Abstract
Clinical predictors of 2-year outcome in preschoolers with ASD were studied in a population-based group of very young children with ASD (n = 208). Children who gained the most (n = 30) and lost the most (n = 23), i.e., increased or decreased their adaptive functioning outcome according to the Vineland Composite Score between study entry (T1) and follow-up (T2), 2 years later were compared. Individual factors that differed significantly between the two outcome groups were cognitive level, age at referral, not passing expected milestones at 18 months, autistic type behavior problems and regression. However, logistic regression analysis showed that only cognitive level at T1 (dichotomized into IQ < 70 and IQ ≥ 70) made a unique statistically significant contribution to outcome prediction (p = <.001) with an odds ratio of 18.01. The findings have significant clinical implications in terms of information at diagnosis regarding clinical prognosis in ASD.
Similar content being viewed by others
References
Alin-Åkerman, B., & Nordberg, L. (1980, 1991). Griffiths developmental scales I and II. Stockholm: Psykologiförlaget AB.
American Psyciatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders. (DSM-IV) Text revision (4th ed.). Washington, DC: American Psychiatric Association.
Anderson, D. K., Liang, J. W., & Lord, C. (2014). Predicting young adult outcome among more and less cognitively able individuals with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 55(5), 485–494.
Anderson, D. K., Oti, R. S., Lord, C., & Welch, K. (2009). Patterns of growth in adaptive social abilities among children with autism spectrum disorders. Journal of Abnormal Child Psychology, 37(7), 1019–1034.
Baghdadli, A., Assouline, B., Sonié, S., Pernon, E., Darrou, C., Michelon, C., et al. (2012). Developmental trajectories of adaptive behaviors from early childhood to adolescence in a cohort of 152 children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(7), 1314–1325.
Barger, B. D., Campbell, J. M., & McDonough, J. D. (2013). Prevalence and onset of regression within autism spectrum disorders: A meta-analytic review. Journal of Autism and Developmental Disorders, 43(4), 817–828.
Barnevik Olsson, M., Carlsson, L. H., Westerlund, J., Gillberg, C., & Fernell, E. (2013). Autism before diagnosis: Crying, feeding and sleeping problems in the first two years of life. Acta Paediatrica, 102(6), 635–639.
Ben Itzchak, E., Lahat, E., Burgin, R., & Zachor, A. D. (2008). Cognitive, behaviour and intervention outcome in young children with autism. Research in Developmental Disabilities, 29(5), 447–458.
Berglund, E., & Eriksson, M. (2000). Communicative development in Swedish children 16–28 months old. The Swedish early communicative development inventory—words and sentences. Scandinavian Journal of Psychology, 41, 133–144.
Bernabei, P., Cerquiglini, A., Cortesi, F., & D’Ardia, C. (2007). Regression versus no regression in the autistic disorder: Developmental trajectories. Journal of Autism and Developmental Disorders, 37(3), 580–588.
Billstedt, E., Gillberg, I. C., & Gillberg, C. (2005). Autism after adolescence: Population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. Journal of Autism and Developmental Disorders, 35(3), 351–360.
Cohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: Replication of the UCLA model in a community setting. Journal of Developmental and Behavioral Pediatrics, 27(S2), 145–155.
Danielsson, S., Gillberg, I. C., Billstedt, E., Gillberg, C., & Olsson, I. (2005). Epilepsy in young adults with autism: A prospective population-based follow-up study of 120 individuals diagnosed in childhood. Epilepsia, 46(6), 918–923.
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 25(1), 17–23.
Eriksson, M. A., Westerlund, J., Hedvall, Å., Åmark, P., Gillberg, C., & Fernell, E. (2013). Medical conditions affect the outcome of early intervention in preschool children with autism spectrum disorders. European Child and Adolescent Psychiatry, 22(1), 23–33.
Fenson, L., Dale, P.S., Reznick, J.S., Bates, E., Thal, D.J., & Pethick, S.J. (1994). Variability in early communicative development. Monographs of the Society for Research in Child Development, 59(5), 1–173.
Fenson, L., Dale, P. S., Reznick, J. S., Thal, D., Bates, E., Hartung, J. P., et al. (1993). The MacArthur Communicative Development Inventories: User’s guide and technical manual. San Diego: Singular Publishing Group.
Fernell, E., Hedvall, A., Norrelgen, F., Eriksson, M., Höglund-Carlsson, L., Barnevik-Olsson, M., et al. (2010). Developmental profiles in preschool children with autism spectrum disorders referred for intervention. Research in Developmental Disabilities, 31(3), 790–799.
Fernell, E., Hedvall, Å., Westerlund, J., Höglund Carlsson, L., Eriksson, M., et al. (2011). Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study. Research in Developmental Disabilities, 32(6), 2092–2101.
Gillberg, C., & Coleman, M. (2000). The biology of autistic syndromes. London: Mac Keith.
Gillberg, C., & Steffenburg, S. (1987). Outcome and prognostic factors in infantile autism and similar conditions: A population-based study of 46 cases followed through puberty. Journal of Autism and Developmental Disorders, 17(2), 273–287.
Harrison, P. L., & Oakland, T. (2003). Adaptive behavior assessment system (2nd ed.). San Antonio: The Psychological Corporation.
Hedvall, A., Fernell, E., Holm, A., Asberg Johnels, J., Gillberg, C., & Billstedt, E. (2013). Autism, processing speed, and adaptive functioning in preschool children. The Scientific World Journal, 2013, 158263.
Hedvall, Å., Westerlund, J., Fernell, E., Holm, A., Gillberg, C., & Billstedt, E. (2014). Autism and developmental profiles in preschoolers: Stability and change over time. Acta Paediatrica, 103(2), 174–181.
Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45(2), 212–229.
Kjelgaard, M. M., & Tager-Flusberg, H. (2001). An investigation of language impairment in autism: Implications for genetic subgroups. Language and Cognitive Processes 1, 16(2–3), 287–308.
Kjellmer, L., Hedvall, Å., Fernell, E., Gillberg, C., & Norrelgen, F. (2012). Language and communication skills in preschool children with autism spectrum disorders: Contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability. Research in Developmental Disabilities, 33(1), 172–180.
Klintwall, L., Holm, A., Eriksson, M., Carlsson, L. H., Olsson, M. B., Hedvall, A., et al. (2011). Sensory abnormalities in autism. A brief report. Research in Developmental Disabilities, 32(2), 795–800.
Krug, D. A., Arick, J., & Almond, P. (1980). Behavior checklist for identifying severely handicapped individuals with high levels of autistic behavior. Journal of Child Psychology and Psychiatry, 21(3), 221–229.
Luyster, R., Kadlec, M. B., Carter, A., & Tager-Flusberg, H. (2008). Language assessment and development in toddlers with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38, 1426–1438.
Luyster, R., Lopez, K., & Lord, C. (2007). Characterizing communicative development in children referred for autism spectrum disorders using the MacArthur-Bates Communicative Development Inventory (CDI). Journal of Child Language, 34, 623–654.
Magiati, I., Charman, T., & Howlin, P. (2007). A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. Journal of Child Psychology Psychiatry, 48, 803–812.
McGovern, C. W., & Sigman, M. (2005). Continuity and change from early childhood to adolescence in autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 46, 401–408.
Munson, J., Faja, S., Meltzoff, A., Abbott, R., & Dawson, G. (2008). Neurocognitive predictors of social and communicative developmental trajectories in preschoolers with autism spectrum disorders. Journal of the International Neuropsychological Society, 14(6), 956–966.
Paul, R., Chawarska, K., Cicchetti, D., & Volkmar, F. (2008). Language outcomes of toddlers with autism spectrum disorders: A two year follow-up. Autism Research, 1(2), 97–107.
Pellicano, E. (2013). Testing the predictive power of cognitive atypicalities in autistic children: Evidence from a 3-year follow-up study. Autism Research, 6(4), 258–267.
Roid, G.H., & Sampers, J.L. (2005). Merrill-Palmer—Revised Scales of Development, Swedish version. Stockholm: Hogrefe Psykologiförlaget AB.
Schopler, E., & Reichler, R. J. (1995). Il Profilo psicoeducativo–revisato (PEP–R). Lucerna: SZH/SPC.
Sparrow, S., Cicchetti, D., & Balla, D. (2005). Vineland adaptive behavior scales (2nd ed.). Circle Pines: American Guidance Service.
Sutera, S., Pandey, J., Esser, E. L., Rosenthal, M. A., Wilson, L. B., Barton, M., et al. (2007). Predictors of optimal outcome in toddlers diagnosed with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 98–107.
Thrum, A., Lord, C., Lee, L., & Newschaffer, C. (2007). Predictors of language acquisition in preschool children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 1721–1734.
Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 33, 489–507.
Warren, Z., McPheeters, M. L., Sathe, N., Foss-Feig, J. H., Glasser, A., & Veenstra-Vanderweele, J. (2011). A systematic review of early intensive intervention for autism spectrum disorders. Pediatrics, 127(5), 1303–1311.
Wechsler, D. (2005). Wechsler Preschool and Primary Scale of Intelligence (Swedish Version). Stockholm: Psykologiförlaget AB.
Acknowledgments
Financial support was given from Wilhelm and Martina Lundgren Foundation, Sven Jerring Foundation and the Gillberg Neuropsychiatry Centre (ÅH), from LifeWatch, Niclas Öberg Foundation (EF), the Per and Ann-Mari Ahlqvist Foundation, and from Alexandra and Ragnar Söderberg (CG).
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hedvall, Å., Westerlund, J., Fernell, E. et al. Preschoolers with Autism Spectrum Disorder Followed for 2 Years: Those Who Gained and Those Who Lost the Most in Terms of Adaptive Functioning Outcome. J Autism Dev Disord 45, 3624–3633 (2015). https://doi.org/10.1007/s10803-015-2509-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10803-015-2509-3