Thesis defence in the University of Oulu

Doctoral Candidate

MPsych Katja Jussila

Faculty and research unit

University of Oulu Graduate School, Faculty of Medicine, PEDEGO, child psychiatry

Field of study

Child psychiatry

Date and time of the thesis defence

1.11.2019 12:00

Place of the thesis defence

Faculty of Medicine, Aapistie 5A, Leena Palotie -auditoriun (101A)

Topic of the dissertation

ON THE AUTISM SPECTRUM? Recognition and assessment of quantitative autism traits in high-functioning school-aged children. An epidemiological and clinical study

Opponent

Professor Ola Shahin, University of Cairo, child psychiatry

Custos

Professor emerita Irma Moilanen, PEDEGO, child psychiatry

Sensory hypersensitivities and autistic traits of male family members are a red flag for autism spectrum disorder

Autism spectrum disorder (ASD) is diagnosed based on behavioral characteristics. It is a highly heritable disorder defined by deficits in social communication and stereotyped patterns of behavior. There is a lot of variability in how these autistic traits manifest in children with ASD, and they can weaken the level of functioning of a child even when manifesting on a subclinical level.

In the present thesis, it was shown that sensory hypersensitivities and autism traitness of male family members multiply a child’s risk for ASD. Auditory hypersensitivity and autism traitness of the father explained the severity of child ASD. Among the non-ASD children, sensory abnormalities were also associated to poorer social competence (more autistic traits). Among these children, both the father’s and the mother’s autism traitness explained the autism traitness of the child. The prevalence of sensory abnormalities was 8% in the general population and 54% among children with ASD.

Recognizing autistic traits can be challenging, especially among high-functioning children. The purpose of this study was to find clues and tools for clinicians for autism trait recognition and assessment when working with these children by investigating the association of sensory abnormalities and autism traitness of family members with the autism traitness of the child. Also the usability of two quantitative measures of autistic traits (ASSQ, SRS) was evaluated.

Information about sensory abnormalities were collected from a whole age group living in the Northern Ostrobothnia Hospital District area (8-year-olds), and their autistic traitness was assessed by collecting parent and teacher evaluations on the Autism Spectrum Screening Questionnaire (ASSQ). When studying autism traitness of family members, information was gathered by collecting Social Responsive Scale (SRS) assessments in ASD and non-ASD family samples. It was found that the brothers and the fathers of children with ASD presented significantly stronger autism traitness than the control boys and their fathers. No such difference was found between sisters of children with ASD and the control girls, nor with ASD mothers and control mothers.

Since sensory abnormalities are known to be rather persistent, they can serve as an early marker of ASD risk. They should be assessed during child health check-ups, and the development of social communication and competence of children with sensory hypersensitivities should be included into the routine developmental follow-ups at child care centers. The same holds for children whose families report ASD or ASD traitness in male family members. Further, since sensory abnormalities are not merely an autism related issue, but affect also 8% of the total child population, they should be taken into account when designing learning environments in school and daycare centers and when making decisions about child group sizes.

The study gave important information to clinicians about the ASSQ- and the SRS -questionnaires. When using the ASSQ to screen for possible ASD, it is essential to collect both parental and teacher evaluations and use the summed score when considering the need for diagnostic evaluations. The SRS is a valid questionnaire for tailoring the focus points of rehabilitation and assessing treatment outcome.

 

Dissertation

Last updated: 23.10.2019