Billstedt Eva, Gillberg I Carina, Gillberg Christopher
Institute of Neuroscience and Physiology, Göteborg University, Sweden.
J Child Psychol Psychiatry. 2007 Nov;48(11):1102-10. doi: 10.1111/j.1469-7610.2007.01774.x.
Few studies have looked at the very long-term outcome of individuals with autism who were diagnosed in childhood.
A longitudinal, prospective, community-based follow-up study of adults who had received the diagnosis of autism (classic and atypical) in childhood (n = 105) was conducted. A structured interview (the Diagnostic Interview for Social and COmmunication disorders--the DISCO) was used in order to evaluate symptoms and symptom patterns 13-22 years after original diagnosis. Childhood measures, including IQ-level at time of childhood diagnosis and communicative speech registered before age 5 years, were studied in relation to the presence of autism symptoms at follow-up.
The classical and atypical autism groups were fairly homogeneously impaired in terms of symptoms in the social interaction category whereas other common childhood autism symptoms, including maladaptive and stereotyped behaviours, were more variable in the study group at follow-up. Odd responses to sensory stimuli were still extremely common. Speech before 5 years of age, IQ, gender, diagnosed medical disorder and onset of epilepsy before 5 years were variables that correlated to outcome on the DISCO algorithm for autistic spectrum disorders (Wing & Gould, 1979) concerning style and quality of social interaction, communication style and pattern of self-chosen activities.
Social interaction problems were still present in the vast majority of adults with autism/atypical autism, but behavioural impairments were much more variable in adulthood. Almost all cases were reported to show persistent perceptual problems. Certain childhood measures were found to prospectively predict adult social interaction style, communication type, and pattern of self-chosen activities, which still met diagnostic criteria for autism/atypical autism in adulthood.
很少有研究关注童年时期被诊断为自闭症的个体的长期结局。
对童年时期被诊断为自闭症（典型和非典型）的成年人（n = 105）进行了一项基于社区的纵向前瞻性随访研究。使用结构化访谈（社交和沟通障碍诊断访谈——DISCO）来评估首次诊断后13 - 22年的症状及症状模式。研究了童年时期的测量指标，包括童年诊断时的智商水平以及5岁前记录的交流性言语，与随访时自闭症症状的存在情况之间的关系。
在社交互动类别方面，典型和非典型自闭症组在症状上的受损程度相当均匀，而其他常见的童年自闭症症状，包括适应不良和刻板行为，在随访研究组中变化更大。对感觉刺激的异常反应仍然极为常见。5岁前的言语、智商、性别、确诊的医学疾病以及5岁前癫痫的发作，这些变量与自闭症谱系障碍（Wing & Gould，1979）的DISCO算法中关于社交互动的方式和质量、沟通方式以及自我选择活动模式的结局相关。
绝大多数患有自闭症/非典型自闭症的成年人仍然存在社交互动问题，但成年期行为障碍的变化更大。几乎所有病例都报告有持续的感知问题。发现某些童年时期的测量指标可以前瞻性地预测成年后的社交互动方式、沟通类型以及自我选择活动模式，这些在成年期仍符合自闭症/非典型自闭症的诊断标准。
