Congruence of instrumental and clinical diagnosis of autism in patients with severe forms of intellectual disabilities

Abstract

Significant overlap in intellectual disability and autism spectrum disorders gave rise to the question of an appropriate screening tool for identification of autism in persons with sub average intellectual functioning. The objective of this research is to estimate the level of agreement between clinical diagnosis of both, typical and untypical autism, and instrumental diagnosis of autism spectrum disorders. The sample consisted of 63 participants with moderate, severe and profound intellectual disabilities who had been previously diagnosed as having autism. They were divided into two subsets: 49 participants with typical autism and 14 participants with milder form of autistic disorder, similar to those seen in persons with pervasive developmental disorder nototherwise specified. Pervasive Developmental Disorder in Mental Retardation Scale (PDDMRS, Kraijer, 2006) was used for instrumental diagnosis. It was revealed that PDD-MRS Scale identified 71.43% of patients with clinical diagnosis of autism, as well as 22.22% patients whose diagnoses were labeled as 'doubtful'. PDD-MRS Scale failed to detect autism in 4 clinically diagnosed participants. It could be concluded that PDD-MRS Scale is simple and useful screening instrument designed for identification of pervasive developmental disorders in persons with intellectual disability.

Značajno preklapanje između intelektualne ometenosti i poremećaja autističkog spektra uslovilo je interesovanje za kreiranjem adekvatnog skrining instrumenta za detekciju autizma kod osoba sa ispodprosečnim intelektualnim funkcionisanjem. Cilj ovog istraživanja je da proceni nivo saglasnosti između kliničke procene tipičnog i atipičnog autizma i instrumentalne dijagnoze poremećaja autističkog spektra. Uzorak se sastoji od 63 ispitanika sa umerenom, teškom i dubokom intelektualnom ometenošću kod kojih je ranije dijagnostikovan autizam. Ispitanici su podeljeni u dva poduzorka. Prvi poduzorak čini 49 ispitanika sa tipičnim autizmom, a drugi 14 ispitanika sa blažim oblicima autizma, sličnim onima koji se viđaju kod osoba sa nespecifikovanim pervazivnim poremećajem razvoja. Za instrumentalnu dijagnostiku korišćena je Skala za detekciju pervazivnih poremećaja razvoja kod osoba sa intelektualnom ometenošću (PDD-MRS skala, Kraijer, 2006). Rezultati istraživanja pokazuju da se ovom skalom identifikuje 71,43% ispitanika sa kliničkom dijagnozom autizma, dok se kod 22,22% pacijenata dijagnoza autizma smatra sumnjivom. Ovom skalom nije detektovano četvoro pacijenata sa kliničkom dijagnozom autizma. Možemo zaključiti da je PDD-MRS skala jednostavan i koristan skrining instrument namenjen detekciji pervazivnih poremećaja razvoja kod osoba sa intelektualnom ometenošću.