Daily living skills in individuals with autism spectrum disorder from 2 to 21 years of age

Bal, Vanessa H.; Kim, So-Hyun; Cheong, Daniel; Lord, Catherine

doi:10.1177/1362361315575840

Cited by 238 publications

(169 citation statements)

References 29 publications

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“…A lower DQ, the absence of functional speech, and increased CARS scores at inclusion predict a LG trajectory for communication, socialization, and daily living skills for most, but not all, participants. Other studies reported a similar relationship with IQ [Smith et al, ; Yang et al, ], autism severity [Yang et al, ], speaking ability [Szatmari et al, ], and nonverbal mental age [Bal, Kim, Cheong, & Lord, ]. In the absence of studies on long‐term effects of intervention, it is not possible to determine whether this poor outcome is intrinsic to a fraction of the autistic population, an effect of the absence of intervention, or limited exposure to learning opportunities.…”

Section: Discussionmentioning

confidence: 94%

Adaptive trajectories and early risk factors in the autism spectrum: A 15‐year prospective study

et al. 2018

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Little is known about long‐term outcomes. We investigate the adaptive trajectories and their risk factors in ASD. Data were obtained from 281 children prospectively followed untill adulthood. The final sample consisted of 106 individuals. Vineland scores were collected at baseline (T1), 3 (T2), 10 (T3), and 15 (T4) years later. A group‐based method was used to identify homogeneous patterns of adaptive skills trajectories. Results show that among the children initially categorized as autistic, 82.6% remained over the ADOS diagnostic threshold, 11.9% converted to atypical autism, and 5.4% fell under the ADOS threshold. Most atypical autism diagnoses were unstable. Most (81.7%) autistic participants had an ID at inclusion. At T1, 59.3% were nonverbal, but only 39% at T4. Most changes occurred between 4 and 8 years of age. Approximately 25% of participants exhibited a “high” growth trajectory, in which progress continues throughout adolescence, and 75% a “low” growth trajectory, characterized by greater autistic symptoms, intellectual disability, and lower language abilities reflected by high CARS scores, low apparent DQ, and speech difficulties, which mostly, but not always, predicted low trajectories. Our findings suggest that the adaptive prognosis of autism is mostly poor in this cohort, biased toward intellectual disability. However, changes in diagnostic, speech, and adaptive status are not uncommon, even for indivduals with low measured intelligence or apparent intellectual disability, and are sometimes difficult to predict. Autism Research 2018, 11: 1455–1467. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Most autism diagnoses given before 5 years of age are stable to adulthood, but one‐fifth of individuals are no longer considered to be autistic, even in a cohort biased toward apparent intellectual disability. Conversely, atypical autism diagnoses are mostly unstable. One‐third of children who are nonverbal at 5 years are verbal within 15 years, mostly before 8 years of age. Concerning adaptive behavior outcomes, only one‐fourth of children exhibit a high‐growth trajectory through at least 15 years.

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Section: Discussionmentioning

confidence: 94%

Adaptive trajectories and early risk factors in the autism spectrum: A 15‐year prospective study

et al. 2018

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“…Mentored, parent-implemented structured teaching (MPST) intervention: Based on parent diaries and interviews completed, the hours of mentored, parent-structured teaching (MPST; a home program modeled after the TEACCH extended diagnostic services (Mesibov, Shea, & Schopler, 2005) from age 2 to 3 were computed. Consistent with analyses from previous studies (Anderson, Liang, & Lord, 2014;Bal, Kim, Cheong, & Lord, 2015) based on the median number of MPST hours (not including children with 0 h), hours of intervention were collapsed into two categories: (a) 'Minimal to None', that is, less than 20 hr; and (b) 'Some', that is, 20 hr or more between the 2-and 3-year-old assessments.…”

Section: Methodsmentioning

confidence: 99%

Longitudinal follow‐up of academic achievement in children with autism from age 2 to 18

Kim

Bal

Lord

2017

Child Psychology Psychiatry

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Many children with ASD achieve basic academic skills commensurate with or higher than their cognitive ability. However, more rigorous screening for learning difficulties may be important for those with average cognitive skills because a significant minority show relative academic delays. Interventions targeting cognitive skills and parent participation in early treatment may have cascading effects on long-term academic development.

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“…In ASD there is wide heterogeneity in the level of functioning across these domains, which is partly linked to development and level of cognitive abilities [Szatmari et al, ; Bal, Kim, Cheong, & Lord, ; Chatham et al, ; Farmer, Swineford, Swedo, & Thurm, ]. Although higher intellectual functioning is typically associated with better adaptive functioning, adaptive behavior tends to be more impaired than what would be expected based on general intellectual and cognitive ability [Bölte & Poustka, ; Klin et al, ; Charman et al, ; Kanne et al, ; Mouga, Almeida, Café, Duque, & Oliveira, ; Chatham et al, ].…”

Section: Introductionmentioning

confidence: 99%

Investigating the factors underlying adaptive functioning in autism in the EU‐AIMS Longitudinal European Autism Project

et al. 2019

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Scientific Abstract Individuals with autism spectrum disorder (ASD) exhibit significant impairments in adaptive functioning that impact on their ability to meet the demands of everyday life. A recurrent finding is that there is a pronounced discrepancy between level of cognitive ability and adaptive functioning, and this is particularly prominent among higher‐ability individuals. However, the key clinical and demographic associations of these discrepancies remain unclear. This study included a sample of 417 children, adolescents, and adults with ASD as part of the EU‐AIMS LEAP cohort. We examined how age, sex, IQ, levels of ASD symptom and autistic trait severity and psychiatric symptomatology are associated with adaptive functioning as measured by the Vineland Adaptive Behavior Scales‐Second Edition and IQ‐adaptive functioning discrepancies. Older age, lower IQ and higher social‐communication symptoms were associated with lower adaptive functioning. Results also demonstrate that older age, higher IQ and higher social‐communication symptoms are associated with greater IQ‐adaptive functioning discrepancy scores. By contrast, sensory ASD symptoms, repetitive and restricted behaviors, as well as symptoms of attention deficit/hyperactivity disorder (ADHD), anxiety and depression, were not associated with adaptive functioning or IQ‐adaptive functioning discrepancy scores. These findings suggest that it is the core social communication problems that define ASD that contribute to adaptive function impairments that people with ASD experience. They show for the first time that sensory symptoms, repetitive behavior and associated psychiatric symptoms do not independently contribute to adaptive function impairments. Individuals with ASD require supportive interventions across the lifespan that take account of social‐communicative ASD symptom severity. Autism Res 2019, 12: 645–657 . © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay summary This study investigated key clinical and demographic associations of adaptive functioning impairments in individuals with autism. We found that older age, lower IQ and more severe social‐communicative symptoms, but not sensory or repetitive symptoms or co‐occurring psychiatric symptoms, are associated with lower adaptive functioning and greater ability‐adaptive function discrepancies. This suggests that interventions targeting adaptive skills acquisition should be flexible in their timing and intensity across developmental periods, levels of cognitive ability and take account of social‐communicative ASD symptom severity.

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Daily living skills in individuals with autism spectrum disorder from 2 to 21 years of age

Cited by 238 publications

References 29 publications

Adaptive trajectories and early risk factors in the autism spectrum: A 15‐year prospective study

Adaptive trajectories and early risk factors in the autism spectrum: A 15‐year prospective study

Longitudinal follow‐up of academic achievement in children with autism from age 2 to 18

Investigating the factors underlying adaptive functioning in autism in the EU‐AIMS Longitudinal European Autism Project

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