Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter

Autismus-Spektrum-Störungen (ASS) sind schwerwiegende, chronisch verlaufende neurologische Entwicklungsstörungen, die durch ein hohes Ausmaß der Beeinträchtigung sozialer und kommunikativer Fertigkeiten sowie durch eine ausgeprägte Heterogenität der Symptomatik gekennzeichnet sind. Interventionen mü...

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1. Verfasser: Hoffmann, Wiebke Astrid
Beteiligte: Rief, Winfried (Prof. Dr. ) (BetreuerIn (Doktorarbeit))
Format: Dissertation
Sprache:Deutsch
Veröffentlicht: Philipps-Universität Marburg 2016
Psychologie
Ausgabe:http://dx.doi.org/10.17192/z2016.0219
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author2 Rief, Winfried (Prof. Dr. )
author2_role ths
topic Screening
Psychologie
screening
ADI-R
Screening
Kinder- und Jugendliche
Autismus
ADI-R
CBCL
children and adolescents
CBCL
autism spectrum disorder
Autismus-Spektrum-Störung
spellingShingle Screening
Psychologie
screening
ADI-R
Screening
Kinder- und Jugendliche
Autismus
ADI-R
CBCL
children and adolescents
CBCL
autism spectrum disorder
Autismus-Spektrum-Störung
Autism Spectrum Disorders (ASD) are chronic neurodevelopmental disorders that are characterized through severe impairments of social, communicative, cognitive and language abilities. The symptomatology is heterogenous in nature and varies considerably from severe ASD with intellectual disability and delays in language development (´low functioning autism´) to ASD without intellectual and language impairments (´high-functioning autism´). As therapeutic interventions with causal effects are not known, interventions have to focus on the modification of individual symptoms. A variety of studies have stated that interventions at the earliest possible stages in the development of the child are associated with better outcomes. Therefore, the detection of early ASD symptoms, particularly through the application of screening instru¬ments is important. Yet, screening instruments for individuals with high functioning autism are rare. In the present cumulus three studies are described that explored the usefulness of screening instruments in the diagnostic assessment of children and adolescents with high functioning ASD. In study 1 a short interview was developed on the basis of an existing gold-standard diagnostic interview. The short interview showed high sensitivity and specificity for the discrimination of individuals with Asperger syndrome (AS) and attentiondeficit-/hyperactivity disorder (ADHD), especially for children and adolescents younger than 11 years. The aim of study 2 was to replicate the findings of study 1 on the basis of an independent and enlarged sample, comprising children and adolescents with high functioning ASD other than AS and children and adolescents with other psychiatric disorders. It could be shown that the short interview can be used for the detection of high functioning ASD as sensitivity was sufficient, yet specificity was low. Therefore, discrimination of ASD and other psychiatric disorders was difficult. Study 3 examined if a questionnaire that was originally designed for the identification of problem behavior in children and adolescents can be used as screening instrument for ASD. The results show a high prevalence of accompanying emotional and behavior problems in children and adolescents with ASD. Furthermore, the evaluated questionnaire is not a suitable screening instrument for the identification of ASD, but it can be used for the assessment of co-occurring behavior problems.
Hoffmann, Wiebke Astrid
Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
publishDate 2016
era_facet 2016
doi_str_mv http://dx.doi.org/10.17192/z2016.0219
edition http://dx.doi.org/10.17192/z2016.0219
title_alt Screening of high functioning autism spectrum disorders in children and adolescents
institution Psychologie
oai_set_str_mv ddc:150
doc-type:doctoralThesis
open_access
xMetaDissPlus
dewey-raw 150
dewey-search 150
genre Psychology
genre_facet Psychology
topic_facet Psychologie
description Autismus-Spektrum-Störungen (ASS) sind schwerwiegende, chronisch verlaufende neurologische Entwicklungsstörungen, die durch ein hohes Ausmaß der Beeinträchtigung sozialer und kommunikativer Fertigkeiten sowie durch eine ausgeprägte Heterogenität der Symptomatik gekennzeichnet sind. Interventionen müssen symptombezogen erfolgen, da bislang keine Therapieformen mit kausaler Wirkung bekannt sind. Da in verschiedenen Studien gezeigt werden konnte, dass sehr frühe Interventionen größere Effekte erzielen als später einsetzende Interventionen, kommt der Früherkennung autistischer Störungen und damit auch der Entwicklung von Screening-Verfahren eine wichtige Bedeutung zu. Es mangelt jedoch an Verfahren, die speziell auf hochfunktionale Autismus-Spektrum-Störungen ausgerichtet sind. In dem vorliegenden Cumulus werden 3 Studien vorgestellt, die sich mit der Erforschung der Möglichkeiten und Grenzen des Einsatzes von Screening-Verfahren in der Diagnostik hochfunktionaler ASS beschäftigt haben. In Studie 1 wurde untersucht, ob eine neu entwickelte Kurzversion eines in der Forschung und in der klinischen Praxis bewährten störungsspezifischen Interviews Kinder und Jugendliche mit Asperger-Syndrom identifizieren kann. Zudem sollte anhand des Kurzinterviews eine Differenzierung der Diagnosen Asperger-Syndrom und Aufmerksamkeits-Defizit/-Hyperaktivitätsstörung (ADHS) möglich sein. Insgesamt zeigte das Kurzinterview eine hohe Sensitivität und Spezifität, insbesondere auch in der Gruppe der Probanden < 11 Jahre. In Studie 2 sollten die Ergebnisse von Studie 1 an einer unabhängigen und erweiterten Stichprobe repliziert und überprüft werden. Es hat sich gezeigt, dass das Kurzinterview zwar prinzipiell zur Identifikation hochfunktionaler ASS geeignet ist und eine ausreichende Sensitivität aufweist, jedoch bei der Abgrenzung zu anderen psychischen Störungen aufgrund einer zu niedrigen Spezifität Probleme auftreten, wie dies auch bei anderen Verfahren, die zur Erfassung von ASS eingesetzt werden, häufig der Fall ist. In der 3. Studie wurde untersucht, inwiefern ein nicht-störungsspezifisches Screening-Verfahren zur Identifizierung von hochfunktionalen Autismus-Spektrum-Störungen eingesetzt werden kann. Die Ergebnisse der 3. Studie machen deutlich, dass das untersuchte Verfahren ungeeignet zur Erfassung von ASS im Screening-Prozess ist. Jedoch zeigen die Ergebnisse, dass durch das untersuchte Verfahren ASS begleitende emotionale und verhaltensbezogene Störungen in ökonomischer Form erhoben werden können. Das untersuchte Verfahren liefert damit wichtige Hinweise für die Planung der Interventionen bei bereits diagnostizierten ASS.
format Dissertation
url http://archiv.ub.uni-marburg.de/diss/z2016/0219/pdf/dwah.pdf
contents Autism Spectrum Disorders (ASD) are chronic neurodevelopmental disorders that are characterized through severe impairments of social, communicative, cognitive and language abilities. The symptomatology is heterogenous in nature and varies considerably from severe ASD with intellectual disability and delays in language development (´low functioning autism´) to ASD without intellectual and language impairments (´high-functioning autism´). As therapeutic interventions with causal effects are not known, interventions have to focus on the modification of individual symptoms. A variety of studies have stated that interventions at the earliest possible stages in the development of the child are associated with better outcomes. Therefore, the detection of early ASD symptoms, particularly through the application of screening instru¬ments is important. Yet, screening instruments for individuals with high functioning autism are rare. In the present cumulus three studies are described that explored the usefulness of screening instruments in the diagnostic assessment of children and adolescents with high functioning ASD. In study 1 a short interview was developed on the basis of an existing gold-standard diagnostic interview. The short interview showed high sensitivity and specificity for the discrimination of individuals with Asperger syndrome (AS) and attentiondeficit-/hyperactivity disorder (ADHD), especially for children and adolescents younger than 11 years. The aim of study 2 was to replicate the findings of study 1 on the basis of an independent and enlarged sample, comprising children and adolescents with high functioning ASD other than AS and children and adolescents with other psychiatric disorders. It could be shown that the short interview can be used for the detection of high functioning ASD as sensitivity was sufficient, yet specificity was low. Therefore, discrimination of ASD and other psychiatric disorders was difficult. Study 3 examined if a questionnaire that was originally designed for the identification of problem behavior in children and adolescents can be used as screening instrument for ASD. The results show a high prevalence of accompanying emotional and behavior problems in children and adolescents with ASD. Furthermore, the evaluated questionnaire is not a suitable screening instrument for the identification of ASD, but it can be used for the assessment of co-occurring behavior problems.
author Hoffmann, Wiebke Astrid
ref_str_mv references
title Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
title_short Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
title_full Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
title_fullStr Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
title_full_unstemmed Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
title_sort Screening von hochfunktionalen Autismus-Spektrum-Störungen im Kindes- und Jugendalter
building Fachbereich Psychologie
license_str http://archiv.ub.uni-marburg.de/adm/urhg.html
first_indexed 2016-06-16T00:00:00Z
last_indexed 2016-06-16T23:59:59Z
language German
publisher Philipps-Universität Marburg
physical 139 pages.
thumbnail http://archiv.ub.uni-marburg.de/diss/z2016/0219/cover.png
spelling diss/z2016/0219 2016 http://dx.doi.org/10.17192/z2016.0219 Screening of high functioning autism spectrum disorders in children and adolescents Autismus-Spektrum-Störungen (ASS) sind schwerwiegende, chronisch verlaufende neurologische Entwicklungsstörungen, die durch ein hohes Ausmaß der Beeinträchtigung sozialer und kommunikativer Fertigkeiten sowie durch eine ausgeprägte Heterogenität der Symptomatik gekennzeichnet sind. Interventionen müssen symptombezogen erfolgen, da bislang keine Therapieformen mit kausaler Wirkung bekannt sind. Da in verschiedenen Studien gezeigt werden konnte, dass sehr frühe Interventionen größere Effekte erzielen als später einsetzende Interventionen, kommt der Früherkennung autistischer Störungen und damit auch der Entwicklung von Screening-Verfahren eine wichtige Bedeutung zu. Es mangelt jedoch an Verfahren, die speziell auf hochfunktionale Autismus-Spektrum-Störungen ausgerichtet sind. In dem vorliegenden Cumulus werden 3 Studien vorgestellt, die sich mit der Erforschung der Möglichkeiten und Grenzen des Einsatzes von Screening-Verfahren in der Diagnostik hochfunktionaler ASS beschäftigt haben. In Studie 1 wurde untersucht, ob eine neu entwickelte Kurzversion eines in der Forschung und in der klinischen Praxis bewährten störungsspezifischen Interviews Kinder und Jugendliche mit Asperger-Syndrom identifizieren kann. Zudem sollte anhand des Kurzinterviews eine Differenzierung der Diagnosen Asperger-Syndrom und Aufmerksamkeits-Defizit/-Hyperaktivitätsstörung (ADHS) möglich sein. Insgesamt zeigte das Kurzinterview eine hohe Sensitivität und Spezifität, insbesondere auch in der Gruppe der Probanden < 11 Jahre. In Studie 2 sollten die Ergebnisse von Studie 1 an einer unabhängigen und erweiterten Stichprobe repliziert und überprüft werden. Es hat sich gezeigt, dass das Kurzinterview zwar prinzipiell zur Identifikation hochfunktionaler ASS geeignet ist und eine ausreichende Sensitivität aufweist, jedoch bei der Abgrenzung zu anderen psychischen Störungen aufgrund einer zu niedrigen Spezifität Probleme auftreten, wie dies auch bei anderen Verfahren, die zur Erfassung von ASS eingesetzt werden, häufig der Fall ist. In der 3. Studie wurde untersucht, inwiefern ein nicht-störungsspezifisches Screening-Verfahren zur Identifizierung von hochfunktionalen Autismus-Spektrum-Störungen eingesetzt werden kann. Die Ergebnisse der 3. Studie machen deutlich, dass das untersuchte Verfahren ungeeignet zur Erfassung von ASS im Screening-Prozess ist. Jedoch zeigen die Ergebnisse, dass durch das untersuchte Verfahren ASS begleitende emotionale und verhaltensbezogene Störungen in ökonomischer Form erhoben werden können. Das untersuchte Verfahren liefert damit wichtige Hinweise für die Planung der Interventionen bei bereits diagnostizierten ASS. Autism Spectrum Disorders (ASD) are chronic neurodevelopmental disorders that are characterized through severe impairments of social, communicative, cognitive and language abilities. The symptomatology is heterogenous in nature and varies considerably from severe ASD with intellectual disability and delays in language development (´low functioning autism´) to ASD without intellectual and language impairments (´high-functioning autism´). As therapeutic interventions with causal effects are not known, interventions have to focus on the modification of individual symptoms. A variety of studies have stated that interventions at the earliest possible stages in the development of the child are associated with better outcomes. Therefore, the detection of early ASD symptoms, particularly through the application of screening instru¬ments is important. Yet, screening instruments for individuals with high functioning autism are rare. In the present cumulus three studies are described that explored the usefulness of screening instruments in the diagnostic assessment of children and adolescents with high functioning ASD. In study 1 a short interview was developed on the basis of an existing gold-standard diagnostic interview. The short interview showed high sensitivity and specificity for the discrimination of individuals with Asperger syndrome (AS) and attentiondeficit-/hyperactivity disorder (ADHD), especially for children and adolescents younger than 11 years. The aim of study 2 was to replicate the findings of study 1 on the basis of an independent and enlarged sample, comprising children and adolescents with high functioning ASD other than AS and children and adolescents with other psychiatric disorders. It could be shown that the short interview can be used for the detection of high functioning ASD as sensitivity was sufficient, yet specificity was low. Therefore, discrimination of ASD and other psychiatric disorders was difficult. Study 3 examined if a questionnaire that was originally designed for the identification of problem behavior in children and adolescents can be used as screening instrument for ASD. The results show a high prevalence of accompanying emotional and behavior problems in children and adolescents with ASD. Furthermore, the evaluated questionnaire is not a suitable screening instrument for the identification of ASD, but it can be used for the assessment of co-occurring behavior problems. Gjevik, E., Eldevik, S., Fjaeran-Granum, T., & Sponheim, E. (2011). Kiddie-SADS reveals high rates of DSM-IV disorders in children and adolescents with autism spectrum disorders. 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