Indian Scale For Assessment Of Autism Research Articles

Comparative efficacy of family mediated intervention versus early intensive behavioural intervention on symptom domains in children with autism spectrum disorder: A randomized controlled trial

BackgroundFamily Mediated Intervention (FMI) and Early Intensive Behavioural Intervention (EIBI) are found to be standard of care for children with Autism Spectrum Disorder (ASD). Comparison of their efficacy were assessed using ISAA as primary outcome measure. MethodsThis study was a parallel arm, open label, randomized active- controlled non-inferiority clinical trial. 50 Children diagnosed with ASD were randomized into FMI and EIBI groups. Clinical status was checked by using Indian scale for assessment of autism (ISAA), Oro- motor and sensory profile at baseline, after three and six months. ResultsDifference between change in mean ISAA score between FMI and EIBI group at the end of 6 months as per protocol (PP) analysis was −7.23 (CI=-18.41, 3.94), which was within pre-defined clinically relevant non-inferiority (NI) margin of – 24. FMI was found to be non-inferior to EIBI at the end of 6 months as the lower bound of 95% CI (-18.41) for ISAA score was higher than NI margin. ISAA scores were found to be statistically lower in both FMI and EIBI groups at the end point compared to baseline which indicated improvement in symptom severity. ConclusionFMI was non-inferior to EIBI as therapy for children with ASD at the end of six months. Finding also indicated longer duration of treatment is required for FMI to be superior. FMI can be recommended for children with ASD in view of improved ISAA scores reported in our study. Clinical trial registration numberCTRI/2020/08/027099 (Registered with Clinical Trials Registry- India)

Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years.

Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional studywhere 30 verbal autistic children, aged eight to 15 years, withintelligence quotient (IQ) > 70 were enrolled after utilizing theBinet Kamat Test of Intelligence (BKT) to assess IQand the Indian Scale for Assessment of Autism (ISAA) tograde severity of autism. The children received GSSI frominterdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2):T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 =64.30 (p < 0.0001). This declining trend at T1, T2, and T3suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention foradolescents with ASD, with effects lasting up to three months post-intervention.

Indian Scale for Assessment of Autism (ISAA): Issues with the Current Assessment Scale and Recommendations for Disability Assessment

Indian Scale for Assessment of Autism (ISAA): Issues with the Current Assessment Scale and Recommendations for Disability Assessment

Feasibility and acceptability of the Indian Autism Screening Questionnaire in clinical and community settings.

We developed and tested the Indian Autism Screening Questionnaire (IASQ), which was reported to be reliable and valid as compared to the Indian Scale for Assessment of Autism (ISAA) and the Childhood Autism Rating Scale -2 (CARS2). The present study describes the feasibility, acceptability, sociodemographic and developmental details of IASQ study participants in 5 settings- a psychiatry outpatients' clinic (n = 145), a specialised paediatric clinic (n = 24), a speciality disability centre (n = 174), a primary school (n = 41) and a government housing colony (n = 255). The IASQ could be easily administered and understood. Consistent with prior reports, the male-female ratio of participants with autism was 3.8:1. Developmental complications were reported more frequently in clinical settings, while delivery by Caesarean section was commoner among community-dwelling higher socioeconomic status mothers (53% of the officers' sample). Mothers of participants with autism more frequently reported Caesarean section birth for the proband (χ2 = 41.61, p < .0001) and prenatal and postnatal complications. Binary logistic regression confirmed that perinatal complications in the mother and father's (older) age at birth of the participant were associated with autism. The IASQ is a reliable, practical tool for screening for autism in clinical and non-clinical settings in India.

Efficacy of Siddha Therapeutics on Mantha Sanni (Autism Spectrum Disorder) Among Pediatric Patients: An Interventional Non-randomized Open-Label Clinical Trial.

Autism Spectrum Disorder (ASD) refers to a collection of neurodevelopmental disorders that affect brain development and can lead to various psychological imbalances in caregivers of affected children. Siddha formulations have been shown to have a role beyond the physical body and play a significant role in managing Mantha sannior ASD. The objective of this study was to examine the impacts of Amukkara chooranam and Yegamooli thylam in the pediatric population diagnosed with ASD. This was a prospective, interventional, non-randomized, open clinical trial involving 30 patients who met the inclusion and exclusion criteria. Patients received Amukkara chooranamat a dose of 300 mg for ages 3-4 years, 500 mg for ages 5-7 years, and 1 gm for ages 8-12 years, twice a day with honey for 90 days, and Yegamooli thylam was administered using the Thuvalai external manipulation technique once a day for 90 days. Scoring by the Indian Scale for Assessment of Autism (ISAA) was documented at the end of the 0th day, 45th day, and 90th day. The scores were compared at each follow-up, and a statistically significant difference was found at the end of the 90th day of treatment with Amukkara chooranam and Yegamooli thylam (P < 0.05). The statistical analysis included calculating the mean and standard deviation of the clinical assessment, parameters both before and after the treatment were 37.66667 ±13.82485. The treatment with Amukkara chooranam and Yegamooli thylam resulted in a clinically significant improvement in clinical assessment parameters in children with ASD.

The Effect of Siddha Medicine in Treating Autism Spectrum Disorder: A Case Report

The heterogeneity, complexity, co-occurring conditions, and lifelong impact are unique features of Autism Spectrum Disorder (ASD), making it a challenging disorder to diagnose and treat. The Siddha medicinal system offers a comprehensive approach to health that extends beyond the corporeal realm. It encompasses emotional, social, spiritual, and intellectual aspects of well-being. Siddha medicine is unique in its holistic approach to healthcare, emphasising the overall well-being of an individual rather than just treating symptoms. It focuses on balancing the body’s three humours, or doshas, to restore equilibrium. This case report describes a 10-year-old male with behavioural complications and Gastrointestinal (GI) symptoms diagnosed with Mantha sanni (ASD). The patient received specialised Siddha interventions, including Amukkara chooranam, Brahmi nei, Mantha ennai, and Varmam (a form of external manipulation). The study evaluated the treatment outcome over 90 days using the Indian Scale for Assessment of Autism (ISAA). The child showed significant improvement in all areas of the ISAA scale, including social relations, language and communication skills, behavioural patterns, emotional responsiveness, cognitive functions, and sensory perception. The overall score, previously indicating moderate autism at 159, improved to 100, indicating mild autism, after treatment. This case report contributes to the scientific literature by providing novel insights into alternative medicine treatments for individuals with ASD. These treatments can help them lead satisfying lives and enhance their quality of existence.

Comparing the Indian Autism Screening Questionnaire (IASQ) and the Indian Scale for Assessment of Autism (ISAA) with the Childhood Autism Rating Scale-Second Edition (CARS2) in Indian settings.

Participants were recruited from three settings: a referral clinic for neurodevelopmental conditions run by the Department of Paediatrics of a tertiary care teaching hospital (NDC OPD), the outpatient department of an institute for disability and rehabilitation (NIEPID), and from the community (CGOC). Persons between ages 3-18 were recruited following consent or assent (parent and child/adolescent). The IASQ was administered by a minimally trained administrator. It was followed by ISAA and the CARS-2 (in alternating order, by different evaluators blind to each other) (CARS2 SV (Standard Version) and CARS2 HF (High Functioning) as applicable). Sensitivity, specificity and area under the Receiver Operator Characteristics (ROC) curve were calculated for IASQ and CARS2, as well as for ISAA and CARS2. Concordance between CARS2 and ISAA was calculated using kappa coefficient. A total of 285 participants (NIEPD n = 124; NDC OPD, n = 4; CGOC n = 157) (a total of 70 with autism and 215 controls) participated. IASQ and CARS2 were administered on 285 participants, while IASQ and ISAA were administered on 264 participants. When IASQ was compared to CARS2, sensitivity was 97%, specificity 81%, PPV 63%, NPV 99% at cut off 1 while these values were 97%, 92%, 79% and 99% respectively at cut off 2. There was high concordance between CARS2 and ISAA (Kappa 0.907, p<0.0001). IASQ has satisfactory sensitivity, specificity and concordance when compared with CARS2; it can be used for screening children with autism in community. The ISAA also showed a high concordance with CARS2, as it had with the older version of CARS.

The Role of Repetitive Transcranial Magnetic Stimulation in the Treatment of Autism Spectrum Disorder

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with impairments in language acquisition, social functioning, and restricted and repetitive behaviors. There is no definitive management for the ASD spectrum. The management options available are not beyond criticism. Hence, the search for new options is actively in progress. Noninvasive brain stimulation interventions such as repetitive transcranial magnetic stimulation (rTMS) appears to be a promising tool for the treatment of ASD. However, the available literature on TMS use in ASD is preliminary. Methods: This was a hospital-based longitudinal study conducted over 50 patients with ASD of 6 to 16 years of age. The Indian Scale for Assessment of Autism (ISAA) was used for the assessment of the extent of disability in these children. They were given 10 sessions of rTMS over a period of 10 days over the left dorsolateral prefrontal cortex (l-DLPFC) and reassessed for any improvement in ISAA score after 1 day and 3 months of completion of all the sessions of rTMS. Results: There was no statistically significant change in the total ISAA score or any of the 6 domains of ISAA after 1 day and 3 months of giving 10 sessions of TMS. There were no significant adverse effects after giving rTMS. In a few patients, mild headache, neck pain, or discomfort at the stimulation site was noted. Conclusion: This study has shown that low-frequency rTMS does not have any significant improvement on the various symptoms of ASD. However, there are no major adverse effects after giving rTMS. Also, it points toward the need for further studies.

Role of Carcinosinum in Autism Spectrum Disorder- A Case series

Introduction: Autism Spectrum Disorder (ASD) is a pervasive developmental disorder having the potential to cause lifelong disability. Individualised homoeopathic remedies are found to be safe and effective in the management of ASD. Cases Summary: Three cases of ASD treated with Carcinosinum at the Child psychiatry unit of the National Homoeopathy Research Institute in Mental Health, Kottayam are presented to show the action of this nosode in ASD. Indian Scale for Assessment of Autism (ISAA), an indigenous tool, was used for the assessment of severity at baseline and subsequent follow-up visits. Remarkable improvement was observed in these three cases. After one year of treatment, the baseline ISAA scores of 151, 127 and 132 turned to 65, 14 and 15, respectively (ISAA score 153 Severe Autism).

Nutrient intake profile, growth patterns and hemoglobin levels in children with ASD – A case control study in Mysuru, India

BackgroundResearch evidence suggests that the prevalence rate of Autism Spectrum Disorder (ASD) is increasing in India. In addition to socio-behavioral problems, diet-related issues are common and recurrent problems experienced by children with ASD. As there is only minimal research work done on these aspects, the present study is carried out as a case control snapshot to investigate the nutrient intakes of ASD children (n = 104) residing in the Mysore region, India. This data is compared with the nutrient intakes of Typically Developing (TD) controls (n = 121). MethodsWe evaluated ASD severity using Indian Scale for assessment of autism (ISAA). All the children aged (2–15 years) were examined for anthropometric measurements and hemoglobin levels. Dietary intakes and mealtime behavior problems were assessed using three-day food records and food frequency questionnaires. ResultsSignificantly (p< = 0.05) lower ZHA, ZWA, ZBMIA values among ASD children were observed. Limited food variety and inadequacy of micronutrient intakes were observed and the ORs of ASD children were at 3.57-fold higher risk for failing to meet the recommendations for calcium. Their risk was 2.17-fold higher for iron, 3.06-fold for zinc, 2.92–fold for folate and 1.87-fold higher for vitamin C compared with the TD children. Overall, mealtime behavior issues and eating problems were higher (28.66%) among ASD than TD (10.51 %).Hemoglobin levels of ASD were significantly (p< = 0.05) lower than TD children. There was a negative partial correlation between Hb levels (8.97 ± 0.91 g/dL) and micronutrients viz., Iron (5.14 ± 2.83 mg), Calcium (2.52 ± 1.41 mg), Zn (2.81 ± 1.90 mg),Folate (83.48 ± 52.57 mg) and Vitamin B6 (0.47 ± 0.29 mg). We found that while controlling the ISSA scores (1.94 ± 0.62), there was no significant difference. Thus signifying ISSA score has strong influence on controlling the relationship between Hb levels and selected micronutrients. ConclusionObservations strongly indicate that well-timed nutritional screening and personalized dietary interventions can prevent/manage the nutritional deficiencies prevalent among ASD children of this region.

Psychometric properties of a screening tool for autism in the community-The Indian Autism Screening Questionnaire (IASQ).

Currently available screening questionnaires for Autism spectrum disorders were tested in developed countries, but many require additional training and many are unsuitable for older individuals, thus reducing their utility in lower/ middle- income countries. We aimed to derive a simplified questionnaire that could be used to screen persons in India. We have previously validated Indian Scale for Assessment of Autism (ISAA), that is now mandated for disability assessment by the Government of India. This detailed tool requires intensive training and it is time consuming. It was used to derive a new screening questionnaire: 1) items most frequently scored as positive by participants with autism in original ISAA validation study were modified for binary scoring following expert review. 2) In a new sample, clinically diagnosed individuals with/without autism were administered the screening tool and ISAA following written informed consent. Its psychometric properties were determined. A 10-item scale named Indian Autism Screening Questionnaire (IASQ) was prepared in Hindi and English. Thereafter 145 parents/caregivers of participants (autism, n = 90, other psychiatric disorders, n = 55) (ages 3-18), were administered IASQ and ISAA (parents/caregivers plus observation) by separate interviewers, blind to each other and to diagnosis. At a cutoff of 1, sensitivity was 99%, specificity 62%, Positive Predictive Value 81%, and Negative Predictive Value 95%. Test-retest reliability was r = 0.767 (CI = 0.62-0.86) and interrater reliability- Krippendorff"s-alpha was 0.872. The area under Receiver Operating Characteristic Curve (ROC) was 95%. There was a significant difference on IASQ-scores between participants with and without a clinical diagnosis of Autism (t = 14.57, p<0.0001). The IASQ is a simple, easy to use screening tool with satisfactory reliability and validity, that can be administered to caregivers in 15 minutes and provides information about DSM 5 criteria for autism. It may be applicable outside India, following additional adaptation, for community-based studies.

Cognitive Development in Children with Autism Spectrum Disorder: A Piaget’s Cognitive Developmental Approach

Children with autism spectrum disorder often experience difficulties in cognitive skills related to understating, comprehending, analyzing, synthesizing, evaluating, and differentiating between two objects. The present study objective to investigate the effect of Piaget based cognitive tasks on the cognitive skills of children with autism spectrum disorder (ASD). Eight children with ASD were selected through purposive sampling and assigned for the intervention program. To measure IQ, the Non-Verbal performance test Raven’s colored progressive matrices test was used, and the Indian scale for assessment of autism (ISAA) was used to measure the level of autism spectrum disorder. The IQ was obtained above 80, mild level of ASD, and 6-12 years of the children were placed for this study. The cognitive skills of children were assessed pre- (before) and post- (after intervention). An intervention program based on Piaget’s cognitive tasks was implemented on ASD children for four weeks (six days per week) with 30 minutes per session. The total scores on cognitive skills of ASD children were enhanced in the post-test score. The effects of the Piaget’s cognitive tasks (concrete operational stage: conservation task, classification, and particular reasoning) intervention were most evident in the task performance rating scale on tasks conservation, classification, and particular reasoning. Children with ASD can benefit from the Piaget based cognitive tasks to enhance cognitive skills. The study findings emphasize the effectiveness of the cognitive skills on Piaget based cognitive tasks intervention, which parents may use, psychologists, special educators who work with ASD children.

Protocol for Development of the Indian Autism Screening Questionnaire: The Screening Version of the Indian Scale for Assessment of Autism.

Introduction:Autism is included as a certifiable disability in the Indian Rights of Persons with Disability Act, 2016. The Indian Scale for Assessment of Autism (ISAA), developed by the Government of India and mandated for certifying disability, is a detailed instrument that needs trained mental health experts and takes time to administer. The current project was planned to develop a simple, easy to use screening tool based on the ISAA to identify possible cases in the community.Methods:The project is planned in three phases. During the first phase, data collected during the development of the ISAA (N = 433/436 children with autism) will be used to identify questions answered as frequently, mostly, and always. During the second phase, the psychometric properties of the screening tool based on these items will be evaluated among research participants recruited from hospitals and special schools (n = 100). In the third phase, the screening questionnaire will be administered in the community (n = 500).Results:The most frequently answered questions will be selected for inclusion in the proposed screening tool. The number of items in the screening tool will be kept as few as possible, with yes or no responsesDiscussion:Indian Autism Screening Questionnaire (IASQ) will be tested as a screening version of ISAA, which can be used by community health workers, teachers, or school counselors. The IASQ will not provide a diagnosis of autism. A positive screening result should be followed by a thorough assessment by a trained specialist. Analyzing the psychometric properties of the test can help ensure cost-effective screening of the community to identify autism.

A pilot trial of a manualized psychoeducation module for parents of children with autism with intellectual disability and intellectual disability alone

Children with autism with/without intellectual disability (ID) and ID alone require regular interventions. Psychoeducation (PE) can empower parents with intervention strategies. The aim of this study was to develop the test efficacy of a simple, short manualized PE module for parents of children with autism with/without comorbid ID and for ID alone. We focused on both autism and ID (A-ID) because we felt that both the groups could benefit from this module.A special module for PE was developed after literature review, inputs from a study group, and discussion with experts. Parents attended eight fortnightly intervention sessions. Children were assessed on the Developmental Screening Test, Indian Scale for Assessment of Autism (ISAA), and the Behavioral Assessment Scale for Indian Children with Mental Retardation (BASIC-MR) before starting and 1 month after completing PE.Consenting parent of parents/of 16 children with A-ID and 14 with ID completed sessions with pre- and postassessment. There was a significant improvement in the majority of domains of ISAA and BASIC-MR Part B in children with both conditions.PE has a wide scope for use across various developmental disorders. The module developed is promising for a wide variety of field workers.

Mobile Application Based Modified Screening and Assessment Tools for Children with Autism

&lt;p class="0abstract"&gt;&lt;span lang="EN-US"&gt;The researchers have focused on mobile application of screening tool to profile a child according to the degree of autism as per Indian Scale for Assessment of Autism (ISAA) with some modification. The work also emphasizes on practical implementation of various educational assessment tools viz. Indian Portage guide, BASIC-MR (Behavioural Assessment Scales for Indian Children with Mental Retardation) Part A, (FACP) Functional Assessment Checklist for Programming to assess children with autism in form of mobile application. The aim of this study is to enhance easiness, to improve accuracy, to monitor the child's progress and to make the whole process a time efficient one.&lt;/span&gt;&lt;/p&gt;

Gut Microbial Dysbiosis in Indian Children with Autism Spectrum Disorders

Autism spectrum disorder (ASD) is a term associated with a group of neurodevelopmental disorders. The etiology of ASD is not yet completely understood; however, a disorder in the gut-brain axis is emerging as a prominent factor leading to autism. To identify the taxonomic composition and markers associated with ASD, we compared the fecal microbiota of 30 ASD children diagnosed using Childhood Autism Rating Scale (CARS) score, DSM-5 approved AIIMS-modified INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD), and Indian Scale for Assessment of Autism (ISAA) tool, with family-matched 24 healthy children from Indian population using next-generation sequencing (NGS) of 16S rRNA gene amplicon. Our study showed prominent dysbiosis in the gut microbiome of ASD children, with higher relative abundances of families Lactobacillaceae, Bifidobacteraceae, and Veillonellaceae, whereas the gut microbiome of healthy children was dominated by the family Prevotellaceae. Comparative meta-analysis with a publicly available dataset from the US population consisting of 20 ASD and 20 healthy control samples from children of similar age, revealed a significantly high abundance of genus Lactobacillus in ASD children from both the populations. The results reveal the microbial dysbiosis and an association of selected Lactobacillus species with the gut microbiome of ASD children.

Cell therapy effects portrayed on positron emission tomography of the brain serve as a new dimension for autism

Cell therapy offers a promising premise in alleviating complex neurological disorders. Autologous bone marrow mononuclear cells (BMMNCs) have been used in many studies and have been documented to have a safe and ethical profile. These cells have shown angiogenetic and immunomodulatory properties in addition to other neuroprotective effects. Precisely, these may serve to address a disorder at a neurophysiological level and thus, hold gratifying results in autism. The literature suggests hypoperfusion and immune alteration as major underlying pathogenetic mechanisms in autism. Herewith, we present a case of autism treated with intrathecal administration of autologous BMMNCs. Results were documented objectively on Indian Scale for Assessment of Autism (ISAA), Childhood Autism Rating Scale (CARS), Clinical Global Impression (CGI) scores and positron emission tomography computerized tomography (PET-CT) scan. On regular follow-up assessment of the patient at 3 mo, at 6 mo (pre 2nd dose) and at 9 mo (i.e., 3 mo post 2nd dose), significant clinical improvement was noted in social relationship, communication and behavior. On the outcome measure, his ISAA score improved from 132 (moderate autism) to 103 (mild autism). On comparison of the PET-CT scan, changes in metabolism correlated with the clinical improvements. On the CGI scores, he showed improvement in all the three domains, with a decrease in the severity of illness and with partial remission of symptoms. This case provides a useful insight into the clinical effects of autologous BMMNCs in autism and guides us to plan future studies and offers a promising premise in alleviating complex neurological disorders.

Assessment of Behavioral disorders of children with Autism

Background: Autistic disorder is a neurological disorder that causes a broad area of behavior impairments in children, including: hyperactivity, short attention span, impulsivity, aggressiveness, self – injurious behavior, tempers tantrum and abnormalities of eating or sleeping may be found. There is an increased rates of autism reached to 10-17% per year. It is the fastest-growing serious developmental disability in the worldwide over the past decades. Objective: The study aims to assess the autistic child behavior. Methodology: A descriptive correlational study was conducted in Jun 15th 2013 to October 15th 2013 on children with autism in Baghdad city. Purposive (non-probability) samples of 78 autistic children who are clients and receive care in the private specialization centers for autism were selected to participate in the current study. The study uses a parent-completed questionnaire for data collection. The behavior of autistic child was assessed using the Indian Scale for Assessment of Autism (ISAA). Results: The findings indicated that most children were males of 4-12 years old with mean 5.78 years. The highest percentage of children reported a moderate level of the impairment in social interaction, behavioral pattern problems, sensory responses abnormalities and lack of emotional responses. And the highest percentage of children reported a mild level in communication difficulties and delay in cognition and perceptual functioning. Half of children reported a moderate level of the total score of behavioral problems for all domains. Conclusions: All autistic children displayed the same behavioral disorders with different levels of severity. There is no significant relationship between the severity of autistic behavior and the child’s age and the child’s sex. Recommendations: The study recommends that Ministry of Health and the Ministry of Labor and Social Affairs policy should give the autistic children support and high quality of services to help them to coping with this disorder. Those children need for special rehabilitative and behavioral programs dealing with their behavioral problems.

Assessment of severity of autism using the Indian scale for assessment of autism.

Background:The Indian Scale for Assessment of Autism (ISAA) was developed to assess the severity of autism among Indian cases.Aims:The present study evaluated the ISAA in relation to the Childhood Autism Rating Scale (CARS) and the Developmental Disability- Children Global Assessment Scale (DD-CGAS).Materials and Methods:Indian children with ICD 10 diagnoses of Autistic disorder (AD, n = 50), Intellectual Disability (ID, n = 50), Attention Deficit Hyperactivity Disorder (ADHD, n = 26), other psychiatric disorders (PD-N=25) and control children without psychiatric disorders (n = 65) were evaluated using the ISAA, DD-CGAS and the CARS (total n = 216).Statistical Analyses:In addition to descriptive statistics and correlation, analysis of variance (ANOVA) was used to assess whether the ISAA scores were significantly different across diagnostic groups.Results:Total ISAA scores were significantly higher among children diagnosed with autistic disorder compared to four other diagnostic groups. Total ISAA scores were significantly correlated with CARS scores and DD-CGAS scores. Groups sub-divided on the basis of recommended ISAA cutoff points of severity showed significant differences in CARS scores.Conclusion:The ISAA can thus be used to assess severity of AD among Indian children.

Diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in chidren aged 2-9 years.

To determine the diagnostic accuracy of Indian Scale for Assessment of Autism (ISAA) in children aged 2-9 year at high risk of autism, and to ascertain the level of agreement with Childhood Autism Rating Scale (CARS). Diagnostic Accuracy study. Tertiary-level hospital. Children aged between 2 and 9 year and considered to be at a high risk for autism (delayed development, and age-inappropriate cognition, speech, social interaction, behavior or play) were recruited. Those with diagnosed Hearing impairment, Cerebral palsy, Attention deficit hyperactivity disorder or Pervasive developmental disorders (PDD) were excluded. Eligible children underwent a comprehensive assessment by an expert. The study group comprising of PDD, Global developmental delay (GDD) or Intellectual disability was administered ISAA by an investigator after one week. Both evaluators were blinded. ISAA results were compared to the Experts diagnosis and CARS scores. Out of 102 eligible children, 90 formed the study group (63 males, mean age 4.5y). ISAA had a sensitivity 93.3, specificity of 97.4, positive and negative likelihood ratios 85.7 and 98.7 and positive and negative predictive values of 35.5 and 0.08, respectively. Reliability was good and validity sub-optimal (r low, in 4/6 domains). The optimal threshold point demarcating Autism from No autism according to Receiver Operating Characteristic curve was ISAA score of 70. Level of agreement with CARS measured by Kappa coefficient was low (0.14). The role of ISAA in 3-9 year old children at high risk for Autism is limited to identifying and certifying Autism at ISAA score of 70. It requires re-examination in 2-3 year olds.