A prospective study of toddlers with ASD: short‐term diagnostic and cognitive outcomes

Abstract

Background Despite recent increases in the number of toddlers referred for a differential diagnosis of autism spectrum disorders (ASD), knowledge of short-term stability of the early diagnosis as well as cognitive outcomes in this cohort is still limited. Method Cognitive, social, and communication skills of 89 clinic-referred toddlers were assessed at the average age of 21.5 (SD = 4.9) months, and reassessed at 46.9 (SD = 7.7) months. Groups with stable and unstable diagnostic presentation were identified and compared on their profile of cognitive and social-communicative skills obtained at the time of initial diagnosis. Results Stability of the ASD diagnosis was 100%; diagnosis of autism was stable in 74% of cases as compared to 83% and 81% in PDD-NOS and Non-ASD groups, respectively. Worsening of social disability symptoms resulting in autism diagnosis was noted in 17% of toddlers initially diagnosed with PDD-NOS and in 19% of toddlers with initial diagnosis of non-ASD disorder. However, marked improvement was noted in approximately 1/4 of children initially presenting with autism, warranting diagnostic reassignment to PDD-NOS at follow-up. An analysis of developmental skills profiles suggests particular relevance of the assessment of verbal and nonverbal communication skills to diagnostic differentiation between subtypes within ASD in the second year of life. Conclusions Stability of ASD diagnosis in toddlers is high, though marked changes in severity of symptoms is to be expected in a minority of cases. Simultaneous consideration of cognitive, social, and communication skills profiles enhances accuracy of diagnostic classification and prediction of outcome.

Retention of Autism Spectrum Diagnoses by Community Professionals

“…10,11 However, the stability of subtype diagnoses within the autism spectrum is more variable. For instance, Chawarska et al 9 found that the stability of autism and PDD-NOS was 74% and 83%, respectively, compared with 100% for the entire category of ASDs; van Daalen et al 12 found that the stability of autism and PDD-NOS was 63% and 54%, respectively, compared with 91% for the entire category of ASDs. Direction of diagnostic changes within the ASD spectrum differs across studies, with some samples showing more movement from PDD-NOS to autism 10 and others showing more movement from autism to PDD-NOS.…”

“…[9][10][11][12] As the number of children identified as having ASDs is growing over time, it is important to explore factors associated with change in classification from ASD to non-ASD to inform early identification and intervention efforts. For all ASDs, the stability of an ASD diagnosis between 2 and 4 years of age has been reported to be as high as 91% to 100%, 9,12 and the stability of an ASD diagnosis between 2 and 9 years of age has been reported to be 88% to 90%. 10,11 However, the stability of subtype diagnoses within the autism spectrum is more variable.…”

Comparação do processo evolutivo de crianças do espectro autístico em diferentes intervenções terapêuticas fonoaudiológicas

“…Other conducted studies have also shown that family engagement ensures that therapeutic goals are enhanced in the household, providing a greater synchronicity and both communicative and social between children and their interlocutors (2)(3)(4)(5)(6)(7)(8)(15)(16)(17)(18)(19)(20) . We note that in the first six months of the study, the extent and speed of the evolutionary process became more evident, especially in the TG group, both in the total values of the ABC, and in the separate areas that comprise it.…”

“…Several authors have stressed the importance of assistance for families due to the severe disturbance in the relational dynamics that takes place because of the impairment in mental and emotional development of their children, which limits the creation and maintenance of reciprocity conditions between the child and his family (14)(15)(16)(17)(18)(19)(20) . Other conducted studies have also shown that family engagement ensures that therapeutic goals are enhanced in the household, providing a greater synchronicity and both communicative and social between children and their interlocutors (2)(3)(4)(5)(6)(7)(8)(15)(16)(17)(18)(19)(20) .…”

“…Children's exposure to different situations, whether overseen by an adult or not, allowed a careful look at their disabilities and communication skills (3,4,(20)(21)(22)(23)(24) . As for multidisciplinary diagnosis, children with Asperger syndrome showed a trend towards greater extent and speed in the evolutionary process both in the analysis of the ABC, and in the Sample of Vocal Behavior (16)(17)(18) .…”