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自闭症症状简要观察:拉丁美洲样本中的验证研究。

The Brief Observation of Symptoms of Autism: Validation study in a Latin American sample.

作者信息

Granana Nora, Astorino Francisco, Richaudeau Alba, Costa Lucas, Fernandez de Carrera Elena, Nanclares Valeria, Sohl Kristin

机构信息

Hospital General de Agudos Carlos G. Durand, Argentina.

Universidad Nacional del Litoral, Argentina.

出版信息

Autism. 2025 Apr;29(4):896-906. doi: 10.1177/13623613241291098. Epub 2024 Dec 3.

Abstract

Autism spectrum disorder presents as a multifaceted condition characterized by pronounced impairments in social communication and behavioral patterns. Diagnosis hinges upon the expertise of clinicians, comprehensive developmental history, and observation of specific behavioral markers. However, in low-income countries, access to screening tools and standardized diagnostic tests for autism spectrum disorder remains profoundly limited. Moreover, the COVID-19 pandemic has exacerbated these challenges, rendering diagnostic protocols impractical. In response to these barriers, the Brief Observation of Symptoms of Autism instrument was developed to facilitate assessments via telehealth during the pandemic. This study aims to validate the use of the Brief Observation of Symptoms of Autism within two Latin American countries, Argentina, and Chile. A cohort of 313 spanning various age groups underwent examination. Psychometric properties of each Brief Observation of Symptoms of Autism module were scrutinized, including sensitivity and specificity against the recommended University of California at Los Angeles cutoffs. Receiver operating characteristic curve analysis yielded credible sensitivity and specificity scores for each module. Confirmatory factor analysis supported a favorable fit across modules, employing a 2-factor model distinguishing Social Affect and Restricted, Repetitive Behaviors. Preliminary findings affirm the validity of the Brief Observation of Symptoms of Autism as an effective diagnostic tool within the Latin American population. Furthermore, its potential extends beyond the pandemic, promising support in the future.Lay abstractAutism spectrum disorder is a complex condition associated with significant impairments in social communication and behavioral functioning. Diagnosis is dependent on clinician expertise, gathering of developmental history, and observation of specific behaviors. The suggested protocols include tools rendered invalid during the pandemic, which created significant barriers for diagnostic assessments. Furthermore, there are additional barriers in low-income countries in access to screening tools and standardized diagnostic tests for autism spectrum disorders that were only exacerbated during COVID-19. The Brief Observation of Symptoms of Autism instrument was developed to improve access to diagnostic assessment via telehealth during this time. The current study sought to validate the use of the Brief Observation of Symptoms of Autism within two Latin American countries. A sample of 313 children and adults from Argentina and Chile were examined. Results showed valid sensitivity and specificity scores with good fit across modules using two factors (i.e. Social Affect and Restricted, Repetitive Behaviors). Preliminary results of the current study demonstrated that the Brief Observation of Symptoms of Autism is a valid instrument for Latin American population and shows promise to be used beyond the pandemic to ease the diagnostic process. This is a collaborative work with BRINCAR Parent Association, who defined the need in our country to run the validation of Brief Observation of Symptoms of Autism and gave us support as the stakeholders at Lancet Commission.

摘要

自闭症谱系障碍是一种多方面的病症,其特征是社交沟通和行为模式存在明显缺陷。诊断取决于临床医生的专业知识、全面的发育史以及对特定行为标志物的观察。然而,在低收入国家,获得自闭症谱系障碍筛查工具和标准化诊断测试的机会仍然极为有限。此外,新冠疫情加剧了这些挑战,使诊断方案变得不切实际。为应对这些障碍,开发了自闭症症状简短观察工具,以方便在疫情期间通过远程医疗进行评估。本研究旨在验证自闭症症状简短观察工具在阿根廷和智利这两个拉丁美洲国家的使用情况。对313名不同年龄组的人群进行了检查。对自闭症症状简短观察工具每个模块的心理测量特性进行了仔细审查,包括针对推荐的加利福尼亚大学洛杉矶分校临界值的敏感性和特异性。受试者工作特征曲线分析得出了每个模块可靠的敏感性和特异性分数。验证性因素分析支持各模块之间的良好拟合,采用区分社交情感和受限、重复行为的双因素模型。初步研究结果证实,自闭症症状简短观察工具作为一种有效的诊断工具在拉丁美洲人群中具有有效性。此外,其潜力不仅限于疫情期间,未来有望提供支持。

摘要

自闭症谱系障碍是一种复杂的病症,与社交沟通和行为功能的显著缺陷有关。诊断依赖于临床医生的专业知识、发育史的收集以及特定行为的观察。建议的诊断方案包括在疫情期间失效的工具,这给诊断评估带来了重大障碍。此外,在低收入国家,获得自闭症谱系障碍筛查工具和标准化诊断测试存在额外障碍,而在新冠疫情期间这些障碍进一步加剧。自闭症症状简短观察工具的开发是为了在此期间通过远程医疗改善诊断评估的可及性。当前研究旨在验证自闭症症状简短观察工具在两个拉丁美洲国家的使用情况。对来自阿根廷和智利的313名儿童和成人进行样本检查。结果显示,使用社交情感和受限、重复行为这两个因素时,各模块具有有效的敏感性和特异性分数,且拟合良好。当前研究的初步结果表明,自闭症症状简短观察工具对于拉丁美洲人群是一种有效的工具,并且有望在疫情之后用于简化诊断过程。这是与BRINCAR家长协会的合作成果,该协会确定了在我国开展自闭症症状简短观察工具验证的必要性,并作为《柳叶刀》委员会的利益相关者给予我们支持。

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