Skip to main content

Advertisement

SpringerLink
Log in

Continuity and Change in Cognition and Autism Severity from Toddlerhood to School Age

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

This paper charted the cognitive and behavioural profiles from toddlerhood to middle childhood in 48 children diagnosed with ASD at 24-months. The Mullen Scales of Early Learning (MSEL) was administered at 24- and 48-months and the Wechsler Abbreviated Scale of Intelligence (WASI) at school age. Autism severity was derived using The Autism Diagnostic Observation Schedule (ADOS) Results: Developmental Disability/Intellectual Disability (DD/ID; Developmental Quotient <70) reduced from 64% at 24-months to 8% at outcome. Seventy-three percent of children continued to meet ADOS cut-off at school age. Conclusion: Diagnoses at 24-months, appear to be reliable and stable. Further research is needed to investigate whether early identification, which provides more opportunity to access early intervention, may in turn facilitate cognitive development over time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  • 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 and Allied Disciplines, 55(5), 485–494. doi:10.1111/jcpp.12178.

    Article  Google Scholar 

  • Barbaro, J., & Dissanayake, C. (2009). Autism spectrum disorders in infancy and toddlerhood: A review of the evidence on early signs, early identification tools, and early diagnosis disorders: Review of the retrospective. Journal of Developmental and Behavioral Pediatrics: JDBP, 30(5), 447–459.

    Article  PubMed  Google Scholar 

  • Barbaro, J., & Dissanayake, C. (2010). Prospective identification of autism spectrum disorders in infancy and toddlerhood using developmental surveillance: the social attention and communication study. Journal of Developmental and Behavioral Pediatrics: JDBP, 31(5), 376–385. doi:10.1097/DBP.0b013e3181df7f3c.

    Article  PubMed  Google Scholar 

  • Barbaro, J., & Dissanayake, C. (2012). Developmental profiles of infants and toddlers with autism spectrum disorders identified prospectively in a community-based setting. Journal of Autism and Developmental Disorders, 42(9), 1939–1948. doi:10.1007/s10803-012-1441-z.

    Article  PubMed  Google Scholar 

  • Barbaro, J., & Dissanayake, C. (2016). Diagnostic stability of autism spectrum disorder in toddlers prospectively identified in a community-based setting: Predictors of change over time. Autism: The International Journal of Research and Practice. DOI:10.1177/1362361316654084.

    Google Scholar 

  • Barbaro, J., Ridgway, L., & Dissanayake, C. (2011). Developmental surveillance of infants and toddlers by maternal and child health nurses in an Australian community-based setting: Promoting the early identification of autism spectrum disorders. Journal of Pediatric Nursing, 26(4), 334–347. doi:10.1016/j.pedn.2010.04.007.

    Article  PubMed  Google Scholar 

  • Charman, T., Jones, C. R. G., Pickles, A., Simonoff, E., Baird, G., & Happé, F. (2010). Defining the cognitive phenotype of autism. Brain Research, 1380(1943), 10–21. doi:10.1016/j.brainres.2010.10.075.

    PubMed  Google Scholar 

  • Charman, T., Taylor, E., Drew, A., Cockerill, H., Brown, J.-A., & Baird, G. (2005). Outcome at 7 years of children diagnosed with autism at age 2: Predictive validity of assessments conducted at 2 and 3 years of age and pattern of symptom change over time. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46(5), 500–513. doi:10.1111/j.1469-7610.2004.00377.x.

    Article  PubMed  Google Scholar 

  • Chawarska, K., Klin, A., Paul, R., & Volkmar, F. (2007). Autism spectrum disorder in the second year: Stability and change in syndrome expression. Journal of Child Psychology and Psychiatry, 2(48), 128–138. doi:10.1111/j.1469-7610.2006.01685.x.

    Article  Google Scholar 

  • Danials, A. M., Rosenberg, R. E., Law, J. K., Lord, C., Kaufmann, W. E., & Law, P. A. (2011). Stability of initial autism spectrum diagnoses in community settings. Journal of Autism and Developmental Disorders, 41, 110–121. doi:10.1007/s10803-010-1031-x.

    Article  Google Scholar 

  • Dykens, E. M., & Lense, M. (2011). Intellectual disabilities and autism spectrum disorder: A cautionary note. In G. Amaral, L. Dawson, & D. Geschwind. (Eds.), Autism spectrum disorders (pp. 261–269). New York: Oxford University Press.

    Google Scholar 

  • Eaves, L. C., & Ho, H. H. (2004). The very early identification of autism: outcome to age 4 1/2–5. Journal of Autism and Developmental Disorders, 34(4), 367–378. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15449513.

  • Flanagan, H. E., Smith, I. M., Vaillancourt, T., Duku, E., Szatmari, P., Bryson, S., Fombonne, E., Mirenda, P., Roberts, W., Volden, J., Waddell, C., Zwaigenbaum, L., Bennett, T., Elsabbagh, M., & Georgiades, S. (2015). Stability and change in the cognitive and adaptive behaviour scores of preschoolers with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(9):2691–2703.

    Article  PubMed  Google Scholar 

  • Fountain, C., Winter, A. S., & Bearman, P. S. (2012). Six developmental trajectories characterize children with autism. Pediatrics, 129(5), e1112–e1120. doi:10.1542/peds.2011-1601.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36, 693–705. doi:10.007/s10803-008-0674-3.

    Article  Google Scholar 

  • 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. doi:10.1111/apa.12455.

    Article  PubMed  Google Scholar 

  • Guthrie, W., Swineford, L. B., Nottke, C., & Wetherby, A. M. (2013). Early diagnosis of autism spectrum disorder: Stability and change in clinical diagnosis and symptom presentation. Journal of Child Psychology and Psychiatry, 54(5), 582–590. doi:10.1111/jcpp.12008.

    Article  PubMed  PubMed Central  Google Scholar 

  • Howlin, P., & Moss, P. (2012). Adults with autism spectrum disorders. Canadian Journal of Psychiatry, 57(5), 275–283.

    PubMed  Google Scholar 

  • Joseph, R. M., Tager-Flusberg, H., & Lord, C. (2002). Cognitive profiles and social-communicative functioning in children with autism spectrum disorder. J Child Psychol Psychiatry, 43(6), 807–821. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12236615.

  • Kleinman, J. M., Ventola, P. E., Pandey, J., Verbalis, A. D., Barton, M., Hodgson, S., & Fein, D. (2008). Diagnostic stability in very young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(4), 606–615. doi:10.1007/s10803-007-0427-8.

    Article  PubMed  Google Scholar 

  • Lincoln, A., Courchesne, E., Allen, M., Hanson, E., & Ene, M. (1998). Neurobiology of Asperger syndrome: Seven case studies and quantitative magnetic resonance imaging findings. In E. Schopler, G. Mesibov, & L. J. Kunce (Eds.), Asperger syndrome or high-functioning autism? (pp. 145–166). New York: Plenum.

  • Lord, C., & Schopler, E. (1989). The role of age at assessment, developmental level, and test in the stability of intelligence scores in young autistic children. Journal of Autism and Developmental Disorders, 19(4), 483–499. doi:10.1007/BF02212853.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-tevised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorder. Journal of Autism and Developmental Disorders, 24. doi:10.1007/BF/02172145.

  • Lord, C.,  Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C.,  Pickles, A., Rutter, M. (2000). The Autism Diagnostic Observation Schedule-Generic: A standard measure of social and communication deficitis associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thrum, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694–701.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M. D., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism diagnostic observation schedule, 2nd edition (ADOS-2). Torrence: Western Psychological Services.

    Google Scholar 

  • 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(4), 401–408. doi:10.1111/j.1469-7610.2004.00361.x.

    Article  PubMed  Google Scholar 

  • Moore, V., & Goodson, S. (2003). How well does early diagnosis of autism stand the test of time? Autism: The International Journal of Research and Practice, 7(1), 47–63.

    Google Scholar 

  • Mullen, E. M. (1995). Mullen scales of early learning. Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Nordin, V., & Gillberg, C. (1998). The long-term course of autistic disorders: Update on follow-up studies. Acta Psychiatrica Scandinavica, 97, 99–108. doi:10.1111/j.1600-0447.1998.tb09970.x.

    Article  PubMed  Google Scholar 

  • Ozonoff, S., Young, G. S., Landa, R. J., Brian, J., Bryson, S., Charman, T., & Iosif, A. M. (2015). Diagnostic stability in young children at risk for autism spectrum disorder: A baby siblings research consortium study. Journal of Child Psychology and Psychiatry and Allied Disciplines, 56(9), 988–998. doi:10.1111/jcpp.12421.

    Article  Google Scholar 

  • Rapin, I. (2003). Value and limitations of preschool cognitive tests, with an emphasis on longitudinal study of children on the autistic spectrum. Brain and Development, 25(8), 546–548. doi:10.1016/S0387-7604(03)00127-X.

    Article  PubMed  Google Scholar 

  • Siegel, D., Minshew, N., & Goldstein, G. (1996). Wechsler IQ Profiles in Diagnosis of high-functioning autism. Journal of Autism and Developmental Disorders, 26(4), 389–406

    Article  PubMed  Google Scholar 

  • Sigman, M., Ruskin, E., Arbelle, S., Corona, R., Dissanayake, C., Espinosa, M., Zierhut, C. (1999). Continuity and change in the social competence of children with autism, Down syndrome, and developmental delays. Monographs of the Society for Research in Child Development, i–139.

  • Smith, T., & Iadarola, S. (2015). Evidence base update for autism spectrum disorder. Journal of Clinical Child & Adolescent Psychology, 44(6), 897–922. doi:10.1080/15374416.2015.1077448.

    Article  Google Scholar 

  • Starr, E. M., Popovic, S., & Mccall, B. P. (2016). Supporting children with autism spectrum disorder at primary school: Are the promises of early intervention maintained? Current Developmental Disorders Reports, 46–56. doi:10.1007/s40474-016-0069-7.

  • Stevens, M. C., Fein, D. A., Dunn, M., Allen, D., Waterhouse, L. H., Feinstein, C., & Rapin, E. (2000). Subgroups of children with autism by cluster analysis: a longitudinal examination. Journal of the American Academy of Child & Adolescent Psychiatry, 39(3), 346–352. doi:10.1097/00004583-2000030000-00017.

    Article  Google Scholar 

  • Sutera, S., Pandey, J., Esser, E. L., Rosenthal, M. A., Wilson, L. B., Barton, M., & Fein, D. (2007). Predictors of optimal outcome in toddlers diagnosed with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(1), 98–107. doi:10.1007/s10803-006-0340-6.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Georgiades, S., Duku, E., Bennett, T. A., Bryson, S., Fombonne, E., Elsabbagh, M. (2015). Developmental trajectories of symptom severity and adaptive functioning in an inception cohort of preschool children with autism spectrum disorder. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2014.2463.

    PubMed  Google Scholar 

  • Turner, L. M., & Stone, W. L. (2007). Variability in outcome for children with an ASD diagnosis at age 2. Journal of Child Psychology and Psychiatry and Allied Disciplines, 48(8), 793–802. doi:10.1111/j.1469-7610.2007.01744.x.

    Article  Google Scholar 

  • Turner, L. M., Stone, W. L., Pozdol, S. L., & Coonrod, E. E. (2006). Follow-up of children with autism spectrum disorders from age 2 to age 9. Autism: The International Journal of Research and Practice, 10(3), 243–265. doi:10.1177/1362361306063296.

    Article  Google Scholar 

  • Wechsler, D. (1999). The Wechsler abbreviated scale of intelligence. London: Pearson Assessment.

    Google Scholar 

Download references

Acknowledgements

This research was not funded. Special acknowledgements to the families involved in the study and to the second and third authors for their guidance, support and contribution to this research project.

Author contributions

All authors made a substantial contribution to conception and design, drafting and revising of the article prior for publication. Authors have been listed in order of their contribution.

Author information

Authors and Affiliations

  1. Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Kingsbury Drive, Bundoora, Melbourne, VIC, 3086, Australia

    Megan L. E. Clark, Josephine Barbaro & Cheryl Dissanayake

Authors
  1. Megan L. E. Clark
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Josephine Barbaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cheryl Dissanayake
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cheryl Dissanayake.

Ethics declarations

Conflict of interest

Megan L. E. Clark, Josephine Barbaro and Cheryl Dissanayake declare a potential conflict of interest with Dr Giacamo Vivanti who was formally affiliated with the Olga Tennison Autism Research Centre.

Ethics 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. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all participant’s parents.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clark, M.L.E., Barbaro, J. & Dissanayake, C. Continuity and Change in Cognition and Autism Severity from Toddlerhood to School Age. J Autism Dev Disord 47, 328–339 (2017). https://doi.org/10.1007/s10803-016-2954-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-016-2954-7

Keywords

Search

Navigation