No abstract available.
Attention Deficit Disorder with Hyperactivity/diagnosis/*epidemiology ; Autistic Disorder/diagnosis/*epidemiology ; Behavior ; Humans ; Prevalence

OBJECTIVES: We examined the agreement between the Autism Diagnostic Observation Schedule (ADOS) and the Childhood Autism Rating Scale (CARS) in the diagnosis of autism spectrum disorder. METHODS: The ADOS and CARS scores of 78 children were retrospectively collected from a chart review. A correlation analysis was performed to examine the concurrent validity between the two measures. Using the receiver operating characteristic (ROC) curve, we determined the optimal cut-off score of the CARS for identifying autism spectrum disorder. RESULTS: The CARS score was significantly correlated with the ADOS score (r=0.808, p < 0.001). Taking ADOS as the ideal standard, the optimal cut-off scores of CARS for identifying autism and autism spectrum were 30 and 24.5, respectively. CONCLUSION: We determined the optimal cut-off scores of CARS for screening and diagnosing autism spectrum disorder.
Appointments and Schedules* ; Autism Spectrum Disorder* ; Autistic Disorder* ; Child ; Diagnosis* ; Humans ; Mass Screening ; Retrospective Studies ; ROC Curve

OBJECTIVE: To evaluate the value of autism screening checklists in the early identification of autism spectrum disorder (ASD). METHODS: A total of 2 571 children who attended the Children's Hospital of Chongqing Medical University and completed autism screening and diagnostic test were enrolled as subjects, among whom 2 074 were diagnosed with ASD, 261 were diagnosed with global developmental delay (GDD), 206 were diagnosed with developmental language disorder (DLD), and 30 had normal development. The sensitivity, specificity, and optimal threshold value of the Modified Checklist for Autism in Toddlers (M-CHAT) and the Autism Behavior Checklist (ABC) for the early identification of ASD were evaluated by the receiver operating characteristic (ROC) curve. RESULTS: The M-CHAT had a high sensitivity of 88.3% but a low specificity of 36.0% for the identification of ASD. Its sensitivity decreased with age, and was maintained above 80% for children aged 16 to < 48 months. The ABC had a high specificity of 87.3% but a low sensitivity of 27.2%, with an optimal cut-off value of 47.5 based on the ROC curve analysis. The multivariate linear regression model based on a combination of the M-CHAT and ABC for screening of ASD showed a specificity of 85.8% and a sensitivity of 56.6%. CONCLUSIONS The M-CHAT has a high sensitivity and a low specificity in the identification of ASD, with a better effect in children aged 16 to < 48 months. The ABC has a high specificity and a low sensitivity. The multiple linear regression model method based on the combined M-CHAT and ABC to screen ASD appears to be effective.
Adolescent ; Autism Spectrum Disorder/diagnosis* ; Autistic Disorder ; Checklist ; Humans ; Infant ; Mass Screening ; ROC Curve

Extraction and analysis of electroencephalogram (EEG) signal characteristics of patients with autism spectrum disorder (ASD) is of great significance for the diagnosis and treatment of the disease. Based on recurrence quantitative analysis (RQA)method, this study explored the differences in the nonlinear characteristics of EEG signals between ASD children and children with typical development (TD). In the experiment, RQA method was used to extract nonlinear features such as recurrence rate (RR), determinism (DET) and length of average diagonal line (LADL) of EEG signals in different brain regions of subjects, and support vector machine was combined to classify children with ASD and TD. The research results show that for the whole brain area (including parietal lobe, frontal lobe, occipital lobe and temporal lobe), when the three feature combinations of RR, DET and LADL are selected, the maximum classification accuracy rate is 84%, the sensitivity is 76%, the specificity is 92%, and the corresponding area under the curve (AUC) value is 0.875. For parietal lobe and frontal lobe (including parietal lobe, frontal lobe), when the three features of RR, DET and LADL are combined, the maximum classification accuracy rate is 82%, the sensitivity is 72%, and the specificity is 92%, which corresponds to an AUC value of 0.781. The research in this paper shows that the nonlinear characteristics of EEG signals extracted based on RQA method can become an objective indicator to distinguish children with ASD and TD, and combined with machine learning methods, the method can provide auxiliary evaluation indicators for clinical diagnosis. At the same time, the difference in the nonlinear characteristics of EEG signals between ASD children and TD children is statistically significant in the parietal-frontal lobe. This study analyzes the clinical characteristics of children with ASD based on the functions of the brain regions, and provides help for future diagnosis and treatment.
Autism Spectrum Disorder/diagnosis* ; Autistic Disorder ; Brain ; Child ; Electroencephalography ; Humans ; Recurrence

OBJECTIVES: Since the awareness of autism spectrum disorders(ASD) is growing, as a result, it is increasing numbers of infants and toddlers being referred to specialized clinics for a differential diagnosis and the importance of early autism spectrum disorders detection is emphasized. This study is to know the difference between ASD and intellectual disability(ID) from comparison of the demographics, clinical characters and obstetric complications. METHODS: The participants are 816 toddlers who visited the developmental delay clinic(DDC) in National Health Insurance Ilsan hospital. The number of toddlers diagnosed as ASD and ID was 324 and 492. 75 toddlers out of 114 who returned to DDC were diagnosed as ID at the first visit but 7 of them had changed diagnosis to ASD at the second visit. After compared ASD with ID from the first visit, we analyzed characters of toddlers who had the changed diagnosis to ASD at the second visit. RESULTS: As a result, the comparison between ASD and ID at the first visit shows that the boys have higher ratio, lower obstetric complication and lower language assessment score in ASD. The toddlers who had the changed diagnosis at the second visit were all boys and they had more cases of family history of developmental delay and had lower score of receptive language developmental quotient. CONCLUSIONS: These findings suggest that sex, language characteristics and obstetric complication could be useful in the early detection of ASD.
Autism Spectrum Disorder* ; Autistic Disorder* ; Demography ; Diagnosis ; Diagnosis, Differential ; Humans ; Infant ; Intellectual Disability* ; Language Development ; National Health Programs

OBJECTIVETo investigate the construct validity of the Autism Spectrum Rating Scale of Revised Chinese Version (RC-ASRS).

METHODSSeven hundred and one children aged 6-12 years old were recruited from one primary school in the Minhang District of Shanghai. The parents of the children completed the RC-ASRS questionnaire. Mpuls 6.0 Software was used to conduct the construct validity analysis.

RESULTSA total of 671 questionnaires (95.7%) were retrieved, involving 368 boys (54.8%) and 303 girls (45.2%). The 3 factor structure of the RC-ASRS had better model fitting indices, 0.051 for root mean square error of approximation (RMSEA), 0.889 for comparative fit index (CFI) and 0.884 for Tucker-Lewis index (TLI), compared with the original ASRS, 0.060 for RMSEA, 0.829 for CFI and 0.823 for TLI.

CONCLUSIONSThe RC-ASRS may serve as a reliable and valid tool for screening autistic symptoms in China.

Autistic Disorder ; diagnosis ; Child ; Child, Preschool ; Female ; Humans ; Male ; Reproducibility of Results ; Surveys and Questionnaires

OBJECTIVETo study the mental health state of parents of children with autism.

METHODSThe mental health state was evaluated by conducting the Symptom Checklist (SCL-90) on parents of 34 children with autism and of 35 healthy children.

RESULTSThe SCL-90 total scores in the fathers (162.5±34.0) and mothers of autistic children (175.1±51.0) were significantly higher than those in healthy children's parents (142.4±42.8 and 152.3±40.6, respectively) (P<0.05). The SCL-90 scores of obsessive-compulsive symptoms, depression, anxiety and paranoia in the fathers of autistic children were significantly higher than those in the fathers of healthy children (P<0.05). The SCL-90 scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, paranoia, psychotic symptoms, hostility and sleep/diet were significantly higher in the mothers of autistic children than those in the mothers of healthy children (P<0.05). The mothers of autistic children presented higher SCL-90 factor scores in interpersonal sensitivity, anxiety and psychotic symptoms than the fathers (P<0.05).

CONCLUSIONSWe should pay more attention to the mental health of parents of autistic children.

Autistic Disorder ; diagnosis ; Child ; Fathers ; Humans ; Mental Health ; Mothers ; Parents ; psychology

OBJECTIVEAbout 30% of autistic cases experience developmental regression around 2 years of age. The clinical course and manifestations of autistic children with regression remain unclear. This study investigated the clinical features of a group of autistic children with regression.

METHODSOne hundred and fifty-two children at ages of 2.5-6.5 years confirmed with autism based on DSM-IV diagnostic criteria were enrolled. They were grouped according to language development: normal or regression. The perinatal history, developmental history and characteristics of regression were investigated. The symptoms were compared between the two groups.

RESULTSRegressions were observed in 33 children (21.7%) at age of between 16 and 21 months, with loss both in communicative skills and social engagement. The regressive group was scored significantly higher on the Childhood Autism Rating Scale (CARS) (P<0.05) and had a relatively higher proportion of severely ill children (66.7% vs 45.4%; P<0.05)compared with the non-regressive group.

CONCLUSIONSRegression as a characteristic symptom occurs in some autistic children and is of value for diagnosis of autism. The autistic children with regression display more severe social and language impairments than those without regression. Regressive autism may be a special subtype.

Autistic Disorder ; diagnosis ; psychology ; Child ; Child Development ; Child, Preschool ; Female ; Humans ; Language Development ; Male ; Social Behavior

OBJECTIVEThe present study investigated the behavioral patterns of autistic children during infancy to provide clues for early identification of childhood autism.

METHODSThe abnormal behaviors of 30 children with autism and 26 children with other developmental disorders in infancy were investigated.

RESULTSThe children with autism presented a series of abnormal behaviors, including no social smile, no eye contact and no respond to own name, and joint attention deficiency, which were distinguished from the children with other developmental disorders. The imitation and attachment behaviors were significantly different between the two groups. Repetitive motor actions and interest peculiarity were only seen in children with autism.

CONCLUSIONSThe children with autism may present a series of abnormal behaviors as early as in infancy. The abnormal behaviors facilitate early diagnosis of autism.

Autistic Disorder ; diagnosis ; psychology ; Child Behavior Disorders ; etiology ; Child, Preschool ; Humans ; Male

OBJECTIVETo analyze and compare Modified Checklist for Autism in Toddlers (M-CHAT) and Checklist for Autism in Toddlers-23 (CHAT-23) in terms of clinical applicability, and to provide a basis for the understanding of early specific clinical manifestations of children with autism.

METHODSA total of 350 children aged 18-36 months who visited the Department of Developmental Pediatrics of Shengjing Hospital of China Medical University were enrolled as subjects. Of the 350 children, 284 who had not been previously diagnosed with autism were screened according to the two checklists. Sixty-eight confirmed cases of autism (including two of the 284 screening subjects diagnosed with autism) were assigned to the autism group, and 278 of the 284 screening subjects (except six children diagnosed with autism, mental retardation or cerebral palsy) were assigned to the control group. The two groups were compared with respect to the positive rate for each item in the checklists. The efficacy of the M-CHAT and CHAT-23 assessment criteria was evaluated by comparative analysis.

RESULTSThe autism group showed the highest positive rate for Item 9. There were significant differences between the two groups in terms of the positive rates for all items except Item 16 (P<0.05). When the assessment criterion was that autism was confirmed if there were positive results for at least 3 of a total of 23 items, M-CHAT showed the lowest rate of missed diagnosis (0%); when the assessment criterion was that autism was confirmed if there were positive results for at least 6 of a total of 23 items, CHAT-23 showed the lowest rate of misdiagnosis (1.77%). The specificity of M-CHAT is lower than that of CHAT-23 (P<0.05). There was no significant difference in sensitivity between the two checklists (P>0.05).

CONCLUSIONSCHAT-23 is more suitable than M-CHAT for clinical autism screening due to higher specificity, as well as having the advantages of low cost, easy completion,high efficiency and easy result judgment.

Autistic Disorder ; diagnosis ; Checklist ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Infant ; Male