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Autism Spectrum Disorders at 20 and 42 Months of Age: Stability of Clinical and ADI-R Diagnosis

Published online by Cambridge University Press:  01 July 1999

Antony Cox
Affiliation:
Bloomfield Clinic and Newcomen Centre, Guy's, King's College, and St Thomas' Medical School, London, U.K.
Kate Klein
Affiliation:
West London Healthcare NHS Trust, Ealing Hospital, London, U.K.
Tony Charman
Affiliation:
Institute of Child Health, University College, London, U.K.
Gillian Baird
Affiliation:
Bloomfield Clinic and Newcomen Centre, Guy's, King's College, and St Thomas' Medical School, London, U.K.
Simon Baron-Cohen
Affiliation:
University of Cambridge, U.K.
John Swettenham
Affiliation:
University College London, U.K.
Auriol Drew
Affiliation:
Bloomfield Clinic and Newcomen Centre, Guy's, King's College, and St Thomas' Medical School, London, U.K.
Sally Wheelwright
Affiliation:
University of Cambridge, U.K.
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Abstract

The association between, and stability of, clinical diagnosis and diagnosis derived from the Autism Diagnostic Interview-Revised (ADI-R; Lord, Rutter, & Le Couteur, 1994) was examined in a sample of prospectively identified children with childhood autism and other pervasive developmental disorders assessed at the age of 20 months and 42 months. Clinical diagnosis of autism was stable, with all children diagnosed with childhood autism at age 20 months receiving a diagnosis of childhood autism or a related pervasive developmental disorder (PDD) at age 42 months. Clinical diagnosis of childhood autism was also reasonably sensitive, with all children who went on to receive a clinical diagnosis of childhood autism at 42 months being identified as having autism or PDD at 20 months. However, clinical diagnosis for PDD and Asperger's syndrome lacked sensitivity at 20 months, with several children who subsequently received these diagnoses at 42 months receiving diagnoses of language disorder or general developmental delay, as well as in two cases being considered clinically normal, at the earlier timepoint. The ADI-R was found to have good specificity but poor sensitivity at detecting childhood autism at 20 months; however, the stability of diagnosis from 20 to 42 months was good. In addition, the ADI-R at age 20 months was not sensitive to the detection of related PDDs or Asperger's syndrome. The continuity and discontinuity between behavioural abnormalities identified at both timepoints in the three domains of impairment in autism was examined, both in children who met final clinical criteria for an autistic spectrum disorder, and for children with language disorder who did not, as well as for a small sample of typically developing children.

Type
Research Article
Copyright
© 1999 Association for Child Psychology and Psychiatry

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