Tuesday, 15 March 2016

Measuring anxiety comorbid to autism

Anxiety, whether reaching clinical thresholds or manifesting as something rather more subtle, is a common theme in autism research and practice these days. I've talked about it enough times on this blog (see here and see here for example) reflective of the growth in this peer-reviewed research area that has continued unabated.

Recognition of just how 'disabling' anxiety can be for someone on the autism spectrum is fairly widely noted these days. Problems however, still remain in terms of (i) how we measure anxiety when comorbid to autism and (ii) which strategies are most appropriate to tackle such issues, bearing in mind their wide impact on at least some of the 'autisms' (see here).

The paper by Jacqui Rodgers and colleagues [1] perhaps brings us one step closer to solving the first issue with the introduction of the "Anxiety Scale for Children - ASD, Parent and Child versions (ASC-ASD)." Readers can find out a little more on this scale from an accompanying website (see here).

Describing how existing anxiety measures "may require adaptation to accommodate characteristics of those with ASD [autism spectrum disorder]" the authors set about doing just that. So: "An adapted version of the RCADS [Revised Child Anxiety and Depression Scale] was created based on empirical evidence of anxiety phenomenology in ASD, which included additional items related to sensory anxiety, intolerance of uncertainty, and phobias." After taking into account the modifications suggested "during focus groups with parents" of children with autism among other things, researchers came up with a new 24-item scale with some good statistics in terms of reliability and validity.

There is still quite a way to go in terms of seeing how the ASC-ASD (various versions) copes with the various demands of autism research and practice but I'm kinda hopeful that we might see some productive results coming from its use. Whether anxiety is more or less likely among various groups on the autism spectrum is perhaps one of the first hurdles posed for the instrument in light of other data on another important comorbidity: depression (see here). I might also suggest that examining correlations between anxiety levels and other more somatic features discussed in the context of autism might also provide some important data too (see here). Please, don't get scared by the suggestion that gastrointestinal issues - now quite well-known to be associated with cases of autism (see here) - might be able to affect or be affected by psychology and behaviour...

That also the concept of 'intolerance of uncertainty' (see here) is included in the anxiety 'mix' is an important addition to the ASC-ASD given the rise and rise of this term with autism in mind [2]. The same goes for the focus on 'sensory anxiety' too, which might accord with an element included in the the latest DSM-5 criteria for autism (see here).

We wait to see what becomes of the ASC-ASD with fingers crossed...

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[1] Rodgers J. et al. Development of the anxiety scale for children with autism spectrum disorder (ASC-ASD). Autism Res. 2016 Feb 17.

[2] Hodgson AR. et al. Facing the Unknown: Intolerance of Uncertainty in Children with Autism Spectrum Disorder. J Appl Res Intellect Disabil. 2016 Feb 12.

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ResearchBlogging.org Rodgers J, Wigham S, McConachie H, Freeston M, Honey E, & Parr JR (2016). Development of the anxiety scale for children with autism spectrum disorder (ASC-ASD). Autism research : official journal of the International Society for Autism Research PMID: 26887910