SYMPTOMS OF AUTISM IN CHILDREN UNDER 36 MONTHS

本研究的主要目的是确定诊断 自闭症的特征存在于36个月以下的儿童中。 虽然许多作者都提到了症状的发展变化， 表达，自闭症的早期表现的实证研究， 少了。 对早期症状的研究具有重要的临床意义， 理论上的影响。 在临床层面， 年轻的年龄可以积累早期参与专业化的好处， 干预方案。 此外，识别早期模式， 症状表达有助于我们理解原发性 自闭症的缺陷。 本研究将采用前瞻性、纵向研究设计。 50名36个月以下的儿童， “自闭症谱系”内的特征将通过 4岁时，他们将接受明确的临床检查， 诊断. 临床和诊断评估将在年龄 2年、3年和4年，并将包括以下措施： 发展/认知功能，接受和表达语言 技能、适应行为和自闭症的严重程度。 诊断评估 将由两名经验丰富的临床医生独立进行。 海内 课堂观察将在2岁和3岁时进行， 评估环境因素对早期 这种疾病的发展过程。 本研究的设计和方法将使我们能够确定： 1)36岁以下自闭症诊断的可靠性 （2）早期症状，是预测的明确的 4岁时诊断为自闭症; 3）相关因素 在两年的时间里， 这个项目 与以前的研究相比， 更大的样本，使用前瞻性而不是回顾性方法， 评价观察者间临床诊断的一致性，以及 考虑环境对生物学变化的影响。

The primary objective of this study is to identify the diagnostic features of autism that are present in children under 36 months of age. Although many authors have alluded to developmental changes in symptom expression, empirical study of the early manifestations of autism has been scant. The study of early symptoms has important clinical and theoretical implications. At a clinical level, children identified at young ages can accrue the benefits of early participation in specialized intervention programs. Moreover, identification of early patterns of symptom expression can contribute to our understanding of the primary deficits of autism. This study will employ a prospective, longitudinal research design. Fifty children under 36 months of age who demonstrate behavioral characteristics within the "autism spectrum" will be followed through the age of 4 years, at which time they will receive a definitive clinical diagnosis. Clinical and diagnostic assessments will occur at the ages of 2, 3, and 4 years, and will include measures of developmental/cognitive functioning, receptive and expressive language skills, adaptive behavior, and severity of autism. Diagnostic assessment will be performed independently by two experienced clinicians. Home and classroom observations will be conducted at the ages of 2 and 3 years to evaluate the influence of environmental factors on the early developmental course of this disorder. The design and methodology of this study will enable us to determine: 1) the reliability of the diagnosis of autism made below the age of 36 months; 2) the early symptoms that are predictive of a definitive diagnosis of autism at 4 years; and 3) the factors that are associated with changes in symptomatology over the two-year period. This project represents an improvement over previous studies in its inclusion of a larger sample, use of prospective rather tan retrospective methodology, evaluation of interobserver agreement for clinical diagnosis, and consideration of environmental influences on changes in symptomatology.