Fifteen-Year Prospective Follow-Up Study of Adult Outcomes of Autism Spectrum Disorders Among Children Attending Centers in Five Regional Departments in France: The EpiTED Cohort.
Amaria Baghdadli, Cécile Rattaz, Cécile Michelon and 2 others
PMID 30701432WHAT IT FOUND
Most children with ASD in this French follow-up still had very slow growth in communication, socialization and daily living skills by young adulthood.
Early autism severity and intellectual level predicted later adaptive outcomes, and language impairment was linked to self-injury.
Key findings
01About 80% of participants had very slow growth in adaptive communication, socialization and daily living skills from preschool to young adulthood; about 20% had faster growth.
02Degree of autism and intellectual level at baseline predicted later adaptive outcomes.
03At young adulthood, challenging behaviours were related to cognitive and language level, ASD severity, and gastrointestinal or sleep problems; language impairment predicted co-occurring self-injurious behaviour.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample came from French public child psychiatry and ASD clinics in 1997 to 1999, and most children had severe forms of ASD or co-occurring intellectual disability, so it may not match today's broader ASD population. Loss to follow-up was about 20% at each stage, and selection bias cannot be ruled out. Intellectual functioning was estimated using different tests across ages, and some participants could not complete tests, so the shift toward severe intellectual disability may partly reflect measurement issues. The study was observational and historical; it did not assign or test interventions, so it cannot show which services caused or prevented the observed outcomes. Many outcomes relied on parent report or records, including milestones, services and parental quality of life.
Declared interests
The authors declare no conflict of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not read the slow adaptive growth as proof that a particular therapy failed, or the link between language impairment and self-injury as proof that improving language will reduce self-injury. This was an observational cohort, not an intervention trial, and it reported associations over time.