An International Clinical Study of Ability and Disability in Autism Spectrum Disorder Using the WHO-ICF Framework.
Soheil Mahdi, Katja Albertowski, Omar Almodayfer and 15 others
PMID 29423605WHAT IT FOUND
Clinician ratings of 122 people with ASD using WHO function categories found frequent difficulties in complex social interaction, attention, stress, communication, and daily tasks.
Family, family attitudes, and health-professional support were the most common environmental factors.
Key findings
01The study found 139 of 161 assessed WHO function categories were rated as relevant in at least 10% of cases, across activities, body functions, and environmental factors. No body structure categories reached the cut-off.
02The most frequent activity difficulties were complex interpersonal interactions (106 cases, 86%), basic interpersonal interactions (104 cases, 85%), and handling stress and other psychological demands (101 cases, 82%).
03The most frequent environmental factors were immediate family (103 cases, 84%), individual attitudes of immediate family members (93 cases, 76%), and health professionals (87 cases, 71%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This was a descriptive cross-sectional study, so it cannot show that any treatment caused or improved a difficulty. The sample came from 11 specialist units and some participants were recruited through ASD interest organisations, so it may not represent all people with ASD. A large part of the sample came from Europe, and South East Asia and Africa were not covered. For some adult and preschool participants, medical records were not available, so ratings relied mainly on interviews. For some children and adolescents, interviews were only with family members, not first-hand. The investigators did not test inter-rater reliability. Few cases with co-morbid intellectual disability were included, which may bias the category list. Gender and age-group differences were not analyzed. Personal factors were described exploratively, not rated, so they are not a standardized measurement.
Declared interests
Funded by the Swedish Research Council, Forskningsrådet för hälsa, arbetsliv och välfärd, Svenska Forskningsrådet Formas, and VINNOVA. No author conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not read these frequency percentages as evidence that a treatment works or that every person with ASD has these problems. The study was a cross-sectional rating of 122 cases from specialist sites, and the ICF Core Set for ASD had not yet been finalized.