Post on 31-Mar-2015
Presented by
Peter D. Marle, B.A.
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
Thesis Proposal Presented By
Peter D. Marle, B.A.
Autism Spectrum Disorder – A Brief History
A. Anecdotal Accounts (see Luther, 1652; Wing, 1997)
1. Changeling babies
2. Feral children (e.g., Victor “wild boy” of Aveyron)
peoplePsychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
Autism Spectrum Disorder – A Brief History
A. Anecdotal Accounts (see Luther, 1652; Wing, 1997)
1. Changeling babies
2. Feral children (e.g., Victor “wild boy” of Aveyron)
B. Scientific Investigation
1. Those prior to “autism”
2. Those who defined “Autism”
a. Leo Kanner
b. Hans Asperger
3. Diagnostic and Statistical Manual of Mental Disorders (DSM)
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
Autism Spectrum Disorder – DSM History
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
A. DSM (1952) and DSM-II (1968)1. Schizophrenic reaction, childhood type2. Autism and schizoid personality disorder?
B. DSM-III (1980)1. Infantile autism
a. full presentationb. residual state
2. Autism and schizophrenia?C. DSM-III-R (1987)
1. Social impairments, communicative impairments, and restricted interestsD. DSM-IV (1994)
1. Asperger’s disorder2. Childhood disintegrative disorder3. Pervasive developmental disorder – not otherwise specified
E. DSM-IV-TR (2000)F. DSM-5 (2011; Press edition due out 2013)
American Psychological Association (APA)
DSM-5 Proposed Changes and Rationale
A. Combine Current PDD diagnoses
B. Level of Severity
- see APA, 2011
Source: http://themindofanapple.blogspot.com/2011/04/autism-awareness-day.html
people Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts
B. Restricted, repetitive patterns of behavior, interests, or activities
C. Symptoms must be present in early childhood
D. Symptoms together limit and impair everyday functioning
people -American Psychiatric Association (APA), 2011
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation of social interaction
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication,
through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people -American Psychiatric Association (APA), 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation of social interaction
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication,
through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people -American Psychiatric Association (APA), 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation of social interaction
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication,
through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people -American Psychiatric Association (APA), 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation of social interaction
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication,
through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people -American Psychiatric Association (APA), 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation of social interaction
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication,
through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people -American Psychiatric Association (APA), 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following:
1. Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced
sharing of interests, emotions, and affect and response to total lack of initiation of social interaction
2. Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication,
through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures.
3. Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing
imaginative play and in making friends to an apparent absence of interest in people -American Psychiatric Association (APA), 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of the following:
1. Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).
2. Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme
distress at small changes).
3. Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects,
excessively circumscribed or perseverative interests).
4. Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
DSM-5 Proposed Criteria for ASD
C. Symptoms must be present in early childhood (but may not become fully manifest
until social demands exceed limited capacities)
D. Symptoms together limit and impair everyday functioning
-APA, 2010
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
Neurological Sequelae
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
General Findings from the Literature
• Increased Gray Matter Density
• White Matter Deficits in Left Hemisphere
• Disrupted Interconnectivity of Cortical Systems
• Reduced size of Corpus Callosum
see Schmitz et al. (2006), Minshew and Williams (2007), and Verhoeven et al. (2010)
Neurological SequelaeInterconnectivity
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
General Aberrations
Social-Emotional Reciprocity
CommunicationPeer
RelationshipsStereotypies Flexibility Perseveration
Sensory Integration
Increased Gray Matter Density in Decreased Activation in
Disrupted Interconnect-ivity Between Frontal and Parietal Lobes
Frontal lobe Dysmaturity in Adolescence
Abnormal rostral frontostriatal systems function
Disrupted Cortical Connectivity
Increased Frontal Lobe Connectedness to Insula
Disrupted Interconnect-ivity Between Limbic and Sensory Systems
Left Inferior Frontal Gyrus
Pregenual Anterior Cingulate Cortex
Decreased Mirror Neuron System Thickness
Decreased Activation inPossibly linked to emotions
Abnormal Left Insula Functioning
Abnormal Activation inParietal Cortex
Hyper Pacinian Corpuscle Receptor Pathways
Anterior Cingulate Gyrus
Anterior Rostral mid Prefrontal Cortex
Problems Associated with Auditory Processing
Subgenual Anterior Cingulate Cortex
Increased Frontal Neuronal Density
Abnormal Somatosensory Cortex Functioning
Right Superior Frontal Gyrus
Fusiform Gyrus Decreased Activation in Anterior Insula Decreased Activation in
Middle Frontal Gyrus (bilateral)
Right Anterior Insula
Broca’s Area Ventrolateral Prefrontal Cortex
Amygdala
White Matter Deficits in Mirror Neuron Sys. Increased Activation in Ventral Striatum Fusiform Gyrus
Left Hemisphere Amygdala Wernicke’s AreaAbnormal Functioning in
Disrupted Cortical Interconnectivity
Posterior Cingulate Cortex
Intraparietal Sulcus Medial Prefrontal Cortex
Reduced Size of Corpus Callosum
Abnormal Posterior Temporal Sulcus Functioning
Inferior Temporal Gyrus
Posterior Cingulate/ Precuneus
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
Neurological SequelaeInterconnectivity
General Aberrations
Social-Emotional Reciprocity
CommunicationPeer
RelationshipsStereotypies Flexibility Perseveration
Sensory Integration
Increased Gray Matter Density in Decreased Activation in
Frontal lobe Dysmaturity in Adolescence
Abnormal rostral frontostriatal systems function
Left Inferior Frontal Gyrus
Pregenual Anterior Cingulate Cortex
Decreased Mirror Neuron System Thickness
Decreased Activation inPossibly linked to emotions
Abnormal Left Insula Functioning
Abnormal Activation inParietal Cortex
Hyper Pacinian Corpuscle Receptor Pathways
Anterior Cingulate Gyrus
Anterior Rostral mid Prefrontal Cortex
Problems Associated with Auditory Processing
Subgenual Anterior Cingulate Cortex
Increased Frontal Neuronal Density
Abnormal Somatosensory Cortex Functioning
Right Superior Frontal Gyrus
Fusiform Gyrus Decreased Activation in Anterior Insula Decreased Activation in
Middle Frontal Gyrus (bilateral)
Right Anterior Insula
Broca’s Area Ventrolateral Prefrontal Cortex
Amygdala
White Matter Deficits in Mirror Neuron Sys. Increased Activation in Ventral Striatum Fusiform Gyrus
Left Hemisphere Amygdala Wernicke’s AreaAbnormal Functioning in
Posterior Cingulate Cortex
Intraparietal Sulcus Medial Prefrontal Cortex
Reduced Size of Corpus Callosum
Abnormal Posterior Temporal Sulcus Functioning
Inferior Temporal Gyrus
Posterior Cingulate/ Precuneus
Disrupted Cortical Interconnectivity
Disrupted Interconnect-ivity Between Frontal and Parietal Lobes
Disrupted Cortical Connectivity
Increased Frontal LobeConnectedness to Insula
Disrupted Interconnect-ivity Between Limbic and Sensory Systems
Autism – Causes and ControversiesA. Bettelheim
1. Kanner2. “Refrigerator Mothers”3. Rimland
B. Vaccinations1. Jenny McCarthy
a. Autism?
C. Genetic Heritability (Hallmayer et al., 2011)1. 37% Mz2. 55% Dz
D. In Vivo Factors (Hallmayer et al., 2011)1. Parental age2. Low birth weight3. Multiple births4. Maternal infections
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
The Present StudyPurpose
A. CASS (Coolidge Autistic Symptom Survey)1. Current alignment2. Age Range
B. DSM-5 changes
Hypotheses
A. A One-Factor Solution will Best Fit the Data
B. Internal Reliability will be Good
C. Test-Retest Reliability will be Adequate
D. The CASS will Differentiate (1) Severe, (2) Mild Autism, and (3) Group-Matched Control Group
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
The Present StudyParticipants
A. Power Analysis based on Marle, Monaghan, Rhoades, and Coolidge (2011)1. (η2 = .66 for three groups)
a. seven children per group necessary (N = 21) 2. (η2 = .14; β = .80)
a. twenty-two children per group necessary (N = 66)
B. Participant characteristics1. Three groups2. Parents of children ages 5 to 17 years3. Collecting data on children’s
a. ageb. age when diagnosedc. age when parents first noticed differencesd. gendere. race and ethnicityf. diagnosisg. medications, h. first behavioral concern
4. Also obtaining information as to who diagnosed the child
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
The Present StudyMaterials
A. Informed Consent Form
B. 90-Item CASS1. Forty-five original items
a. socializationb. speech and languagec. nonverbal communicationd. repetitive/stereotyped behavior
2. Forty-five new itemsa. social communicationb. restricted interests and repetitive behaviorsc. twenty-one retrospective items
C. Demographic Information Sheet
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
The Present StudyProcedure
A. Packets1. Delivered to parents (via psychology classes, autism resource centers, or participating school district classes)2. Parents return SASE envelopes
B. Packets will take about 30 min to complete
C. Participants from psychology classes will be offered SONA credit
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
The Present StudyProposed Data Analysis
Hypothesis 1. A One-Factor Solution will Best Fit the Data1. PCA with varimax rotation
Hypothesis 2. Internal Reliability will be Good1. Cronbach’s α ≥ .80
Hypothesis 3. Test-Retest Reliability will be Adequate1. Thirty parents will be asked to complete the CASS two times (1 week interval)2. r ≥ .80
Hypothesis 4. The CASS will Differentiate (1) Severe, (2) Mild Autism, and (3) Group- Matched Control Group
1. Oneway ANOVA2. Tukey’s HSD
Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism
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Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism