Adult outcome for children with autism
Adult outcome for children with autism
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DOI：
10.1111/j.1469-7610.2004.00215.x
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发表时间：
2004-02-01
影响因子：
7.6
通讯作者：
Rutter, M
中科院分区：
文献类型：
--
作者：
Howlin, P;Goode, S;Rutter, M
背景：关于孤独症长期预后的信息有限。众所周知，智商低于50的人的结果很差，但对智商高于50的人的系统研究很少。方法：对68名儿童期表现智商在50以上的孤独症患者进行成人随访。首次就诊时的平均年龄为7岁（范围3-15岁）;随访时的平均年龄为29岁（范围21-48岁）。结果测量包括标准化的认知、语言和成绩测试。关于社交、沟通和行为问题的信息来自自闭症诊断访谈。结果如下：虽然少数成年人已经达到相对较高的独立水平，但大多数人仍然非常依赖其家庭或其他支助服务。很少有人独自生活，有亲密的朋友或永久的工作。沟通能力普遍受损，阅读和拼写能力很差。定型的行为或兴趣往往持续到成年。10人患上了癫痫。总体而言，只有12%被评为“非常好”的结果; 10%被评为“好”，19%被评为“一般”。大多数被评为“差”（46%）或“非常差”（12%）的结果。儿童时期表现智商至少为70的人比智商低于70的人有更好的结果。然而，在正常的智商范围内，结果是非常可变的，在个人层面上，无论是语言智商还是操作智商都被证明是一致的预后指标。结论：尽管近年来自闭症成年人的预后有所改善，但许多人仍然高度依赖他人的支持。这项研究提供了一些关于预后指标的信息，但需要对与良好或不良结局相关的儿童变量进行更细致的研究。
Background: Information on long-term prognosis in autism is limited. Outcome is known to be poor for those with an IQ below 50, but there have been few systematic studies of individuals with an IQ above this. Method: Sixty-eight individuals meeting criteria for autism and with a performance IQ of 50 or above in childhood were followed up as adults. Their mean age when first seen was 7 years (range 3-15 years); at follow-up the average age was 29 years (range 21-48 years). Outcome measures included standardised cognitive, language and attainment tests. Information on social, communication and behavioural problems was obtained from the Autism Diagnostic Inter-view (ADI). Results: Although a minority of adults had achieved relatively high levels of independence, most remained very dependent on their families or other support services. Few lived alone, had close friends, or permanent employment. Communication generally was impaired, and reading and spelling abilities were poor. Stereotyped behaviours or interests frequently persisted into adulthood. Ten individuals had developed epilepsy. Overall, only 12% were rated as having a 'Very Good' outcome; 10% were rated as 'Good' and 19% as 'Fair'. The majority was rated as having a 'Poor' (46%) or 'Very Poor' (12%) outcome. Individuals with a childhood performance IQ of at least 70 had a significantly better outcome than those with an IQ below this. However, within the normal IQ range outcome was very variable and, on an individual level, neither verbal nor performance IQ proved to be consistent prognostic indicators. Conclusions: Although outcome for adults with autism has improved over recent years, many remain highly dependent on others for support. This study provides some information on prognostic indicators, but more fine-grained research is needed into the childhood variables that are associated with good or poor outcome.