Anxiety Disorders in Autistic Spectrum Children and Adolescents - Assignment Example

? Anxiety Disorders in Autistic Spectrum Children and Adolescents of Anxiety Disorders in Autistic Spectrum Children and Adolescents Van Steensel, Bo?gels, and Perrin (2011) state that children and adolescents who have Autistic Spectrum Disorders (ASD) are more prone to have anxiety or anxiety disorders than other types of children. Van Steensel et al. state that although many researchers have studied this issue, they have not specifically said which anxiety disorders ASD children and adolescents are most prone to experience. Because they found this gap in the literature, they decided to create a study that may answer the question of which anxiety disorders ASD children and adolescents experience most. The authors did not do their own individual study; instead, they studied other research. There were no hypotheses listed in this study, but the authors state that the purpose of their research was to systematic review all studies they could find that reported on anxiety disorders with ASD youth, and estimate the incidences of each anxiety disorder in ASD youth. The study by van Steensel et al.(2011) used a systematic review of 31 different studies that involved 2,121 ASD youth. The researchers began with a systematic search of databases that included PsyInfo, PubMed, Web of Science and ERIC. The authors used several search words that included Autism, Asperger, Pervasive Development Disorder, and PDD and they used other types of word phrases like comorbidity, anxiety disorder, and anxious (p. 303). The authors primarily used the abstracts of each article they studied to for relevance to ASD and to youth. Also, the abstracts had to say that the anxiety disorder had been assessed by using a standardized anxiety disorder scale or through diagnostic interviews. van Steensel et al.(2011) used several criteria for deciding which research studies would be used for their meta-analysis: The reports had to be about children and youth who were diagnosed with ASD. The study had to be data based and was not a review of the literature study. The study provided the number of subjects for each study and children had to have a DSM-IV anxiety disorder. The mean age of children in the study had to be less than 18 years of age. van Steensel et al. (2011) found 86 initial studies, and from those studies a total of 31 studies met the criteria. The two diagnostic instruments that were used most often were the Autism Diagnostic Interview-Revised (ADI-R) instrument and the Autism Diagnostic Observation Schedule-Generic (ADOS-G). Is a semi-structured interview that is conducted with the caregiver or caregivers that has them describe their child’s behavior and their child’s development. There were three behavioral measures for this test: reciprocal social interaction, communication, and restricted and repetitive behaviors (p. 305). The authors state that an algorithm was used to establish the specific diagnosis of autism. The ADOS-G is also a semi-structured instrument that is used to observe the behavior of children who may have Autism but who do not yet have a diagnosis. There are four parts of the assessment and each part of the assessment has a separate algorithm used to develop the diagnosis. The scores for the ADOS-G stem from scores that exceed the cut-off in the social behavior and communication sections. Out of the 31 studies that were selected by van Steensel et al. (2011), 14 used one of the instruments described and five used a second way to confirm a diagnosis of ASD or to establish an agreement about the ASD diagnosis between raters. Also, reviewers in the studies that van Steensel et al. (2011) chose to analyze were also used previous case histories and interviews with caregivers to verify that the children and youth had been diagnosed with ASD. As van Steensel et al. (2011) reviewed each research study, they calculated the ASD for each group, using the subtitles of autistic disorder, Asperger’s Syndrome and PDD-NOS (the authors did not provide definitions for these). They used a difficult system to code the data that was difficult to understand and to transfer to this report. One point that the authors make is that there could be publication bias in the research articles they read. Publication bias suggests that research studies that have a high level of success are more apt to be published than those that do not have a significant level of success. Van Steensel et al. (2011) also stated that the validity of the studies was better when the sample size was small. The authors used two meta-analyses for the data. One meta-analysis had a moderator, the other did not. The authors used the first meta-analyses as a way to establish which types of anxiety were found in the studies and which anxiety orders in general were established in each section. They also looked at the anxiety disorders by separating them out into specific disorders. As an example, they broke some down into the categories of obsessive-compulsive disorder, anxiety disorder, or specific anxiety disorders. The first set of meta-analyses did not contain moderators. They also tested for homogeneity by using Q statistics and tested them at x = .05. Van Steensel et al. (2011) used the second meta-analyses set to test whether specific anxiety rates were varied across studies and whether they corresponded to the portions of the subjects that had autistic disorder. The authors also checked to see if the interviews and questionnaires were used to assess the different ASD. Both meta-analyses were used to estimate the prevalence of anxiety order in children and youth with ASD, and secondly to understand whether age or IQ had anything to do with the prevalence of anxiety disorder. The results of the study by van Steensel et al. (2011) showed that 40% of children and youth with one of the ASD had clinically higher levels of anxiety and at least one anxiety disorder. This statistic was consistent with other research that the authors cited that was not studies that were a part of their particular study. Van Steensel et al. also found that 30% of the youth from the research a specific phobia, 17% were found to have obsessive-compulsive disorder, another approximately 17% had social anxiety disorder and agoraphobia, and 15% had generalized anxiety disorder. Other disorders that made less than 15% were separation anxiety and panic disorder. This study showed the first premise that there are specific anxieties disorders that ASD children and youth have and that should be treated in addition to their ASD. The authors also found that when a child or youth had an IQ below 70, they were more prone to have the anxiety. When IQ was between 70 and 87, and the child or youth had ASD, the incidences of anxiety would also show, but only in the fixed affect mode. The authors state that more research should be done in this area to gain a better understanding. van Steensel et al. (2011) also found that those children and adolescents who were diagnosed with PDD-NOS were most prone to also have the anxiety disorder. The other ASD children and youth that were prone to anxiety were those with Asperger’s Syndrome and autistic disorder and specific phobia. Obsessive-compulsive disorder was also associated more with autistic disorder and Asperger’s syndrome was associated with lower rates of specific phobia and obsessive-compulsive disorder. The article by van Steensel et al. (2011) presented interesting information on the ASD and anxiety. In the studies that they reviewed, they were able to identify what they set out in the beginning to do. They also were able to find areas where more research is needed. There may be other studies that will be done to see more specific issues around autism and anxiety because of this particular article. Reference Van Steensel, F. J. A., Bo?gels, S. M., and Perrin,S. (2011). Anxiety disorders in children and adolescents with Autism Spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14, 302=317. DOI 10.1007/s10567-011-0097-0 Read More