OBJECTIVE: The DSM-IV-TR specifies 12 behavioral features that can occur in hundreds of possible combinations to meet diagnostic criteria for autism spectrum disorder (ASD). This paper describes the frequency and variability with which the 12 behavioral features are documented in a population-based cohort of 8-year-old children under surveillance for ASD, and examines whether documentation of certain features, alone or in combination with other features, is associated with earlier age of community identification of ASD. METHOD: Statistical analysis of behavioral features documented for a population-based sample of 2,757 children, 8 years old, with ASD in 11 geographically-defined areas in the US participating in the Autism and Developmental Disabilities Monitoring Network in 2006. RESULTS: The median age at ASD identification was inversely associated with the number of documented behavioral features, decreasing from 8.2 years for children with only seven behavioral features to 3.8 years for children with all 12. Documented impairments in nonverbal communication, pretend play, inflexible routines, and repetitive motor behaviors were associated with earlier identification, whereas impairments in peer relations, conversational ability, and idiosyncratic speech were associated with later identification. CONCLUSIONS: The age dependence of some of the behavioral features leading to an autism diagnosis, as well as the inverse association between age at identification and number of behavioral features documented, have implications for efforts to improve early identification. Progress in achieving early identification and provision of services for children with autism may be limited for those with fewer ASD behavioral features, as well as features likely to be detected at later ages.
OBJECTIVE: The DSM-IV-TR specifies 12 behavioral features that can occur in hundreds of possible combinations to meet diagnostic criteria for autism spectrum disorder (ASD). This paper describes the frequency and variability with which the 12 behavioral features are documented in a population-based cohort of 8-year-old children under surveillance for ASD, and examines whether documentation of certain features, alone or in combination with other features, is associated with earlier age of community identification of ASD. METHOD: Statistical analysis of behavioral features documented for a population-based sample of 2,757 children, 8 years old, with ASD in 11 geographically-defined areas in the US participating in the Autism and Developmental Disabilities Monitoring Network in 2006. RESULTS: The median age at ASD identification was inversely associated with the number of documented behavioral features, decreasing from 8.2 years for children with only seven behavioral features to 3.8 years for children with all 12. Documented impairments in nonverbal communication, pretend play, inflexible routines, and repetitive motor behaviors were associated with earlier identification, whereas impairments in peer relations, conversational ability, and idiosyncratic speech were associated with later identification. CONCLUSIONS: The age dependence of some of the behavioral features leading to an autism diagnosis, as well as the inverse association between age at identification and number of behavioral features documented, have implications for efforts to improve early identification. Progress in achieving early identification and provision of services for children with autism may be limited for those with fewer ASD behavioral features, as well as features likely to be detected at later ages.
Authors: W L Stone; E B Lee; L Ashford; J Brissie; S L Hepburn; E E Coonrod; B H Weiss Journal: J Child Psychol Psychiatry Date: 1999-02 Impact factor: 8.982
Authors: Susan Risi; Catherine Lord; Katherine Gotham; Christina Corsello; Christina Chrysler; Peter Szatmari; Edwin H Cook; Bennett L Leventhal; Andrew Pickles Journal: J Am Acad Child Adolesc Psychiatry Date: 2006-09 Impact factor: 8.829
Authors: Andy J Frey; Jason W Small; Edward G Feil; John R Seeley; Hill M Walker; Steven Forness Journal: Educ Train Autism Dev Disabil Date: 2016-01-19
Authors: Anita K Chisholm; Vicki A Anderson; Natalie A Pride; Stephanie Malarbi; Kathryn N North; Jonathan M Payne Journal: Neuropsychol Rev Date: 2018-08-11 Impact factor: 7.444
Authors: Benjamin Zablotsky; Lisa J Colpe; Beverly A Pringle; Michael D Kogan; Catherine Rice; Stephen J Blumberg Journal: Am J Intellect Dev Disabil Date: 2017-01
Authors: Anita L Pedersen; Sydney Pettygrove; Zhenqiang Lu; Jennifer Andrews; F John Meaney; Margaret Kurzius-Spencer; Li-Ching Lee; Maureen S Durkin; Christopher Cunniff Journal: Child Psychiatry Hum Dev Date: 2017-08
Authors: Babu George; M S Razeena Padmam; M K C Nair; M L Leena; G L Prasanna; Paul Swamidhas Sudhakar Russell Journal: Indian J Pediatr Date: 2014-11-28 Impact factor: 1.967