Wednesday, November 07, 2007

Hidden Horde Found

Matson, J, L., Wilkins, J., Boisjoli, J, A., Smith, K, R. (2007). The validity of the autism spectrum disorders-diagnosis for intellectually disabled adults (ASD-DA). Research in Developmental Disabilities. [Epublished ahead of print].

50% of the adults in this study were diagnosed with an PDD (Autistic Disorder or PDD-NOS). The article does not make it clear whether these were rediagnoses or not.

Abstract

"Psychologists interviewed direct-care staff using a battery of assessment measures including the autism spectrum disorders-diagnosis for intellectually disabled adults (ASD-DA), the Diagnostic Assessment for the Severely Handicapped-II (DASH-II), the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER), the Socialization domain of the Vineland Adaptive Behavior Scales (VABS), and a checklist containing criteria for autism and PDD-NOS from the DSM-IV-TR and ICD-10. Three hundred and seven intellectually disabled (ID) adolescents and adults ranging in age from 16 to 88 were assessed. Participants were diagnosed with either ID and ASD (autism or PDD-NOS; n=156) or ID and no Axis I diagnosis (n=151). A modification of the multitrait-multimethod approach was used to establish the convergent and discriminant validity of the ASD-DA. The scale proved to have robust convergent validity when correlated with the DSM-IV-TR/ICD-10 checklist, MESSIER, and Socialization domain of the VABS. Additionally, discriminant validity was demonstrated by comparing the ASD-DA to items from the DASH-II (measure of general psychopathology). The implications of these data are discussed."


12 Comments:

Blogger LIVSPARENTS said...

Can you please forward to Anne Mcelroy/Dachel? She and A-Champ have been worried about finding the adults forever, I'm sure she'll be comforted to know that they are no longer lost...

10:35 AM  
Blogger Bev said...

They are looking for these guys over at HuffPo, too.

11:44 AM  
Blogger Fore Sam said...

So, how many of the 307 were over 77 years old?

12:29 PM  
Blogger Joseph said...

Contact the authors, John. The range was 16 to 88, so what do you think?

50% is considerably higher than I've seen in the past, and some could argue the number of autistic adults has increased in the population with intellectual disabilities. In 1982, Shah & Wing found that 38% of those in a mental handicap hospital met criteria for what we would now call autism.

6:26 PM  
Blogger Fore Sam said...

Joe,
I think that 306 of them were between 16 and 25 with one old person with Alzheimer's who they misdiagnosed. That's why I asked for clarification.
That's good thinking about intellectual disabilities, Joe. Since autism is one of those things, it only stands to reason it would be included.
Were the folks Wing would now call autistic verbal and smearing feces or were they high functioning Aspies who you would toss into the autism category?

7:20 PM  
Blogger Interverbal said...

Fore Sam,

The age range for ASD group was 16-75. The ASD average age was 48.8 (SD=10.9).

The age range for the ID group was 28-88. The ID average age was 55.5 (SD=13.9).

There was autistic 77 year olds, but the mean ages were within a standard deviation of each other. In other words, the averages were the same and the group sizes were nearly equivalent (156 vs 151).

In this case intellectual disabilities means "mental retardation". This was diagnosed by comparing a IQ score with adaptive behavior, which is exactly how it should be done. The center that ran this study has ID as a pre-requisite for inclusion in their center.

All persons both both in the ID group and ASD group had ID. No persons with Aspergers Disorder or average or above intelligence were present.

8:44 PM  
Blogger Interverbal said...

Folks, I have made an error in my interpretation. The ASD diagnoses may or may not have been rediagnoses. The article is not clear on this.

I apologize for any confusion this may have caused.

8:48 PM  
Blogger Interverbal said...

A further clarification.

Contact with the authors has suggested that the total population in the centers was closer to 800 person. This means that persons with autism in these centers make less of the total center population than some of us have previosuly thought.

8:15 PM  
Anonymous sammy the northpaw said...

I don't understand your last comment, Interverbal.

They administered tests that show ASD's to 307 clients all of whom had been in the program for more than 6 months. If the 307 were representative of the rest of the clients then there's no reason to think that the rest of the group of clients didn't also have a similar composition. Or maybe I don't understand your point.

If there was bias in the sample, for instance if the 307 contained all of the autistic people in the program and none were excluded from the sample, then the ratio of autistic to non-autitic clients would be more like 1/4 instead of 1/2... if I did the math correctly.

If every developmental program thought to have mainly MR (ID) people in it actually has 1/4 to 1/2 who are undiagnosed autistic (with MR) then that is a huge number of people.

Considering how many of them have died because of abuse from people who work in institutions, there would be more older ones.

Considering that a person like Fore Sam with obvious violent inclinations, used to work with the disabled, it makes one shudder to think of what the disabled in day-care situations face from their "caregivers."

Fore Sam you are so redundant. Give it up because you will never get a penny from your future vaccine law suit. Figure the odds man. You have zero chance of getting a penny based on your son's supposed advances on ALA. Dosing him based on advice coming from a nobody, and with no labwork showing any mercury coming out.

2:37 AM  
Blogger Interverbal said...

Sammy,

What was meant by my last comment was that the authors used all available autistics in their centers then matched a similar number of folks with just ID.

7:08 AM  
Anonymous sammy the northpaw said...

Interverbal,

How did they arrive at who all of their autisics were? I mean, how would they know who were all of their autistics without administering the instruments to all of their clients?

Obviously, they did administer the tests to all of those they labeled autistic or PDD,nos... I'm very puzzled. I guess I'll have to look at the paper again and maybe email the authors for clarification.

I realize that the main purpose of the paper was to verify the accuracy of their instruments as used on adults, but it's still very odd. I'd be happy to go with the 1/4 of their clients are autistic, is that how you understand it?

2:29 AM  
Blogger Interverbal said...

Hi Sammy,

Yes, as I undertand it, the authors had pre-identifified all availale autistics.

What I am happy about in this study is that it contains a pile of grown up autistics. According to some, these person do not exist.

2:37 PM  

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