The adult outcome of children referred for autism: typology and prediction from childhood
The adult outcome of children referred for autism: typology and prediction from childhood
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DOI：
10.1111/jcpp.13180
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发表时间：
2020-01-19
影响因子：
7.6
通讯作者：
Lord, Catherine
中科院分区：
文献类型：
--
作者：
Pickles, Andrew;McCauley, James B.;Lord, Catherine
背景自闭症谱系障碍是高度异质性的，在复杂的成人生活中并不是如此。能够总结这种复杂性，并对我们预测童年结果的信心有一些概念，将有助于临床实践和规划。方法对123名早期诊断研究(Lord等人，《普通精神病学文献》，2006，63,694)的数据进行潜在类分布分析，以类型学的形式总结2岁左右自闭症儿童的多方面成人早期结局。描述类的形式和儿童时期的预测性。结果在定义了15项指标后，成人结果被减少到4个潜在类别，其中认知和功能指标的差异很大，而情感指标的差异很小。从2岁到9岁的儿童智商和症状严重程度测量可以很好地、逐步更准确地预测班级。从成人量表中去掉言语和非言语智商和自闭症症状严重程度的测量并没有改变潜在班级的数量；但是，班级组成发生了一些变化，而且更难预测。结论虽然对成人结局进行经验性总结是可能的，但需要仔细考虑应该优先考虑的方面。从儿童时期采取的相应措施可以很好地预测出一种重视认知结果的结果类型，即使在考虑到从复杂模型到小样本的预测偏差之后也是如此。然而，成人结果的主观幸福感和情感方面与功能结果的相关性很弱，而且从童年开始就很难预测。
Background Autism Spectrum Disorder is highly heterogeneous, no more so than in the complex world of adult life. Being able to summarize that complexity and have some notion of the confidence with which we could predict outcome from childhood would be helpful for clinical practice and planning. Methods Latent class profile analysis is applied to data from 123 participants from the Early Diagnosis Study (Lord et al., Archives of General Psychiatry, 2006, 63, 694) to summarize in a typology the multifacetted early adult outcome of children referred for autism around age 2. The form of the classes and their predictability from childhood is described. Results Defined over 15 measures, the adult outcomes were reduced to four latent classes, accounting for much of the variation in cognitive and functional measures but little in the affective measures. The classes could be well and progressively more accurately predicted from childhood IQ and symptom severity measurement taken at age 2 years to age 9 years. Removing verbal and nonverbal IQ and autism symptom severity measurement from the profile of adult measures did not change the number of the latent classes; however, there was some change in the class composition and they were more difficult to predict. Conclusions While an empirical summary of adult outcome is possible, careful consideration needs to be given to the aspects that should be given priority. An outcome typology that gives weight to cognitive outcomes is well predicted from corresponding measures taken in childhood, even after account for prediction bias from fitting a complex model to a small sample. However, subjective well-being and affective aspects of adult outcome were weakly related to functional outcomes and poorly predicted from childhood.