comment on: When an Early Diagnosis of Autism Spectrum Disorder Resolves, What Remains?

1 May

Having just discussed a study on what happens after autism “recovery” it may be worth taking a look at another study that just came out this week. This study isn’t yet published but was presented at a conference:

When an Early Diagnosis of Autism Spectrum Disorder Resolves, What Remains?

The abstract is below, but in this study group there were significant gains in a subgroup and a loss of ASD diagnosis. The subgroup had much less intellectual disability on follow up.

And they also had a number of other disabilities and support needs. Most still had some diagnosis, if not ASD. Most were still getting some level of extra support in school.

BACKGROUND: It has been documented that some children with early diagnosis of Autism Spectrum Disorder (ASD) do not meet criteria for the diagnosis at a later age. It is unclear, however, if deficits remain after ASD symptomatology resolves.
OBJECTIVE: To characterize residual learning, cognitive, emotional/behavioral diagnoses and educational needs of a group of children with early ASD diagnosis that resolved.
DESIGN/METHODS: Review of 38 children diagnosed with ASD at a University-affiliated inner-city early intervention program 2003-2013 who had follow up evaluation indicating resolution of the original ASD diagnosis. The group represents 7% of the 569 children diagnosed with ASD by the program during this period. Original and follow up diagnoses were made by an experienced multidisciplinary team based on DSM-IV criteria, Childhood Autism Rating Scale(CARS) and/or the Autism Diagnostic Observation Schedule(ADOS). All children had re-evaluation an average of 4 years later. Initial cognitive level was based on the Bayley, and follow up on WPPSI, WISC, or Stanford Binet. Data collected included: demographics, cognitive level, CARS, diagnoses and services originally and at follow up.
RESULTS: Mean age at initial diagnosis 2.6±0.9y and at follow up 6.4±2.8y. 80% male; 44% Hispanic, 36% Caucasian, 10% African American; 46% had Medicaid. Mean initial CARS 32±3 and at follow up 25±4. The initial ADOS (21/38) categorized 29% as autism and 67% ASD and was negative at follow up when available (23/38). On initial cognitive testing (29/38): 33% with intellectual disability, 23% borderline, 44% average. At follow up (33/38): 6% borderline, the rest average. At follow up, 68% had language/learning disability, 49% externalizing problems (Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Disruptive Behavior Disorder), 24% internalizing problems (mood, anxiety, OCD, selective mutism), 5% significant mental health diagnosis (psychosis.nos), and 8% warranted no diagnoses. 26% were in mainstream academic settings without support and 13% with support, 29% in integrated settings, and 21% in self-contained classes.
CONCLUSIONS: When an early ASD diagnosis resolves, at least in the early years, there are often learning and emotional/behavioral diagnoses that remain. Understanding the full range of possible outcomes is important for parents, clinicians, and the educational system.


By Matt Carey

Advertisements

5 Responses to “comment on: When an Early Diagnosis of Autism Spectrum Disorder Resolves, What Remains?”

  1. usethebrainsgodgiveyou May 3, 2015 at 13:15 #

    It isn’t surprising that 2 year old children 33% are considered ID, 23% considered borderline while 4 years later only 6% are considered borderline. The tests are verbally intensive. My son’s verbal went from what I am guessing was about 50 at age 4 (that of a two year old), to 126 at age 18. No ABA at all. It’s not necessary for verbal development. What is surprising is 100% of the kids in the study were not ID, at least not borderline. I don’t know what to think of that. It doesn’t make a bit of sense unless this _is_ the “new autism”, without ID. And it began in 2003.

    When the neurologist studied my son’s behavior at age 3, along with an EKG and MRI…he said he was not autistic. That his “Semantic Pragmatic Disorder” would manifest in a learning disability, as 68% of the kids did in this study. But 100% without ID…hmm…am I reading that wrong?

    I think a LOT of LD kids are being labelled autistic. At one time, the definition of LD included a normal or above average IQ, at least 30 years ago, until IDEA changed the definition.

    • usethebrainsgodgiveyou May 14, 2015 at 15:17 #

      I did read it wrong. That was the 7% who were OO.

  2. ~ Liz ~ November 17, 2015 at 18:54 #

    It’s unfortunate the way this presentation was written.

    “38 children diagnosed with ASD at a University-affiliated inner-city early intervention program 2003-2013 who had follow up evaluation indicating resolution of the original ASD diagnosis.”

    What of the others in the original group of 569 who may still have an ASD diagnosis, but were also exited from special ed by their first review.

    Very misleading. I can see already the usual suspects claiming EI fails 93% of the time; however, nothing could be further from the truth.

    Was this paper ever published?

Trackbacks/Pingbacks

  1. Identifying & Caring for Children with Autism – Earlychildhood NEWS … | Early Childhood Parenting - May 2, 2015

    […] comment on: When an Early Diagnosis of Autism Spectrum … https://leftbrainrightbrain.co.uk/Original and follow up diagnoses were made by an experienced multidisciplinary team based on DSM-IV criteria, Childhood Autism Rating Scale(CARS) and/or the Autism Diagnostic Observation Schedule(ADOS). […]

  2. Asperger syndrome | Early Childhood Parenting - May 4, 2015

    […] comment on: When an Early Diagnosis of Autism Spectrum Disorder Resolves …Left Brain Right Brain, on Fri, 01 May 2015 11:56:28 -0700The group represents 7% of the 569 children diagnosed with ASD by the program during this period. Original and follow up diagnoses were made by an experienced multidisciplinary team based on DSM-IV criteria, Childhood Autism Rating Scale(CARS) … […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: