International Meeting for Autism Research: Differences in Early Symptom Presentation Between Children with a History of Autism Who Achieve An “Optimal Outcome,” and Children with Persisting Autism
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Differences in Early Symptom Presentation Between Children with a History of Autism Who Achieve An “Optimal Outcome,” and Children with Persisting Autism

Friday, May 21, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
10:00 AM
M. Helt , Psychology, University of Connecticut, Storrs, CT
T. Dumont-Mathieu , Psychology, University of Connecticut, Storrs, CT
I. M. Eigsti , Psychology, University of Connecticut, Storrs, CT
M. L. Barton , Department of Psychology, University of Connecticut, Storrs, CT
E. Troyb , Department of Psychology, University of Connecticut, Storrs, CT
K. E. Tyson , Department of Psychology, University of Connecticut, Storrs, CT
M. A. Rosenthal , Psychology, University of Connecticut, Storrs, CT
A. Orinstein , Department of Psychology, University of Connecticut, Storrs, CT
L. Naigles , Department of Psychology, University of Connecticut, Storrs, CT
E. A. Kelley , Psychology, Queen's University, Kingston, ON, Canada
M. C. Stevens , Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital / Yale University, Hartford, CT
R. T. Schultz , Pediatrics, Children's Hospital of Philadelphia and the University of Pennsylvania, Philadelphia, PA
D. A. Fein , Department of Psychology, University of Connecticut, Storrs, CT
Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support.  Several recent studies suggest that this small subset of children, once diagnosed with ASD, achieve an "optimal outcome" (Sutera et al., 2007, Kelley et al., 2006, and Helt et al., 2008).

Objectives: The purpose of the current study was to investigate differences in the early presentation of autistic symptoms in children who later go on to achieve optimal and sub-optimal outcomes.

Methods:  Complete medical history forms and Autism Diagnostic Interviews (ADI) were collected from parents of children and young adults with an “Optimal Outcome” (OO) (n = 28), ages 8-21 (M =13.0), and children with High Functioning Autism (HFA) (n = 18), ages 8-18 (M = 13.4). Groups did not differ in gender (p = .42), age (p = .77), or WASI full-scale IQ (p = .35). Full-Scale IQ means were M = 110.35, and M = 114.04, for the HFA and OO groups, respectively. Results: Parents of OO children were significantly more likely to report that their child had lost skills (28.5 %) than parents of HFA children (5 %), c2 (3) = 0.048.  Parents of OO children were also more likely to report that they never perceived any differences in the intonation, volume, rhythm, or rate of their child’s voice (29%) or that any perceived differences in these qualities of the child’s voice were quite mild (46%).  In contrast, parents of children with HFA were more likely to report moderate (56%) or severe (14%) differences in their child’s prosody at the time the child began to speak, c2 (3) = 0.049.  No differences were found between these groups on average age of diagnosis, household income, additional medical diagnoses, multiplex/simplex status, or any other specific ASD symptoms appearing early in the course of the disorder.

Conclusions: The high number of OO children reported to have lost skills is consistent with previous studies that have reported a high number of regressive cases among children who go on to lose their ASD diagnosis (Fein, Dixon, Paul, & Levin, 2005) and may imply that there are distinct subtypes of ASD with distinct developmental trajectories.

Differences in prosody are common (perhaps even universal) amongst children and adults with ASD and may be the most disabling symptom for high functioning indiviudals (McCann & Peppe, 2003; Paul et al., 2005). Early differences in prosody between OO and HFA groups may imply its potential for aiding in the determination of the severity of an ASD at the time of diagnosis.

See more of: Clinical Phenotype
See more of: Clinical Phenotype
See more of: Clinical & Genetic Studies