Abstract
The purpose of this study was to profile the mental development of children aged 18 to 96 months with autism spectrum disorder (ASD) using the Chinese version of the Griffiths Mental Development Scales (GMDS), and to explore the relationships between developmental levels and ASD severity, the sex of the child and the age of ASD diagnosis. Children with ASD (n = 398; 337 boys, 61 girls) were recruited and ASD severity evaluated using the Autism Behavior Checklist and the Childhood Autism Rating Scale, while the GMDS was used to evaluate the children’s mental development. Study participants were divided into groups according to GMDS general and subscale quotients, ASD severity, sex, and age. The majority of groups divided according to the GMDS quotients exhibited an unbalanced distribution in respect of the six domains of the GMDS and there were significant differences within the six subscale quotients. Autism severity, sex and age had significant effects on the overall level of development of autistic children. The quotients recorded for the children with more severe ASD were significantly lower than those for the children with less severe ASD. A markedly higher proportion of developmental delay was recorded for girls than boys in relation to the performance subscale. The locomotor quotient decreased in line with age at diagnosis, while autism severity and age had significant effects on the general and subscale quotients and sex had a significant effect on performance quotient. Children with ASD exhibit an uneven cognitive development profile, and their overall developmental levels are affected by autism severity, sex and age. Specific cognitive domains differ according to sex in children with ASD. Locomotor skills tend to decrease according to the age at diagnosis for autistic children aged 18 to 84 months. Autism severity and age are also associated with the level of functioning in different cognitive areas. These findings contribute to define the cognitive developmental profiles of children with ASD.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental condition, and individuals with the condition typically exhibit a range of atypical social interactions, communication difficulties, the presence of repetitive and stereotyped behavior, and restricted interests
The purpose of the present study is to profile the developmental levels of 398 children (18 to 96 months old) with ASD across the different areas of the Griffiths Mental Development Scales (GMDS), in order to explore whether there are unbalances between these areas, and to analyze the correlations between the developmental levels measured and the severity of the ASD, the sex of the assessed child, and the age at which they were first diagnosed with ASD as an attempt to provide a theoretical basis for interventions and educational decision-making in respect of children with ASD
All of the children with suspected ASD were examined through reviews of their current health, developmental history, and family history, as well as through a clinical physical examination and parental interviews carried out by at least two developmental pediatricians with reference to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria (American Psychiatric Association, 2013)
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental condition, and individuals with the condition typically exhibit a range of atypical social interactions, communication difficulties, the presence of repetitive and stereotyped behavior, and restricted interests. There may be sex differences in the autistic symptoms and cognitive development level of children with ASD, leading to the underrecognition and under-diagnosis of girls with ASD, exaggerating the sex imbalance (Van Wijngaarden-Cremers et al, 2014; Carpenter et al, 2019). Individuals with ASD often experience additional developmental disorders, with roughly 30% of those with ASD exhibiting other intellectual disabilities (IDs) (American Psychiatric Association, 2013). Autistic children with low developmental levels require more early intensive intervention to promote their developmental progress (Hinnebusch et al, 2017), and children with ASD who do not receive diagnoses of IDs and other developmental disorders may experience poorer developmental outcomes (Miller et al, 2019)
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