Developmental Diagnostic

About: Developmental Diagnostic is a research topic. Over the lifetime, 10 publications have been published within this topic receiving 60 citations.

Developmental Diagnostic assessment for children suspected to have developmental disabilities. An interdisciplinary model of care

Abstract: Introduction: A comprehensive developmental diagnostic assessment (DDA) is recommended for children suspected to have a developmental disability to confirm the presence of the primary condition and assess for related health conditions, including aetiology, and develop a management plan. Parents usually have a range of questions and needs that arise from their concern about their child’s difficulties, about their experience of and recommendations for DDA and intervention and justifiably expect these to be addressed. Person centred care is the primary ethical concern when working with populations at risk, challenging clinicians to embed this into their models of care and systemic service planning issues. International guidelines recommend that this process involves a team and yet there is little discussion about different models of team assessments. We describe an interdisciplinary model of team based assessment involving social worker, clinical neuropsychologist and paediatrician and the theoretical, enablers and experience of this model of care. Short description of practice change implemented: Each discipline is involved in the full assessment, recognising the importance of collaboration and a interdisciplinary DDA approach. Each clinician retains discipline specific clinical responsibility, but collaborates throughout DDA and development of management plan. Involvement of the social worker specifically facilitates consideration of the social context and social consequence of a disability diagnosis. Aim and theory of change: The aim of this model of care is to more effectively and seamlessly embed person centred care in the diagnostic assessment process by integrating comprehensive psychometric assessments, paediatric diagnostic assessment and systematised parent support before, during and after the assessment. The theories, context and goals of the disciplines will be described as well as the experience of the individuals involved in this team based assessment. Impact for the parents as well as their issues and concerns that arise will be highlighted. Targeted population and stakeholders: Children suspected to have a developmental disability is the primary target population for this team, however, an interdisciplinary model of team based assessment and management may be suitable for a range of vulnerable populations with complex health or developmental concerns. Key stakeholders include parents, referrers, other service providers and the health service funding bodies who balance health outcomes with health service investment. Comments on sustainability: Interdisciplinary models of care can be perceived to be expensive in a system where health service funding favours occasions of service. Limited evidence about the impact of different models of care can bias service provision towards a single discipline or fragmented care via multiple disciplines. Comments on transferability: This interdisciplinary model of DDA can be implemented in a range of health contexts in which these disciplines, knowledge and theories are well established. It is a viable model that may better address the complexities involved in diagnostic assessments and elevate the experiences and needs of parents through that critical period. Further research is necessary to understand the barriers, enablers and impact of different models of care for young children with developmental disabilities and their parents.

The Autism Spectrum: Autism screening and diagnostic evaluation

Abstract: In order to maximize the benefits of treatment, children with autism should be identified and diagnosed as early as possible. This chapter will address screening for autism spectrum disorders in community and high-risk populations and the components of a comprehensive diagnostic evaluation. Instruments used for screening and diagnostic assessment will be described. Discussion will also touch upon two other aspects of evaluation: investigating the etiology of autism in an individual child, and identifying comorbid conditions that occur commonly in children with ASDs. Screening Screening of young children to detect those who might have, or be at risk for, ASDs may be implemented in a number of settings: in primary care physicians’ offices and clinics, in developmental diagnostic centers and in early intervention programs. Such screening can be described as being of two types, depending on setting and purpose. Level 1 screening takes place in primary care or community settings and aims to differentiate children who are at risk for autism from the rest of the population. Level 2 screening generally takes place in early intervention programs and diagnostic centers and aims to distinguish children with ASDs from those with other developmental disabilities. Level 2 screening may thereby also contribute to establishing a diagnosis of autism.

Validating the Developmental, Diagnostic and Dimensional Interview - Short Form Adult Version (3Di-sva): a diagnostic interview for autism spectrum disorders in adults

Abstract: Department of Health (2010) guidelines highlight the importance of diagnosis for adults with autism spectrum disorders (ASD) who have not previously had their condition recognised. Reliable, valid and user-friendly diagnostic tools must therefore be available. Part 1: This section critically appraises and systematically reviews 12 studies examining the NICE (2012) recommended adult ASD diagnostic tools. It concludes that there is good evidence to support the use of the Ritvo Asperger Diagnostic Scale-Revised(RAADS-R) and Autism Diagnostic Observation Schedule (ADOS), with some support for the use of the Autism Diagnostic Interview-Revised (ADI-R). However the Adult Asperger Assessment (AAA), Asperger Syndrome Diagnostic Interview (ASDI) and Diagnostic Interview for Social and Communication Disorders (DISCO) appear to have insufficient evidence at present. Further research is indicated for all the instruments. Part 2: This section presents a study of a new informant report diagnostic tool, the Developmental, Diagnostic and Dimensional Interview - Short Form Adult Version (3Di-sva). The 3Di-sva interview was completed with an informant for 27 ASD and 27 non-clinical comparison participants. It demonstrated good psychometric properties, including good internal consistency and inter-rater reliability, and strong sensitivity and specificity. The 3Di-sva is a time and cost-efficient tool, which could be suitable for use as part of a multi-dimensional adult ASD assessment. The study was completed as part of a joint project with McKenner (2015), who examined the 3Di-sva when used in a clinical comparison population. Part 3: This section is a critical appraisal which reflects upon areas relevant to both the literature review and empirical paper. The main focus of the discussion is upon on the idea of ideal versus achievable research and upon my learning process about research within NHS settings.

Problems with developmental diagnostic procedures

Abstract: After mentioning historical origins of developmental diagnostics, the present article focuses on some of the problems attached to procedures used in developmental diagnostics, as for example the Denver Scales well known and widely distributed in the Federal Republic of Germany, the Munchener Funktionelle Entwicklungsdiagnostik (Munich Functional Developmental Diagnostics), and the Federal Early Diagnostic Program for early discovery of developmental disorders. From this, criteria for the construction and evaluation of developmental tests are derived.