Discriminating between Autism and Disinhibited Social Engagement Disorder in a clinical context

Davidson-Jamieson, Claire (2024) Discriminating between Autism and Disinhibited Social Engagement Disorder in a clinical context. PhD thesis, University of Glasgow.

Abstract

Clinicians are concerned about making accurate differential diagnoses between Autism and Disinhibited Social Engagement Disorder (DSED) because both groups of children may present with social relationship and communication difficulties, yet DSED is associated with maltreatment and Autism is not. The overall objective of the thesis was to identify any skills or behaviours which may help clinicians discriminate between these two diagnostically distinct groups.

This thesis brings together the findings of an-depth case study investigation, discussed across four separate but related papers, each of which addresses a gap in our knowledge regarding DSED, and how it may be differentiated from Autism. Paper 1 is a systematic review assessing the social functioning of children with DSED. Paper 2 directly compares the profiles of children with Autism, children with DSED and children who are typically developing (TD) via current ‘gold standard’ autism assessment and an unstructured behavioural observation called the Live assessment. Papers 3 and 4 expand on the areas of possible differentiation which were highlighted in papers 1 and 2; language and social communication (paper 3) and sensory processing (paper 4).

Specific differences in skills/behaviours of children with Autism in the case study, compared to the children with DSED, were most apparent within the domain of social communication, suggesting that future research focused on differentiating Autism from DSED should focus on this area. There was also a tentative suggestion that some sensory behaviours may be more ‘Autism-specific.’ For complex cases, a change in approach from standardised structured Autism assessment to a holistic neurodevelopmental approach using unstructured observation, which includes conversational elements, and increases the social challenge may more easily elucidate the differences between core Autism behaviours, DSED-specific behaviours and other co-occurring neurodevelopmental conditions like Attention-Deficit/Hyperactivity Disorder (ADHD) which can complicate the picture. While awareness raising and training may be indicated, we do have tools, like the Live assessment and clinical expertise, such as Speech and Language Therapists (SLTs), available, which can be utilised to support differential diagnosis of the ‘hard to assess’ cases.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: R Medicine > R Medicine (General)
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Funder's Name: Castang Foundation (CASTANGF)
• Supervisor's Name: Minnis, Professor Helen, Gillberg, Professor Christopher and Lowit, Professor Anja
• Date of Award: 2024
• Depositing User: Theses Team
• Unique ID: glathesis:2024-84491
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 12 Aug 2024 14:52
• Last Modified: 12 Aug 2024 15:34
• Thesis DOI: 10.5525/gla.thesis.84491
• URI: https://theses.gla.ac.uk/id/eprint/84491

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