Autism in adults: symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood
Autism in adults: symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood
复制标题
DOI：
10.1111/j.1469-7610.2007.01774.x
复制
发表时间：
2007-11-01
影响因子：
7.6
通讯作者：
Gillberg, Christopher
中科院分区：
文献类型：
--
作者：
Billstedt, Eva;Gillberg, I. Carina;Gillberg, Christopher
背景：很少有研究关注儿童时期被诊断为自闭症的个体的长期预后情况。
方法：对儿童时期被诊断为自闭症（典型和非典型）的成年人（n = 105）进行了一项纵向、前瞻性、基于社区的随访研究。使用结构化访谈（社会与沟通障碍诊断访谈，即DISCO）来评估在初次诊断后13 - 22年的症状及症状模式。研究了儿童时期的相关指标，包括儿童诊断时的智商水平以及5岁前记录的语言交流能力，并将其与随访时自闭症症状的存在情况相关联。
结果：在社会交往类别症状方面，典型和非典型自闭症组的受损情况相当一致，而其他常见的儿童自闭症症状，包括适应不良和刻板行为，在随访研究组中差异较大。对感觉刺激的异常反应仍然极为常见。5岁前的语言能力、智商、性别、确诊的疾病以及5岁前癫痫发作情况等变量，与自闭症谱系障碍的DISCO算法（温格和古尔德，1979）中关于社会交往方式和质量、沟通方式以及自主选择活动模式的结果相关。
结论：绝大多数自闭症/非典型自闭症成年人仍然存在社会交往问题，但行为障碍在成年期的差异更大。据报告，几乎所有病例都表现出持续的感知问题。某些儿童时期的指标被发现可前瞻性地预测成年人的社会交往方式、沟通类型以及自主选择活动模式，这些在成年期仍然符合自闭症/非典型自闭症的诊断标准。
Background: Few studies have looked at the very long-term outcome of individuals with autism who were diagnosed in childhood. Methods: A longitudinal, prospective, community-based follow-up study of adults who had received the diagnosis of autism (classic and atypical) in childhood (n = 105) was conducted. A structured inter-view (the Diagnostic Interview for Social and COmmunication disorders the DISCO) was used in order to evaluate symptoms and symptom patterns 13-22 years after original diagnosis. Childhood measures, including IQ-level at time of childhood diagnosis and communicative speech registered before age 5 years, were studied in relation to the presence of autism symptoms at follow-up. Results: The classical and atypical autism groups were fairly homogeneously impaired in terms of symptoms in the social interaction category whereas other common childhood autism symptoms, including maladaptive and stereotyped behaviours, were more variable in the study group at follow-up. Odd responses to sensory stimuli were still extremely common. Speech before 5 years of age, IQ, gender, diagnosed medical disorder and onset of epilepsy before 5 years were variables that correlated to outcome on the DISCO algorithm for autistic spectrum disorders (Wing & Gould, 1979) concerning style and quality of social interaction, communication style and pattern of self-chosen activities. Conclusions: Social interaction problems were still present in the vast majority of adults with autism/atypical autism, but behavioural impairments were much more variable in adulthood. Almost all cases were reported to show persistent perceptual problems. Certain childhood measures were found to prospectively predict adult social interaction style, communication type, and pattern of self-chosen activities, which still met diagnostic criteria for autism/atypical autism in adulthood.