Nordin V, Gillberg C
Department of Child and Adolescent Psychiatry, Göteborg University, Annedals Clinics, Sweden.
Acta Psychiatr Scand. 1998 Feb;97(2):99-108. doi: 10.1111/j.1600-0447.1998.tb09970.x.
The majority of children with autism show deviance and socially or psychiatrically handicapping conditions throughout life. Only a small proportion of those with classical childhood autism lead independent adult lives. Others, particularly those with 'high-functioning' autism and so-called Asperger syndrome will improve enough to live an independent adult life. The level of mental retardation and other comorbid conditions (such as medical syndromes and other neuropsychiatric disorders, including epilepsy) is important in predicting outcome. An IQ below 50 around school age predicts severe restriction of social and adaptive functioning in adult life. The absence of communicative speech at 5-6 years of age is indicative of a poorer long-term overall outcome. There is a clear co-variation between IQ and level of communication, but probably there is some prognostic factor in language development apart from this. Measures of flexibility and cognitive shifting abilities tend to be good predictors of social outcome in a few studies. There is a continued need for prospective, longitudinal studies of children with autism spectrum disorders, particularly in Asperger syndrome. The role of interventions of various kinds needs to be addressed in such studies.
大多数自闭症儿童一生都表现出异常以及社交或精神方面的障碍。只有一小部分典型儿童自闭症患者能成年后独立生活。其他患者，尤其是那些患有“高功能”自闭症和所谓阿斯伯格综合征的患者，会有足够改善从而成年后独立生活。智力迟钝程度和其他共病情况（如医学综合征和其他神经精神障碍，包括癫痫）对预测预后很重要。学龄期智商低于50预示着成年后社交和适应功能会受到严重限制。5 - 6岁时无交流性言语表明长期总体预后较差。智商和交流水平之间存在明显的共变关系，但除此之外，语言发展可能还有一些预后因素。在一些研究中，灵活性和认知转换能力的测量往往是社交预后的良好预测指标。持续需要对自闭症谱系障碍儿童，尤其是阿斯伯格综合征儿童进行前瞻性纵向研究。此类研究需要探讨各种干预措施的作用。
