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Diagnostic Stability in Very Young Children with Autism Spectrum Disorders

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Abstract

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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Acknowledgments

We gratefully acknowledge the assistance of participating pediatricians and staff in their offices, as well as providers in the Connecticut and Massachusetts Birth-to-Three Early Intervention systems. We would like to thank Jillian Wood, Executive Director of the Hezekiah Beardsley Chapter of the American Academy of Pediatrics, who assisted in recruiting participating physician offices and promoted the study state-wide, as well our dedicated undergraduate research assistants, and the children and families who participated. We would also like to extend sincere thanks to members of the Early Detection Advisory Board, especially Ho-Wen Hsu, MD, and Mark Greenstein, MD, for their wise advice and support. Graduate students Leandra Berry, Hilary Boorstein, Emma Esser, Saasha Sutera, and Mike Rosenthal, and Gail Marshia, Project Coordinator, were invaluable in conducting all aspects of the study. This paper was prepared from the masters thesis of Jamie M. Kleinman at the University of Connecticut. This study is supported by NIH grant R01 HD039961 and Maternal and Child Health Bureau grant R40 MC00270 and prior grants from the National Association for Autism Research, NIMH, and the Department of Education.

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Author notes

  1. Diana L. Robins

    Present address: Georgia State University, Atlanta, GA, USA

Authors and Affiliations

  1. Department of Psychology, University of Connecticut, 406 Babbidge Rd., Storrs, CT, 06269-1020, USA

    Jamie M. Kleinman, Pamela E. Ventola, Juhi Pandey, Alyssa D. Verbalis, Marianne Barton, Sarah Hodgson, James Green, Thyde Dumont-Mathieu, Diana L. Robins & Deborah Fein

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  1. Jamie M. Kleinman
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  2. Pamela E. Ventola
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  3. Juhi Pandey
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  4. Alyssa D. Verbalis
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  6. Sarah Hodgson
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  7. James Green
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  9. Diana L. Robins
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  10. Deborah Fein
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Correspondence to Jamie M. Kleinman.

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Kleinman, J.M., Ventola, P.E., Pandey, J. et al. Diagnostic Stability in Very Young Children with Autism Spectrum Disorders. J Autism Dev Disord 38, 606–615 (2008). https://doi.org/10.1007/s10803-007-0427-8

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  • DOI: https://doi.org/10.1007/s10803-007-0427-8

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