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.
"De nombreux parents d'adultes présentant un TSA estiment qu'ils seraient incapables de vivre de façon autonome et sans soutien, peu importe la sévérité du trouble autistique qui les caractérise (Barnard et al., 2001). Ainsi, après avoir démontré que la majorité des adultes autistes ayant obtenu un niveau de fonctionnement de faible à moyen ne jouissent pas de bonnes conditions, selon la définition habituelle, les auteurs Billstedt et al. (2005), tout comme leurs prédécesseurs Ruble et Dalrymple (1993), proposent de revoir la définition de « bonnes conditions » et la façon dont ces conditions sont mesurées dans les études afin de tenir compte de la satisfaction des personnes présentant un TSA. "
"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). "
"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). "
[Show abstract][Hide abstract] 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
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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