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Stability of Autism Spectrum Disorder in Young Children with Diverse Backgrounds

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Abstract

Determining diagnostic stability of ASD, as well stability of functioning in early childhood, is relevant to prevalence, best practices for communicating early ASD diagnoses to caregivers, families’ experiences, and developmental trajectories. Generalizability of findings from prior research has been limited by small and homogenous samples, short follow-up time intervals, and inconsistent diagnostic procedures. This report presents follow-up evaluations of 60 children (86.7% male, mean age: 51.3 months) with diverse backgrounds (79.7% racial/ethnic minorities) who received initial ASD diagnoses before 36 months of age (mean age: 27 months). Fifty-three children (88.3%) met diagnostic criteria for ASD at follow-up, a proportion consistent with previous studies. On average, children demonstrated significant cognitive gains and ASD symptom improvement. Clinical implications of findings are discussed.

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References

  • Akshoomoff, N. (2006). Use of the Mullen Scales of Early Learning for the assessment of young children with autism spectrum disorders. Child Neuropsychology, 12(4–5), 269–277. https://doi.org/10.1080/09297040500473714.

    Article  PubMed  PubMed Central  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revision). Washington, D.C.: Author.

  • 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. https://doi.org/10.1111/jcpp.12178.

    Article  PubMed  Google Scholar 

  • Ben Itzchak, E., & Zachor, D. A. (2009). Change in autism classification with early intervention: Predictors and outcomes. Research in Autism Spectrum Disorders, 3(4), 967–976. https://doi.org/10.1016/j.rasd.2009.05.001.

    Article  Google Scholar 

  • Bieleninik, Ł., Posserud, M. B., Geretsegger, M., Thompson, G., Elefant, C., & Gold, C. (2017). Tracing the temporal stability of autism spectrum diagnosis and severity as measured by the Autism Diagnostic Observation Schedule: A systematic review and meta-analysis. PLoS ONE, 12(9), e0183160. https://doi.org/10.1371/journal.pone.0183160.

    Article  PubMed  PubMed Central  Google Scholar 

  • Charman, T., & Baird, G. (2002). Practitioner review: Diagnosis of autism spectrum disorder in 2- and 3-year-old children. Journal of Child Psychology and Psychiatry, 43(3), 289–305. https://doi.org/10.1111/1469-7610.00022.

    Article  PubMed  Google Scholar 

  • Chawarska, K., Klin, A., Paul, R., Macari, S., & Volkmar, F. (2009). A prospective study of toddlers with ASD: Short-term diagnostic and cognitive outcomes. Journal of Child Psychology and Psychiatry, 50(10), 1235–1245. https://doi.org/10.1111/j.1469-7610.2009.02101.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, 48(2), 128–138. https://doi.org/10.1111/j.1469-7610.2006.01685.x.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. https://doi.org/10.1037/0033-2909.112.1.155.

    Article  PubMed  Google Scholar 

  • 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(Suppl2), S145–S155. https://doi.org/10.1097/00004703-200604002-00013.

    Article  PubMed  Google Scholar 

  • Corsello, C. M., Akshoomoff, N., & Stahmer, A. C. (2013). Diagnosis of autism spectrum disorders in 2-year-olds: A study of community practice. Journal of Child Psychology and Psychiatry, 54(2), 178–185. https://doi.org/10.1111/j.1469-7610.2012.02607.x.

    Article  PubMed  Google Scholar 

  • Cox, A., Klein, K., Charman, T., Baird, G., Baron-Cohen, S., Swettenham, J.,… Wheelwright, S. (1999). Autism spectrum disorders at 20 and 42 months of age: Stability of clinical and ADI-R diagnosis. Journal of Child Psychology and Psychiatry, 40(5), 719–732. https://doi.org/10.1111/1469-7610.00488.

  • Daniels, A. M., Rosenberg, R. E., Law, J. K., Lord, C., Kaufmann, W. E., & Law, P. A. (2011). Stability of initial autism spectrum disorder diagnoses in community settings. Journal of Autism and Developmental Disorders, 41(1), 110–121. https://doi.org/10.1007/s10803-010-1031-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Darrou, C., Pry, R., Pernon, E., Michelon, C., Aussilloux, C., & Baghdadli, A. (2010). Outcome of young children with autism: Does the amount of intervention influence developmental trajectories? Autism, 14(6), 663–677.

    Article  PubMed  Google Scholar 

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J.,… Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125(1), e17–e23. https://doi.org/10.1542/peds.2009-0958.

  • 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. https://doi.org/10.1023/B:JADD.0000037414.33270.a8.

    Article  PubMed  Google Scholar 

  • Elliott, C. (2007). Differential Ability Scales (2nd ed.). San Antonio, TX: Harcourt Assessment.

    Google Scholar 

  • Esler, A. N., Bal, V. H., Guthrie, W., Wetherby, A., Weismer, S. E., & Lord, C. (2015). The Autism Diagnostic Observation Schedule, toddler module: Standardized severity scores. Journal of Autism and Developmental Disorders, 45(9), 2704–2720. https://doi.org/10.1007/s10803-015-2432-7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fein, D., Barton, M., Eigsti, I., Kelley, E., Naigles, L., Schultz, R. T.,… Tyson, K. (2013). Optimal outcome in individuals with a history of autism. Journal of Child Psychology and Psychiatry, 54(2), 195–205. https://doi.org/10.1111/jcpp.12037.

  • Flanagan, H. E., Smith, I. M., Vaillancourt, T., Duku, E., Szatmari, P., Bryson, S.,… Waddell, C. (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. https://doi.org/10.1007/s10803-015-2433-6.

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

    Article  PubMed  PubMed Central  Google Scholar 

  • Georgiades, S., Bishop, S. L., & Frazier, T. (2017). Editorial perspective: Longitudinal research in autism—introducing the concept of ‘chronogeneity’. Journal of Child Psychology and Psychiatry, 58(5), 634–636. https://doi.org/10.1111/jcpp.12690.

    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. https://doi.org/10.1111/jcpp.12008.

    Article  PubMed  Google Scholar 

  • Helt, M., Kelley, E., Kinsbourne, M., Pandey, J., Boorstein, H., Herbert, M., et al. (2008). Can children with autism recover? If so, how? Neuropsychology Review, 18(4), 339–366. https://doi.org/10.1007/s11065-008-9075-9.

    Article  PubMed  Google Scholar 

  • 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. https://doi.org/10.1007/s10803-007-0427-8.

  • Lord, C., & Bishop, S. L. (2010). Autism spectrum disorders: Diagnosis, prevalence, and services for children and families. Social Policy Report, 24(2), 1–23.

    Article  Google Scholar 

  • Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63(6), 694–701. https://doi.org/10.1001/archpsyc.63.6.694.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule: ADOS-2. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55(1), 3–9. https://doi.org/10.1037/0022-006X.55.1.3.

    Article  PubMed  Google Scholar 

  • Mahli, P., & Singhi, P. (2011). Follow-up of children with autism spectrum disorders: Stability and change in diagnosis. Indian Journal of Pediatrics, 78(8), 941–945. https://doi.org/10.1007/s12098-011-0370-8.

    Article  Google Scholar 

  • Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among Medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41(12), 1447–1453. https://doi.org/10.1097/00004583-200212000-00016.

    Article  PubMed  Google Scholar 

  • Mullen, E. M. (1995). Mullen Scales of Early Learning (AGS ed.). Circle Pines, MN: American Guidance Service, Incorporated.

    Google Scholar 

  • Oono, I. P., Honey, E. J., & McConachie, H. (2013). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews, 4, Art. No. CD009774. https://doi.org/10.1002/14651858.cd009974.pub2.

  • Orinstein, A. J., Helt, M., Troyb, E., Tyson, K. E., Barton, M. L., Eigsti, I.,… Fein, D. A. (2014). Intervention for optimal outcome in children and adolescents with a history of autism. Journal of Developmental and Behavioral Pediatrics, 35(4), 247–256. https://doi.org/10.1097/dbp.0000000000000037.

  • 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. Advance online publication. https://doi.org/10.1111/jcpp.12421.

  • Pickles, A., Le Couteur, A., Leadbitter, K., Salomone, E., Cole-Fletcher, R., Tobin, H.,… Green, J. (2016). Parent-mediated social communication therapy for young children with autism (PACT): Long-term follow-up of a randomised controlled trial. The Lancet, 388(10059), 2501–2509. https://doi.org/10.1016/s0140-6736(16)31229-6.

  • Sheldrick, R. C., Frenette, E., Vera, J. D., Mackie, T. I., Martinez-Pedraza, F., Hoch, N., … Carter, A. S. (2019). What drives detection and diagnosis of autism spectrum disorder? Looking under the hood of a multi-stage screening process in early intervention. Journal of Autism and Developmental Disorders, 49(6):2304–2319. https://doi.org/10.1007/s10803-019-03913-5.

  • Siller, M., & Morgan, L. (2018). Systematic review of research evaluating parent-mediated interventions for young children with autism: Years 2013 to 2015. In M. Siller & L. Morgran (Eds.), Handbook of parent-mediated interventions for very young children with autism (pp. 1–21). Cham: Springer.

    Chapter  Google Scholar 

  • Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A. (2016). Vineland Adaptive Behavior Scales, Third Edition (Vineland-3). San Antonio, TX: Pearson.

    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. https://doi.org/10.1007/s10803-006-0340-6.

  • 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, 48(8), 793–802. https://doi.org/10.1111/j.1469-7610.2007.01744.x.

    Article  PubMed  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, 10(3), 243–265. https://doi.org/10.1177/1362361306063296.

    Article  PubMed  Google Scholar 

  • van Daalen, E., Kemner, C., Dietz, C., Swinkels, S. N., Buitelaar, J. K., & van Engeland, H. (2009). Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age. European Child and Adolescent Psychiatry, 18(11), 663–674. https://doi.org/10.1007/s00787-009-0025-8.

    Article  PubMed  Google Scholar 

  • Wachtel, K., & Carter, A. S. (2008). Reaction to diagnosis and parenting styles among mothers of young children with ASDs. Autism, 12(5), 575–594. https://doi.org/10.1177/1362361308094505.

    Article  PubMed  Google Scholar 

  • Wiggins, L. D., Baio, J., Schieve, L., Lee, L., Nicholas, J., & Rice, C. E. (2012). Retention of autism spectrum diagnoses by community professionals: Findings from the Autism and Developmental Disabilities Monitoring Network, 2000 and 2006. Journal of Developmental and Behavioral Pediatrics, 33(5), 387–395. https://doi.org/10.1097/DBP.0b013e3182560b2f.

    Article  PubMed  PubMed Central  Google Scholar 

  • Woolfenden, S., Sarkozy, V., Ridley, G., & Williams, K. (2012). A systematic review of the diagnostic stability of autism spectrum disorder. Research in Autism Spectrum Disorders, 6(1), 345–354. https://doi.org/10.1016/j.rasd.2011.06.008.

    Article  Google Scholar 

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Acknowledgements

This paper is based on the doctoral dissertation of Dr. Ivy Giserman-Kiss, for which Dr. Carter was the committee chairperson. Funding for this project was provided by HRSA (R40MC26195), NIMH (R01MH104400), Autism Speaks, the UMB Office of Graduate Studies, and the UMB Graduate Student Assembly. The authors would like to acknowledge the children and families who participated in this project, the Early Intervention agency staff, as well as the graduate students and staff of the UMB Child Development Lab who were integral in data collection. The authors would also like to specifically thank Melanie Feldman for her support with all aspects of this project.

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IGK and ASC conceived of and designed the project together. IGK collected the data, performed data analysis, and wrote the paper, with significant input, feedback, and support from ASC.

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Correspondence to Ivy Giserman-Kiss.

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All study procedures were approved by the institutional review board and informed consent from participants’ legal guardians was documented in writing.

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Giserman-Kiss, I., Carter, A.S. Stability of Autism Spectrum Disorder in Young Children with Diverse Backgrounds. J Autism Dev Disord 50, 3263–3275 (2020). https://doi.org/10.1007/s10803-019-04138-2

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