Optimal outcome in individuals with a history of autism
Optimal outcome in individuals with a history of autism
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DOI：
10.1111/jcpp.12037
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发表时间：
2013-02-01
影响因子：
7.6
通讯作者：
Tyson, Katherine
中科院分区：
文献类型：
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作者：
Fein, Deborah;Barton, Marianne;Tyson, Katherine
背景：尽管自闭症谱系障碍（ASD）通常被视为终身残疾，但文献表明，少数自闭症患者会失去该诊断。然而，这种现象的存在及其频率和解释仍存在争议：他们最初是否被误诊，这是否是罕见事件，他们是否失去了完整的诊断，但仍存在严重的社交和沟通障碍，还是他们失去了自闭症的所有症状并且在社交方面能在正常范围内发挥功能？
方法：本研究通过将一组最佳结果个体（OO组，n = 34）在标准化测量中的功能与年龄、性别和非言语智商匹配的高功能自闭症个体（HFA组，n = 44）或正常发育个体（TD组，n = 34）进行比较，对其进行记录。在本研究中，最佳结果要求除了失去诊断外，还需失去自闭症的所有症状，并且在社交互动和沟通的非自闭症范围内发挥功能。所探究的领域包括语言、面部识别、社交、沟通和自闭症症状。
结果：最佳结果组和正常发育组在社交、沟通、面部识别或大多数语言子量表上的平均得分没有差异，尽管有3名最佳结果个体在面部识别上得分低于平均水平。在发育早期，最佳结果组在社交领域比高功能自闭症组表现出更轻微的症状，但在沟通和重复行为方面有同样严重的困难。
结论：尽管不排除在社交互动或认知的更细微方面可能存在缺陷，但研究结果证实了自闭症谱系障碍出现最佳结果的可能性，并表明该组在正常范围内具有整体功能水平。
Background: Although autism spectrum disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a rare event, did they lose the full diagnosis, but still suffer significant social and communication impairments or did they lose all symptoms of ASD and function socially within the normal range? Methods: The present study documents a group of these optimal outcome individuals (OO group, n = 34) by comparing their functioning on standardized measures to age, sex, and nonverbal IQ matched individuals with high-functioning autism (HFA group, n = 44) or typical development (TD group, n = 34). For this study, optimal outcome requires losing all symptoms of ASD in addition to the diagnosis, and functioning within the nonautistic range of social interaction and communication. Domains explored include language, face recognition, socialization, communication, and autism symptoms. Results: Optimal outcome and TD groups mean scores did not differ on socialization, communication, face recognition, or most language subscales, although three OO individuals showed below-average scores on face recognition. Early in their development, the OO group displayed milder symptoms than the HFA group in the social domain, but had equally severe difficulties with communication and repetitive behaviors. Conclusions: Although possible deficits in more subtle aspects of social interaction or cognition are not ruled out, the results substantiate the possibility of OO from autism spectrum disorders and demonstrate an overall level of functioning within normal limits for this group.