期刊
AUTISM
卷 20, 期 7, 页码 888-892出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1362361315614979
关键词
autism spectrum disorder; diagnostic stability; middle childhood; sibling; toddler
资金
- Canadian Institutes of Health Research
- Autism Speaks
- Autism Speaks Canada
- NeuroDevNet
- Simons Foundation
- Stollery Children's Hospital Foundation Chair in Autism
- Joan and Jack Craig Chair in Autism Research
Considerable evidence on autism spectrum disorder emergence comes from longitudinal high-risk samples (i.e. younger siblings of children with autism spectrum disorder). Diagnostic stability to age 3 is very good when diagnosed as early as 18-24months, but sensitivity is weaker, and relatively little is known beyond toddlerhood. We examined stability and change in blinded, clinical best-estimate diagnosis from age 3 to middle childhood (mean age=9.5years) in 67 high-risk siblings enrolled in infancy. Good agreement emerged for clinical best-estimate diagnoses (89.6% overall; kappa=0.76, p<0.001, 95% confidence interval=0.59-0.93). At age 3, 18 cases (26.9%) were classified with autism spectrum disorder: 17 retained their autism spectrum disorder diagnosis (94.4%; 13 boys, 4 girls) and 1 no longer met autism spectrum disorder criteria at follow-up. Among non-autism spectrum disorder cases at age 3, 43/49 remained non-autism spectrum disorder at follow-up (87.8%; 22 boys, 21 girls) and 6/49 met lower autism symptomatology criteria (Later-Diagnosed; 3 boys, 3 girls). Later-diagnosed cases had significantly lower autism spectrum disorder symptomatology and higher receptive language at age 3 and trends toward lower autism symptoms and higher cognitive abilities at follow-up. Emerging developmental concerns were noted in all later-diagnosed cases, by age 3 or 5. High-risk children need to be followed up into middle childhood, particularly when showing differences in autism-related domains.
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