https://ebookmass.com/product/neural-engineering-techniques-
Instant digital products (PDF, ePub, MOBI) ready for you
Download now and discover formats that fit your needs...
(eTextbook PDF) for Educating Students with Autism Spectrum Disorder
https://ebookmass.com/product/etextbook-pdf-for-educating-studentswith-autism-spectrum-disorder/ ebookmass.com
Differential Diagnosis of Autism Spectrum Disorder
Katherine K. M. Stavropoulos
https://ebookmass.com/product/differential-diagnosis-of-autismspectrum-disorder-katherine-k-m-stavropoulos/
ebookmass.com
PEERS? for Young Adults: Social Skills Training for Adults with Autism Spectrum Disorder and Other Social Challenges 1st Edition – Ebook PDF Version
https://ebookmass.com/product/peers-for-young-adults-social-skillstraining-for-adults-with-autism-spectrum-disorder-and-other-socialchallenges-1st-edition-ebook-pdf-version/ ebookmass.com
Make Your Data Speak: Creating Actionable Data through Excel For Non-Technical Professionals 1st Edition Alex Kolokolov
https://ebookmass.com/product/make-your-data-speak-creatingactionable-data-through-excel-for-non-technical-professionals-1stedition-alex-kolokolov/ ebookmass.com
Industrial Oil Crops 1st Edition Hayes
https://ebookmass.com/product/industrial-oil-crops-1st-edition-hayes/
ebookmass.com
Musical Illusions and Phantom Words Diana Deutsch
https://ebookmass.com/product/musical-illusions-and-phantom-wordsdiana-deutsch/
ebookmass.com
Top 50 SAT Reading, Writing, and Language Skills, 3rd Edition Brian Leaf
https://ebookmass.com/product/top-50-sat-reading-writing-and-languageskills-3rd-edition-brian-leaf/
ebookmass.com
Social Policy in the Islamic World 1st ed. Edition Ali Akbar Tajmazinani
https://ebookmass.com/product/social-policy-in-the-islamic-world-1sted-edition-ali-akbar-tajmazinani/
ebookmass.com
Uphill: A Memoir 1st Edition Jemele Hill
https://ebookmass.com/product/uphill-a-memoir-1st-edition-jemele-hill/
ebookmass.com
Scripting Farming Simulator with Lua: Unlocking the Virtual Fields 1st Edition Zander Brumbaugh
https://ebookmass.com/product/scripting-farming-simulator-with-luaunlocking-the-virtual-fields-1st-edition-zander-brumbaugh/
ebookmass.com
NEURALENGINEERINGTECHNIQUESFOR AUTISMSPECTRUMDISORDER,VOLUME2
Thispageintentionallyleftblank
NEURALENGINEERING TECHNIQUESFOR AUTISMSPECTRUM DISORDER,VOLUME2
DIAGNOSISANDCLINICALANALYSIS
Editedby
AymanS.El-Baz
UniversityofLouisville,Louisville,KY,UnitedStates;UniversityofLouisville atAlameinInternationalUniversity(UofL-AIU)
JasjitS.Suri
ATHEROPOINT,Roseville,CA,UnitedStates
AcademicPressisanimprintofElsevier 125LondonWall,LondonEC2Y5AS,UnitedKingdom
525BStreet,Suite1650,SanDiego,CA92101,UnitedStates 50HampshireStreet,5thFloor,Cambridge,MA02139,UnitedStates TheBoulevard,LangfordLane,Kidlington,OxfordOX51GB,UnitedKingdom
Copyright©2023ElsevierInc.Allrightsreserved.
Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,electronicormechanical, includingphotocopying,recording,oranyinformationstorageandretrievalsystem,withoutpermissioninwritingfromthe publisher.Detailsonhowtoseekpermission,furtherinformationaboutthePublisher’spermissionspoliciesandour arrangementswithorganizationssuchastheCopyrightClearanceCenterandtheCopyrightLicensingAgency,canbefound atourwebsite: www.elsevier.com/permissions .
ThisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightbythePublisher(otherthanasmay benotedherein).
MATLABs isatrademarkofTheMathWorks,Inc.andisusedwithpermission.TheMathWorksdoesnotwarrantthe accuracyofthetextorexercisesinthisbook.Thisbook’suseordiscussionofMATLABs softwareorrelatedproducts doesnotconstituteendorsementorsponsorshipbyTheMathWorksofaparticularpedagogicalapproachorparticular useoftheMATLABs software.
Notices
Knowledgeandbestpracticeinthisfieldareconstantlychanging.Asnewresearchandexperiencebroadenour understanding,changesinresearchmethods,professionalpractices,ormedicaltreatmentmaybecomenecessary.
Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgeinevaluatingandusingany information,methods,compounds,orexperimentsdescribedherein.Inusingsuchinformationormethodstheyshouldbe mindfuloftheirownsafetyandthesafetyofothers,includingpartiesforwhomtheyhaveaprofessionalresponsibility.
Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,oreditors,assumeanyliabilityforany injuryand/ordamagetopersonsorpropertyasamatterofproductsliability,negligenceorotherwise,orfromanyuseor operationofanymethods,products,instructions,orideascontainedinthematerialherein.
ISBN:978-0-12-824421-0
ForInformationonallAcademicPresspublications visitourwebsiteat https://www.elsevier.com/books-and-journals
Publisher: MaraE.Conner
AcquisitionsEditor: ChrisKatsaropoulos
EditorialProjectManager: EmilyThomson
ProductionProjectManager: FahmidaSultana
CoverDesigner: MilesHitchen
TypesetbyMPSLimited,Chennai,India
Dedication
Withloveandaffectiontomymotherandfather,whoselovingspiritsustainsmestill
Tomylatelovingparents,immediatefamily,andchildren
AymanEl-Baz
JasjitS.Suri
Thispageintentionallyleftblank
Listofcontributorsxiii
Abouttheeditorsxvii
Acknowledgmentsxix
PART1
Autismandclinicalanalysis:Diagnosis
1.Remotetelehealthassessmentsfor autismspectrumdisorder3
ANGELAV.DAHIYA,JENNIFERR.BERTOLLO, CHRISTINAG.MCDONNELLANDANGELASCARPA
1.1Introduction3
1.1.1In-personstandardizedassessmentsforautism spectrumdisorder4
1.1.2Significanceofremoteassessmentsforautism spectrumdisorder5
1.2Telehealthassessments6
1.2.1Videoconferencing(live/invivo)7
1.2.2Asynchronousvideoanalysis:current9
1.2.3Asynchronousvideoanalysis: retrospective10
1.2.4Mobileapplications11
1.2.5Onlinewebsites14
1.2.6Otherformsoftechnology15 1.3Implications16
1.3.1Futuredirections16 References17
2.Maternalimmunedysregulationand autismspectrumdisorder21
ALEXANDRARAMIREZ-CELIS, DANIELLE(HYUNJUNG)KIMANDJUDYVANDEWATER
2.1Introduction21
2.2Cytokinesandchemokines(overview)22
2.2.1Cytokinesandchemokinesinthecentral nervoussystem23
2.2.2Effectofcytokine/chemokineproductionin braindevelopment23
2.2.3Maternalimmunedysregulationand developmentaloutcomesofoffspring25
2.2.4Maternalimmuneactivationandautism spectrumdisorder26
2.2.5Maternalstressandautismspectrum disorder27
2.2.6Maternalgutmicrobiomeandautism spectrumdisorder28
2.2.7Alterationsincytokineandchemokine profilesduringgestationandtheneonatal period29
2.3Autoantibodiesreactivetobrainantigens36
2.3.1Autoantibodyoverview36
2.3.2Autoantibodiesandbrainpathologies37
2.3.3Autoantibodiesandautismspectrum disorder38
2.3.4Maternalautoantibodiesand neurodevelopmentalalterations39
2.3.5Maternalautoantibody-relatedautism spectrumdisorderoverview40
2.3.6MARASDanimalmodels44
2.3.7Maternalautoantibody-related fetal-braintargetsandautismspectrum disorder46
2.3.8Maternalautoantibodiesaspotential autismspectrumdisorder-risk biomarkers48
2.4Concludingremarks48 References49
3.Readingdifferencesineye-trackingdata asamarkerofhigh-functioningautismin adultsandcomparisontoresultsfrom web-relatedtasks63
VICTORIAYANEVA,LEANHA,SUKRUERASLAN, YELIZYESILADAANDRUSLANMITKOV
3.1Introduction63 3.2Relatedwork65
3.3Automateddetectionofhigh-functioningautismin adultswitheye-trackingdatafromwebtasks66
3.4Theproposedapproach67
3.4.1Datacollection68
3.4.2Participants68
3.4.3Stimuliandtasks69
3.4.4Apparatus70
3.4.5Procedure70
3.4.6Datapreprocessing71
3.5Experiments71
3.6Results73
3.7Discussion75
3.8Conclusion77
3.9Opendata77
References77
4.Parentsofchildrenwithautism spectrumdisorders:interventionswithand forthem81
LILIANAP.ROJAS-TORRES,YURENAALONSO-ESTEBAN ANDFRANCISCOALCANTUD-MARI ´ N
4.1Introduction81
4.2Parentparticipationinearlycomprehensive interventionprograms82
4.2.1Parentaltraining83
4.2.2PivotalResponseTrainingProgram84
4.2.3TreatmentandEducationofAutisticrelated CommunicationHandicappedChildren Program84
4.2.4EarlyStartDenverModel85
4.3Programsforthedevelopmentofparent child interaction85
4.3.1Hanen’smorethanwords85
4.3.2Preschoolautismcommunicationtrial85
4.3.3JointAttentionSymbolicPlay,Engagement, andRegulation86
4.3.4ImprovingParentsasCommunication Teachers86
4.3.5Parent childinteractiontherapy87
4.3.6SteppingStonesTripleP87
4.4Parent childinterventionbasedonanxiety reduction88
4.4.1Cognitivebehavioraltherapyforanxiety reductioninchildrenwithautismspectrum disorderswithparentalintervention88
4.4.2Mindfulness-basedintervention89
4.5Conclusion90 References91
5.Applicationsofmachinelearning methodstoassistthediagnosisofautism spectrumdisorder99
MAHMOUDELBATTAH,ROMUALDCARETTE, FEDERICACILIA,JEAN-LUCGUE ´ RINAND GILLESDEQUEN
5.1Introduction99
5.2Backgroundandrelatedwork100
5.2.1Analysisofvisualattentionin autism100
5.2.2Machinelearningforautism diagnosis101
5.3Datadescription103
5.3.1Participants103
5.3.2Experimentalprotocol104
5.3.3Visualizationofeye-tracking scanpaths104
5.4Unsupervisedlearning:clusteringofeye-tracking scanpaths106
5.4.1Imagepreprocessing107
5.4.2Featureextractionusingprincipalcomponent analysisandt-SNE107
5.4.3Featureextractionusingdeep autoencoder107
5.4.4K-Meansclustering109
5.4.5Qualityofclusters110
5.4.6Clusteranalysis111
5.5Supervisedlearning:classificationmodel113
5.5.1Datapreprocessingandaugmentation113
5.5.2Modeldesign113
5.5.3Classificationaccuracy113
5.6Demoapplication114
5.7Limitations116
5.8Conclusions116 References116
6.Potentialapproachesandrecent advancesinbiomarkerdiscoveryinautism spectrumdisorders121
6.1Introduction121
6.2Diagnosisandcategoriesofbiomarkers122
6.2.1Humanbrainconnectome:structural, functional,andmolecularneuroimaging biomarkersforautismspectrumdisorder122
SALAMSALLOUM-ASFAR,AHMEDK.ELSAYEDAND SARAA.ABDULLA
6.2.2Molecularbiomarkers122
6.2.3Maternalandpaternalbiomarkers: pregnancyanditspotentialassociationwith ASD133
6.2.4Nextgenerationofdiagnostic biomarkers137
6.3Conclusion139 References140
7.Detectionandidentificationofwarning signsofautismspectrumdisorder: instrumentsandstrategiesforits application147
J.M.SALGADO-CACHO,M.R.GO ´ MEZ-SOLER, M.L.RI ´ OS-RODRI ´ GUEZANDY.DEDIEGO-OTERO
7.1Introduction147
7.2Importanceofearlydetection148
7.3Differentialdiagnosis149
7.3.1Abriefhistoryoftherelationshipbetween autismandpsychosis150
7.3.2Similarities150
7.3.3Distinguishingfeatures152
7.4Detectionandscreeningprocess155
7.5SymptomdetectionvsDiagnosis156
7.6Impactonthefamilyofdetectinganddiagnosing AutismSpectrumDisorder158
7.7Choiceofscreeninginstrumentsaccordingtoageof applicationandculturalenvironmentof implementation159
7.8Discussion163
7.9Conclusions166 References166
8.Machinelearninginautism spectrumdisorderdiagnosisand treatment:techniquesand applications173
ARJUNSINGH,ZOYAFAROOQUI,BRANDENSATTLER, EMILYLI,SRUSHTINERKAR,MICHAELHELDEAND UNYIMEUSUA
8.1Introduction173
8.2Utilizingmachinelearningalgorithmstodiagnose autismspectrumdisorder175
8.2.1Datasetwithbehavioralcharacteristics176
8.2.2Datasetwithpersonal/cognitive characteristics178
8.2.3Recommendations180
8.3Featureanalysis181
8.3.1Dimensionalityreduction181
8.3.2Featurerepresentation184
8.3.3Recommendations186
8.4Technologicalapplications187
8.5Conclusion190 References190
9.Inhibitionoflysine-specificdemethylase 1enzymeactivitybyTAK-418asanovel therapyforautism195
9.1Introduction195
9.2Lysine-specificdemethylase1asthepotential therapeutictargetforautismspectrumdisorder196
9.2.1Druggabilityintargetingepigenetic factors196
9.2.2Potentialtherapeuticfunctionsoflysinespecificdemethylase1inhibition197
9.2.3Concernregardingtheon-targettoxicityof generallysine-specificdemethylase1 inhibitors197
9.3Discoveryofthe“enzymeactivity-specific” inhibitorsoflysine-specificdemethylase1198
9.3.1Originalscreeningflow198
9.3.2DiscoveryofT-448andTAK-418199
9.3.3UniqueinhibitorymechanismofT-448and TAK-418199
9.3.4LowriskofhematologicaltoxicitybyT-448 andTAK-418inrodents202
9.3.5PreclinicalefficacyofT-448andTAK418202
9.3.6HypothesisofthemechanismofactionofT448andTAK-418205
9.4Discussion206
9.5Conclusion207
References207
10.Behavioralphenotypefeaturesof autism213
HUIYUDUAN,JESUSGUTIERREZ,ZHAOHUICHE, PATRICKLECALLETANDGUANGTAOZHAI
10.1Introduction213
10.2Eyemovementbehaviorphenotypeofautism215
10.2.1Naturalstimuli215
SATORUMATSUDAANDHARUHIDEKIMURA
10.2.2Facestimuli220
10.2.3Gaze-followingstimuli224
10.3Actionbehaviorphenotype228
10.3.1Datasetandanalysis228
10.3.2Methodsandresults228
10.4Drawingbehaviorphenotype231
10.4.1Dataset231
10.4.2Analysis231
10.4.3Resultsanddiscussion233
10.5Discussionandconclusion233
References235
11.Developmentofananimated infographicaboutautisticspectrum disorder239
ELISAMARIABEZERRAMAIA,SORAIAMAYANESOUZA MOTA,ROSANEMEIREMUNHAKDASILVA, REINALDOANTONIOSILVA-SOBRINHOAND ADRIANAZILLY
11.1Introduction239
11.2Infographics240
11.2.1Studypopulation240
11.2.2Development240
11.2.3Validationandtesting241
11.3Results242
11.4Discussion248
11.5Conclusion250
References250
12.Fundamentalsofmachine-learning modelingforbehavioralscreening anddiagnosisofautismspectrum disorder253
ABDULMALIKA.LAWAN,NADIRECAVUS, RUFA’IYUNUSA,USAMAI.ABDULRAZAKAND SADIYATAHIR
12.1Introduction253
12.2Currentautismspectrumdisorderscreeningand diagnosticpractices255
12.2.1Commonlyusedautismspectrumdisorder screeninginstruments255
12.2.2Commonproblemswithcurrentautism spectrumdisorderscreeninganddiagnostic practices255
12.3Machinelearning-basedassessmentofautism spectrumdisorder256
12.3.1Commonlyuseddatasetsformachine learning-basedbehavioralassessmentof autismspectrumdisorder258
12.3.2Dimensionalityreduction258
12.3.3Commonlyuseddimensionalityreduction techniques258
12.3.4Classificationalgorithms259
12.3.5Modelselection260
12.3.6Confusionmatrix264 12.4Conclusion265
References266
13.Acomprehensivestudyonatlas-based classificationofautismspectrumdisorder usingfunctionalconnectivityfeaturesfrom resting-statefunctionalmagneticresonance imaging269
13.1Introduction269
13.2Overviewoffunctionalmagneticresonance imaging270
13.2.1Clinicalapplication271
13.3Literaturereview272
13.3.1Structuralmagneticresonanceimagingbasedautismdetection272
13.3.2Functionalmagneticresonanceimagingbasedautismdetection273
13.3.3Structuralandfunctionalmagneticresonance imaging-basedautismdetection273
13.4Materialsandmethods275
13.4.1Preprocessing276
13.4.2Bloodoxygenleveldependenttime-series signalextractionfromfourdimensional functionalmagneticresonanceimaging data277
13.4.3Buildingfunctionalconnectivitymatrix281
13.4.4Featurevector283
13.4.5Classification283
13.5Experimentalresultsandanalysis286
13.5.1Datasetdescription287
13.5.2Evaluationofautismspectrumdisorder detectionframework287
13.5.3Performanceevaluationusing model-2290
13.6Conclusion292
13.7Futurework293 References293
FARIAZARINSUBAHANDKAUSHIKDEB
14.Event-relatedpotentialsandgamma oscillationsinEEGasfunctionaldiagnostic biomarkersandoutcomesinautism spectrumdisordertreatmentresearch297
ESTATEM.SOKHADZE,MOHAMEDSHABAN, AYMANS.EL-BAZ,ALLANTASMAN,LONNIESEARSAND
MANUELF.CASANOVA
14.1Introduction297
14.2Neurophysiologicalbiomarkers298
14.2.1Introductiontoevent-relatedpotentials andevokedbrainwavesoscillations298
14.2.2RationaleforapproachusingEEG/ERP measuresinstudyingattentionin ASD299
14.2.3Visualoddballtaskwithillusory figures300
14.2.4ERPdataacquisitionandsignal processing300
14.2.5Event-relatedpotentialsinautismand ADHD300
14.2.6ERPmeasuresinillusoryfigure(Kanizsa) categorizationtask301
14.2.7MotorpreparationdeficitsinASD303
14.2.8ERPinPosnercuedspatialattention task304
14.2.9 LateralizedReadinessPotential (LRP)asan indexofmotorpreparationinASDand ADHD304
14.3Gammaoscillationsaspotentialneuromarkersin neurodevelopmentaldisorders306
14.3.1Gammaoscillations306
14.3.2Corticalexcitation/inhibition(E/I)bias andbrainwaveoscillations307
14.3.3GammaoscillationsinASD308
14.3.4Hemisphericasymmetryofgamma309
14.4ERPandinducedgammaoscillationsinfacial categorizationtaskinASD,ADHD,andTD groups310
14.4.1ERPresultsinToMtask310
14.4.2InducedgammaanalysisandresultsinToM task311
14.5EvokedandinducedEEGdataacquisitionand processinginKanizsaoddballtask312
14.6Conclusions314
References314
Index321
Thispageintentionallyleftblank
Listofcontributors
SaraA.Abdulla NeurologicalDisordersResearch Center,QatarBiomedicalResearchInstitute, HamadBinKhalifaUniversity,Qatar Foundation,Doha,Qatar
UsamaI.Abdulrazak DepartmentofPaediatrics, PeterboroughCityHospital,NorthWestAnglia NHSFoundationTrust,Peterborough,United Kingdom
FranciscoAlcantud-Marı ´ n Departmentof DevelopmentalandEducationalPsychology, UniversityofValencia,Valencia,Spain
YurenaAlonso-Esteban Departmentof DevelopmentalandEducationalPsychology, UniversityofValencia,Valencia,Spain
JenniferR.Bertollo DepartmentofPsychology, VirginiaTech,Blacksburg,VA,UnitedStates
RomualdCarette EvolucareTechnologies,VillersBretonneux,France
ManuelF.Casanova DepartmentofPsychiatry& BehavioralSciences,UniversityofLouisville, Louisville,KY,UnitedStates
NadireCavus DepartmentofComputer InformationSystems,NearEastUniversity, Nicosia,Cyprus;ComputerInformationSystems ResearchandTechnologyCentre,NearEast University,Nicosia,Cyprus
ZhaohuiChe ShanghaiJiaoTongUniversity, China
FedericaCilia CRP-CPOLab,Universityof PicardieJulesVerne,Amiens,France
RosaneMeireMunhakdaSilva Universityof WesternofParana,IguassuFalls,StateofParana, Brazil
AngelaV.Dahiya DepartmentofPsychology, VirginiaTech,Blacksburg,VA,UnitedStates
Y.DeDiego-Otero FacultyofPsychology, UniversityofMa ´ laga,Ma ´ laga,Spain
KaushikDeb DepartmentofComputerScience andEngineering,ChittagongUniversityof Engineering&Technology,Chattogram, Bangladesh
GillesDequen MISLab,UniversityofPicardie JulesVerne,Amiens,France
HuiyuDuan ShanghaiJiaoTongUniversity,China
MahmoudElbattah MISLab,Universityof PicardieJulesVerne,Amiens,France;Facultyof EnvironmentandTechnology,Universityofthe WestofEngland,Bristol,UnitedKingdom
AymanS.El-Baz UniversityofLouisville, Louisville,KY,UnitedStates;Universityof LouisvilleatAlameinInternationalUniversity (UofL-AIU)
AhmedK.Elsayed NeurologicalDisorders ResearchCenter,QatarBiomedicalResearch Institute,HamadBinKhalifaUniversity,Qatar Foundation,Doha,Qatar
SukruEraslan MiddleEastTechnicalUniversity, NorthernCyprusCampus,Kalkanlı,Guzelyurt, Mersin,Turkey
ZoyaFarooqui ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
M.R.Go ´ mez-Soler AdolfoDı´azAmbrona CommunityHealthCentre,Me ´ ridaHospital, Badajoz,Spain
Jean-LucGue ´ rin MISLab,UniversityofPicardie JulesVerne,Amiens,France
Jesu ´ sGutie ´ rrez UniversidadPolite ´ cnicade Madrid,Spain
LeAnHa ResearchInstituteinInformation andLanguageProcessing,Universityof Wolverhampton,Wolverhampton,UnitedKingdom
MichaelHelde ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
Danielle(HyunJung)Kim DepartmentofInternal Medicine,DivisionofRheumatology,Allergy, andClinicalImmunology,Universityof California,Davis,CA,UnitedStates
HaruhideKimura TakedaPharmaceutical CompanyLimited,Kanagawa,Japan
AbdulmalikA.Lawan DepartmentofComputer Science,KanoUniversityofScienceand Technology,Wudil,Nigeria;Departmentof ComputerInformationSystems,NearEast University,Nicosia,Cyprus;Computer InformationSystemsResearchandTechnology Centre,NearEastUniversity,Nicosia,Cyprus
PatrickLeCallet NantesUniversite ´ ,France
EmilyLi ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
ElisaMariaBezerraMaia UniversityofWesternof Parana,IguassuFalls,StateofParana,Brazil
SatoruMatsuda TakedaPharmaceuticalCompany Limited,Kanagawa,Japan
ChristinaG.McDonnell DepartmentofPsychology, UniversityofWyoming,Laramie,WY,UnitedStates
RuslanMitkov ResearchInstituteinInformation andLanguageProcessing,Universityof Wolverhampton,Wolverhampton,United Kingdom
SoraiaMayaneSouzaMota UniversityofWestern ofParana,IguassuFalls,StateofParana,Brazil
SrushtiNerkar ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
AlexandraRamirez-Celis DepartmentofInternal Medicine,DivisionofRheumatology,Allergy, andClinicalImmunology,Universityof California,Davis,CA,UnitedStates
M.L.Rı´os-Rodrı ´ guez FacultyofPsychology, UniversityofMa ´ laga,Ma ´ laga,Spain
LilianaP.Rojas-Torres Departmentof DevelopmentalandEducationalPsychology, UniversityofValencia,Valencia,Spain
J.M.Salgado-Cacho FacultyofPsychology, UniversityofMa ´ laga,Ma ´ laga,Spain;Hogar Abierto,Ma ´ laga,Spain
SalamSalloum-Asfar NeurologicalDisorders ResearchCenter,QatarBiomedicalResearch Institute,HamadBinKhalifaUniversity,Qatar Foundation,Doha,Qatar
BrandenSattler ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
AngelaScarpa DepartmentofPsychology, VirginiaTech,Blacksburg,VA,UnitedStates
LonnieSears DepartmentofPediatrics,University ofLouisville,Louisville,KY,UnitedStates
MohamedShaban ElectricalandComputer Engineering,UniversityofSouthAlabama, Mobile,AL,UnitedStates
ReinaldoAntonioSilva-Sobrinho Universityof WesternofParana,IguassuFalls,StateofParana, Brazil
ArjunSingh ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
EstateM.Sokhadze UniversityofSouthCarolina SchoolofMedicineGreenville,Greenville,SC, UnitedStates
FariaZarinSubah DepartmentofComputer ScienceandEngineering,ChittagongUniversity ofEngineering&Technology,Chattogram, Bangladesh;DepartmentofComputerScience andEngineering,UniversityofAsiaPacific, Dhaka,Bangladesh
SadiyaTahir DepartmentofPediatrics,Murtala MuhammadSpecialistHospital,Kano,Nigeria
AllanTasman DepartmentofPsychiatry& BehavioralSciences,UniversityofLouisville, Louisville,KY,UnitedStates
UnyimeUsua ARQuestStudentScienceand EngineeringNetwork,Irvine,CA,UnitedStates
JudyVandeWater DepartmentofInternal Medicine,DivisionofRheumatology,Allergy, andClinicalImmunology,Universityof California,Davis,CA,UnitedStates
VictoriaYaneva ResearchInstituteinInformation andLanguageProcessing,Universityof Wolverhampton,Wolverhampton,UnitedKingdom
YelizYesilada MiddleEastTechnicalUniversity, NorthernCyprusCampus,Kalkanlı,Guzelyurt, Mersin,Turkey
Rufa’iYunusa DepartmentofPathology,Aminu KanoTeachingHospital,Kano,Nigeria
GuangtaoZhai ShanghaiJiaoTongUniversity, China
AdrianaZilly UniversityofWesternofParana, IguassuFalls,StateofParana,Brazil
Thispageintentionallyleftblank
Abouttheeditors
AymanS.El-Baz isadistinguishedprofessor attheUniversityofLouisville,Kentucky, UnitedStatesandtheUniversityofLouisville atAlameinInternationalUniversity(UofLAIU),NewAlameinCity,Egypt.Dr.El-Baz earnedhisBScandMScdegreesinelectrical engineeringin1997and2001,respectively.He earnedhisPhDinelectricalengineeringfrom theUniversityofLouisvillein2006.Dr.El-Baz wasnamedasafellowforCoulter,AIMBE, andNAIforhiscontributionstothefieldof biomedicaltranslationalresearch.Dr.El-Baz hasalmosttwodecadesofhands-onexperience inthefieldsofbio-imagingmodelingandnoninvasivecomputer-assisteddiagnosissystems. Hehasauthoredorcoauthoredmorethan700 technicalarticles(182journals,46books, 97bookchapters,253refereed-conference papers,214abstracts,and38USpatentsand disclosures).
JasjitS.Suri PhD,MBA,isaninnovator, visionary,scientist,andaninternationally knownworldleaderinbiomedicalengineering anditsmanagement.Dr.Surireceived theDirectorGeneral’sGoldMedalin1980and isafellowof(1)InstituteofElectricaland ElectronicEngineers,(2)AmericanInstitute ofMedicalandBiologicalEngineering,(3) AmericanSocietyofUltrasoundinMedicine, (4)AmericanSocietyofVascularMedicine, and(5)AsiaPacificVascularSociety.Heisalso therecipientoftheLifetimeAchievement AwardfromMarquis.Heiscurrentlythe ChairmanofAtheroPoint,Roseville,CA, UnitedStates,dedicatedtoimagingtechnologiesforcardiovascularandstroke.Hehaswon numerousawards,has~25,000citations,coauthored50books,and50patentinventions,and hasanH-index~80.
Thispageintentionallyleftblank
Acknowledgments
Thecompletionofthisbookcouldnothave beenpossiblewithouttheparticipationand assistanceofsomanypeoplewhosenames maynotallbeenumerated.Theircontributions aresincerelyappreciatedandgratefully acknowledged.However,theeditorswould
liketoexpresstheirdeepappreciationand indebtednessparticularlytoDr.AliH. MahmoudandAhmedSharafeldeenfortheir endlesssupport.
AymanS.El-Baz JasjitS.Suri
Thispageintentionallyleftblank
PART1
Autismandclinicalanalysis: Diagnosis
Thispageintentionallyleftblank
Remotetelehealthassessmentsforautism spectrumdisorder
AngelaV.Dahiya1,JenniferR.Bertollo1,ChristinaG.McDonnell2 andAngelaScarpa1
1DepartmentofPsychology,VirginiaTech,Blacksburg,VA,UnitedStates
2DepartmentofPsychology, UniversityofWyoming,Laramie,WY,UnitedStates
1.1Introduction
Autismspectrumdisorder(ASD),diagnosed inabout1inevery54childrenintheUnited States,isaneurodevelopmentaldisordercharacterizedbytwodomainsofdiagnosticcriteria describedinthe“DiagnosticandStatistical ManualofMentalDisorders-5thEdition” (DSM-5; [1]):persistentdifficultieswithsocial communicationandreciprocalinteractions, andthepresenceofrestrictedandrepetitive behaviorsorinterests(RRBs).Socialcommunicationdifficultiesmayincludedifficultieswith socio-emotionalreciprocity(e.g.,reducedor differentwaysofinitiatingorrespondingto socialinteractionsandsharinginterestsor emotionswithothers;reducedordifferentconversationalstyles),nonverbalcommunication behaviors(e.g.,differencesintheuseofeye
contact,gestures,facialexpressions,etc.),and difficultywithrelationshipswithothers [1] RRBsmayincludestereotypedorrepetitive behaviors(e.g.,motormovements,objectuse, orspeech),insistenceonsameness(e.g.,significantdifficultywithtransitions,strongpreferenceforroutines),restrictedorfixated interests,ordifferencesinsensoryresponses andinterests [1].Thesecoredomainscan impactvariousaspectsofday-to-dayfunctioning,includingsocialcommunication,relationships,employment,adaptivebehaviorskills, andqualityoflife.
Itiswelldocumentedthatearlysupports leadtogreaterindependenceandqualityoflife forautistic1 individuals [2],butaccesstoservicesishamperedbydelayedidentificationand diagnosis [3].Infact,researchindicatesthat ASDcanbereliablydiagnosedasearlyastwo
1 Givenrecentliteratureandself-advocacyeffortsvoicingoppositiontoperson-firstlanguage,thecurrentchapter frequentlyutilizesidentity-firstlanguageinstead,includingusingtheterm“autistic”ratherthan“individualswithASD” [83,84].However,werecognizethatthismaynotbethepreferenceofeverypersonintheautismcommunityatthistime.
yearsofage,butthemedianageoffirstdiagnosisintheUnitedStatesis4yearsand3months [4].Inadditiontoracial,ethnic,andsexand genderdisparitiesinthetimelinessofautism identification(see [5],forreview),childrenin remoteorruralcommunities,andthosebelow thepovertyline,arediagnosedsignificantly laterthanthoseinurbanormoreaffluentcommunities [6,7].Barrierssuchasgeographicisolation,financialinstability,lackoflocalresources, andmorerecently,theCOVID-19pandemic thatrequiresphysicaldistancing,arechallenges thatmanyremotecommunitiescontinuetoface [8,9].EvenpoorurbancommunitiesfaceasimilarlackofASDprovideravailabilitycompared towealthiercommunities [10],andallindividualsmayfaceuncontrollablecircumstances thatcreateaccessbarriersregardlessoflocale (e.g.,naturaldisasters,snowstorms,illness).As such,remoteassessmentopportunitiesforASD diagnosiswidenourcapacitytoreachasmany peopleaspossiblewhentheyareunableto cometoaclinicinpersonorsimplydonothave accesstoexpertsintheircommunity.
1.1.1In-personstandardizedassessments forautismspectrumdisorder
PriortoformaldiagnosticassessmentforASD, screeningmethodsareintendedto“catch”characteristicsofASDearlyindevelopmentandsubsequentlyreferachildforathoroughdiagnostic assessmentifautisticfeaturesarepresent.The AmericanAcademyofPediatricsrecommends universalautismscreeningforallchildren throughoutinfancyandtoddlerhood;specifically, theyrecommendallchildrenbescreenedfor broadbehavioralanddevelopmentalconcernsat 9,18,and30months,andspecificallyforASD usingastandardizedscreeningtoolat18-and 24-monthwellvisits [11].However,adoptionof theserecommendationshasbeeninconsistent,as notallgoverningorganizationsputforwardthe samescreeningrecommendationsandresulting
policymandates [12].Onecommonrouteofuniversalscreeningistohaveprimarycarephysiciansorstaffadministeranevidence-based screeningmeasuresuchastheModified ChecklistforAutisminToddlers Revisedwith Follow-up(discussedinmoredetaillaterinthis chapter)duringchildwellvisits,inorderto increasethechancesofflaggingchildrenwith developmental,social,orcommunicationconcernswhomayotherwisegounnoticeduntil beginningpreschoolorKindergarten.Oncea screeninginstrumentorqualifiedprofessional (e.g.,pediatrician)identifiescharacteristicssuggestingincreasedlikelihoodofbeingonthe autismspectrum,thechildisthenreferredfora comprehensivediagnosticassessment.
Currently,standardface-to-faceASDdiagnosticassessmentsconsistofseveralhoursof testing,includingadevelopmentalhistory interviewwithoneormorecaregivers(e.g., AutismDiagnosticInterview-Revised,ADI-R; [13])andanobservationalbehavioralassessmentwiththeindividualsuspectedtomeetcriteriaforadiagnosisofASD(e.g., Autism DiagnosticObservationSchedule,2ndEdition, ADOS-2; [14]).Atpresent,manyexpertsconsiderthesetwomeasurestocomprisethe “goldstandard”protocolforanASDevaluationandthustheyarebothwidelyusedinstruments.TheADI-Rgathersnecessarymedical anddevelopmentalinformation,whileevaluatingsocialcommunication(e.g.,stereotyped utterances,littleuseofnonverbalcommunication),reciprocalinteractionandpeerrelationships(e.g.,limitedresponsetoothers,lackof reciprocalconversationabilities),andRRBs (e.g.,presenceofpreoccupations,complex bodymannerisms,sensoryinterests).The ADOS-2usesspecificinteractiontasksto promptfortheaforementionedsocialcommunicationdifferencesandRRBs,whichatrained clinicianfacilitates,observes,andcodes.In additiontotheADI-RandtheADOS-2,an assessmentbatteryoftenincludesmeasuresof cognitiveandlanguageabilitiestofurther
specifyanyco-occurringintellectualorlanguageimpairment.Multidisciplinaryevaluationsalsoincorporatespeech-language assessments,school-basedreports,ormedical consultations [15].Finally,parent-orcaregiverreportofadaptivebehaviorfunctioning(i.e., whetheranindividualhasdevelopedtheageexpectedskillsnecessarytofunctionindaily life)andothercharacteristics(e.g.,restricted interests,sensorydifferences,emotiondysregulation,anxiety)arealsotypicallycollectedto strengthendiagnosticdecisionsandrecommendationsforservicesoraccommodations.
Professionalsrecommendadministrationof thisorasimilarlycomprehensiveprotocolin ordertoscreenanddiagnoseASD,butmany providersmayonlyutilizeoneofthemethods duetothelengthoftime,cost,andrequired trainingtoadminister aninvolvedbatteryof interviewandobservationalmethods [16].Such adiagnosticprotocolrequiresseveralhoursof directface-to-facecontact,aswellasasignificant amountofresourcesinordertotrainproviders onthecorrectadministrationandscoringtechniquesoftheseassessments.Thus,peopleseeking adiagnosisofASDareoftenonlongwaitlistsor leftundiagnosed [17].Withthiscontextinmind, itisimperativetoexploreefficienttoolsthatcan decreasetimeandcost,whileincreasingaccessibilityandimplementationofscreeninganddiagnosticassessments.
Severalrecenteffortshavebeenmadeto overcometimeandresourcebarriersbydevelopingshorterobservationmeasuresthatcanbe administeredbycommunityproviderswithout substantialtraining(i.e., [18,19]).However, technology-basedortelehealthmodalitiescan provideanotherviableandmoreaccessible alternativetoin-persondiagnosticevaluations. Previousresearchhasexaminedtechnologyas ameanstodeliverassessmentservicesfor autisticchildreninacost-effectiveway [20], whichisconsistentwithcurrenttelehealth therapypractices [21,22] andwillbefurther exploredthroughoutthischapter.
1.1.2Significanceofremoteassessments forautismspectrumdisorder
Currently,thecriticalneedforremoteassessmentsforthescreeninganddiagnosisofASDis highlightedbytheCOVID-19pandemic,which hasnecessitatedsocialdistancing,quarantining, andgovernment-issuedstay-at-homeorders acrossthecountryandworld.Asaresult,many clinicsandproviderswereforcedtopausetheir servicesuntiltheywereeitherpermittedtosee clientsface-to-face,orwereabletodevelopand implementalternativemeansofreachingfamilies remotely.IntheUnitedStates,in-personoperationswerehaltedaltogetherforseveralmonths andmanyprovidersstillhavenotreturnedto thefullyin-personoperationstheyreliedon priortoCOVID-19,insteadmaintainingfullto partialtelehealth-basedserviceoptions.
Evenpriortothepandemic,theaveragewaitlisttobeseenbyanautism-specificprovider spannedfromseveralmonthstomorethana yearforacomprehensivediagnosticevaluation, dependingonlocation [23].Althoughresearch consistentlysupportsthatASDcanbediagnosed reliablyinchildrenasyoungas2yearsofage andparentalconcernmayariseevenearlier,childrenintheUnitedStatesarenotdiagnoseduntil afterfouryearsofageonaverage,one-thirdof autisticchildrenhavestillnotbeendiagnosedby 8yearsofage,andmanyindividualsdonot receiveadiagnosisuntiladolescenceoreven adulthood [4,24].Thesefactsareparticularly alarminggiventhewell-documentedbenefitsof receivingsupportsorservicespriortotheageof three,andevenasyoungas18monthsofage, forimprovinglong-termqualityoflifeandadaptiveoutcomesforautisticindividuals [2,25]. Further,becausemanyaspectsofserviceaccess suchasinsurancecoverageandpublicschool accommodationsdependuponaformaldiagnosisofASD,theimportanceofatimelydiagnostic assessmentcannotbeoverstated.Duringthe COVID-19pandemic,alreadylongwaitlistshave increasedfurther.
