Adaptation and Validation of the Autism Mental Status Examination (AMSE) in Chile: seeking to reduce the diagnostic gap

Irarrázaval, Matías; López, Isabel; Figueroa, Cecilia; Cabezas, Marcia; Yañez, Cristián; Rodillo, Eliana; Riesle, Sofía; Rivera, Tamara; García, Ricardo

Adaptación y Validación del Examen de Estado Mental del Autismo (AMSE) en Chile: buscando reducir la brecha diagnóstica

dc.contributor		en-US
dc.contributor		es-ES
dc.creator	Irarrázaval, Matías
dc.creator	López, Isabel
dc.creator	Figueroa, Cecilia
dc.creator	Cabezas, Marcia
dc.creator	Yañez, Cristián
dc.creator	Rodillo, Eliana
dc.creator	Riesle, Sofía
dc.creator	Rivera, Tamara
dc.creator	García, Ricardo
dc.date	2023-08-18
dc.date.accessioned	2023-11-29T13:40:49Z
dc.date.available	2023-11-29T13:40:49Z
dc.identifier	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4476
dc.identifier	10.32641/andespediatr.v94i4.4476
dc.identifier.uri	https://revistaschilenas.uchile.cl/handle/2250/238983
dc.description	Early detection of Autism is a challenge in Chile and Latin America. Gold-standard evaluations are expensive and difficult to access. The Autism Mental Status Exam (AMSE) is a brief, structured, observational instrument for clinical use with promising results. Objective: To adapt and validate the AMSE in a sample of Spanish-speaking children and adolescents at risk of Autism Spectrum Disorder (ASD) using the ADOS-2 as a comparison. Subjects and Method: Children and adolescents aged 15m-17yo consulting due to language and communication problems and/or suspected ASD. The AMSE was administered during clinical evaluation. The ADOS-2 was administered by independent evaluators, blinded to the study, which determined diagnostic categories as: Non-Autism Spectrum Disorder (Non-ASD), Autism Spectrum Disorder (ASD), or Autism (AUT). Psychometric characteristics of the AMSE were assessed and, using the ROC curve, a cut-off point was calculated, identifying sensitivity, specificity, positive, and negative predictive value. Results: Sixty-four children participated, 56 were males (87.5%), with a mean age of 6.6y (SD: 3.6). They were distributed as Non-ASD: 12 (18.8%), ASD: 19 (29.7%), and AUT: 33 (51.6%) according to the ADOS-2. The AMSE scores differed significantly among the three categories (p<0.0001). Internal consistency was mode- rate and Cronbach’s alpha was 0.61. The cut-off point was ≥6 (Sensitivity 0.79, Specificity 0.92, AUC: 0.91). A second analysis according to language level suggests a greater diagnostic accuracy of the AMSE for the group with lower language development, maintaining the same optimal cut-off point (≥6). Conclusions: The AMSE shows adequate psychometric properties, good capacity, and accuracy to support the diagnosis of ASD. Its brevity, low cost, and easy integration into clinical practice make it an alternative with great potential for timely recognition and referral of children with ASD.	en-US
dc.description	La detección precoz del Autismo es un desafío en Chile y América Latina. Las evaluaciones gold-stan- dard son de alto costo y difícil disponibilidad. El Examen de Estado Mental para Autismo (AMSE) es un instrumento breve, estructurado, observacional, para uso clínico con promisorios resultados. Objetivo: Adaptar y validar AMSE en muestra de niños, niñas y adolescentes (NNA) hispanohablantes con riesgo de Espectro Autista (EA) utilizando como comparación ADOS-2. Sujetos y Métodos: NNA de 15m-17a, consultantes por problemas de lenguaje, comunicación y/o sospecha de EA. AMSE fue administrado durante evaluación clínica. ADOS-2 fue administrado por evaluadores independientes, ciegos, determinando categorías: No Espectro Autista (NoEA), Espectro Autista (EA) o Autismo (AUT). Se evaluó características psicométricas de AMSE y usando curva ROC se calculó punto de corte, identificando sensibilidad, especificidad, valor predictivo positivo y negativo. Resultados: Participaron 64 NNA, 56 varones (87,5%), con edad promedio 6,6 años (DE:3,6). Se distribuyeron según ADOS-2 en NoEA:12 (18,8%), EA:19 (29,7%), AUT:33 (51,6%). Los puntajes AMSE difirieron significativamente entre las tres categorías (p < 0,0001). AMSE tuvo consistencia interna moderada, con Alfa de Cronbach 0,61. Punto de corte ≥ 6 puntos (sensibilidad 0,79 especificidad 0,92, AUC: 0,91). Un segundo análisis según nivel de lenguaje sugiere mayor precisión diagnóstica de AMSE para el grupo con menor desarrollo de lenguaje, manteniéndose punto de corte óptimo de ≥ 6 puntos.Conclusión: AMSE muestra adecuadas propiedades psicométricas, buena capacidad y precisión para respaldar el diagnóstico de EA. Su brevedad, bajo costo y fácil integración a la práctica clínica, lo hacen una alternativa de gran potencial para el reconocimiento y derivación oportunos de NNA en EA.	es-ES
dc.format	application/pdf
dc.format	application/pdf
dc.language	spa
dc.language	eng
dc.publisher	Sociedad Chilena de Pediatría	es-ES
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4476/4526
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/view/4476/4618
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4476/15122
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4476/15123
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4476/15124
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4476/15125
dc.relation	http://www.revistachilenadepediatria.cl/index.php/rchped/article/downloadSuppFile/4476/15137
dc.rights	Copyright (c) 2023 Andes Pediatrica	es-ES
dc.rights	http://creativecommons.org/licenses/by/4.0	es-ES
dc.source	Revista Chilena de Pediatría; Vol. 94, Núm. 4 (2023): Julio - Agosto; 475-484	en-US
dc.source	Andes Pediatrica; Vol. 94, Núm. 4 (2023): Julio - Agosto; 475-484	es-ES
dc.source	2452-6053
dc.source	2452-6053
dc.subject		en-US
dc.subject	Autism; Autism Spectrum Disorder; AMSE; ADOS-2; Early Detection; Screening	en-US
dc.subject		es-ES
dc.subject	Autismo; Espectro Autista; AMSE; ADOS-2; Detección Precoz; Tamizaje	es-ES
dc.title	Adaptation and Validation of the Autism Mental Status Examination (AMSE) in Chile: seeking to reduce the diagnostic gap	en-US
dc.title	Adaptación y Validación del Examen de Estado Mental del Autismo (AMSE) en Chile: buscando reducir la brecha diagnóstica	es-ES
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/publishedVersion
dc.type		en-US
dc.type		es-ES

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