Variability in outcome for children with an ASD diagnosis at age 2
Variability in outcome for children with an ASD diagnosis at age 2
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DOI：
10.1111/j.1469-7610.2007.01744.x
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发表时间：
2007-08-01
影响因子：
7.6
通讯作者：
Stone, Wendy L.
中科院分区：
文献类型：
--
作者：
Turner, Lauren M.;Stone, Wendy L.
背景：很少有研究对2岁时被诊断为自闭症谱系障碍（ASD）的儿童的结局进行研究。需要研究来了解症状-或诊断-随时间变化的儿童。本研究的目的是检查一个仔细定义的2岁ASD儿童样本的行为和诊断结果，并确定儿童和环境因素，有助于在4岁的结果的变化。研究方法：48名2岁时被诊断为自闭症或非特异性广泛性发育障碍（PDDNOS）的儿童被随访至4岁。诊断措施包括自闭症诊断观察计划-通用（ADOS-G）和2岁和4岁的临床诊断，以及4岁的ADI-R。结果：ASD诊断（自闭症或PDDNOS）的诊断稳定性为63%，自闭症诊断为68%。在随访时未能达到ASD诊断标准的儿童更有可能：1）在初始评估时为30个月或更小; 2）自闭症症状较轻，特别是在社交领域; 3）2岁时认知得分较高。稳定和不稳定诊断的儿童之间没有差异的干预服务量。在诊断不稳定的儿童中，除一人外，所有人都继续患有发育障碍，最常见的是语言领域。结论：在本研究中，ASD的稳定性低于以前报道的，这一发现主要归因于30个月或更小时被诊断的儿童。临床实践的影响进行了讨论。
Background: Few studies have examined the variability in outcomes of children diagnosed with autism spectrum disorder (ASD) at age 2. Research is needed to understand the children whose symptoms - or diagnoses - change over time. The objectives of this study were to examine the behavioral and diagnostic outcomes of a carefully defined sample of 2-year-old children with ASD, and to identify child and environmental factors that contribute to variability in outcomes at age 4. Methods: Forty-eight children diagnosed with autism or pervasive developmental disorder not otherwise specified (PDDNOS) at age 2 were followed to age 4. Diagnostic measures included the Autism Diagnostic Observation Schedule - Generic (ADOS-G) and clinical diagnosis at ages 2 and 4, and the ADI-R at age 4. Results: Diagnostic stability for an ASD diagnosis (autism or PDDNOS) was 63%, and for an autism diagnosis was 68%. Children who failed to meet diagnostic criteria for ASD at follow-up were more likely to: 1) be 30 months or younger at initial evaluation; 2) have milder symptoms of autism, particularly in the social domain; and 3) have higher cognitive scores at age 2. No differences between children with stable and unstable diagnoses were found for amount of intervention services received. Among the children with unstable diagnoses, all but one continued to have developmental disorders, most commonly in the area of language. Conclusions: The stability of ASD was lower in the present study than has been reported previously, a finding largely attributable to children who were diagnosed at 30 months or younger. Implications for clinical practice are discussed.