children with ASD consistently showed more impairments in spontaneous expressive language captured on the OSEL compared to language skills measured by other more structured standardized assessments, despite moderate convergent validity among those measures. Results suggest that impairments in the spontaneous and functional use of expressive language persist into middle childhood for many children with ASD, and a comprehensive assessment approach can lead to more precisely targeted treatment addressing specific language profiles. LAY SUMMARY: This study aimed to examine the variable language profiles in children with ASD. Children with ASD were shown to have impairments in the structure, meaning, and social use of language. These challenges were captured best by a measure that was created to assess the spontaneous use of language in a naturalistic environment. The results of this study emphasize the importance of a comprehensive assessment of language in ASD to inform treatment. Autism Res 2021, 14: 720-732. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

Symptoms of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) often co-occur, challenging timely and accurate diagnosis. We assessed the performance of three parent-report measures in discriminating ASD from ADHD without ASD (ADHDw/oASD) in school-age verbally fluent children. We examined the Autism Symptom Interview (ASI) School-Age and two widely used parent questionnaires: Social Responsiveness Scale-2nd Edition (SRS-2) and Social Communication Questionnaire-Lifetime (SCQ-L). Receiver operating characteristic curves assessed each instrument’s performance against the best-estimate clinician DSM-5 diagnosis of ASD or of ADHDw/oASD (n=74, n=102, respectively; 6-11 years). These yielded moderate accuracies: AUC=0.85, 0.79, 0.78 for SCQ-L, ASI, SRS-2, respectively. AUC pairwise comparisons reached our statistical significance (p

Distinguishing between symptoms of ASD and symptoms of other disorders can be a challenge. Chapter 3 provides a brief overview of diagnoses that may present as ASD but are not, such as attention deficit/hyperactivity disorder, intellectual disability, and oppositional defiant disorder. Clinicians should keep in mind that the disorders discussed in this chapter are only a few of the psychiatric disorders that have symptoms that can overlap with symptoms of ASD. This chapter will focus on symptoms that seem similar across disorders as well as ways in which clinicians may distinguish between disorders. It is important to consult the DSM for other differential diagnoses. The chapter discusses how the diagnoses are similar and different to ASD and provides vignettes as examples.