Change in Autism Symptoms and Maladaptive Behaviors in Adolescents and Adults with an Autism Spectrum Disorder

Shattuck, Paul; Seltzer, Marsha Mailick; Greenberg, Jan S.; Orsmond, Gael I.; Bolt, Daniel M.; Kring, Sheilah R.; Lounds, Julie J.; Lord, Catherine

doi:10.1007/s10803-006-0307-7

Cited by 466 publications

(423 citation statements)

References 32 publications

(54 reference statements)

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“…A related study, however, did directly predict change in maladaptive behaviors over time. Shattuck et al (42) found that baseline measures predicted 36% of variance in the change in maladaptive behaviors and that age, intellectual disability, language ability, and sex accounted for an additional 7% of the total variance (42). Together, our results indicate that functional brain imaging data provide a marked increase in predictive power over using behavioral data alone.…”

Section: Discussionsupporting

confidence: 50%

“…Second, we have only two time points in our design. Behavioral studies with multiple data-collection time points (7,13,42) found that some participants show nonmonotonic functions of improvement or decline over time and cyclical change in impairment. Having more time points in a future study would allow us to also investigate the stability of change in symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Resting-state functional connectivity predicts longitudinal change in autistic traits and adaptive functioning in autism

Plitt

Barnes

Wallace

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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Although typically identified in early childhood, the social communication symptoms and adaptive behavior deficits that are characteristic of autism spectrum disorder (ASD) persist throughout the lifespan. Despite this persistence, even individuals without cooccurring intellectual disability show substantial heterogeneity in outcomes. Previous studies have found various behavioral assessments [such as intelligence quotient (IQ), early language ability, and baseline autistic traits and adaptive behavior scores] to be predictive of outcome, but most of the variance in functioning remains unexplained by such factors. In this study, we investigated to what extent functional brain connectivity measures obtained from resting-state functional connectivity MRI (rs-fcMRI) could predict the variance left unexplained by age and behavior (follow-up latency and baseline autistic traits and adaptive behavior scores) in two measures of outcome-adaptive behaviors and autistic traits at least 1 y postscan (mean follow-up latency = 2 y, 10 mo). We found that connectivity involving the so-called salience network (SN), default-mode network (DMN), and frontoparietal task control network (FPTCN) was highly predictive of future autistic traits and the change in autistic traits and adaptive behavior over the same time period. Furthermore, functional connectivity involving the SN, which is predominantly composed of the anterior insula and the dorsal anterior cingulate, predicted reliable improvement in adaptive behaviors with 100% sensitivity and 70.59% precision. From rs-fcMRI data, our study successfully predicted heterogeneity in outcomes for individuals with ASD that was unaccounted for by simple behavioral metrics and provides unique evidence for networks underlying long-term symptom abatement.rs-fMRI | autism | machine learning | ASD | adaptive behavior A lthough typically identified in childhood, the social communication symptoms that are characteristic of autism spectrum disorder (ASD) persist throughout the lifespan (1, 2). On average, individuals with ASD show smaller age-related improvements in adaptive behaviors, including daily living skills critical for independent living, than do typically developing (TD) peers (2-4). The burden of prolonged clinical symptom expression, coupled with limited adaptive behaviors, leads to a relatively poor prognosis for a majority of adults with ASD. For example, only 12% of adults with ASD achieve "very good" outcomes, defined by a high level of independence (5). Adolescence and young adulthood are poorly understood in ASD. Although there seems to be a great deal of change during this time, the nature of this change varies across studies, with a handful of studies reporting a decline in functioning (2, 3, 6), others reporting general improvement (7, 8), and still others reporting a quadratic course of autistic symptoms and adaptive functioning where the trajectory peaks in late adolescence (9) or the late 20s (10) and begins to fall subsequently.Predictors of positive outcomes in ASD includ...

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Resting-state functional connectivity predicts longitudinal change in autistic traits and adaptive functioning in autism

Plitt

Barnes

Wallace

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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“…It is unknown if these changes were developmental effects, reflecting regression to the mean as has been seen in ADHD research (Milich et al 1980), or are the result of some combination of these influences. These optimistic findings are consistent with much of the follow-up literature (Seltzer et al 2004;Shattuck et al 2007), although the signal in this study may be somewhat stronger than in previous studies.…”

Section: Time-related (Maturational) Changessupporting

confidence: 91%

Tolerability, Safety, and Benefits of Risperidone in Children and Adolescents with Autism: 21-Month Follow-up After 8-Week Placebo-Controlled Trial

Aman

Rettiganti

Nagaraja

et al. 2015

Journal of Child and Adolescent Psychopharmacology

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Objective: Risperidone has demonstrated efficacy for acute (8 week) and intermediate length (6 month) management of severe irritability and aggression in children and adolescents with autism. Less is known about the long-term effects of risperidone exposure in this population. We examined the tolerability, safety, and therapeutic benefit of risperidone exposure over a 1-2 year follow-up period. Methods: In a naturalistic study, 84 children and adolescents 5-17 years of age (from an original sample of 101) were assessed an average of 21.4 months after initial entry into a placebo-controlled 8 week trial of risperidone for children and adolescents with autism and severe irritability. They were assessed at baseline and at follow-up on safety and tolerability measures (blood, urinalysis, electrocardiogram [ECG], medical history, vital signs, neurological symptoms, other adverse events), developmental measures (adaptive behavior, intelligence quotient [IQ]), and standardized rating instruments. Treatment over the follow-up period, after completion of protocol participation, was uncontrolled. Statistical analyses assessed outcome over time with or without prolonged risperidone therapy. Results: Two-thirds of the 84 subjects continued to receive risperidone (mean 2.47 mg/day, S.D. 1.29 mg). At follow-up, risperidone was associated with more enuresis, more excessive appetite, and more weight gain, but not more adverse neurological effects. No clinically significant events were noted on blood counts, chemistries, urinalysis, ECG, or interim medical history. Regardless of drug condition at follow-up, there was considerable improvement in maladaptive behavior compared with baseline, including core symptoms associated with autism. Height and weight gains were elevated with risperidone. Social skills on Vineland Adaptive Behavior Scale (VABS) improved with risperidone. Parent-rated Aberrant Behavior Checklist (ABC) Irritability subscale scores were reduced in those taking risperidone at follow-up. Several other measures of maladaptive behavior (some related to socialization) also showed improved functioning in association with risperidone on the ABC or on the Modified Real Life Rating Scale. Conclusions: Increased appetite, weight gain, and enuresis are risks associated with long-term risperidone. Our data suggest that these risks were balanced by longer-term behavioral and social benefits for many children over 1.8 years of ongoing treatment.

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“…The new definition of ASD in the DSM-5 is does not limit the initial manifestations to the first 3 years of life and this provides the liberty to take into account the fact that presentation may vary with the severity of the disorder and cultural attitudes towards aspects of communication and adaptation to change (47).…”

Section: Autism Spectrum Disordermentioning

confidence: 99%

Schizophrenia as a diagnosis of exclusion

Atbaşoğlu¹,

Kokurcan²

2014

Dusunen Adam

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Change in Autism Symptoms and Maladaptive Behaviors in Adolescents and Adults with an Autism Spectrum Disorder

Cited by 466 publications

References 32 publications

Resting-state functional connectivity predicts longitudinal change in autistic traits and adaptive functioning in autism

Resting-state functional connectivity predicts longitudinal change in autistic traits and adaptive functioning in autism

Tolerability, Safety, and Benefits of Risperidone in Children and Adolescents with Autism: 21-Month Follow-up After 8-Week Placebo-Controlled Trial

Schizophrenia as a diagnosis of exclusion

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