OTSLPCohortAutism : the international journal of research and practice2019

Mortality in individuals with autism spectrum disorder: Predictors over a 20-year period.

Leann Smith DaWalt, Jinkuk Hong, Jan S Greenberg and 1 others

PMID 30818975

WHAT IT FOUND

In adults and adolescents with autism, poorer health, lower daily living independence, and greater early social reciprocity impairment predicted higher mortality risk over 20 years.

Deaths were premature, but this is an association, not proof treatment changes survival.

Key findings

01During 20 years, 26 of 406 individuals with ASD died, and the average age at death was 39 years.

02Each one-point higher daily living independence score was associated with a 6.5% lower mortality risk over 20 years.

03Each one-point higher lifetime social reciprocity impairment score was associated with a 27% higher mortality risk over 20 years.

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

Only individuals who survived to age 10 were eligible, and 75% of the cohort were still alive at the end, so the analysis had censoring at both ends. The sample was a volunteer community cohort and was largely Caucasian, so results may not apply to more diverse populations. The adults were from an earlier service landscape and had a larger proportion with co-occurring intellectual disability than children diagnosed today. Causes of death were known for many cases but did not capture the sequence of health problems before death. Only 26 deaths were observed during follow-up.

Declared interests

No author conflicts of interest are reported in the supplied text. The publication types indicate NIH extramural and non-U.S. government research support.

The easy way to misread this

Do not conclude that improving daily living skills or social reciprocity will reduce mortality. The study observed associations over 20 years and did not test treatment effects.

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