Department of Paediatrics, KEM Hospital and Research Centre, Pune, Maharashtra, India.
Neonatal Directorate, KEM Hospital for Women, Perth, Western Australia.
J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa104.
Assessing the stability of the diagnosis of autism spectrum disorder (ASD) in children is important. Only few such studies have been reported from India. We aimed to assess the stability after 18-30 months, of an initial diagnosis of ASD based on DSM-5, in children ≤ 5 years of age using Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2).
A total of 125 children with ASD diagnosed by DSM-5 at ≤ 5 years of age were followed up at 18-30 months using ADOS-2, which is considered as the 'gold-standard' observational assessment for diagnosing ASD and hence suitable for confirming the stability of the diagnosis.
Similar to previous studies from developed countries, the stability of ASD diagnosis was 80%. There was no significant correlation between gender, socioeconomic status and the stability of the final diagnosis. All the children continued to have some developmental difficulties mainly in the domain of language, attention or social communication.
Our results suggest that DSM-5 can be used for the initial diagnosis ASD to initiate early intervention for children with this condition in resource-limited set-ups. Adequately powered prospective studies with long-term follow-up are needed to confirm our findings.
评估儿童自闭症谱系障碍（ASD）诊断的稳定性很重要。来自印度的此类研究很少。我们旨在使用自闭症诊断观察量表，第二版（ADOS-2），评估≤ 5 岁儿童基于 DSM-5 的 ASD 初始诊断在 18-30 个月后的稳定性。
共有 125 名≤ 5 岁被 DSM-5 诊断为 ASD 的儿童，在 18-30 个月时使用 ADOS-2 进行随访，ADOS-2 被认为是诊断 ASD 的“金标准”观察评估，因此适合确认诊断的稳定性。
与发达国家的先前研究相似，ASD 诊断的稳定性为 80%。性别、社会经济地位与最终诊断的稳定性之间没有显著相关性。所有儿童继续存在一些发育困难，主要在语言、注意力或社会沟通领域。
我们的研究结果表明，DSM-5 可用于 ASD 的初始诊断，以在资源有限的环境中为患有这种疾病的儿童提供早期干预。需要进行具有长期随访的充分加权前瞻性研究来证实我们的发现。
