Journal of Autism and Developmental Disorders

, Volume 47, Issue 12, pp 3967–3982 | Cite as

Autism Spectrum Disorders and Low Mental Age: Diagnostic Stability and Developmental Outcomes in Early Childhood

  • Alexander J. Hinnebusch
  • Lauren E. Miller
  • Deborah A. Fein
Original Paper


Some children with autism spectrum disorders (ASDs) exhibit low mental age (Low-MA; i.e., cognitive functioning below 12 months). We examined diagnosis, symptom severity, and development in children with ASD-low MA (n = 25), autistic disorder (n = 111), and PDD-NOS (n = 82) at ages two and four. We predicted that some ASD-low MA children would demonstrate just intellectual impairment and not autism symptoms on follow-up, with social deficits at age two attributable to global delays. Instead, most ASD-low MA children (96%) had an ASD at follow-up, compared to children initially diagnosed with autistic disorder (86.5%) or PDD-NOS (73.2%). They showed the least developmental progress and highest symptom severity. Results support diagnosing ASDs in children functioning below a 12-month level.


Autism spectrum disorders Low mental age Developmental growth Diagnostic stability Autism severity 



The authors wish to thank the families and clinicians who participated in the current study, as well as the Early Detection Study research team at the University of Connecticut for their assistance with data collection.


This study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant number R01HD039961) and the Maternal and Child Health Bureau (Grant number R40MC00270).

Author Contributions

AH participated in conception of the study design, data collection, performance of statistical analyses, and drafting of the manuscript; LM participated in performance of statistical analyses, interpretation of the data, and revising of the manuscript; DF participated in conception of the study design, data collection, interpretation of the data, and revising of the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

Deborah Fein is part owner of M-CHAT-R, LLC, which receives royalties from companies that incorporate the M-CHAT-R into commercial products and charge for its use. Data reported in the current paper is from the freely available paper versions of the M-CHAT and M-CHAT-R. Alexander Hinnebusch and Lauren Miller declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Alexander J. Hinnebusch
    • 1
  • Lauren E. Miller
    • 2
  • Deborah A. Fein
    • 2
  1. 1.Department of Physical Medicine and RehabilitationUniversity of Michigan Health SystemAnn ArborUSA
  2. 2.Department of Psychological SciencesUniversity of ConnecticutStorrsUSA

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