Autism after Adolescence: Population-based 13- to 22-year Follow-up Study of 120 Individuals with Autism Diagnosed in Childhood
ABSTRACT Prospective population-based follow-up study of 120 individuals with autism followed from childhood to adulthood.
Individuals with autism, diagnosed in childhood, were followed prospectively for a period of 13-22 years and re-evaluated at ages 17-40 years. The instruments used at follow-up were the DISCO, WAIS-R, WISC-III, Vineland Adaptive Behavior Scales, psychiatric-medical examination and GAF-scale. A set of criteria was used for the classification of outcomes, taking into consideration employment, higher education/vocational training, independent living and peer relations.
Six of the 120 (5%) had died at the time of follow-up, and six declined participation. Overall outcome was poor in 78% of cases. Only four individuals were independent albeit leading fairly isolated lives. Childhood IQ-level was positively correlated with better adult outcome, as was the existence of some communicative phrase speech at age six years.
Children with autism as diagnosed in the 1960s, 1970s, and 1980s may have an even worse psychosocial outcome than previously believed.
- SourceAvailable from: Michael Lombardo
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- "Lord and colleagues (Lord et al., 2012) recently concluded that ''intrinsic'' biological factors (i.e., different biological factors underlying ASD subgroups with different clinical course) might better explain variable clinical change, although such biological explanations have yet to be identified. Given both the widespread heterogeneity in early language development (Anderson et al., 2007; Kjelgaard and Tager-Flusberg , 2001; Pickles et al., 2014) and its importance in relation to core trajectories of symptom severity (Gotham et al., 2012), alongside the predictive power of early language levels on later outcomes (Bennett et al., 2008; Billstedt et al., 2005; Gillberg and Steffenburg, 1987; Gotham et al., 2012; Howlin, 2003; Howlin et al., 2000, 2014; Szatmari et al., 2000, 2003, 2009; Venter et al., 1992), it is important for the field to develop ways in which the ASD population could be stratified into plausible and clinically relevant neurodevelopmental subtypes. Taking this stratification approach would help to accelerate the translational process from discovery of novel biological markers to ways in which better treatments could be developed and individualized to specific phenotypes (Kapur et al., 2012). "
ABSTRACT: Autism (ASD) is vastly heterogeneous, particularly in early language development. While ASD language trajectories in the first years of life are highly unstable, by early childhood these trajectories stabilize and are predictive of longer-term outcome. Early neural substrates that predict/precede such outcomes are largely unknown, but could have considerable translational and clinical impact. Pre-diagnosis fMRI response to speech in ASD toddlers with relatively good language outcome was highly similar to non-ASD comparison groups and robustly recruited language-sensitive superior temporal cortices. In contrast, language-sensitive superior temporal cortices were hypoactive in ASD toddlers with poor language outcome. Brain-behavioral relationships were atypically reversed in ASD, and a multimodal combination of pre-diagnostic clinical behavioral measures and speech-related fMRI response showed the most promise as an ASD prognosis classifier. Thus, before ASD diagnoses and outcome become clinically clear, distinct functional neuroimaging phenotypes are already present that can shed insight on an ASD toddler's later outcome. VIDEO ABSTRACT. Copyright © 2015 Elsevier Inc. All rights reserved.Neuron 04/2015; 86(2). DOI:10.1016/j.neuron.2015.03.023 · 15.98 Impact Factor
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- "Individuals with autism spectrum disorders (ASD) are highly heterogeneous in their language abilities (Tager- Flusberg et al. 2005). Achievement of ''useful speech,'' or expressive language that may be used frequently, communicatively , referentially, and in a semantically diverse manner, by the end of the preschool years predicts later social and vocational success for individuals with ASD (Billstedt et al. 2005; DeMyer et al. 1973; Howlin et al. 2000; Kobayashi et al. 1992; Venter et al. 1992). Receptive language in the preschool years has also been linked with long-term outcomes of adolescents and young adults with autism (Howlin et al. 2004; Venter et al. 1992). "
ABSTRACT: Eighty-seven preschoolers with autism spectrum disorders who were initially nonverbal (under 6 words in language sample and under 21 parent-reported words said) were assessed at five time points over 16 months. Statistical models that accounted for the intercorrelation among nine theoretically- and empirically-motivated predictors, as well as two background variables (i.e., cognitive impairment level, autism severity), were applied to identify value-added predictors of expressive and receptive spoken language growth and outcome. The results indicate that responding to joint attention, intentional communication, and parent linguistic responses were value-added predictors of both expressive and receptive spoken language growth. In addition, consonant inventory was a value-added predictor of expressive growth; early receptive vocabulary and autism severity were value-added predictors of receptive growth.Journal of Autism and Developmental Disorders 04/2015; 45(5):1254-1270. DOI:10.1007/s10803-014-2286-4 · 3.34 Impact Factor
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- "In addition to a focus on the growing numbers of children with ASD, there are increased concerns about the bleak outcomes for adolescents and adults with ASD. As a group, individuals with ASD tend to achieve limited independence as they move into adulthood, struggling with finding employment, establishing friendships and social networks, and living independently (Beadle-Brown et al. 2006; Billstedt et al. 2005; Howlin et al. 2004). In addition, individuals with ASD seem to have poorer outcomes compared to individuals with other disabilities (Esbensen et al. 2010; Seltzer et al. 2004), reflecting a need for educational programs that are specifically designed to address the needs of individuals with ASD. "
ABSTRACT: Researchers have highlighted engagement as a critical component of effective interventions for students with autism spectrum disorder (ASD), yet there is limited research related to engagement in school-age children with ASD. This descriptive study was designed to examine joint engagement and its relationship with classroom factors and student characteristics. The sample included 25 elementary and middle school students with ASD. Mixed level modeling was used to examine relationships between joint engagement and classroom factors and student characteristics. Joint engagement was significantly related to group size, use of student-directed practices, autism severity, and expressive communication skills. These findings have important implications for educational policies and practices and future research related to engagement and effective interventions for students with ASD.Journal of Autism and Developmental Disorders 03/2015; 45:2392-2410. DOI:10.1007/s10803-015-2406-9 · 3.34 Impact Factor