"Frank" presentations as a novel research construct and element of diagnostic decision-making in autism spectrum disorder
"Frank" presentations as a novel research construct and element of diagnostic decision-making in autism spectrum disorder
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DOI：
10.1002/aur.1706
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发表时间：
2017-04-01
期刊：
影响因子：
4.7
通讯作者：
Miller, Judith
中科院分区：
文献类型：
--
作者：
de Marchena, Ashley;Miller, Judith
许多自闭症患者都有一种独特的行为表现，可以在短时间内识别出来，这种现象我们称之为坦率的自闭症。这种现象已经被非正式地讨论了几十年，也许是作为典型的ASD；然而，没有统一的经典表现，经典自闭症似乎并不对应于功能水平。因此，无论是坦率的自闭症还是典型的自闭症，都没有被描述或研究为一种研究结构。为了启动对坦率的自闭症谱系障碍的实证研究，我们调查了151名临床医生，他们来自诊断自闭症谱系障碍的各个学科。受访者完成了一份关于坦率的ASD的13项问卷，使用混合方法对其进行分析。97%的受访者熟悉这种现象。受访者估计，40%的自闭症谱系障碍患者有坦率的表现。受访者报告说，与坦率陈述相关的最高度具体的行为是互惠受损的一般感觉，目光接触的质量，非典型的声乐韵律，运动习惯的存在，以及非典型的步态或姿势。总的来说，受访者报告说，他们能很快地发现坦率的特征，大多数人在互动或观察的前十分钟内就能形成印象。虽然没有经过经验研究，但坦率的ASD表现对于诊断临床医生来说是熟悉的，并且似乎是基于ASD诊断标准的核心行为（例如，互惠受损），以及诊断标准中缺失的行为（例如，非典型步态或姿势）。我们在ASD的诊断决策和行为表型的背景下讨论这些发现。自闭症Res2016,。(c) 2016国际自闭症研究学会，Wiley期刊，Inc。孤独症杂志，2017,(10):653-662。(c) 2016国际自闭症研究学会，Wiley期刊，Inc。
Many individuals with ASD have a distinctive behavioral presentation that is recognizable within moments, a phenomenon we call frank ASD. This phenomenon has been discussed informally for decades, perhaps as classic ASD; however, there is no unitary classic presentation, and classic autism does not seem to correspond to level of functioning. Thus, neither frank nor classic autism has been delineated or studied as a research construct. To initiate the empirical study of frank ASD, we surveyed 151 clinicians, from a range of disciplines that diagnose ASD, about this phenomenon. Respondents completed a 13-item questionnaire about frank ASD, which was analyzed using a mixed-methods approach. Ninety-seven percentage of respondents were familiar with the phenomenon. Respondents estimated that 40% of the ASD population has a frank presentation. Respondents reported the most highly specific behaviors associated with frank presentations were a general sense of impaired reciprocity, quality of eye contact, atypical vocal prosody, presence of motor mannerisms, and atypical gait or posture. In general, respondents reported detecting frank features rapidly, with the majority forming their impressions within the first ten minutes of interaction or observation. Although unstudied empirically, frank presentations of ASD are familiar to diagnosing clinicians, and appear to be based on behaviors both central to ASD diagnostic criteria (e.g., impaired reciprocity), and absent from diagnostic criteria (e.g., atypical gait or posture). We discuss these findings within the context of diagnostic decision-making and behavioral phenotyping of ASD. Autism Res2016,. (c) 2016 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 653-662. (c) 2016 International Society for Autism Research, Wiley Periodicals, Inc.