Vers une refonte du système : une analyse exploratoire des traits neurodivergents dans une population d'enfants adressés pour une évaluation de l'autisme

Titre original en anglais : Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment

Cette publication est incluse dans le projet « Contributions académiques de personnes autistes sur l’autisme ». un auteur·ice de cette publication est identifié·e comme autiste dans le projet.

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Lang, J., Wylie, G., Haig, C., Gillberg, C., & Minnis, H. (2024). Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment. PLOS ONE, 19(1), e0296077. https://doi.org/10.1371/journal.pone.0296077

Publication date: 10/01/2024 Ajout dans AutiHub: 18/09/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
5
Auteur·ices de la publication identifié·es comme autistes
1 / 5 (20,0 %)
  1. Jason Lang *
  2. Georgia Wylie
  3. Caroline Haig
  4. Christopher Gillberg
  5. Helen Minnis

Résumé

Contexte Les services de santé pour enfants dans de nombreux pays passent d'évaluations diagnostiques cloisonnées par affection unique à une prise en compte du neurodéveloppement dans un sens plus holistique. L'importance du chevauchement clinique et de la cooccurrence de différents neurotypes lors de l'évaluation d'enfants neurodivergents est de plus en plus reconnue. À l'aide d'un plan d'évaluation transversale de service, nous avons étudié le chevauchement des neurodivergences dans une cohorte d'enfants adressés pour une évaluation de l'autisme, en nous concentrant sur les domaines de la motricité, de l'apprentissage et du niveau d'attention/d'activité. Nous avons cherché à déterminer quelle proportion d'enfants d'une cohorte adressée pour une évaluation de l'autisme présentait des traits de neurodivergences supplémentaires, et quelle proportion faisait l'objet d'investigations supplémentaires. Méthodes Nous avons évalué les dossiers médicaux anonymisés d'enfants âgés de deux à 17 ans adressés pour une évaluation de l'autisme. Nous avons utilisé des questionnaires validés pour évaluer les traits neurodivergents. Un système de score pondéré a été élaboré afin de déterminer les traits dans chaque domaine neurodéveloppemental, et un score supérieur à la médiane a été considéré comme indiquant un trait neurodivergent. Les éléments attestant d'investigations supplémentaires ont été consignés. Nous avons ensuite examiné les relations entre les traits autistiques et les traits de neurodivergence supplémentaire. Résultats 114 participants ont été inclus dans l'évaluation. 62,3 % (n = 71) avaient rempli des questionnaires pour l'analyse. Parmi eux, 71,8 % (n = 51) ont obtenu un score supérieur à la médiane pour au moins un neurotype supplémentaire, indiquant la présence d'autres traits neurodivergents, et 88,7 % (n = 64) ont reçu un diagnostic d'autisme. Seulement 26,3 % des enfants présentant des éléments attestant de neurotypes supplémentaires ont fait l'objet d'investigations supplémentaires au-delà de leur évaluation de l'autisme. Conclusions Nos résultats démontrent l'important chevauchement entre des traits neurodivergents supplémentaires dans une population d'enfants adressés pour suspicion d'autisme et montrent que seule une faible proportion a fait l'objet d'investigations supplémentaires. L'utilisation de questionnaires standardisés pour mettre en évidence des neurodivergences supplémentaires pourrait être utile pour améliorer le caractère holistique des évaluations neurodéveloppementales.

Background Children’s health services in many countries are moving from single condition diagnostic silo assessments to considering neurodevelopment in a more holistic sense. There has been increasing recognition of the importance of clinical overlap and co-occurrence of different neurotypes when assessing neurodivergent children. Using a cross-sectional service evaluation design, we investigated the overlap of neurodivergences in a cohort of children referred for autism assessment, focusing on motor, learning, and attention/activity level domains. We aimed to determine what proportion of children in a cohort referred for an autism assessment showed traits of additional neurodivergences, and what proportion were further investigated. Methods We evaluated anonymised medical records of children aged between two and 17 years referred for autism assessment. We used validated questionnaires to assess for neurodivergent traits. A weighted scoring system was developed to determine traits in each neurodevelopmental domain and a score above the median was considered to indicate a neurodivergent trait. Evidence of further investigations were recorded. We then examined the relationships between autism traits and traits of additional neurodivergence. Results 114 participants were included for evaluation. 62.3% (n = 71) had completed questionnaires for analysis. Of these, 71.8% (n = 51) scored greater than the median for at least one additional neurotype, indicating the presence of other neurodivergent traits, and 88.7% (n = 64) attracted a diagnosis of autism. Only 26.3% of children with evidence of additional neurotypes were further investigated beyond their autism assessment. Conclusions Our results demonstrate the extensive overlap between additional neurodivergent traits in a population of children referred with suspected autism and show that only a small proportion were further investigated. The use of standardised questionnaires to uncover additional neurodivergences may have utility in improving the holistic nature of neurodevelopmental assessments.

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Références citées
60
Avec un DOI
47
Sans DOI, à partir du texte brut de la bibliographie
13
3 / 60 (5,0 %) références citées comprennent au moins une personne identifiée comme autiste.
Références avec données à compléter
9 / 60 (15,0 %)
Références avec noms d’auteurices détectés
51 / 60 (85,0 %)
Sans nom d’auteurice détecté
9
Sans titre structuré
9
Sans identifiant stable
11
Références avec noms bruts d’auteurices restant à vérifier
9
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0
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Noms d’auteurices détectés dans la bibliographie citée
228
À partir du DOI ou de métadonnées externes
228
À partir du texte brut validé de la bibliographie
0
Noms bruts déjà validés
0
Noms bruts restant à vérifier
18
43 / 228 (18,9 %) noms sont associés à un·e auteurice déjà présent·e dans AutiHub. 185 / 228 (81,1 %) noms ne sont pas encore associés.
Noms associés à une personne identifiée comme autiste
4 / 228 (1,8 %)
Calculé sur l’ensemble des noms d’auteurices détectés dans la bibliographie citée. Parmi les noms associés à un·e auteurice déjà présent·e dans AutiHub : 4 / 43 (9,3 %). Personnes distinctes identifiées comme autistes : 4 / 212 (1,9 %).
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