Caregiver stress during the first year after diagnosis of an Autism Spectrum Disorder

Caregiver burden and marital adjustment of mothers of children diagnosed with Autism Spectrum Disorder (ASD) were assessed at baseline, i.e., within six months of diagnosis (n = 79), and again 12 months later (n = 65), using predictors from the double ABCX family adaptation model, e.g., life demands, social support, appraisal, coping. Although there were no changes over time in burden or marital adjustment, participants reported increased positive appraisals of having a child with autism, increased support from providers and decreased use of problem focused coping. Cross-sectionally at Time 2, hypothesized predictors of marital adjustment and caregiver burden derived from the literature and from stress and coping theory (Lazarus & Folkman, 1984) were largely confirmed. Longitudinally, after adjusting for baseline levels in the multiple regressions, better marital adjustment at 12 months was associated with changes over time in three predictor variables: decreased negative appraisal, decreased pile-up stress, and increased general social support. Predictors of increased caregiver burden at 12 months, after adjusting for baseline levels, were increased negative appraisal, increased avoidant coping and decreased problem focused coping.     

The effects of a parent-focused intervention for children with a recent diagnosis of autism spectrum disorder on parenting stress and competence

This paper reports on the effects of two types of parent-focused intervention, for parents of children with autism spectrum disorder (ASD) aged 2–4 years and within 6 months of diagnosis, on parent's perceptions of stress and competence. Interventions aimed to decrease parenting stress and increase parenting competence by embedding empirically supported parenting strategies within family routines. Families were assigned to a professionally supported intervention that included a workshop and 10 home-visits (n = 17) or to a self-directed video based intervention (n = 22). Development in social communication was greater for children of families receiving professional support as measured by a caregiver questionnaire but not on a clinically measured behavior sample. Improvements in adaptive behavior were greater for children in the professionally supported intervention when relatively low adaptive behavior scores had been demonstrated at pre-intervention. The professionally supported intervention resulted in reduced child-related parenting stress and increased parenting self-efficacy relative to the self-directed intervention. The findings support the importance of providing individualized information and professional support around the time of diagnosis for families who have a child with ASD.     

The link between emotion regulation,social functioning,and depression in boys with ASD

PurposeSymptoms of depression are common in children and adolescents with an autism spectrum disorder (ASD), but information about underlying developmental factors is limited. Depression is often linked to aspects of emotional functioning such as coping strategies, but in children with ASD difficulties with social interactions are also a likely contributor to depressive symptoms.MethodologyWe examined several aspects of emotional coping (approach, avoidant, maladaptive) and social functioning (victimization, negative friendship interactions) and their relation to depression symptoms in children with ASD (N = 63) and typically developing (TD) peers (N = 57). Children completed a battery of self-report questionnaires.ResultsLess approach and avoidant, but more maladaptive coping strategies, and poor social functioning were uniquely associated with more symptoms of depression in children with ASD. Only less approach and more maladaptive coping were uniquely associated with depression severity in TD boys.ConclusionsUnlike TD boys, boys with ASD who report using avoidant strategies to deal with stressful situations report fewer symptoms of depression, suggesting that this may be an adaptive emotion regulation strategy. However, understanding the role of over-arousal in this process, inferences about long-term effects of this strategy, its causality and direction of effects will require additional research.     

Role of parental occupation in autism spectrum disorder diagnosis and severity

Some have suggested that parents of children with autism spectrum disorder (ASD) may present with less recognizable autistic-like phenotypic characteristics, leading them to highly systemizing occupations. Using secondary analysis of data from two previous studies of children with ASD, we tested associations between parental occupations and ASD diagnosis and the association of parental occupational characteristics on ASD severity. We found that fathers in healthcare (P < 0.01) and finance (P = 0.03) were more likely to have children with ASD. Additionally, joint effects of parental technical occupations were associated with communication (P < 0.01) and social impairment (P = 0.04). These results support that a “broader phenotype” and possible assortative mating in adults with autistic-like characteristics might contribute to intergenerational transmission and having offspring with greater ASD severity.     

A comparison of family financial and employment impacts of fragile X syndrome,autism spectrum disorders,and intellectual disability

This study compares the family financial and employment impacts of having a child with fragile X syndrome (FXS), autism spectrum disorder (ASD), or intellectual disabilities (ID). Data from a 2011 national survey of families of children with FXS were matched with data from the National Survey of Children with Special Health Care Needs 2009–2010 to form four analytic groups: children with FXS (n = 189), children with special health care needs with ASD only (n = 185), ID only (n = 177), or both ASD and ID (n = 178). Comparable percentages of parents of children with FXS (60%) and parents of children with both ASD and ID (52%) reported that their families experienced a financial burden as a result of the condition, both of which were higher than the percentages of parents of children with ASD only (39%) or ID only (29%). Comparable percentages of parents of children with FXS (40%) and parents of children with both ASD and ID (46%) reported quitting employment because of the condition, both of which were higher than the percentages of parents of children with ID only (25%) or ASD only (25%). In multivariate analyses controlling for co-occurring conditions and functional difficulties and stratified by age, adjusted odds ratios for the FXS group aged 12–17 years were significantly elevated for financial burden (2.73, 95% CI 1.29–5.77), quitting employment (2.58, 95% CI 1.18–5.65) and reduced hours of work (4.34, 95% CI 2.08–9.06) relative to children with ASD only. Among children aged 5–11 years, the adjusted odds ratios for the FXS group were elevated but statistically insignificant for financial burden (1.63, 95% CI 0.85–3.14) and reducing hours of work (1.34, 95% CI 0.68–2.63) relative to children with ASD only. Regardless of condition, co-occurring anxiety or seizures, limits in thinking, reasoning, or learning ability, and more irritability were significantly associated with more caregiver financial and employment impacts. Proper management of anxiety or seizures and functional difficulties of children with FXS or other developmental disabilities may be important in alleviating adverse family caregiver impacts.     

Longitudinal outcome and recovery of social problems after pediatric traumatic brain injury (TBI): Contribution of brain insult and family environment

Pediatric traumatic brain injury (TBI) can result in a range of social impairments, however longitudinal recovery is not well characterized, and clinicians are poorly equipped to identify children at risk for persisting difficulties. Using a longitudinal prospective design, this study aimed to evaluate the contribution of injury and non-injury related risk and resilience factors to longitudinal outcome and recovery of social problems from 12- to 24-months post-TBI. 78 children with TBI (injury age: 5.0–15.0 years) and 40 age and gender-matched typically developing (TD) children underwent magnetic resonance imaging including a susceptibility-weighted imaging (SWI) sequence 2–8 weeks post-injury (M = 39.25, SD = 27.64 days). At 12 and 24-months post- injury, parents completed questionnaires rating their child’s social functioning, and environmental factors including socioeconomic status, caregiver mental health and family functioning. Results revealed that longitudinal recovery profiles differed as a function of injury severity, such that among children with severe TBI, social problems significantly increased from 12- to 24-months post-injury, and were found to be significantly worse than TD controls and children with mild and moderate TBI. In contrast, children with mild and moderate injuries showed few problems at 12-months post-injury and little change over time. Pre-injury environment and SWI did not significantly contribute to outcome at 24-months, however concurrent caregiver mental health and family functioning explained a large and significant proportion of variance in these outcomes. Overall, this study shows that longitudinal recovery profiles differ as a function of injury severity, with evidence for late-emerging social problems among children with severe TBI. Poorer long-term social outcomes were associated with family dysfunction and poorer caregiver mental health at 24-months post injury, suggesting that efforts to optimize the child’s environment and bolster family coping resources may enhance recovery of social problems following pediatric TBI.     

Individual and family factors associated with self-esteem in young people with epilepsy: A multiple mediation analysis

ObjectiveAs young people experience added demands from living with epilepsy, which may lead to poor psychosocial adjustment, it is essential to examine mechanisms of change to provide practitioners with knowledge to develop effective interventions. The aim of this study was to examine individual and family-level factors – stress and illness perceptions, coping behaviors and family resilience – that promote or maintain young people's self-esteem.MethodsFrom November 2013 to August 2014, young people attending a neurology clinic in KK Women's and Children's Hospital, Singapore, participated in a cross-sectional survey (n = 152; 13–16 years old). Multiple mediation analyses were conducted to evaluate whether these variables mediated the relationship between illness severity (i.e., low, moderate, high) and self-esteem.ResultsMultiple mediation analyses demonstrated that illness severity had a direct effect on young people's self-esteem. Compared to those with moderate illness severity (reference group), young people with low severity had significantly higher self-esteem (c = 3.42, p < 0.05); while those with high severity had a more negative view of themselves (c = − 3.93, p < 0.001). Illness severity also had an indirect influence on self-esteem through its effects on mediators, such as perceived stress, illness perceptions and family resilience (D₁: Total ab = 3.46, 95% CI 1.13, 5.71; D₂: Total ab = − 2.80, 95% CI − 4.35, − 1.30). However, young people's coping levels did not predict their self-esteem, when accounting for the effects of other variables.SignificanceThe continued presence of seizure occurrences is likely to place greater demands on young people and their families: in turn, increased stress and negative illness perceptions negatively affected family processes that promote resilience. As the mediating effect of these modifiable factors were above and beyond the contributions of illness characteristics and young people's levels of coping, this has implications for developing individual and family interventions aimed to support young people living with epilepsy.     

The role of family cohesion in the psychological adjustment of non-Hispanic White and Hispanic mothers of children with autism spectrum disorder

The current study utilizes a process-oriented approach to understand both personal and family factors influencing the development of depressive symptoms among non-Hispanic White and Hispanic mothers of children with ASD. Family cohesion was hypothesized to mediate the associations between the personal factors (optimism, benefit finding, social support) and depressive symptoms. Mothers of 117 children with ASD (Hispanic n = 73; non-Hispanic White n = 44) completed measures of depressive symptoms, family cohesion, social support, optimism, and benefit finding. Results from this study indicate that optimism, benefit finding, and social support are important predictors of positive maternal adjustment. Furthermore, these factors contribute to better family functioning, namely family cohesion. The mediation models containing optimism, benefit finding, partner and family support were significant for both Hispanic and non-Hispanic White mothers, suggesting a similar mediation process for both racial/ethnic groups. However, family cohesion was a significant mediator of the relationship between friend support and depressive symptoms for Hispanic mothers only. The results of this study complement and extend previous research examining family functioning among mothers of children with ASD and have implications for the development of interventions aimed at increasing maternal well-being.     

Group cognitive behaviour therapy (CBT) for social interaction anxiety in adults with autism spectrum disorders (ASD)

BackgroundGroup social skills interventions (SSI) are partially effective for addressing the communication and social interaction impairments experienced by individuals with autism spectrum disorders (ASD). Social anxiety has been found to be a moderating mechanism for SSI in young people with ASD. Comparatively few studies have investigated the effectiveness of SSI in the adult ASD population, and none so far have investigated group approaches incorporating SSI and anxiety management techniques.MethodThe present study describes the design and evaluation of a non-randomised single-arm, 11 week group interaction anxiety and social skills intervention, piloted on three occasions during routine clinical practice at an adult ASD service. The intervention was informed by a cognitive behaviour therapy (CBT) framework. Eighteen cognitively-able adult males with ASD attended. Outcome measures were completed pre- and post-intervention.ResultsSelf-reported social anxiety improved (p = 0.01, d = 0.65). Low mood, general anxiety and functioning did not change significantly (p > 0.05, d < 0.20). Qualitative feedback indicated that participants found the intervention to be acceptable and useful for improving social knowledge and coping strategies, and reducing avoidance behaviours. Attrition was low (n = 2).ConclusionsThese results suggest that integrating SSI and anxiety management techniques in a group format is acceptable to adults with ASD, and can reduce symptoms of social anxiety. Whether SSI enhance social skills in adults requires further investigation. In clinical practice, consideration should be given to augmenting SSI with CBT techniques designed to target concurrent symptoms of social anxiety.     

Psychometric properties of the French Version of the Social Responsiveness Scale in autism spectrum disorder with or without attention deficit hyperactivity disorder

ObjectivesThe Social Responsiveness Scale (SRS) is an instrument that is commonly used to screen for Autism Spectrum Disorder (ASD). Attention Deficit Hyperactive Disorder (ADHD) frequently occurs with ASD and both disorders share some phenotypic similarities. In the present study, we aimed to determine the psychometric properties of the French version of the Social Responsiveness Scale (SRS) and its 5 subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerisms) to discriminate between children with ADHD and those with ASD (differential diagnosis) and children with ADHD from those with a dual diagnosis of ADHD and ASD (comorbid diagnosis).MethodSRS total scores and the 5 subscores of the SRS were compared between 4 groups of children: ADHD (n = 32), ASD + ADHD (n = 30), ASD (n = 31) and typical neurodevelopment (TD; n = 30) children. The discriminant validity was estimated using the Area Under the ROC Curves (AUC).ResultsSRS Social cognition (AUC = 0.73) and Autistic mannerisms (AUC = 0.70) subscores were the most discriminating for differential diagnosis of ASD and ADHD. SRS total scores (AUC = 0.70), and Social communication (AUC = 0.66) and Autistic mannerisms (AUC = 0.75) subscores were the most discriminating for comorbid diagnosis of ASD among ADHD children.ConclusionThe SRS autistic mannerisms subscore was found to be clinically relevant for both differential diagnosis of ASD and ADHD and comorbid diagnoses of ASD among ADHD children but with a modest discriminant power.     

Predictors of disclosure management behavior at the end of 1-year follow-up in Korean adults with newly diagnosed epilepsy

PurposeEpilepsy is a concealable stigmatizing condition. We investigated the factors predicting disclosure management behavior in Korean adults with newly diagnosed epilepsy.MethodsThis longitudinal multicenter study included Korean adults with newly diagnosed epilepsy. Using statistical analyses, we determined at the end of a 1-year follow-up whether Disclosure Management Scale (DMS) scores were predicted by demographic, clinical, and psychosocial variables, including felt stigma, stress coping style, personality traits, social support, and experienced discrimination from society.ResultsOf a total of 121 participants, 69% reported that they often or sometimes kept their diagnosis a secret from others and rarely or never talked to others about their epilepsy. The average DMS score was 5.8 (SD = 2.9, range 0–11). In univariate analyses, DMS scores were significantly associated with an emotion-focused coping style (r = 0.320, p < 0.001), social support (r = − 0.185, p < 0.05), and experienced discrimination (p < 0.05). Emotion-focused coping was the only independent predictor of a higher DMS score. Felt stigma, personality traits, and seizure freedom were not related to the DMS score.ConclusionsTwo-thirds of Korean adults with newly diagnosed epilepsy often or sometimes keep their epilepsy a secret. Emotion-focused coping is the most important predictor of concealment of epilepsy diagnosis at the end of a 1-year follow-up, although social support and episodes of experienced discrimination are also associated with disclosure management strategies.     

The double ABCX model of family adaptation in families of a child with an autism spectrum disorder attending an Australian early intervention service

It is well established that families caring for a child with an autism spectrum disorder (ASD) experience increased psychological distress compared to other families (e.g., Baker-Ericzén, Brookman-Frazee, & Stahmer, 2005; Lee et al., 2009). However, little research has captured the range of variables linked to family outcomes, and research in the early childhood period has been largely atheoretical. The current study sought to investigate the applicability of the double ABCX Model of Family Adaptation (McCubbin & Patterson, 1983) in understanding the factors underlying family outcomes when children with ASD attend early intervention. Participants included 43 parents (18 males, 25 females) of children aged 2.5 to 6 years (M = 49.35, SD = 9.21 months; 8 female, 35 male) with ASD who were attending an autism-specific intervention service. Participants completed standardised questionnaire measures of constructs of the double ABCX Model. As predicted by the model, family systems outcomes (individual, relationship, or family) were linked to symptom severity (challenging behaviour), pile-up demands, internal and external resources, appraisals, and active-avoidant coping styles. Level of ASD symptoms however, were not significantly linked to outcomes. Limitations, directions for future research, and practical implications are discussed.     

Preliminary study of family accommodation in youth with autism spectrum disorders and anxiety: Incidence,clinical correlates,and behavioral treatment response

Anxiety symptoms are common in youth with autism spectrum disorders (ASD) and directly associated with symptom severity and functional impairment. Family accommodation occurs frequently among individuals with obsessive-compulsive and anxiety disorders; to date, no data exist on the nature and correlates of family accommodation in youth with ASD and anxiety, as well as its relationship to cognitive-behavioral therapy outcome. Forty children with ASD and a comorbid anxiety disorder participated. Clinicians administered measures of ASD and anxiety disorder caseness, anxiety symptom severity, and family accommodation; parents completed questionnaires assessing social responsiveness, internalizing and externalizing behaviors, and functional impairment. A subsample of youth (n = 24) completed a course of cognitive-behavioral therapy. Family accommodation was common and positively correlated with anxiety symptom severity, but not functional impairment, general internalizing symptoms, externalizing behavior, or social responsiveness. Family accommodation decreased following cognitive-behavioral therapy with decreases in family accommodation being associated with decreases in anxiety levels. Treatment responders reported lower family accommodation frequency and lower parent impact relative to non-responders. Clinical implications of this study in assessing and psychotherapeutically treating youth with ASD and comorbid anxiety are discussed.     

Couple relationships among parents of children and adolescents with Autism Spectrum Disorder: Findings from a scoping review of the literature

To explore commonly-held assumptions regarding the risk of couple breakdown in families of children with Autism Spectrum Disorder (ASD), a scoping review of quantitative (n = 39), qualitative (n = 15), and mixed (n = 5) studies was conducted. Findings include themes related to marriage and divorce rates, relationship satisfaction and conflict, and other significant variables. Parents and service providers of individuals with ASD will benefit from knowing that strategies such as developing common goals, increasing partner respect, securing social support, reducing stress, and instilling hope are all factors which support the development and maintenance of positive couple and co-parenting relationships.     

The influence of patient,caregiver, and family factors on symptoms of anxiety and depression in children and adolescents with intractable epilepsy

ObjectiveThe objective was to evaluate the association of caregiver and family factors with symptoms of anxiety and depression in children and adolescents with medically refractory localization-related epilepsy (i.e., failed at least two epilepsy medications).MethodForty-four children (ages 6–11 years) and 65 adolescents (ages 12–18 years) and their parents participated in this multicentered, observational, cross-sectional study. Univariable and multivariable linear regressions were used to evaluate the influence of multiple patient, caregiver, and family characteristics on self-reported symptoms of anxiety and depression in the children and adolescents.ResultsAmong children, depressive symptoms were associated with a lower proportion of life with seizures (β = .344, p = .022), caregiver depression (β = .462, p = .002), poorer family relationships (β = .384, p = .010), and poorer family mastery and social support (β = .337, p = .025); in multivariable analysis, proportion of life with epilepsy and parental depression remained significant. No significant predictors of anxiety were found among children. Among adolescents, depressive symptoms were associated with caregiver unemployment (β = .345, p = .005) and anxiety (β = .359, p = .003), low household income (β = .321, p = .012), poorer family mastery and social support (β = .334, p = .007), and greater family demands (β = .326, p = .008); in multivariable analysis, caregiver unemployment and anxiety remained significant. Greater anxiety symptoms among adolescents were associated with females (β = .320, p = .009) and caregiver depression (β = .246, p = .048) and anxiety (β = .392, p = .001) and poorer family mastery and social support (β = .247, p = .047); in multivariable analysis, female sex and caregiver anxiety remained significant.SignificanceThese findings highlight the central role of caregiver psychopathology, which is amenable to intervention, on children and adolescents' symptoms of anxiety and depression. Addressing caregiver psychopathology may improve children and adolescents' quality of life even if seizure control is not attained.     

Hyper-responsiveness to touch mediates social dysfunction in adults with autism spectrum disorders

This study investigated whether hyper-responsiveness to touch serves as a mediating variable that predicts social dysfunction in adults with autism spectrum disorders (ASD). Data were obtained from all adults with administratively defined intellectual disability in a region in Sweden (n = 915, where 143 had ASD). A multiple mediation modeling analysis revealed a well-fitted model (Satorra–Bentler scaled chi-square = 10.91, df = 7, p = 0.14, CFI = 0.99, RMSEA = 0.025), demonstrating that social dysfunction among adults with ASD was completely mediated by hyper-responsiveness to touch followed by impairment of speech and aggressive/destructive behavior. The results demonstrated that in adulthood, the tactile sensory system is foundational for social functioning in people with ASD, with diagnosis and intervention implications.     

High plasma neopterin levels in Chinese children with autism spectrum disorders

BackgroundNeopterin, a pteridine mainly synthesized by activated macrophages, is a marker of inflammation, immune system activation and an active participant in Autism spectrum disorders (ASD). The aim of this study was to assess the clinical significance of plasma neopterin levels in ASD.MethodsEighty patients diagnosed with ASD and 80 sex and age matched typically developing children were assessed for plasma levels of neopterin at admission. Plasma neopterin levels were measured using a human ELISA kit and severity of ASD were evaluated with the Childhood Autism Rating Scale (CARS) score.ResultsWe found that the mean plasma neopterin level was significantly (P < 0.0001) higher in children with ASD as compared to controls. Plasma neopterin increased with increasing severity of ASD as defined by the CARS score. Based on the ROC curve, the optimal cutoff value of plasma neopterin level as an indicator for auxiliary diagnosis of ASD was projected to be 8.5 nmol/L, which yielded a sensitivity of 84.2% and a specificity of 80.1%, with the area under the curve at 0.876 (95% CI, 0.825–0.928). Elevated neopterin (≥8.5 nmol/L) was an independent diagnosis indicator of ASD with an adjusted OR of 12.11 (95% CI: 5.48–28.11; P < 0.0001).ConclusionsThese results indicated that autistic children had higher plasma levels of neopterin, and elevated plasma neopterin levels may be associated with severity of ASD among Chinese children.     

Subjective well-being among family caregivers of individuals with developmental disabilities: The role of affiliate stigma and psychosocial moderating variables

Studies have shown that stigmatization is linked to lower quality of life; however, only scant research has examined the association between family caregivers’ internalization of stigma (affiliate stigma) and their subjective quality of life (subjective well-being, SWB). Furthermore, studies have rarely examined this association via comparison between caregivers of individuals with different developmental disabilities in addition to examining the influence of psychosocial protective factors. These were the aims of the current study. Family caregivers (N = 176) of individuals with autism spectrum disorders (ASD), intellectual disabilities (ID), and physical disabilities (PD) completed a self-report structured questionnaire including scales measuring SWB, affiliate stigma, burden, positive meaning in caregiving, social support and self-esteem. Results showed that SWB of family caregivers was below the average normative level and especially low for caregivers of individuals with ASD. The strongest predictors of SWB were caregivers’ self-esteem, social support, positive meaning in caregiving, and affiliate stigma. Furthermore, an interaction was found between affiliate stigma and diagnosis, showing that among caregivers of individuals with ASD, greater levels of stigma were associated with lower ratings of SWB, whereas such an association was not found among caregivers of individuals with ID or PD. Findings from this study point to the importance of supporting caregivers across the life-span in order to decrease stigma, improve social support and self-esteem and improve SWB. Further, findings point to the need to respond differentially to the various developmental disabilities.     

Autism spectrum disorder symptoms in children with ADHD: A community-based study

This study examined the prevalence of autism spectrum disorder (ASD) symptoms in a community-based sample of children with attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls. We also examined the relationship between ASD symptoms and ADHD subtype, ADHD symptom severity and child gender. Participants were 6–10-year-old children (164 ADHD; 198 non-ADHD control) attending 43 schools in Melbourne, Australia, who were participating in the Children's Attention Project. ADHD was assessed in two stages using the parent and teacher Conners’ 3 ADHD index and the Diagnostic Interview Schedule for Children IV (DISC-IV). ASD symptoms were identified using the Social Communication Questionnaire (SCQ). Unadjusted and adjusted linear and logistic regression examined continuous and categorical outcomes, respectively. Children with ADHD had more ASD symptoms than non-ADHD controls (adjusted mean difference = 4.0, 95% confidence interval (CI) 2.8; 5.3, p < 0.001, effect size = 0.7). Boys with ADHD had greater ASD symptom severity than girls with ADHD (adjusted mean difference = 2.9, 95% CI 0.8; 5.2, p = 0.01, effect size = 0.4). Greater ADHD symptom severity was associated with greater ASD symptom severity (regression co-efficient = 1.6, 95% CI 1.2; 2.0, p < 0.001). No differences were observed by ADHD subtype. Greater hyperactive/impulsive symptoms were associated with greater ASD symptoms (regression coefficient = 1.0; 95% CI 0.0; 2.0, p = 0.04) however, this finding attenuated in adjusted analyses (p = 0.45). ASD symptoms are common in children with ADHD. It is important for clinicians to assess for ASD symptoms to ensure appropriate intervention.     

An in-depth examination of optimal outcome children with a history of autism spectrum disorders

Previous research has suggested that some children with autism spectrum disorders (ASD) may improve to such an extent that they lose their diagnosis, yet little research has examined these ‘optimal outcome’ children in depth. We examined multiple aspects of functioning in a group of 13 optimal outcome (OO) children, matched on age, gender, and non-verbal IQ to a group of typically developing children (N = 14) and a group of high-functioning children with ASD who still retained a diagnosis on the autism spectrum (N = 14). These children were tested on average about eight years after they had been diagnosed (OO = 93 months, HFA = 94 months). Unlike their high-functioning peers with ASD, the OO group's adaptive and problem behavior scores fell within the average range. They also showed average language and communication scores on all language measures. The HFA group, however, continued to show pragmatic, linguistic, social, and behavioral difficulties. The OO children tended to have been diagnosed at younger ages and were significantly more likely to have received intensive early intervention. Although the high-functioning children with ASD continued to show difficulties in the behavioral realm, the individuals in the OO group were functioning within the average range on all measures. Future research should address how this optimal outcome is achieved.