Trajectories of Autism Severity in Children Using Standardized ADOS Scores
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OBJECTIVES: To plot longitudinal trajectories of autism spectrum disorder (ASD) severity from early childhood to early adolescence. In line with reported trajectories in toddlers, we hypothesize that a substantial minority of children will show marked changes in ASD severity over time, with "Improvers" demonstrating the highest mean baseline and rate of growth in verbal IQ (VIQ). METHODS: Patients included 345 clinic referrals and research participants with best-estimate clinical diagnoses of ASD at 1 or more time points, and repeated Autism Diagnostic Observation Schedule (ADOS), VIQ, and nonverbal IQ scores. Standardized ADOS severity scores were applied to 1026 assessments collected longitudinally between the ages of 2 and 15 (VIQ at most recent assessment: mean = 58, SD = 35). Scores were fitted for latent severity trajectory classes with and without covariates. Adaptive behavior and VIQ trajectories over time were modeled within each of the best-fit latent classes. RESULTS: A 4-class model best represented the observed data. Over 80% of participants were assigned to persistent (stable) high or moderately severe classes; 2 small classes respectively increased or decreased in severity over time. Age, gender, race, and nonverbal IQ did not predict class membership; VIQ was a significant predictor. Baseline VIQ was highest in the improving and worsening classes; it increased at the greatest rate in the improving class. Adaptive behavior declined in all but the improving class, with consistent impairment in all classes. CONCLUSIONS: If replicated, identified trajectory classes of ADOS severity may contribute to clinical prognosis and to subtyping samples for neurobiological and genetic research.
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Some evidence suggests that ADOS-2 standardized scores may be useful for identifying different trajectories of ASD severity.
“These scores have little relation to age or IQ (Kanne et al. 2011, Shumway et al. 2012), and some evidence suggests that they may be useful for identifying different trajectories of ASD severity (Gotham et al. 2012).”
From Recent Advances in Autism Research as Reflected in DSM-5 Criteria for Autism Spectrum Disorder (2015) · cites this paper as Gotham et al. 2012
Childhood language ability, especially the acquisition of language before age 5, and general intellectual ability are significant predictors of autistic features and adaptive behavior in autistic people.
“These studies have repeatedly shown that childhood language ability, especially the acquisition of language before age 5 (Eaves and Ho 2008;Gotham et al. 2012;Lotter 1974;Magiati et al. 2014;Pickles et al. 2014;Szatmari et al. 2003;Venter et al. 1992) and general intellectual ability (Bal et al. 2015;Gillberg and Steffenburg 1987;Howlin et al. 2013) are significant predictors of autistic features”
From Childhood Executive Function Predicts Later Autistic Features and Adaptive Behavior in Young Autistic People: a 12-Year Prospective Study (2019) · cites this paper as Gotham et al. 2012
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- Authors
- Gotham, K., Pickles, A., & Lord, C.
- Affiliations
- University of Michigan (US)
- King's College London (GB)
- Weill Cornell Medicine (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2012-11-01
- Volume
- 130
- Issue
- 5
- Pages
- e1278-e1284
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3483889
- OpenAlex
- W1965364605
- Cited by
- 271
- References
- 23
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 19 · 2023: 34 · 2022: 31 · 2021: 33 · 2020: 20 · 2019: 19 · 2018: 22 · 2017: 17 · 2016: 13 · 2015: 17 · 2014: 8 · 2013: 12 · 2012: 1
- FWCI
- 6.23
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Autism Speaks (AS2482)
- U.S. Public Health Service (NIMH RO1 MH57167)
- National Institute of Mental Health (T32 MH 18921, R25MH057167, T32MH018921, F32MH066469, MH066469)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD015052, U19HD035482, P30 HD-15052, HD-35482-01, P01HD035482)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, autism severity, longitudinal trajectories, verbal IQ, nonverbal intelligence, adaptive behavior, ASD subtypes, prognosis, children and adolescents
- MeSH terms
- Adolescent, Autistic Disorder, Child, Child, Preschool, Female, Humans, Male, Severity of Illness Index
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