Subject(s)
Autistic Disorder , Early Diagnosis , Transients and Migrants , Humans , Autistic Disorder/diagnosis , Child , Mass Screening , Chile , Child, PreschoolABSTRACT
Coronavirus disease (COVID-19) and confinement have affected access to the health system and have impacted people's mental health, particularly families of children with autism spectrum di sorder (ASD). OBJECTIVE: To investigate the perceptions of parents of children with ASD regarding benefits, positive changes, and difficulties in behavioral management at home during the first con finement due to COVID-19 in Chile. SUBJECTS AND METHODS: We performed an exploratory cross sectional qualitative study including 118 parents of individuals with ASD aged between 2 and 15 years. An online questionnaire, prepared by a multidisciplinary committee of national experts using Delphi methodology was applied, which contains four open-ended questions related to children's behavior (difficulties, improvements, benefits, and professional support required) during the pan demic. RESULTS: Parents perceived that confinement increased emotional stress for adults and chil dren, which could exacerbate behavioral problems. The interviewees perceived improvements in child social-affective, individual autonomy, and communication skills. The family and resilience aspects, such as time-sharing that emerged during the pandemic to support children's needs, were appreciated. Parents also reported the need for professional support in behavioral and emotional management during confinement. CONCLUSION: Caregivers value the integration of the family into therapies during confinement. It is necessary to complement these results with additional studies exploring different life contexts of families with children with ASD in Chile and the impacts of long term confinement.
Subject(s)
Autism Spectrum Disorder , COVID-19 , Adult , Humans , Child , Adolescent , Child, Preschool , Autism Spectrum Disorder/therapy , Autism Spectrum Disorder/psychology , Pandemics , Cross-Sectional Studies , COVID-19/epidemiology , ParentsABSTRACT
AIM AND METHODS: Cross-sectional data from 118 Chilean children with ASD collected during the pandemic outbreak of COVID-19 in 2020 were evaluated to analyze predictors of behavioral problem impairment. RESULTS: Forty-five percent of parents stated that their children's behavioral difficulties increased in intensity or frequency. The adjusted predictors were having a family member hospitalized with COVID-19 (OR = 4.11; 95% CI = 1.53-11.1) and parents' mental health disorders during the pandemic (OR = 2.43; 95% CI = 1.01-5.83). CONCLUSION: Potentially modifiable psychosocial factors affecting children's behavior should be considered in a possible second outbreak.
Subject(s)
Autism Spectrum Disorder , COVID-19 , Autism Spectrum Disorder/epidemiology , Child , Cross-Sectional Studies , Disease Outbreaks , Humans , Pandemics , Parents , SARS-CoV-2ABSTRACT
INTRODUCTION: Screening for Autism Spectrum Disorders (ASD) using the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) increases early detection, allowing early interventions and improving prognosis. This tool is part of the management in case of suspected ASD in several clinical guidelines. The objective of this article was to conduct the concurrent and discrimi nant validation and the reliability analysis of M-CHAT-R/F in the Chilean population. PATIENTS AND METHOD: This is the second stage of the cross-cultural adaptation of cross-sectional design. M-CHAT- R/F was applied to a sample of 20 children with suspected ASD and 100 randomly selected healthy control children, aged between 16-30 months. Autism Diagnostic Observation Schedule (ADOS-2), considered as reference, was applied to the 20 patients of the clinical sample, to 20 children of the healthy control sample and to those cases of the healthy control sample with M-CHAT-R/F positive. Cronbach alpha was calculated, as well as M-CHAT-R/F and ADOS-2 correlation, sensitivity, and specificity analyses. RESULTS: In the healthy sample, M-CHAT-R/F was positive in two patients, with one of them positive and the other one negative for ASD with ADOS-2 test. In the clinical sample, M- CHAT-R/F was positive in all cases, three of them were negative in the ADOS-2 test. The Alfa relia bility of M-CHART-R/T was 0,889, the discriminant sensitivity and specificity were 100% and 98%, and the concurrent ones were 100% and 87.5% respectively. CONCLUSIONS: The Chilean M-CHAT- R/F version was reliable, sensitive and specific, similar to the original test, which opens the possibility for its use in clinical samples and for research. Validating M-CHAT-R/F is an ongoing process which must be further developed.
Subject(s)
Autism Spectrum Disorder/diagnosis , Mass Screening/methods , Case-Control Studies , Child, Preschool , Chile , Cross-Sectional Studies , Early Diagnosis , Female , Humans , Infant , Male , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
INTRODUCCIÓN: El tamizaje de los Trastornos del Espectro Autista (TEA) mediante el Modified Chec klist for Autism in Toddlers - Revised with Follow Up (M-CHAT-R/F) aumenta la detección precoz, posibilitando intervenciones tempranas y mejorando el pronóstico. Este instrumento es parte del algoritmo de manejo ante la sospecha de TEA en diversas guías clínicas. El objetivo fue realizar la validación concurrente, discriminante y el análisis de confiabilidad del M-CHAT-R/F en una pobla ción chilena. PACIENTES Y MÉTODO: Esta es la segunda etapa de la adaptación transcultural, de diseño transversal. Se aplicó M-CHAT-R/F a una muestra de 20 niños con sospecha de TEA y 100 niños de control sano seleccionados al azar, de 16-30 meses de edad. Se aplicó Autism Diagnostic Observation Schedule (ADOS-2), considerado como referencia, a los 20 pacientes de la muestra clínica, a 20 niños de la muestra de control sano y a aquellos casos de la muestra de control sano con M-CHAT-R/F po sitivo. Se calculó alfa de Cronbach, análisis de correlación de M-CHAT-R/F y ADOS-2 y sensibilidad y especificidad. RESULTADOS: En el grupo de control sano, M-CHAT-R/F resultó alterado en 2 pacien tes, siendo uno positivo y otro negativo para TEA con ADOS-2. En muestra clínica el M-CHAT-R/F fue positivo en todos, con test de ADOS-2 negativo en 3 casos. La confiabilidad Alfa del M-CHAT- R/F fue =0,889, la sensibilidad y especificidad discriminante de 100 y 98% y la concurrente 100% y 87,5% respectivamente. CONCLUSIÓN: M-CHAT-R/F en su versión chilena resultó fiable, sensible y específico de manera similar al original, lo cual abre la posibilidad de su utilización en población clínica y para investigación. La validación es un proceso continuo que se debe profundizar.
INTRODUCTION: Screening for Autism Spectrum Disorders (ASD) using the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F) increases early detection, allowing early interventions and improving prognosis. This tool is part of the management in case of suspected ASD in several clinical guidelines. The objective of this article was to conduct the concurrent and discrimi nant validation and the reliability analysis of M-CHAT-R/F in the Chilean population. PATIENTS AND METHOD: This is the second stage of the cross-cultural adaptation of cross-sectional design. M-CHAT- R/F was applied to a sample of 20 children with suspected ASD and 100 randomly selected healthy control children, aged between 16-30 months. Autism Diagnostic Observation Schedule (ADOS-2), considered as reference, was applied to the 20 patients of the clinical sample, to 20 children of the healthy control sample and to those cases of the healthy control sample with M-CHAT-R/F positive. Cronbach alpha was calculated, as well as M-CHAT-R/F and ADOS-2 correlation, sensitivity, and specificity analyses. RESULTS: In the healthy sample, M-CHAT-R/F was positive in two patients, with one of them positive and the other one negative for ASD with ADOS-2 test. In the clinical sample, M- CHAT-R/F was positive in all cases, three of them were negative in the ADOS-2 test. The Alfa relia bility of M-CHART-R/T was 0,889, the discriminant sensitivity and specificity were 100% and 98%, and the concurrent ones were 100% and 87.5% respectively. CONCLUSIONS: The Chilean M-CHAT- R/F version was reliable, sensitive and specific, similar to the original test, which opens the possibility for its use in clinical samples and for research. Validating M-CHAT-R/F is an ongoing process which must be further developed.