PS 571 Asperger Syndrome Diagnostic Scale PowerPoint

7/23/2019 PS 571 Asperger Syndrome Diagnostic Scale PowerPoint

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Asperger Syndrome

Diagnostic Scale (“ASDS”)-Brenda Smith Myles, Stacey Jones

Bock, Richard ! Simpson ("##$)

-Diana %elly, &S '$' (#*)



Brie+ istory o+ AspergersSyndrome

• eo %anner delineates the diagnosticcriteria +or A.tism (aka “%annersSyndrome”)!

• $/01 %anner identi2es a gro.p o+ a.tisticchildren, apparently “normal”, 3.t 4hoare na56e, lack appropriate speechpragmatics and prosody, lack empathy,and ha6e poor non-6er3al comm.nication!

(78ono9, et al!, "##:; <reeman et al!, "##")

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istory cont!

• =n $//, ans Asperger descri3es asimilar gro.p o+ a.tistic 3oys, 3.tnotes no speech delay, the presence o+

motor cl.msiness, and a late onset o+social de2cits!

(78ono9 et al!, "##:; <reeman et! al, "##")

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istory cont!

• >ol9 ? Barlo4, in $@, descri3e a similargro.p o+ children diagnosed 4ith schi8oidpersonality disorder characteristics

considered to 3e sta3le personality traits!• =n $*$, >ing translates Aspergers paper

into nglish and demonstrates theconnection to %anners $/0 gro.p!

(78ono9 et al!, "##:1 <reeman et al!, "##")!

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istory cont!

• =n $*, Ro.rke descri3es yet anothergro.p o+ children 4ho ha6e 3eenidenti2ed as ha6ing CD

ne.ropsychological pro2les essentiallya.tistic-like de2cits 3.t 4ith 4ell-de6eloped “rote” 6er3al repertoires!

(78ono9 et al!, "##:; <reeman et al!, "##")

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AS =ncl.ded =n DSM-=

• By $/, eno.gh 6arying 6ie4s o+ ASres.lted in the consens.s that ASsho.ld 3e incl.ded in the DSM-=

.nder the category o+ &DD!

(78ono9 et al!, "##:; <reeman et al!, "##")

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E.rrent De3ate =n ASAssessment

• o4 to assess AS 6s! other &DDsF

• >hat characteristics o6erlapF

•

Are the characteristics inimical onlyto AS to permit di9erential diagnosis,and, i+ so, 4hat are they and ho4 tomeas.re themF

• >hen are these characteristicscapa3le o+ acc.rate meas.rementF

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DSM-=-GR Eriteria +or AS

• Same H.alitati6e social impairment,restricti6e and stereotypic 3eha6iorpatterns and impairment in social,

occ.pational or important area o++.nctioning!

• Icept ! ! !

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DSM-=-GR- AS .ali2ers

• Co clinically signi2cant delay in the onset o+1

– ang.age (single 4ords at "; comm.nicati6ephrases -0);

–

Age-appropriate sel+-help skills, adapti6e 3eha6ior(other than social), and en6ironmental c.riosity!

– Eriteria not met +or another &DD or Schi8ophrenia!

(DSM-=1 American &sychiatric Association, $/; DSM-=-GR,American &sychiatric Association, "###)!

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Ghe ASDS

• De6eloped in "##$!

• :# item test, rated as o3ser6ed ($) ornot o3ser6ed (#)!

• Rater needs to 3e an “appropriateperson” 4ith reg.lar, s.stained contact4ith eIaminee +or at least " 4eeks,

(e!g!, parent, teacher)!• Iaminer is person scoring and

interpreting the ASDS res.lts!

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ASDS cont!

• Appropriate +or ages :-$*

• Eompletion time $#-$: min.tes

•

Scale normed on $$: indi6id.als+rom "$ states in the K!S!

• &ro6ides standard scores and

percentile ranks

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Relia3ility <rom Man.al

• Eron3achs ($:$) coeLcient alpha.sed to determine internal consistencyo+ the instr.ment and s.3scales!

• igher consistency on ASDS as a 4holeto s.ggest AS, 3.t less relia3le on thes.3scales indi6id.ally, th.s

recommends s.3scales 3e .sed only todetermine relati6e indi6id.al strengthsand 4eaknesses, not to identi+y AS

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=nterrater Relia3ility

• $/ AS s.3ects (mean age $") rated3y teachers ? parents!

• Ghe res.lting correlation coeLcient+or the AS calc.lated 4as !0 considered strong, statisticallysigni2cant, and indicati6e that

ratings 4ill 3e similar across di9erentraters 4ith the same s.3ect!

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alidity <rom Man.al

• 6idence 4as pro6ided +or threetypes o+ 6alidity1

– Eontent

– Eriterion

– Eonstr.ct

(=nterestingly, there is no disc.ssion o+eIternal 6alidity)!

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Eontent alidity

• =tem Analysis1

– =tems on ASDS deri6ed +rom the DSM-=,the =ED-$#; AS literat.re on R=E and

&sych=n+o data3ases ($@:-$), andAspergers $// research! ' res.ltingcategories com3ines into :!

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=tem Discrimination

• An item analysis 4as not done at separateage le6els since research indicate thatthere is not relationship 3et4een age and

ASDS scores!• =tem discrimination 4as tested 3y the

&earson item-total-score correlation indeI,yielding statistical signi2cance, and

coeLcients indicating items 4ell-eIceeded minim.m criteria +or magnit.de!

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Eriterion alidity

• ASDS a3ility to di9erentiate amongstdi9erent diagnostic gro.ps!

• " gro.ps1 $$: diagnosed 4ith AS;

normati6e gro.p o+ $@@ 4ith a.tism,3eha6ior disorders, ADD, D!

• Discriminant analysis sho4ed astatistically signi2cant di9erence3et4een the mean AS +or the AS andnon-AS samples; acc.racy o+ *:Ncorrect classi2cation!

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Eonstr.ct alidity-ypotheses

• AS characteristics not correlated 4ith age,so AS sho.ld not 3e related to age!

• ASDS item characteri8e AS and sho.ld

correlate 4ith total test score• As ASDS meas.re AS characteristics, it

sho.ld not correlate strongly 4ith scale +ora.tism

• ASDS meas.res AS characteristics andsho.ld di9erentiate 3et4een AS and non-ASgro.ps!

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ASDS 6al.ation o+ AS Age

• ittle p.3lished research 3y $-"##$!

• Eorrelated ASDS ra4 scores 3et4eensample gro.ps, ages :-$*!EoeLcient o+ !$/ con2rms nopractical relation!

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Discriminant alidity

• Eorrelated ASDS scores 4ith OARSscores!

• OARS targets a.tism and ASDS targets

AS!

• Eorrelational coeLcient 4as notsigni2cant, magnit.de reported as

moderate!• Gh.s, concl.sions that ASDS and OARS

meas.re di9erent conditions!

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Oro.p Di9erentiation

• Ipectation that each gro.ps res.ltssho.ld make sense1 that indi6id.alsnot ha6ing AS 4o.ld ha6e AS and

s.3scale scores signi2cantly di9erentthan those ha6ing AS

• Mean s.3scale and H.otient standard

scores 4ere signi2cantly higher +orthose 4ith AS!

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Ghe Gest =tsel+

• Ghe :# items are di6ided into :s.3scales1 – ang.age1 Recepti6e ? Ipressi6e ()

–

Social1 reciprocity, eye contact, gest.res,perspecti6e ($0)

– Maladapti6e1 73sessions, rit.als, ro.tinechange, 3eha6ioral control, anIiety ($$)

–

Eogniti6e1 rote ? 6is.al memory,intelligence, related cogniti6e iss.es ($#)

– Sensorimotor1 a.ditory, tactile, ol+actory,g.statory sensiti6ities; 2ne ? gross motor

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ASDS =nstr.ctions

• Iaminers man.al incl.des1

–Speci2c administration ? scoringproced.res1 comp.ting ?con6erting ra4 scores, standardscores, percentile ranks, and theres.ltant Asperger Syndrome

.otient (AS)!

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Scoring

• Gotal ra4 scores con6erted 3y ta3le intoNile and AS! (AS has a mean o+ $##and standard de6iation o+ $:, compares

this indi6id.al 4ith others 4ith AS!)

• Ra4 score +or each s.3scale con6erted

in Nile rank and standards scores!(Mean o+ $#, standard de6iation o+ 0)!

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&ro2le

• &ro2le o+ Scores1 scatter plotgraphic plotting o+ s.3scale standardscores and AS!

• &ro6ides 6is.al assessment o+likelihood o+ AS and the areas o+strength and 4eakness!

• igher scores P greater pro3a3ility o+AS!

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Iaminers Man.al Ea.tions

• Ghe ASDS res.lts may 3e indicati6e o+AS, 3.t does not diagnose AS as alltesting has error and con+o.nds to 3e

considered• Ad6ises comprehensi6e e6al.ation +or

diagnosis

• S.ggests that ASDS has .tility inaiding diagnosis ? in treatmentplanning or modi2cation

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ASDS >ritten Report

• <orm incl.des a 3rie+ 4ritten report1

– Description o+ speci2c symptomso3ser6ed,

– <.nctional impact on s.3ect,

– =mplications and recommendations re14ork, leis.re, instr.ction

–

Recommendations +or strategies andinter6entions regarding instr.ction,3eha6ior, parenting, and related ser6ices

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arly De6elopment=nter6ie4

• =n addition, the ASDS incl.des $# keyH.estions (also in the H.estionnaire)to Qesh o.t additional in+ormation on

the onset o+ symptoms, relati6ese6erity, relati6ity across settings!

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Reasons Go Kse ASDS

• Ghe ASDS is easy to administer

• Gakes little time, $#-$: min.tes

•

asy to score and scale and read• Allo4s +or additional in+ormation on

an indi6id.al s.3ects idiosyncrasies

that is .se+.l in treatment planning!

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Rele6ant Research on ASDS

• 7nly one re6ie4 co.ld 3e locatedgi6ing strong s.pport +or the ASDS asa tool to di9erentiate AS +rom

a.tism!

(Mirenda, &!, "##0)!

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imitations cont!

• Ghe most signi2cant limitation o+ theASDS is the lack o+ agreed .ponoperational di9erential diagnostic

components to disting.ish AS +rom oras a 6ariant o+ a.tism, <A, and &DD-C7S!

(Goth ? %ing, "##*; Boggs et al!, "##'; Eamp3ell, J!M!, "##:; McEonachcie et al!, "##:; 78ono9 et al!,"##:; <reeman et al!, "##"; Blair, %! A! ("##0)!

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• OARS meas.res a.tism!

• OADS and the %AD=, the only other ASspeci2c tests also ha6e same

4eaknesses as ASDS 4ith respect todiagnoses 6eri2cation!

• %AD= has strong psychometrics, ASDS

the 4eakest! %AD= also has age gro.ps!(Eamp3ell, J!M!, "##:; McEonachie et al!, "##:;

78ono9 et al!, "##:; Blair, %!, "##0)!

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• Some st.dies note that most i+ not allsymptoms seen in a.tism are seen in AS;other recent st.dies s.ggest that AS and

a.tism appear di9erent at yo.ng age,that 3y adolescence the di9erences areless apparent, and indi6id.als appearless distinct! &erhaps the “co.rse”

sho.ld 3e incl.ded in screening!(Boggs et al!, "##'); McEonachie et al!, "##:; 78ono9et al!, "##:; <reeman et al!, "##")!

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• Ghe de3ate also s.ggests that todetermine the presence o+ AS1

– e6al.ate the type and .se o+ lang.age ?

skills that appear, not simply their age o+onset;

– presence o+ hyperacti6ity, depression,motor cl.msiness

– the “co.rse” o+ repetiti6e 3eha6iors

(Boggs 4t al!, "##'; (78ono9 et al!, "##:;McEonachie, et al!, "##:)!

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ASDS Eompared Go 7ther Gools

• Ghere are no p.3lished comparison st.diesthat 4o.ld .se the ASDS alone or rank it ass.perior to other AS-speci2c screening tools!

•

7ne st.dy +o.nd that %AD= to 3e the mostthoro.gh; one pre+erred the ASS (3.t co.ldnot recommend any scale); one +o.nd acom3ination o+ the ASDS, OARS and SSRS to

3e most relia3le!(Boggs et al!, "##'; 78ono9 et al!, "##:; Eamp3ell, J!M!,

"##:)!

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Re+erences

• Blair, %! A! ("##0) Gest re6ie4 o+ the Asperger SyndromeDiagnostic Scale! <rom &lake, B! S!, =mpara J!! E!, ? Spies,R!A! (ds), The fteenth mental measurements yearbook,[ lectronic 6ersion! Retrie6ed $:"##*, +rom the B.ros=nstit.tes Test reviews Online 4e3site1

http1444!.nl!ed.3.ros!

• Boggs, %! M!, Oross, A! M!, ? Oohm, E! ! ("##')! alidity o+the Asperger Syndrome Diagnostic Scale! Journal o

Developmental and Physical Disabilities, 1!", $'0-$*"!

•

Eamp3ell, J! M! ("##:)! Diagnostic assessment o+Aspergers disorder1 A re6ie4 o+ 26e third-party ratingscales! Journal o #utism and developmental Disorders,$%!1, ":- 0:!

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Re+erences cont!

• <reeman, B! J!, Eronin, &!,? Eandela, &! ("##")! Aspergersyndrome or a.tistic disorderF Ghe diagnosticdilemma! &ocus On #utism and OtherDevelopmental Disabilities, 1'!$, $/:-$:$!

• Ooldstein, S! ("##")! Re6ie4 o+ the Asperger SyndromeDiagnostic Scale! Journal o #utism and DevelopmentalDisorders, $"!(, '$$-'$/!

• McEonachie, !, Eo.te.r, A! !,? oney, ! ("##:)! Ean a

diagnosis o+ Asperger syndrome 3e made in 6eryyo.ng children 4ith s.spected a.tism spectr.m disorderF Journal o #utism and Developmental Disorders, $%!",$'@-$@'!

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Re+erences cont!

• Mirenda, &! ("##0) Gest re6ie4 o+ the Asperger SyndromeDiagnostic Scale! <rom &lake, B! S!, =mpara J!! E!, ? Spies, R!A!(ds), The fteenth mental measurements yearbook,[ lectronic 6ersion! Retrie6ed $:"##*, +rom the B.ros=nstit.tes Test reviews Online 4e3site1

http1444!.nl!ed.3.ros!• Myles, B!S!, Bock, S! J!, ? Simpson, R! ! ("##$)! #sper)er

*yndrome Dia)nostic *cale +#*D*, &R7-D, A.stin, G!

• 78ono9, S!, Ooodlin-Jones, B! !, ? Solomon, M! ("##:)!6idence-3ased assessment o+ a.tism spectr.m disorders inchildren and adolescents! Journal o -linical -hild and

#dolescent Psycholo)y, $.!$, :"0-:/#!

• Goth, %!, ? %ing, B!!, ("##*)! Aspergers syndrome1 diagnosisand treatment! The #merican Journal o Psychiatry, 1(%!, :*-

'0!

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PS 571 Asperger Syndrome Diagnostic Scale PowerPoint