Autism spectrum symptoms in children with neurological disorders

Chinese Medicine

Astri J Lundervold²  Christopher Gillberg¹  Maj-Britt Posserud³  Mari Hysing²  Hilde K Ryland² 

[1] Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Centre for Child and Adolescent Mental Health and Welfare, Uni Research, Bergen, Norway;Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway

关键词: The Autism Spectrum Screening Questionnaire;    Autism spectrum symptoms;    Neurological disorders;    Children;   

Others  :  791213
DOI  :  10.1186/1753-2000-6-34

 received in 2012-08-20, accepted in 2012-11-08,  发布年份 2012

【 摘 要 】

Background

The aims of the present study were to assess symptoms associated with an autism spectrum disorder (ASD) in children with neurological disorders as reported by parents and teachers on the Autism Spectrum Screening Questionnaire (ASSQ), as well as the level of agreement between informants for each child.

Methods

The ASSQ was completed by parents and teachers of the 5781 children (11–13 years) who participated in the second wave of the Bergen Child Study (BCS), an on-going longitudinal population-based study. Out of these children, 496 were reported to have a chronic illness, including 99 whom had a neurological disorder. The neurological disorder group included children both with and without intellectual disabilities.

Results

Children with neurological disorders obtained significantly higher parent and teacher reported ASSQ scores than did non-chronically ill children and those with other chronic illnesses (p<.01; ES = .50-1.01), and 14.1% were screened above the positive cutoff score for ASD according to their combined parent and teacher ASSQ scores. Parent/teacher agreement over ASSQ scores for children with neurological disorders was moderate to high for the total score and for three sub scores generated from a factor analysis, and low to moderate for single items.

Conclusions

The ASSQ identifies a high rate of ASD symptoms in children with neurological disorders, and a large number of children screened in the positive range for ASD. Although a firm conclusion awaits further clinical studies, the present results suggest that health care professionals should be aware of potential ASD related problems in children with neurological disorders, and should consider inclusion of the ASSQ or similar screening instruments as part of their routine assessment of this group of children.

【 授权许可】

   
2012 Ryland et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Gillberg C: Double syndromes: autism associated with genetic, medical and metabolic disorders. In Cognitive and Behavioural Abnormalities of Pediatric Diseases. Edited by Nass RD, Frank Y. Oxford University Press, New York; 2010:11-29.
• [2]American Psychiatric Association: Diagnostic and statistical manual of mental disorders. Revised 4 edition. Author, Washington, DC; 2000.
• [3]Ehlers S, Gillberg C, Wing L: A screening questionnaire for Asperger syndrome and other high-functioning autism spectrum disorders in school age children. J Autism Dev Disord 1999, 29(2):129-141.
• [4]Robins DL, Fein D, Barton ML, Green JA: The modified checklist for autism in toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord 2001, 31(2):131-144.
• [5]Kuban KC, O'Shea TM, Allred EN, Tager-Flusberg H, Goldstein DJ, Leviton A: Positive screening on the Modified Checklist for Autism in Toddlers (M-CHAT) in extremely low gestational age newborns. J Pediatr 2009, 154(4):535-40 e531.
• [6]Krug DA, Arick J, Almond P: Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. J Child Psychol Psychiatry 1980, 21(3):221-229.
• [7]Fernell E, Gillberg C, von Wendt L: Autistic symptoms in children with infantile hydrocephalus. Acta Paediatr Scand 1991, 80(4):451-457.
• [8]Schopler E, Reichler RJ, DeVellis RF, Daly K: Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS). J Autism Dev Disord 1980, 10(1):91-103.
• [9]Lindquist B, Carlsson G, Persson EK, Uvebrant P: Behavioural problems and autism in children with hydrocephalus: a population-based study. Eur Child Adolesc Psychiatry 2006, 15(4):214-219.
• [10]Berument SK, Rutter M, Lord C, Pickles A, Bailey A: Autism screening questionnaire: diagnostic validity. Br J Psychiatry 1999, 175:444-451.
• [11]Clarke DF, Roberts W, Daraksan M, Dupuis A, McCabe J, Wood H, Snead OC 3rd, Weiss SK: The prevalence of autistic spectrum disorder in children surveyed in a tertiary care epilepsy clinic. Epilepsia 2005, 46(12):1970-1977.
• [12]Hendriksen JG, Vles JS: Neuropsychiatric disorders in males with duchenne muscular dystrophy: frequency rate of attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, and obsessive–compulsive disorder. J Child Neurol 2008, 23(5):477-481.
• [13]Lord C, Rutter M, Le Couteur A: Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 1994, 24(5):659-685.
• [14]Ekstrom AB, Hakenas-Plate L, Samuelsson L, Tulinius M, Wentz E: Autism spectrum conditions in myotonic dystrophy type 1: a study on 57 individuals with congenital and childhood forms. Am J Med Genet B Neuropsychiatr Genet 2008, 147B(6):918-926.
• [15]Kilincaslan A, Mukaddes NM: Pervasive developmental disorders in individuals with cerebral palsy. Dev Med Child Neurol 2009, 51(4):289-294.
• [16]Kadesjo B, Gillberg C: The comorbidity of ADHD in the general population of Swedish school-age children. J Child Psychol Psychiatry 2001, 42(4):487-492.
• [17]Levy SE, Giarelli E, Lee LC, Schieve LA, Kirby RS, Cunniff C, Nicholas J, Reaven J, Rice CE: Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United States. J Dev Behav Pediatr 2010, 31(4):267-275.
• [18]Klein-Tasman BP, Phillips KD, Lord C, Mervis CB, Gallo FJ: Overlap with the autism spectrum in young children with Williams syndrome. J Dev Behav Pediatr 2009, 30(4):289-299.
• [19]Gillberg C: The ESSENCE in child psychiatry: early symptomatic syndromes eliciting neurodevelopmental clinical examinations. Res Dev Disabil 2010, 31(6):1543-1551.
• [20]Bax MC, Flodmark O, Tydeman C: Definition and classification of cerebral palsy. From syndrome toward disease. Dev Med Child Neurol Suppl 2007, 109:39-41.
• [21]Dosreis S, Weiner CL, Johnson L, Newschaffer CJ: Autism spectrum disorder screening and management practices among general pediatric providers. J Dev Behav Pediatr 2006, 27(2 Suppl):S88-S94.
• [22]Kadesjo B, Gillberg C, Hagberg B: Brief report: autism and Asperger syndrome in seven-year-old children: a total population study. J Autism Dev Disord 1999, 29(4):327-331.
• [23]Lesinskiene S: Children with Asperger syndrome: specific aspects of their drawings. Int J Circumpolar Health 2002, 61(Suppl 2):90-96.
• [24]Mattila ML, Jussila K, Kuusikko S, Kielinen M, Linna SL, Ebeling H, Bloigu R, Joskitt L, Pauls D, Moilanen I: When does the Autism Spectrum Screening Questionnaire (ASSQ) predict autism spectrum disorders in primary school-aged children? Eur Child Adolesc Psychiatry 2009, 18(8):499-509.
• [25]Petersen DJ, Bilenberg N, Hoerder K, Gillberg C: The population prevalence of child psychiatric disorders in Danish 8- to 9-year-old children. Eur Child Adolesc Psychiatry 2006, 15(2):71-78.
• [26]Webb E, Morey J, Thompsen W, Butler C, Barber M, Fraser WI: Prevalence of autistic spectrum disorder in children attending mainstream schools in a Welsh education authority. Dev Med Child Neurol 2003, 45(6):377-384.
• [27]Guo YQ, Tang Y, Rice C, Lee LC, Wang YF, Cubells JF: Validation of the Autism Spectrum Screening Questionnaire, Mandarin Chinese Version (CH-ASSQ) in Beijing. China, Autism; 2011.
• [28]Posserud MB, Lundervold AJ, Gillberg C: Validation of the autism spectrum screening questionnaire in a total population sample. J Autism Dev Disord 2009, 39(1):126-134.
• [29]Wing L, Leekam SR, Libby SJ, Gould J, Larcombe M: The diagnostic interview for social and communication disorders: background, inter-rater reliability and clinical use. Journal of child psychology and psychiatry, and allied disciplines 2002, 43(3):307-325.
• [30]Posserud B, Lundervold AJ, Steijnen MC, Verhoeven S, Stormark KM, Gillberg C: Factor analysis of the Autism spectrum screening questionnaire. Autism 2008, 12(1):99-112.
• [31]Goodman R: The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of child psychology and psychiatry, and allied disciplines 1999, 40(5):791-799.
• [32]Goodman R: Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatr 2001, 40(11):1337-1345.
• [33]Hysing M, Elgen I, Gillberg C, Lundervold AJ: Emotional and behavioural problems in subgroups of children with chronic illness: results from a large-scale population study. Child Care Health Dev 2009, 35(4):527-533.
• [34]Achenbach TM, McConaughy SH, Howell CT: Child/adolescent behavioral and emotional problems: implications of cross-informant correlations for situational specificity. Psychol Bull 1987, 101(2):213-232.
• [35]Kumpulainen K, Rasanen E, Henttonen I, Moilanen I, Piha J, Puura K, Tamminen T, Almqvist F: Children's behavioural/emotional problems: a comparison of parents' and teachers' reports for elementary school-aged children. Eur Child Adolesc Psychiatry 1999, 8(Suppl 4):41-47.
• [36]Munkvold L, Lundervold A, Lie SA, Manger T: Should there be separate parent and teacher-based categories of ODD? Evidence from a general population. J Child Psychol Psychiatry 2009, 50(10):1264-1272.
• [37]Posserud MB, Lundervold AJ, Gillberg C: Autistic features in a total population of 7-9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). J Child Psychol Psychiatry 2006, 47(2):167-175.
• [38]Mattila ML, Kielinen M, Jussila K, Linna SL, Bloigu R, Ebeling H, Moilanen I: An epidemiological and diagnostic study of Asperger syndrome according to four sets of diagnostic criteria. J Am Acad Child Adolesc Psychiatry 2007, 46(5):636-646.
• [39]Huberty TJ, Austin JK, Harezlak J, Dunn DW, Ambrosius WT: Informant agreement in behavior ratings for children with epilepsy. Epilepsy Behav 2000, 1(6):427-435.
• [40]Hysing M, Elgen I, Gillberg C, Lie S, Lundervold AJ: Chronic physical illness and mental health in children. Results from a large-scale population study. J Child Psychol Psychiatry 2007, 48(8):785-792.
• [41]Heiervang E, Stormark KM, Lundervold AJ, Heimann M, Goodman R, Posserud M-B, Ullebø AK, Plessen KJ, Bjelland I, Lie SA, et al.: Psychiatric disorders in Norwegian 8- to 10-year-olds: an epidemiological survey of prevalence, risk factors, and service use. J Am Acad Child Adolesc Psychiatry 2007, 46(4):438-447.
• [42]Stormark KM, Heiervang E, Heimann M, Lundervold A, Gillberg C: Predicting nonresponse bias from teacher ratings of mental health problems in primary school children. J Abnorm Child Psychol 2008, 36(3):411-419.
• [43]Statistics Norway: Immigration and immigrants 2008. Statistical Analyses. Statistics Norway, Oslo; 2009.
• [44]Hysing M, Sivertsen B, Stormark KM, Elgen I, Lundervold AJ: Sleep in children with chronic illness, and the relation to emotional and behavioral problems–a population-based study. J Pediatr Psychol 2009, 34(6):665-670.
• [45]DiGuiseppi C, Hepburn S, Davis JM, Fidler DJ, Hartway S, Lee NR, Miller L, Ruttenber M, Robinson C: Screening for autism spectrum disorders in children with Down syndrome: population prevalence and screening test characteristics. J Dev Behav Pediatr 2010, 31(3):181-191.
• [46]Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Lawrence Erlboum Associates, Hillsdale, NJ; 1988.
• [47]Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Meas 1960, 20:37-46.
• [48]Fleiss JL: Statistical methods for rates and proportions. 2nd edition. Wiley, New York; 1981.