Diagnostic Stability in Very Young Children with Autism Spectrum Disorders
Open accessAbstract
Autism Spectrum Disorders (ASD) diagnosis in very young children may be delayed due to doubts about validity. In this study, 77 children received a diagnostic and developmental evaluation between 16 and 35 months and also between 42 and 82 months. Diagnoses based on clinical judgment, Childhood Autism Rating Scale, and the Autism Diagnostic Observation Schedule were stable over time. Diagnoses made using the Autism Diagnostic Interview were slightly less stable. According to clinical judgment, 15 children (19%) moved off the autism spectrum by the second evaluation; none moved onto the spectrum. Results indicate diagnostic stability at acceptable levels for diagnoses made at age 2. Movement off the spectrum may reflect true improvement based on maturation, intervention, or over-diagnosis at age 2.
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The changes to SCQ and VABS-II scores are attributable to treatment rather than maturational effects.
“Similarly, we would contend that the changes to SCQ and VABS-II scores are attributable to treatment rather than maturational effects for two main reasons: 1) Without intervention, ASD symptoms are generally thought to be stable over time, particularly where symptoms are at the more severe end of the spectrum [34]; and 2) The SCQ and VABS-II have acceptable test-retest reliability, suggesting that”
From Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. (2013) · cites this paper as [34]
Without intervention, ASD symptoms are generally thought to be stable over time, particularly where symptoms are at the more severe end of the spectrum.
“Without intervention, ASD symptoms are generally thought to be stable over time, particularly where symptoms are at the more severe end of the spectrum [34]”
From Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. (2013) · cites this paper as [34]
Kleinman et al. did not report notable changes in MSEL scores in a sample of 46 children with Autistic disorder assessed between 16-35 months and again between 42-82 months.
“Similarly, Kleinman et al. [34] did not report notable changes in MSEL scores in a sample of 46 children with Autistic disorder who were first assessed between 16 and 35 months and again between 42 and 82 months, an age range analogous to that used in the present study.”
From Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. (2013) · cites this paper as [34]
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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Lord, C., Rutter, M., & Le Couteur, A. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172145 · Cited by 9,065 · see citing works
Bayley Scales of Infant Development
(2007) · Sage eBooks · doi:10.4135/9781412952644.n48 · Cited by 4,242 · see citing works
Mullen Scales of Early Learning
Bradley‐Johnson, S. (1997) · Psychology in the Schools · doi:10.1002/(sici)1520-6807(199710)34:4 · Cited by 2,329 · see citing works
Vineland Adaptive Behavior Scales
Sparrow, S. S. (2010) · Springer eBooks · doi:10.1007/978-0-387-79948-3_1602 · Cited by 1,974 · see citing works
Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1010738829569 · Cited by 1,563 · see citing works
Self-citationBayley Scales of Infant Development
Lennon, E. M., Gardner, J. M., Karmel, B. Z., & Flory, M. J. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-809324-5.23376-2 · Cited by 1,310 · see citing works
Early recognition of children with autism: a study of first birthday home videotapes
Osterling, J., & Dawson, G. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172225 · Cited by 1,290 · see citing works
Baranek, G. T. (1999) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1023080005650 · Cited by 1,027 · see citing works
Can Autism be Detected at 18 Months?
Baron‐Cohen, S., Allen, J., & Gillberg, C. (1992) · The British Journal of Psychiatry · doi:10.1192/bjp.161.6.839 · Cited by 861 · see citing works
Schopler, E., Reichler, R. J., DeVellis, R. F., & Daly, K. (1980) · PsycTESTS Dataset · doi:10.1037/t49458-000 · Cited by 859 · see citing works
Follow‐Up of Two‐Year‐Olds Referred for Possible Autism
Lord, C. (1995) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1995.tb01669.x · Cited by 645 · cited 9× · see citing works
“However, a number of recent studies have shown that ASD can be accurately detected in children under the age of 3 years (Charman and Baird 2002; Cox et al. 1999; Eaves and Ho 2004; Lord 1995; Moore and Goodson 2003; Stone et al. 1999).”
BackgroundResultInfluentialPsychological Markers in the Detection of Autism in Infancy in a Large Population
Baron‐Cohen, S., Cox, A., Baird, G., Swettenham, J., Nightingale, N., Morgan, K., Drew, A., & Charman, T. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.168.2.158 · Cited by 605 · see citing works
Harris, S. L., & Handleman, J. S. (2000) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1005459606120 · Cited by 604 · see citing works
Parental recognition of developmental abnormalities in autism
GIACOMO, A. D., & Fombonne, E. J. (1998) · European Child & Adolescent Psychiatry · doi:10.1007/s007870050058 · Cited by 596 · see citing works
The diagnosis of autism and Asperger syndrome: findings from a survey of 770 families
Howlin, P., & Asgharian, A. (1999) · Developmental Medicine & Child Neurology · doi:10.1017/s0012162299001656 · Cited by 500 · see citing works
Practitioner Review: Diagnosis of autism spectrum disorder in 2‐ and 3‐year‐old children
Charman, T., & Baird, G. (2002) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00022 · Cited by 446 · see citing works
Autism Spectrum Disorders at 20 and 42 Months of Age: Stability of Clinical and ADI-R Diagnosis
Cox, A., Klein, K., Charman, T., Baird, G., Baron‐Cohen, S., Swettenham, J., Drew, A., & Wheelwright, S. J. (1999) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00488 · Cited by 429 · see citing works
Can Autism Be Diagnosed Accurately in Children Under 3 Years?
Stone, W. L., Lee, E. B., Ashford, L., Brissie, J. S., Hepburn, S., Coonrod, E. E., & Weiss, B. (1999) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00435 · Cited by 428 · see citing works
Autism in Infancy and Early Childhood
Volkmar, F., Chawarska, K., & Klin, A. (2005) · Annual Review of Psychology · doi:10.1146/annurev.psych.56.091103.070159 · Cited by 400 · see citing works
Predictors of Optimal Outcome in Toddlers Diagnosed with Autism Spectrum Disorders
Sutera, S., Pandey, J., Esser, E. L., ROSENTHAL, M. A., Wilson, L. B., Barton, M. L., Green, J., Hodgson, S., Robins, D. L., Dumont-Mathieu, T. M., et al. (2007) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0340-6 · Cited by 341 · see citing works
Self-citationRegression and word loss in autistic spectrum disorders
Lord, C., Shulman, C., & DiLavore, P. S. (2004) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2004.t01-1-00287.x · Cited by 325 · see citing works
Vineland Adaptive Behavior Scales
Braaten, E. (2018) · The SAGE Encyclopedia of Intellectual and Developmental Disorders · doi:10.4135/9781483392271.n529 · Cited by 306 · see citing works
Bryson, S. E., Rogers, S. J., & Fombonne, E. J. (2003) · The Canadian Journal of Psychiatry · doi:10.1177/070674370304800802 · Cited by 275 · see citing works
How Well Does Early Diagnosis of Autism Stand the Test of Time?
Moore, V., & Goodson, S. (2003) · Autism · doi:10.1177/1362361303007001005 · Cited by 241 · see citing works
Autism Under Age 3 Years: A Clinical Study of 28 Cases Referred for Autistic Symptoms in Infancy
Gillberg, C., Ehlers, S., Schaumann, H., Jakobsson, G., Dahlgren, S. O., Lindblom, R., Bågenholm, A., Tjuus, T., & Blidner, E. (1990) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1990.tb00834.x · Cited by 240 · see citing works
Agreement Among Four Diagnostic Instruments for Autism Spectrum Disorders in Toddlers
Ventola, P. E., Kleinman, J. M., Pandey, J., Barton, M. L., Allen, S. T., Green, J., Robins, D. L., & FEIN, D. A. (2006) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-006-0128-8 · Cited by 197 · see citing works
Self-citationJOCELYN, L. J., CASIRO, O. G., BEATTIE, D., BOW, J., & KNEISZ, J. (1998) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-199810000-00002 · Cited by 140 · see citing works
SIEGEL, B., PLINER, C., ESCHLER, J., & ELLIOTT, G. R. (1988) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-198808000-00004 · Cited by 132 · see citing works
Moore, V., & Goodson, S. (2003) · Autism · doi:10.1177/1362361303007001018 · Cited by 111 · see citing works
Eaves, L. C., & Ho, H. H. (1996) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172276 · Cited by 110 · see citing works
A structured parent interview for identifying young children with autism
Stone, W. L., & Hogan, K. L. (1993) · Journal of Autism and Developmental Disorders · doi:10.1007/bf01046106 · Cited by 101 · see citing works
Journal of Child and Adolescent Psychiatry
(2019) · Journal of Child and Adolescent Psychiatry · doi:10.14302/issn.2643-6655 · Cited by 94 · see citing works
Wing, L. (1989) · Springer eBooks · doi:10.1007/978-1-4899-0882-7_2 · Cited by 46 · see citing works
Differential Ability Scales (DAS)
Kamphaus, R. W. (2005) · Springer eBooks · doi:10.1007/978-0-387-29149-9_13 · Cited by 37 · see citing works
Providing services to children with autism (ages 0 to 2 years) and their families
Prizant, B. M., & Wetherby, A. M. (1988) · Topics in Language Disorders · doi:10.1097/00011363-198812000-00003 · Cited by 24 · see citing works
Autism in young children: An update
Mays, R. M., & Gillon, J. E. (1993) · Journal of Pediatric Health Care · doi:10.1016/0891-5245(93)90022-a · Cited by 18 · see citing works
Providing Services to Children with Autism (Ages 0 to 2 Years) and Their Families
Prizant, B. M., & Wetherby, A. M. (1989) · Focus on Autism and Other Developmental Disabilities · doi:10.1177/108835768900400201 · Cited by 11 · see citing works
Flanagan, O., & Nualláin, S. O. (2001) · PubMed · Cited by 7 · see citing works
Using the ADI-R to diagnose autism in preschool children
Lord, C., Storoschuk, S., Rutter, M., & Pickles, A. (1993) · Infant Mental Health Journal · doi:10.1002/1097-0355(199323)14:3
Flagged first, then by citations
Research works printed but not linked: 1
- Lord C, Rutter M, DiLavore P, Risi S. Autism diagnostic observation schedule-WPS edition. Los Angles, CA: Western Psychological Services; 1999. [Google Scholar]
Cited by
Sorted by citations
Allison, C., Auyeung, B., & Baron-Cohen, S. (2012) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2011.11.003 · Cited by 1,016 · see citing works
Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007
Kogan, M. D., Blumberg, S. J., Schieve, L. A., Boyle, C. A., Perrin, J. M., Ghandour, R. M., Singh, G. K., Strickland, B. B., Trevathan, E., & van Dyck, P. C. (2009) · Pediatrics · doi:10.1542/peds.2009-1522 · Cited by 892 · see citing works
Preference for geometric patterns early in life as a risk factor for autism
Pierce, K., Conant, D., Hazin, R., Stoner, R., & Desmond, J. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.113 · Cited by 486 · see citing works
Luyster, R., Gotham, K., Guthrie, W., Coffing, M., Petrak, R., Pierce, K., Bishop, S., Esler, A., Hus, V., Oti, R., et al. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0746-z · Cited by 468 · see citing works
Zwaigenbaum, L., Bryson, S., Lord, C., Rogers, S., Carter, A., Carver, L., Chawarska, K., Constantino, J., Dawson, G., Dobkins, K., et al. (2009) · Pediatrics · doi:10.1542/peds.2008-1606 · Cited by 444 · see citing works
Self-citationClinical Genetic Testing for Patients With Autism Spectrum Disorders
Shen, Y., Dies, K. A., Holm, I. A., Bridgemohan, C., Sobeih, M. M., Caronna, E. B., Miller, K. J., Frazier, J. A., Silverstein, I., Picker, J., et al. (2010) · Pediatrics · doi:10.1542/peds.2009-1684 · Cited by 394 · see citing works
Herbert, M. R. (2010) · Current Opinion in Neurology · doi:10.1097/wco.0b013e328336a01f · Cited by 356 · see citing works
Can Children with Autism Recover? If So, How?
Helt, M., Kelley, E., Kinsbourne, M., Pandey, J., Boorstein, H., Herbert, M., & Fein, D. (2008) · Neuropsychology Review · doi:10.1007/s11065-008-9075-9 · Cited by 353 · see citing works
Self-citationPlitt, M., Barnes, K. A., & Martin, A. (2015) · NeuroImage: Clinical · doi:10.1016/j.nicl.2014.12.013 · Cited by 335 · see citing works
Keen, D., Couzens, D., Muspratt, S., & Rodger, S. (2010) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2009.09.009 · Cited by 271 · see citing works
Barbaro, J., & Dissanayake, C. (2009) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3181ba0f9f · Cited by 257 · see citing works
Detecting, Studying, and Treating Autism Early: The One-Year Well-Baby Check-Up Approach
Pierce, K., Carter, C., Weinfeld, M., Desmond, J., Hazin, R., Bjork, R., & Gallagher, N. (2011) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2011.02.036 · Cited by 256 · see citing works
Eapen, V., Črnčec, R., & Walter, A. (2013) · BMC Pediatrics · doi:10.1186/1471-2431-13-3 · Cited by 230 · see citing works
“[34] did not report notable changes in MSEL scores in a sample of 46 children with Autistic disorder who were first assessed between 16 and 35 months and again between 42 and 82 months, an age range analogous to that used in the present study.”
BackgroundResultAutism spectrum disorder in fragile X syndrome: a longitudinal evaluation
Hernandez, R. N., Feinberg, R. L., Vaurio, R., Passanante, N. M., Thompson, R. E., & Kaufmann, W. E. (2009) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.32848 · Cited by 178 · see citing works
Zwaigenbaum, L., Bryson, S. E., Brian, J., Smith, I. M., Roberts, W., Szatmari, P., Roncadin, C., Garon, N., & Vaillancourt, T. (2016) · Autism Research · doi:10.1002/aur.1585 · Cited by 165 · see citing works
Peters-Scheffer, N., Didden, R., Korzilius, H., & Matson, J. (2012) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2012.04.006 · Cited by 148 · see citing works
ECHO Autism STAT: Accelerating Early Access to Autism Diagnosis
Mazurek, M. O., Curran, A., Burnette, C., & Sohl, K. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3696-5 · Cited by 148 · see citing works
Wiggins, L. D., Reynolds, A., Rice, C. E., Moody, E. J., Bernal, P., Blaskey, L., Rosenberg, S. A., Lee, L.-C., & Levy, S. E. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2287-3 · Cited by 145 · see citing works
“…16.9 % of children with a previous ASD diagnosis did not meet SEED criteria for an ASD, which could suggest improvement in symptoms or challenges with ASD assessment and diagnosis at young ages (Lord et al. 2006; Kleinman et al. 2008; Sutera et al. 2007; Turner et al. 2006; Wiggins et al. 2012).”
InfluentialPatterns of developmental trajectories in toddlers with autism spectrum disorder
Lord, C., Luyster, R., Guthrie, W., & Pickles, A. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0027214 · Cited by 142 · see citing works
Kentrou, V., de Veld, D. M., Mataw, K. J., & Begeer, S. (2019) · Autism · doi:10.1177/1362361318785171 · Cited by 133 · see citing works
Matson, J. L., Matheis, M., Burns, C. O., Esposito, G., Venuti, P., Pisula, E., Misiak, A., Kalyva, E., Tsakiris, V., Kamio, Y., et al. (2017) · European Psychiatry · doi:10.1016/j.eurpsy.2016.10.007 · Cited by 107 · see citing works
Pramparo, T., Lombardo, M. V., Campbell, K., Barnes, C. C., Marinero, S., Solso, S., Young, J., Mayo, M., Dale, A., Ahrens‐Barbeau, C., et al. (2015) · Molecular Systems Biology · doi:10.15252/msb.20156108 · Cited by 88 · see citing works
Crowdsourced validation of a machine-learning classification system for autism and ADHD
Duda, M., Haber, N., Daniels, J., & Wall, D. P. (2017) · Translational Psychiatry · doi:10.1038/tp.2017.86 · Cited by 105 · see citing works
Change in autism classification with early intervention: predictors and outcomes.
Ben Itzchak, E., & Zachor, D. A. (2009) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2009.05.001 · Cited by 63 · see citing works
Validity of DSM-IV syndromes in preschoolers with autism spectrum disorders
Lecavalier, L., Gadow, K. D., Devincent, C. J., Houts, C. R., & Edwards, M. C. (2011) · Autism · doi:10.1177/1362361310391115 · Cited by 29 · see citing works
The Behavioral Manifestations of Autism Spectrum Disorders
Kim, S. H., & Lord, C. (2013) · The Neuroscience of Autism Spectrum Disorders · doi:10.1016/b978-0-12-391924-3.00002-8 · Cited by 31 · see citing works
Larsen, K., Aasland, A., & Diseth, T. H. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3355-2 · Cited by 17 · see citing works
Autism and epistemology III: child development, behavioral stability, and reliability of measurement
Fisch, G. S. (2012) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.35269 · Cited by 13 · see citing works
- Authors
- Kleinman, J. M., Ventola, P. E., Pandey, J., Verbalis, A. D., Barton, M., Hodgson, S., Green, J., Dumont-Mathieu, T., Robins, D. L., & Fein, D.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Kleinman, Jamie M.
- ORCID
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2007-10-09
- Volume
- 38
- Issue
- 4
- Pages
- 606-615
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- PMC
- PMC3625643
- OpenAlex
- W2077830280
- Cited by
- 272
- References
- 40
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 5 · 2022: 17 · 2021: 16 · 2020: 10 · 2019: 12 · 2018: 13 · 2017: 17 · 2016: 32 · 2015: 20 · 2014: 18 · 2013: 21 · 2012: 26
- FWCI
- 5.84
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- U.S. Public Health Service (R40 MC00270)
- Maternal and Child Health Bureau
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039961)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- autism spectrum disorder, diagnostic stability, very young children, early diagnosis, Childhood Autism Rating Scale, Autism Diagnostic Observation Schedule, clinical judgment, developmental evaluation, overdiagnosis, maturation
- MeSH terms
- Autistic Disorder, Child, Child, Preschool, Diagnosis, Differential, Female, Humans, Male, Severity of Illness Index, Prevalence, Early Diagnosis
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