Journal of Autism and Developmental Disorders

, Volume 37, Issue 9, pp 1735–1747 | Cite as

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

  • Paul T. ShattuckEmail author
  • Marsha Mailick Seltzer
  • Jan S. Greenberg
  • Gael I. Orsmond
  • Daniel Bolt
  • Sheilah Kring
  • Julie Lounds
  • Catherine Lord
Original paper


This study examined change prospectively in autism symptoms and maladaptive behaviors during a 4.5 year period in 241 adolescents and adults with an autism spectrum disorder who were 10–52 years old (mean = 22.0) when the study began. Although many individuals’ symptoms remained stable, a greater proportion of the sample experienced declines than increases in their level of autism symptoms and maladaptive behaviors, and there were significant improvements in mean levels of symptoms. Individuals with mental retardation had more autism symptoms and maladaptive behaviors than those without mental retardation, and they improved less over time. Compared to adolescents, older sample members (31 and older) had fewer maladaptive behaviors and experienced more improvement in these behaviors over time.


Autism symptoms Maladaptive behaviors Lifespan development 



Support for the preparation of this paper was provided by the National Institute on Aging (R01 AG08768) and the National Institute of Child Health and Human Development (T32 HD07489 and P30 HD03352). We also thank the individuals with autism and their families who participated in this study.


  1. Agresti, A. (1996). An introduction to categorical data analysis. New York: John Wiley & Sons.Google Scholar
  2. Aman, M. G., Lam, K. S. L., & Collier-Crespin, A. (2003). Prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of Ohio. Journal of Autism and Developmental Disorders, 33(5), 527–534.PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision (4th-TR edn.). Washington, DC: American Psychiatric Association.Google Scholar
  4. Bruininks, R. H., Woodcock, R. W., Weatherman, R. F., & Hill, B. K. (1996). Scales of Independent Behavior—Revised: Riverside Publishing.Google Scholar
  5. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd edn.). New York: Academic Press.Google Scholar
  6. Cohen, P., Cohen, J., West, S. G., & Aiken, L. S. (2002). Applied multiple regression/correlation analysis for the behavioral sciences (3rd edn.). Lawrence: Erlbaum Associates.Google Scholar
  7. Dawson, B., & Trapp, R. G. (2004). Basic and clinical biostatistics. New York: Lange Medical Books, McGraw-Hill.Google Scholar
  8. Fecteau, S., Mottron, L., Berthiaume, C., & Burack, J. A. (2003). Developmental changes of autistic symptoms. Autism, 7(3), 255–268.PubMedCrossRefGoogle Scholar
  9. Filipek, P. A., Accardo, P. J., Baranek, G. T., Cook Jr., E. H., Dawson, G., Gordon, B., et al. (1999). The screening and diagnosis of autistic spectrum disorders. Journal of Autism and Developmental Disorders, 29(6), 439–484.Google Scholar
  10. Finkel, S. (1995). Causal analysis with panel data (Vol. 105). Thousand Oaks, CA: Sage.Google Scholar
  11. Glutting, J., Adams, W., & Sheslow, D. (2000). Wide range intelligence test. Wilmington, DE: Wide Range, Inc.Google Scholar
  12. Hill, A., Bolte, S., Petrova, G., Beltcheva, D., Tacheva, S., & Poustka, F. (2001). Stability and interpersonal agreement of the interview-based diagnosis of autism. Psychopathology, 34(4), 187–191.PubMedCrossRefGoogle Scholar
  13. Hollander, E., Phillips, A. T., & Yeh, C. C. (2003). Targeted treatments for symptom domains in child and adolescent autism. Lancet, 362, 732–734.PubMedCrossRefGoogle Scholar
  14. 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.PubMedCrossRefGoogle Scholar
  15. Howlin, P., Mawhood, L., & Rutter, M. (2000). Autism and developmental receptive language disorder—a follow-up comparison in early adult life II: Social, behavioural, and psychiatric outcomes. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 41(5), 561–578.PubMedGoogle Scholar
  16. Kline, R. B. (2004). Beyond significance testing: Reforming data analysis methods in behavioral research. Washington, DC: American Psychological Association.Google Scholar
  17. Lecavalier, L. (2005). Behavioral and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders (in press).Google Scholar
  18. Lecavalier, L., Aman, M., McDougle, C. J., McCracken, J., Vitiello, B., Tierney, E., et al. (2006). Validity of the autism diagnostic interview—revised. American Journal on Mental Retardation, 111(3), 199–215.PubMedCrossRefGoogle Scholar
  19. Lord, C., & Bailey, A. (2002). Autism spectrum disorders. In M. Rutter, & E. Taylor (Eds.), Child and adolescent psychiatry (pp. 664–681). Oxford: Blackwell Scientific.Google Scholar
  20. Lord, C., Pickles, A., McLennan, M., Rutter, M., Bregman, J., Folstein, S., et al. (1997). Diagnosing autism: Analyses of data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27(5), 501–517.PubMedCrossRefGoogle Scholar
  21. Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.PubMedCrossRefGoogle Scholar
  22. Mawhood, L., Howlin, P., & Rutter, M. (2000). Autism and developmental receptive language disorder—a comparative follow-up in early adult life. I: Cognitive and language outcomes. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 41(5), 547–559.PubMedGoogle Scholar
  23. McClintock, K., Hall, S., & Oliver, C. (2003). Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of Intellectual Disability Research, 47, 405–416.PubMedCrossRefGoogle Scholar
  24. McGovern, C. W., & Sigman, M. (2005). Continuity and change from early childhood to adolescence in autism. Journal of Child Psychology and Psychiatry, 46(4), 401–408.PubMedCrossRefGoogle Scholar
  25. Mesibov, G. B., Schopler, E., Schaffer, B., & Michal, N. (1989). Use of the Childhood Autism Rating scale with autistic adolescents and adults. Journal of the Academy of Child and Adolescent Psychiatry, 28(4), 538–541.CrossRefGoogle Scholar
  26. Nordin, V., & Gillberg, C. (1998). The long-term course of autistic disorders: Update on follow-up studies. Acta Psychiatrica Scandinavica, 97, 99–108.PubMedGoogle Scholar
  27. Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2003). Interpretation of changes in health-related quality of life: The remarkable universality of half a standard deviation. Medical Care, 41(5), 582–592.PubMedCrossRefGoogle Scholar
  28. Piven, J., Harper, J., Palmer, P., & Arndt, S. (1996). Course of behavioral change in autism: A retrospective study of high-IQ adolescents and adults. Journal of the Academy of Child and Adolescent Psychiatry, 35(4), 523–529.CrossRefGoogle Scholar
  29. Seltzer, M. M., Krauss, M. W., Shattuck, P. T., Orsmond, G., Swe, A., & Lord, C. (2003). The symptoms of autism spectrum disorders in adolescence and adulthood. Journal of Autism and Developmental Disorders, 33(6), 565–581.PubMedCrossRefGoogle Scholar
  30. Seltzer, M. M., Shattuck, P., Abbeduto, L., & Greenberg, J. S. (2004). Trajectory of development in adolescents and adults with autism. Mental Retardation and Developmental Disabilities Research Reviews, 10, 234–247.PubMedCrossRefGoogle Scholar
  31. Shea, S., Turgay, A., Carroll, A., Schulz, M., Orlik, H., Smith, I., et al. (2004). Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics, 114(5), 634–641.CrossRefGoogle Scholar
  32. Shea, V., & Mesibov, G. (2005). Adolescents and adults with autism. In F. R. Volkmar, R. Paul, A. Klin, & D. J. Cohen (Eds.), Handbook of autism and pervasive developmental disorders. Hoboken, NJ: John Wiley & Sons.Google Scholar
  33. Sparrow, S. S., Carter, A. S., & Cicchetti, D. V. (1993). Vineland screener: Overview, reliability, validity, administration, and scoring. New Haven, CT: Yale University Child Study Center.Google Scholar
  34. Szatmari, P. (2000). The classification of autism, Asperger’s syndrome, and pervasive developmental disorder. Canadian Journal of Psychiatry, 45, 731–738.Google Scholar
  35. Taris, T. W. (2000). A primer in longitudinal data analysis. London: Sage.Google Scholar
  36. Tonge, B. J., & Einfeld, S. (2003). Psychopathology and intellectual disability: The Australian child to adult longitudinal study. International Review of Research in Mental Retardation, 26, 61–91.CrossRefGoogle Scholar
  37. Volkmar, F. R., & Klin, A. (2005). Issues in the classification of autism, related conditions. In F. R. Vokmar, R. Paul, A. Klin, & D. J. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (pp. 5–41). Hoboken, NJ: John Wiley and Sons.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Paul T. Shattuck
    • 1
    Email author
  • Marsha Mailick Seltzer
    • 1
  • Jan S. Greenberg
    • 1
  • Gael I. Orsmond
    • 2
  • Daniel Bolt
    • 3
  • Sheilah Kring
    • 3
  • Julie Lounds
    • 3
  • Catherine Lord
    • 4
  1. 1.University of WisconsinMadisonUSA
  2. 2.Boston UniversityBostonUSA
  3. 3.University of WisconsinMadisonUSA
  4. 4.University of MichiganAnn ArborUSA

Personalised recommendations