Autism in Toddlers: Can Observation in Preschool Yield the Same Information as Autism Assessment in a Specialised Clinic?

Gunilla Westman Andersson,Carmela Miniscalco,Christopher Gillberg,Ulrika Johansson

doi:10.1155/2013/384745

Abstract

We wanted to know whether preschool observation of children suspected of suffering from autism can provide the same information about core autism symptoms as the Autism Diagnostic Observation Schedule (ADOS) performed in a clinic. Forty 2–4-year-old children (9 girls, 31 boys), referred for assessment of suspected autism spectrum disorder participated in the study. The symptom areas covered by the ADOS algorithm were scored by an education specialist after free-field observation of each child in the preschool without using the prescribed ADOS materials. The ADOS was then completed in a clinic setting by examiners blind to the preschool results. Excellent agreement across results obtained at the two different types/settings of observations was found. The only significant difference found was with regard to spontaneous initiation of joint attention. The present study does not address the issue of whether or not one of the methods used is superior to the other when it comes to determining the “true” level of “autism problems” in these children. However, it is of interest that free-field preschool observation of children with suspected autism using a structured checklist yields very similar information as that obtained at ADOS assessment performed in a clinic setting.

Highlights

Autism spectrum disorder (ASD) has symptom onset early in life and a prevalence of about one percent of the general population [1]
In some cases the score was somewhat higher in Autism Diagnostic Observation Schedule (ADOS) clinical, and in some cases it was higher in the preschool observation
The main finding of this study was that preschool observation by an autism-experienced rater of children with suspected ASD, yielded almost the same amount and type of information, as highly structured ADOS assessment performed by two specially trained clinicians in a specialised clinic setting

Summary

Introduction

Autism spectrum disorder (ASD) has symptom onset early in life and a prevalence of about one percent of the general population [1]. Most children with ASD have problems with generalisation, which affects their behaviour in different contexts. Young children with ASD have more nonfunctional and repetitive play than typically developing children [2], and impairment in play, imitation, and joint attention are important predictors of autism [3, 4]. Systematic research has highlighted the importance of early intervention for children with ASD [5,6,7]. It follows that early detection is crucial and that valid assessment tools designed for young children (and taking possible gender differences into account) are needed [8, 9]

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Conclusion