Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders

Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders
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DOI:
10.1111/jcpp.12178
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发表时间:
2014-05-01
影响因子:
7.6
通讯作者:
Lord, Catherine
Lord, Catherine
中科院分区:
医学1区
文献类型:
--
作者:
Anderson, Deborah K.;Liang, Jessie W.;Lord, Catherine

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背景:青壮年自闭症谱系障碍(ASD)的结果范围以及与这种多样性相关的儿童早期因素对临床医生和科学家具有重要意义。方法这项前瞻性研究为2岁时被诊断为ASD的儿童提供了一个独特的机会来预测17年后的结果。诊断和心理测量工具在2到19岁之间使用,数据来自2,3和19,包括在这项研究中。只要有可能,临床医生在不知道先前评估的情况下进行测试。照顾者通过问卷调查提供了更多信息。结果VIQ和NVIQ评分一起预测19岁时出现严重智力障碍的概率约为85%,但对于智力中等或更高的年轻人来说,预测青壮年结局更为复杂。到19岁时,9%的参与者基本上克服了与ASD相关的核心困难,不再保留诊断。这些结果非常积极的年轻人更有可能参与了治疗,与其他有认知能力的自闭症年轻人(VIQ&>=70)相比,他们在2至3岁之间重复行为的减少更多。非常积极的结果青少年在2岁时与有认知能力的自闭症患者的表型没有差异,但两组都不同于认知能力较差的个体(VIQ
Background The range of outcomes for young adults with Autism Spectrum Disorders (ASD) and the early childhood factors associated with this diversity have implications for clinicians and scientists. Methods This prospective study provided a unique opportunity to predict outcome 17years later for a relatively large sample of children diagnosed with ASD at 2 years old. Diagnostic and psychometric instruments were administered between 2 and 19 with data from 2, 3, and 19 included in this study. Clinicians administered tests without knowledge of previous assessments whenever possible. Caregivers provided additional information through questionnaires. Results Significant intellectual disabilities at 19 were predicted by age 2 about 85% of the time from VIQ and NVIQ scores together, though prediction of young adult outcome for youths with average or higher intelligence was more complex. By 19, 9% of participants had largely overcome core difficulties associated with ASD and no longer retained a diagnosis. These youths with Very Positive Outcomes were more likely to have participated in treatment and had a greater reduction in repetitive behaviors between age 2 and 3 compared to other Cognitively Able youths (VIQ >= 70) with ASD. Very Positive Outcome youths did not differ phenotypically from Cognitively Able ASD individuals at 2 but both groups differed from Cognitively Less Able individuals (VIQ