Long-term Outcomes of Toddlers With Autism Spectrum Disorders Exposed to Short-term Intervention
(Impact Factor: 5.47).
11/2012; 130(Supplement):S186-S190. DOI: 10.1542/peds.2012-0900Q
To examine long-term outcomes of toddlers with autism spectrum disorder (ASD) who received a 6-month early intervention at age 2.
Forty-eight toddlers diagnosed with an ASD received a 6-month evidence-based intervention. Cognitive (IQ) and communication ability, as well as severity of autism symptoms, were assessed by using standardized measures at preintervention (Time 1 [T1]; mean [M] age = 27 months), postintervention (T2; M age = 35 months), short-term follow-up (T3; M age = 41 months), and long-term follow-up (T4; M age = 72 months).
From pre- to postintervention, significant gains in IQ and Vineland Communication domain standard scores as well as a reduction in ASD severity were achieved (all P < .01). Between T2 and T3, the 6-month period immediately after completion of the intervention, IQ and Communication scores stabilized and ASD severity increased significantly (P < .05). During the long-term follow-up period (T3-T4), IQ and Communication scores significantly increased again, but ASD severity increased significantly as well (all P < .05). For overall trajectory (T1-T4), robust gains were observed for both IQ and communication; ASD severity did not change.
Findings highlight the potential for positive long-term outcomes in toddlers with ASD. Additional research is needed to understand the relation between early exposure to uninterrupted intervention and developmental gains, and whether initial reduction in ASD symptom severity can be sustained through targeted intervention.
Available from: Sarah S. Mire
- "Early intervention is a key prognostic indicator of more positive outcomes in youth with ASD (Corsello 2005; Itzchak and Zachor 2011; Woods and Wetherby 2003). Although various early intervention programs currently exist and comparative efficacy research is mixed, reported positive outcomes include gains in cognitive functioning (Landa and Kalb 2012; Sallows and Graupner 2005), communication (Landa and Kalb 2012; Woods and Wetherby 2003), adaptive behavior (Eikeseth et al. 2012; Reichow 2012), and fewer social problems and problem behaviors (Eikeseth et al. 2007). "
[Show abstract] [Hide abstract]
ABSTRACT: Autism spectrum disorder (ASD) diagnoses are made based on a pattern of behavioral symptoms, yet a growing body of research indicates that when, and indeed whether, an individual receives a diagnosis of ASD is influenced by myriad demographic factors including race, ethnicity, socioeconomic status (SES), and parental education level. The current manuscript provides a focused review of a subset of existing literature chosen to demonstrate how demographic factors may be related to the identification of individuals with ASD within the United States. Several possible explanations for existing disparities are discussed, along with clinical implications for professionals working with children from diverse backgrounds who are suspected of having ASD. Additional research in this area is needed to facilitate development of effective means to eliminate the diagnostic disparities.
Available from: Mary Elizabeth Blue
[Show abstract] [Hide abstract]
ABSTRACT: The Food and Drug Administration (FDA) has approved two mechanism-based treatments for tuberous sclerosis complex (TSC)-everolimus and vigabatrin. However, these treatments have not been systematically studied in individuals with TSC and severe autism. The aim of this review is to identify the clinical features of severe autism in TSC, applicable preclinical models, and potential barriers that may warrant strategic planning in the design phase of clinical trial development. A comprehensive search strategy was formed and searched across PubMed, Embase and SCOPUS from their inception to 2/21/12, 3/16/12, and 3/12/12 respectively. After the final search date, relevant, updated articles were selected from PubMed abstracts generated electronically and emailed daily from PubMed. The references of selected articles were searched, and relevant articles were selected. A search of clinicaltrials.gov was completed using the search term "TSC" and "tuberous sclerosis complex". Autism has been reported in as many as 60% of individuals with TSC; however, review of the literature revealed few data to support clear classification of the severity of autism in TSC. Variability was identified in the diagnostic approach, assessment of cognition, and functional outcome among the reviewed studies and case reports. Objective outcome measures were not used in many early studies; however, diffusion tensor imaging of white matter, neurophysiologic variability in infantile spasms, and cortical tuber subcategories were examined in recent studies and may be useful for objective classification of TSC in future studies. Mechanism-based treatments for TSC are currently available. However, this literature review revealed two potential barriers to successful design and implementation of clinical trials in individuals with severe autism-an unclear definition of the population and lack of validated outcome measures. Recent studies of objective outcome measures in TSC and further study of applicable preclinical models present an opportunity to overcome these barriers.
Available from: Gal Meiri
[Show abstract] [Hide abstract]
ABSTRACT: Treatment Early signs Genetics Pharmacotherapy Neurobiology a b s t r a c t On April 2013 experts in the field of autism from Italy and Israel convened in Jerusalem to discuss and finalize clinical recommendations for early diagnosis and intervention in Autism Spectrum Disorders (ASDs). In this paper, we summarize the results of this Italian eIsraeli consensus conference. ASDs constitute a class of severe and heterogeneous neurodevelopmental conditions caused by atypical brain development beginning during early prenatal life, reflecting many genetic, neurobiological and environmental influences. The first clinical signs of ASDs begin to be evident in children between 12 and 18 months of age, often after a period of relatively typical postnatal development. Recent longitudinal studies reveal substantial diversity in developmental trajectories through childhood and adolescence. Some intervention approaches have been demonstrated to be effective in improving core symptoms of ASDs, even if the heterogeneity and developmental nature of the disorder make it implausible that only one specific treatment will be best for all chil-dren with ASDs. More randomized control trials (RCTs) on early intervention are needed to identify the most effective strategies and provide the most efficient allocation of resources during the critical early intervention time period. Future research should focus on linking biological phenotypes with specific genotypes, thus establishing a foundation for the development of diagnostic screening tools and individualization of treatments. ª 2013 Published by Elsevier Ltd on behalf of European Paediatric Neurology Society. (P. Curatolo). c Participants listed in the Appendix. Official Journal of the European Paediatric Neurology Society e u r o p e a n j o u r n a l o f p a e d i a t r i c n e u r o l o g y x x x (2 0 1 3) 1 e1 2
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.