Adult Manifestation of Milder Forms of Autism Spectrum Disorder; Autistic and Non-autistic Psychopathology.
E H Horwitz, R A Schoevers, K Greaves-Lord and 2 others
PMID 32052317WHAT IT FOUND
Parent and self reports showed more autistic traits in adults with earlier milder autism diagnoses, but most did not meet standard observation criteria.
Comorbidity and education were similar, while they used more mental health care and medication.
Key findings
01Adults with an earlier autism diagnosis had higher parent-rated and self-rated total autistic-trait scores than other clinical adults, but self-rated differences were not significant on every subscale.
02Only 30 of 162 in the earlier autism group exceeded the original ADOS autism cutoff, and 31 of 162 exceeded the revised cutoff, compared with 1 of 29 in the non-autism clinical group.
03Lifetime psychiatric comorbidity was common in both groups and did not differ significantly, but more adults with earlier autism diagnoses used psychoactive medication or had contacts with specialized mental health service over the last 6 months.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The childhood autism diagnoses came from a psychiatric register and were not confirmed at that time with standardized measures, so some people may not have had autism, especially under stricter current criteria. The comparison group had many different psychiatric diagnoses, so it is not a clean non-autism reference. The structured interview used for comorbidity has little experience in people diagnosed with autism, and it did not assess eating disorders, psychosis, personality disorders, adjustment disorders, or autism itself. Only a limited set of social and academic outcomes was examined, so it does not show daily living or adaptive functioning. The ADOS comparison group was only 29 participants, so ADOS findings should be read cautiously. The earlier autism group had higher IQ scores than the comparison group, so differences in education or functioning may partly reflect that rather than autism alone.
The easy way to misread this
Do not read a childhood milder autism label as a current formal autism diagnosis. Only 30 of 162 exceeded the original ADOS cutoff and 31 of 162 exceeded the revised cutoff, while parent-rated traits were still higher than in other clinical adults.