Diagnostic outcomes for autistic children as they transition to adulthood

Introduction: Longitudinal studies of autistic people show that the behavioural features of autism generally endure into adulthood, although there is striking variability in the long-term outcomes of these individuals. Here,... [ view full abstract ]

Introduction:
Longitudinal studies of autistic people show that the behavioural features of autism generally endure into adulthood, although there is striking variability in the long-term outcomes of these individuals. Here, we examine the diagnostic and adaptive outcomes of a cohort of autistic youth followed over a 12-year period to better understand this variability.

Methodology:
A prospective longitudinal design was employed. Participants were 28 young people (2 female) with an autism diagnosis, who completed detailed cognitive and diagnostic assessment at Time 1 (M 5.4 years, SD 0.98 years) and again at Time 2 (M 17.1 years, SD 0.88 years). Both parent and self-report measures of adaptive functioning were also collected at follow-up.

Results:
18% of participants no longer met diagnostic criteria at follow-up as measured by the ADOS-2. These participants were no different from those who continue to meet diagnostic criteria in terms of verbal IQ, t(26) = 0.61, p = 0.61 or non-verbal IQ, t(26) = 0. 99, p=0.33, at follow-up but had significantly higher non-verbal IQ, t(26) = 2.08, p = 0.04, at Time 1. There were, however, no differences in terms of Time 2 parent or self-reported adaptive functioning between those who continued to meet instrument criteria for autism compared to those who did not.

Conclusion:
This study demonstrates diagnostic discontinuity for a significant minority of autistic young people (one fifth of the sample). Despite no longer meet the diagnostic threshold for autism at follow-up, they nevertheless report significant difficulties in aspects of their day-to-day functioning.

This work is funded by the School of Psychology at The University of Western Australia. Liz Pellicano has received grant or research support from the UK’s Medical Research Council and Economic and Social Research Council,... [ view full abstract ]

This work is funded by the School of Psychology at The University of Western Australia. Liz Pellicano has received grant or research support from the UK’s Medical Research Council and Economic and Social Research Council, The Leverhulme Trust, the European Council, the Australian Research Council, the Nuffield Foundation, Research Autism, and the Waterloo Foundation. Lorcan Kenny’s employment was funded by The Pears Foundation.