Cited by 271Autism Spectrum Disorder ResearchChild Nutrition and Feeding IssuesGenetics and Neurodevelopmental Disorders

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Trajectories of Autism Severity in Children Using Standardized ADOS Scores

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Gotham, Katherine, Pickles, Andrew, Lord, Catherine·2012·Pediatrics

DOI 10.1542/peds.2011-3668PMC PMC3483889

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Abstract

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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Authors: Gotham, K., Pickles, A., & Lord, C.
Affiliations: University of Michigan (US)
King's College London (GB)
Weill Cornell Medicine (US)
ORCID: Gotham, Katherine
Pickles, Andrew
Lord, Catherine
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
DOI: 10.1542/peds.2011-3668
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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Trajectories of Autism Severity in Children Using Standardized ADOS Scores

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