ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation.

A Louwerse,K Greaves-Lord,F Verheij,J Van Der Ende,L P Dekker,F C Verhulst,P F A De Nijs,A R Van Gool,M L J M Eussen,C Verheij

doi:10.1007/s10803-015-2595-2

Abstract

The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were administered in childhood (ages 6–12) and in adolescence (ages 12–20) to 72 individuals with a pervasive developmental disorder-not otherwise specified (PDD-NOS). ADOS calibrated severity scores showed a large stability (r = .51). Psychiatric comorbidity in childhood and adolescence were not associated with ASD severity in adolescence. Mental health care use (87 %) and special education needs were high (71 %). Reevaluation of ASD severity and psychiatric comorbidity later in life seem useful when PDD-NOS is diagnosed in childhood.

Highlights

In the past decades, the number of children diagnosed with autism spectrum disorder (ASD) increased fourfold (Duchan and Patel 2012)
The bivariate correlation between the Wave 1 Autism Diagnostic Observation Schedule (ADOS) calibrated severity scores (CSS) and the Wave 2 ADOS CSS was .51 (p \ .001) with an OR 8.9, meaning that the odds of an ADOS Autism spectrum disorders (ASD) classifications was 8.9 times higher for individuals with an ADOS ASD classification at Wave 1 compared to individuals without an ADOS ASD classification at Wave 1.The intraclass correlation (ICC) was .65 (p \ .001)
The Reliable Change Index (RCI) resulted in information concerning the stability of ASD symptom severity from childhood to adolescence

Summary

Introduction

The number of children diagnosed with autism spectrum disorder (ASD) increased fourfold (Duchan and Patel 2012). The recent development of the Autism Diagnostic Observation Schedule (ADOS-2) calibrated severity scores (CSS) creates the possibility to examine stability of clinically observed ASD severity across development, since this continuous measure can be used to quantitatively compare the level of ASD symptom severity over time, investigating stability using a dimensional approach (Gotham et al 2009, Hus and Lord 2014). The long-term stability of ASD severity in cognitively able individuals with PDD-NOS, and the association with psychiatric comorbidity and societal functioning, need further investigation using a dimensional approach and state-of-the art assessment methods. Functioning (i.e. mental health care use, SEN and age-appropriate reciprocal friendships) in adolescence

Participants

Results

Discussion