Evaluation of ASD Severity in Children Aged 2-6 Years Using the Assessment Treatment Evaluation Checklist

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International Journal Of Artificial Intelegence Research ISSN: 2579-7298 Vol 6, No 1.1, June 2022

Evaluation of ASD Severity in Children Aged 2-6 Years Using the Assessment Treatment Evaluation Checklist

Neny Triana^a,1*, Mohammad Sulchan^b,2, Maria Mexitalia^c,3, Maria Suryani^c,4

aFaculty of Medicine, Diponegoro University, Semarang,^cPediatric Department, Faculty of Medicine, Diponegoro University, Semarang,^bNutrition Department, Faculty of Medicine, Diponegoro University, Semarang,^cDepartment of Nursing, STIKES Elisabeth

Semarang,

1Nenytriana979797@gmail.com,²mohsulchan@gmail.com,³dr.mexitalia@gmail.com,⁴mariahandoko22@gmail.com

*corresponding author

ARTICLE INFO ABSTRACT

Article history:

Received 31 Apr 2022 Revised 6 May 2022 Accepted 13 June 2022

A child can be diagnosed with autism spectrum disorder (ASD) before they are two years old. Children with ASD will show symptoms of social interaction and communication disorders, repetitive behaviours, and an extremely narrow range of activities of interest. Early ASD treatment will result in significant improvement in ASD symptoms. The assessment treatment evaluation checklist (ATEC) instrument is a commonly used instrument to evaluate the severity of ASD after being given therapy. This study aims to evaluate the severity of ASD in children aged 2-6 years using the ATEC instrument. This study used a cross-sectional design. A total of 66 ASD children aged 2-6 years from the autism clinic selected by simple random sampling were involved in the study. ASD severity was measured with the ATEC instrument by therapists from the autism clinic. Data on respondent characteristics such as gender and age diagnosed with ASD were evaluated. One-way ANOVA test was used in this study. The overall ASD severity at age 2,3,4,5,6 years was 96.45, 99.50, 94.23, 94.83, 100.87 respectively (possible score range is 0-179). There was no difference in the severity of ASD in each age group of children 2-6 years (p=0.878). There is no difference in the severity of ASD in children aged 2-6 years. ASD children need appropriate action to improve the severity of ASD from an early age on an ongoing basis .

Keywords:

autism spectrum disorder, children, ATEC, age, severity

I. Introduction

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders [1]. The prevalence of ASD globally continues to increase every year [2], [3]. One ASD child will be found out of every 36 children [4]. Children with ASD will show symptoms such as social interaction and communication disorders, repetitive behaviours, and an extremely narrow range of activities of interest [1]. A child can be diagnosed with ASD when he is less than 2 years old with an average age of 4 years [1]. ASD children are found more in boys than girls [2], [5].

ASD child development disorders involve complex pathophysiological processes, which involve interactions between genetic and environmental factors [6]. The presence of infection during pregnancy in the mother can contribute to the incidence of ASD in children [7]. The presence of child infection after birth can also cause ASD [4], [8]. The infection will affect the function of the nerves in the brain that regulate cognitive function, communication, and behavior [9].

After a child is diagnosed with ASD, generally parents will check their child to the doctor for therapy so that their child's condition gets better. Previous research has found that giving therapy to improve the development of children with ASD will be more effective if it is given early [10]. The previous longitudinal study found that the ASD symptom improvement slow down during the transition to school period namely six years old [11]. Therapy is generally given in a special clinic for people with autism. Therapy given to children with ASD can be in the form of behavioral DOI: https://doi.org/10.29099/ijair.v6i1.2.704 W : http://ijair.id | E : info@ijair.id

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therapy, vitamins and minerals, and special diets such as casein-free and gluten-free diets, speech therapy, sensory integration therapy, and cognitive therapy [4], [12]. However, there is no standard therapy for children with ASD [4].

ASD children who have received various therapies need to be evaluated for their severity improvement [13]. The Autism Treatment Evaluation Checklist (ATEC) is an instrument that is generally used by medical personnel to evaluate the effectiveness of the therapy given [14]. ASD children can be evaluated for their development of communication, social interaction, sensory and behavior [14], [15]. This study will evaluate the developmental level of ASD children taken from autism clinics where children have started receiving developmental therapy by therapists.

II. Method

This study used a cross-sectional design involving 66 ASD children recruited from 14 autism clinics by simple random sampling. The inclusion criteria in this study were children diagnosed with ASD by a pediatrician, aged 2-6 years, and allowed by their parents to participate in the study by signing an informed consent. Children with cerebral palsy disorders, heart problems, and mental disorders. ASD severity was evaluated using the ATEC instrument by therapists at the autism clinic. The total ATEC score that an ASD child might get is 0-179, where a lower score indicates an improvement in ASD severity. The score ranges for the severity sub-level on communication were 0-28, social interaction was 0-40, sensory was 0-36, and behavioral/physical was 1-75. The age of the child with ASD detection and the sex of the child with ASD were evaluated in this study.

Numerical data is displayed with mean ± standard deviation (SD), while categorical data is in the form of frequency and percentage. The Kolmogorov-Smirnov test is used to see the distribution of numerical data. The one-way anova test with LSD is used to see differences in the level of development of children with ASD based on age. This study has received approval from the ethical commission of the medical faculty of Diponegoro University, Semarang (No.

238/EC/KEPK/FK-UNDIP/X/2020).

III. Results and Discussion

A total of 66 ASD children participated in this study. The characteristics of the participants are shown in table 1. The majority of participants were 4 years old (32.31%), male (87.69%), and ASD was detected when they were less than 2 years old 39 (60%).

Table 1. Participants Characteristics

Characteristics n(%)

Age

2 years 11(16.70)

3 years 14(21.20)

4 years 21(31.80)

5 years 12(18.20)

6 years 8(12.10)

Gender

Male 58(87.88)

Female 8(12.12)

Age at ASD diagnosis

<2 years 27(40.90)

≥2 years 39(59.10)

Table 2 shows the average severity of ASD and each ASD symptom in the 2-6 year age group.

The overall severity of ASD in the 2-6 years age group did not show any significant difference (p=0.878). The severity level based on ASD symptoms, namely communication, social interaction, sensory, and behavior did not show a significant difference with p values of 0.846, 0.811, 0.187, and 0.502 respectively.

Table 2. one-way anova analysis

Neny Triana et al (Evaluation of ASD Severity in Children Aged 2-6 Years Using the Assessment Treatment Evaluation Checklist)

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ISSN: 2579-7298 International Journal Of Artificial Intelegence Research Vol 6, No 1.1, June 2022

2 years 3 years 4 years 5 years 6 years p

ASD severity 96.45 ± 13.99 99.50 ± 20.96 94.23 ± 21.58 94.83 ± 14.71 100.87 ± 17.03 0.878 Communication 23.00 ± 5.77 22.92 ± 7.94 22.19 ± 6.88 24.25 ± 3.95 21.00 ± 6.88 0.846 Social interaction 24.63 ± 8.23 24.85 ± 9.30 23.38 ± 8.00 26.16 ± 7.21 22.00 ± 8.29 0.811 Sensory 22.00 ± 5.15 20.78 ± 7.57 19.47 ± 6.71 15.92 ± 6.08 20.75 ± 4.26 0.187 Behaviour 28.63 ± 11.12 30.92 ± 11.55 29.85 ± 11.63 28.83 ± 11.96 37.12 ± 8.93 0.502

Discussion

This study evaluated the severity of ASD in a group of children aged 2 to 6 years. It was found that the majority of respondents in this study were male. In accordance with the results of previous studies that boys experience more ASD than girls [2], [3]. Children with ASD can be found in children younger than 2 years [3]. As many as 40% of children in this study had been diagnosed with ASD. Parents stated that after being diagnosed with ASD, their child was immediately given therapy at the clinic to improve their child's condition. This shows that 40% of children have received ASD therapy from the age of less than 2 years. Previous studies have found that the earlier children receive ASD therapy, the more optimal results will be shown [14].

The results of the study found that there was no difference in the overall severity of ASD and in each symptom group in children aged 2-6 years. ASD severity was evaluated using the ATEC instrument. However, the highest severity was seen in the 6-year-old group (100.87), and the lowest severity level in the 4-year-old group (94.23), where the possible score range is 0-170. Lower ATEC score indicates improvement in ASD severity.Following the previous study that the severity improvement in children at six years old [13].

Children with ASD will experience developmental disorders in the form of disturbances in communication, behavior and social interaction [1]. They have difficulty communicating with others, establishing relationships with others, do not care about the environment around them, and tend to do repetitive behaviors. This disorder is used as the basis for a child diagnosed with ASD [1]. Participants in this study were diagnosed by pediatricians at an ASD clinic.

The results showed that there was no difference in the severity of ASD both in communication, social interaction, sensory and behavior in the 2-6 years old group. Based on the scores for each ASD symptom, it was found that the severity of ASD in communication and social interaction was found in the 5 years old group, while for sensory 2 years and for behavior in the 6 years old group.

They had received therapy to improve the ASD symptoms. However, the duration of therapy can also affect the severity of ASD. The sooner ASD treatment is obtained, it is hoped that the symptoms of communication disorders, social interaction, sensory and behavior can be improved.

There are several limitations in this study. Researchers did not evaluate the duration of therapy and the type of therapy each respondent received. However, the age at which ASD was diagnosed can provide an overview of the duration of acquired therapy.

IV. Conclusion

There is no difference in the severity of ASD in the age group of children 2-6 years. Appropriate and early intervention is necessary to improve the severity of ASD.

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