New model may better predict outcomes for children with autism and autistic spectrum disorders

July 05, 2005

A new classification tool may allow healthcare professionals treating children with autism and autism-related disorders to more systematically sort out the combination of traits in the condition, and to better predict how children may improve over time. If the model holds up to further study, it may also allow researchers to gauge the effectiveness of different autism treatments.

Developmental pediatrician James Coplan, M.D., reports on a study of 91 children he saw between 1997 and 2002 at the Regional Autism Center of The Children's Hospital of Philadelphia. Most patients were pre-schoolers or of elementary school age, and predominantly boys. The study appears in the July 2005 issue of Pediatrics.

The children in the study had autistic spectrum disorders (ASD), a group of neurodevelopmental disorders of impaired social communication. Those disorders include classic autism, pervasive developmental disorder and Asperger's syndrome. Dr. Coplan studied the relationship among three variables: the severity of the disorder (called atypicality), general intelligence (measured as IQ or developmental quotient) and time.

"These disorders are dynamic and change over time," says Dr. Coplan. "Although they are traditionally classified into mutually exclusive diagnostic boxes, they tend to blend into each other, and this model provides a way to look continuously at ASD, as the symptoms occur and develop along the autistic spectrum, and as the symptoms change over time."

Some children have severe autistic symptoms but high intelligence; others have mild symptoms and mental retardation, or combinations in between, he added. In explaining the model to parents, he sometimes draws an analogy to weight and height. Just as each individual can have a different combination of weight and stature, someone can have an individual combination of intelligence and degree of autism.

One central finding of the study, said Dr. Coplan, is that children in the normal range of intelligence (an IQ of 70 or above) show significant improvement in their ASD symptoms over time. "We can offer the hopeful message to parents that many children with ASD will improve as part of the natural course of the condition," he said. This finding reinforced impressions by Dr. Coplan and many previous researchers about clinical outcomes for children with ASD.

Dr. Coplan cautions that although the model has predictive value for clinical outcomes when looking at average outcomes for groups of children, it will not necessarily predict a course for each individual patient. Rather it would provide a "roadmap" on which to plot a child's progress over time.

The model still must be confirmed in larger studies of populations of children with ASD, not just in a sample from one clinic, according to Dr. Coplan.

If larger studies validate the model, he adds, it may become a benchmark to help researchers evaluate the effectiveness of particular ASD treatments. "Many currently popular therapies may be capitalizing on the natural history of ASD, and claiming such improvement on their own behalf," he writes in the paper. If patients improved more than would be anticipated from the model's outline of the natural course of ASD alone, that might provide evidence for a treatment's success.

Additionally, the model might shed light into causes of ASD, as yet unknown. Children with ASD from different causes may follow different developmental paths," says Dr. Coplan, and studying those patterns may help researchers to better identify causes for the diseases.

Dr. Coplan has since left Children's Hospital to establish a private practice, Neurodevelopmental Pediatrics of the Main Line, in Rosemont, Pa. Dr. Coplan's co-author was Abbas F. Jawad, Ph.D., of the Division of Biostatistics and Epidemiology of The Children's Hospital of Philadelphia, and the University of Pennsylvania School of Medicine. The Regional Autism Center at Children's Hospital houses a large interdisciplinary program for the diagnosis and treatment of children with ASD.
-end-
About The Children's Hospital of Philadelphia: The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit www.chop.edu.

Children's Hospital of Philadelphia

Related Autism Articles from Brightsurf:

Autism-cholesterol link
Study identifies genetic link between cholesterol alterations and autism.

National Autism Indicators Report: the connection between autism and financial hardship
A.J. Drexel Autism Institute released the 2020 National Autism Indicators Report highlighting the financial challenges facing households of children with autism spectrum disorder (ASD), including higher levels of poverty, material hardship and medical expenses.

Autism risk estimated at 3 to 5% for children whose parents have a sibling with autism
Roughly 3 to 5% of children with an aunt or uncle with autism spectrum disorder (ASD) can also be expected to have ASD, compared to about 1.5% of children in the general population, according to a study funded by the National Institutes of Health.

Adulthood with autism
The independence that comes with growing up can be scary for any teenager, but for young adults with autism spectrum disorder and their caregivers, the transition from adolescence to adulthood can seem particularly daunting.

Brain protein mutation from child with autism causes autism-like behavioral change in mice
A de novo gene mutation that encodes a brain protein in a child with autism has been placed into the brains of mice.

Autism and theory of mind
Theory of mind, or the ability to represent other people's minds as distinct from one's own, can be difficult for people with autism.

Potential biomarker for autism
A study of young children with autism spectrum disorder published in JNeurosci reveals altered brain waves compared to typically developing children during a motor control task.

Autism often associated with multiple new mutations
Most autism cases are in families with no previous history of the disorder.

State laws requiring autism coverage by private insurers led to increases in autism care
A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health has found that the enactment of state laws mandating coverage of autism spectrum disorder (ASD) was followed by sizable increases in insurer-covered ASD care and associated spending.

Autism's gender patterns
Having one child with autism is a well-known risk factor for having another one with the same disorder, but whether and how a sibling's gender influences this risk has remained largely unknown.

Read More: Autism News and Autism Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.