Brief Report: Symptom Onset Patterns and Functional Outcomes in Young Children with Autism Spectrum Disorders

Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, MD 20892-1255, USA.
Journal of Autism and Developmental Disorders (Impact Factor: 3.06). 03/2011; 41(12):1727-32. DOI: 10.1007/s10803-011-1203-3
Source: PubMed


This study examined the relationship between onset status and current functioning using a recently proposed onset classification system in 272 young children with autism spectrum disorder (ASD). Participants were classified into one of the following groups, based on parent report using the Autism Diagnostic Interview--Revised: Early Onset (symptoms by 12 months, no loss), Delay + Regression (symptoms by 12 months plus loss), Plateau (no early symptoms or loss), and Regression (no early symptoms, followed by loss). Findings indicate that current functioning does not differ according to onset pattern, calling into question the use of onset categorizations for prognostic purposes in children with ASD.

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Available from: Audrey Thurm, Oct 07, 2015
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    • "Ozonoff et al. [32] identified three patterns of onset of ASD: early onset, regression, and plateau. More research is needed, bearing in mind that symptom emergence can be considered as a continuum of many phenotypes containing different characteristics and varying in severity [5,32,33]. "
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    ABSTRACT: Background Little is known about the stability of behavioural and developmental problems as children develop from infants to toddlers in the general population. Therefore, we investigated behavioural profiles at two time points and determined whether behaviours are stable during early development. Methods Parents of 4,237 children completed questionnaires with 62 items about externalizing, internalizing, and social-communicative behaviour when the children were 14–15 and 36–37 months old. Factor mixture modelling identified five homogeneous profiles at both time points: three with relatively normal behaviour or with mild/moderate problems, one with clear communication and interaction problems, and another with pronounced negative and demanding behaviour. Results More than 85% of infants with normal behaviour or mild problems at 14–15 months were reported to behave relatively typically as toddlers at 36–37 months. A similar percentage of infants with moderate communication problems outgrew their problems by the time they were toddlers. However, infants with severe problems had mild to severe problems as toddlers, and did not show completely normal behaviour. Improvement over time occurred more often in children with negative and demanding behaviour than in children with communication and interaction problems. The former showed less homotypic continuity than the latter. Conclusions Negative and demanding behaviour is more often transient and a less specific predictor of problems in toddlerhood than communication and interaction problems.
    Child and Adolescent Psychiatry and Mental Health 07/2014; 8(1):19. DOI:10.1186/1753-2000-8-19
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    • "However, the M:F ratio has not been specifically examined in the subpopulation of ASD and epilepsy. Furthermore , previous studies have not described M:F ratio differences in ASD with developmental regression [Parr et al., 2011; Shumway et al., 2011]. As ASD occurs more frequently in males, we hypothesized that the relatively small group of females with ASD may have a different clinical expression than males. "
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    ABSTRACT: Autism spectrum disorder (ASD) is a heritable disorder occurring predominantly in males. The aim of this study was to compare sex differences in the prevalence of specific neurological phenotypes commonly described in ASD. The study included 663 participants, aged 18 months to 15 years, diagnosed with ASD. Neurological and behavioral assessments were performed using standardized tests, and obtaining medical, developmental, and familial histories from the parents. Phenotypes under investigation were macro- and microcephaly, developmental regression, minor neurological and musculoskeletal deficits (MNMD), and seizures. Male : female ratio in the ASD group was 6.7:1. No sex differences in autism severity, cognitive ability, and adaptive functioning were noted. Mean head circumference percentile for males (50.1 ± 25.6) was significantly larger than females (43.4 ± 30.2). Micro- and macrocephaly were more frequent in ASD than expected (5.9%; 18.1%, respectively). Microcephaly in females (15.1%) was significantly more prevalent than in males (4.5%). The prevalence of macrocephaly in both sexes did not differ significantly. Regression was noted in 30.2% of the females with ASD, significantly higher than in males (18.9%). MNMD was documented in 73.8% of the females, significantly higher than in males (57.1%). M:F ratio decreased in a group with two or more phenotypes (3.6:1), while male predominance was more significant in the group without phenotypes (13.6:1). Neurological phenotypes associated with ASD are more prevalent in females than in males, resulting in more complex clinical and neurological manifestations in females. Therefore, involvement of different etiologies is suggested in ASD in females. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
    Autism Research 12/2013; 6(6). DOI:10.1002/aur.1319 · 4.33 Impact Factor
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    • "s with respect to differences in outcome between the two seemingly dichotomous groups ( e . g . , Davidovitch , Glick , Holtzman , Tirosh , & Safir , 2000 ; Hansen et al . , 2008 ) , even when other onset categories and those that con - sider early delays have been included ( Jones & Campbell , 2010 ; Kalb et al . , 2010 ; Ozonoff et al . , 2011 ; Shumway et al . 2011 ) . Categories ( e . g . , regression , no regression ) , in - cluding those that account for early delays ( e . g . , early delays þ loss ) , entail arbitrary boundaries for skill attainment and loss , both of which were found to be continuously distributed in the present study . Thus , the term regressive AUT may not be appropriate in"
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    ABSTRACT: The purpose of this study was to extend the literature on the ontogeny of autism spectrum disorder (ASD) by examining early attainment and loss of specific sociocommunicative skills in children with autism (AUT; n = 125), pervasive developmental disorder not otherwise specified (PDD-NOS; n = 42), nonspectrum developmental delays (n = 46), and typical development (n = 31). The ages of skill attainment and loss were obtained from a caregiver interview. The findings indicated that children with AUT, PDD-NOS, and developmental delays diverged from typically developing children in attainment of sociocommunicative skills early in the first year of life. Loss of at least one skill was reported in a majority of children with AUT and PDD-NOS. Significant delays in attainment of skills were also reported in children who lost skills. The wide variation in skill attainment and loss reported across children indicates that symptom onset and regression may be best represented continuously, with at least some early delay and loss present for a great majority of children with ASD.
    Development and Psychopathology 11/2013; 26(1):1-12. DOI:10.1017/S0954579413000874 · 4.89 Impact Factor
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