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Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician

BACKGROUND: Autism spectrum disorder is a complex condition with wide variation in type and severity that involves persistent challenges in social interaction, speech and nonverbal communication, restricted/repetitive behaviours and adaptive behaviours. In recent years, research has deepened the stu...

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Autores principales: Di Renzo, Magda, di Castelbianco, Federico Bianchi, Alberto, Villani, Antonio, Del Vecchio, Giovanni, Corsello, Vanadia, Elena, Petrillo, Massimiliano, Davide, Trapolino, Racinaro, Lidia, Rea, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977604/
https://www.ncbi.nlm.nih.gov/pubmed/33736673
http://dx.doi.org/10.1186/s13052-021-01008-5
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author Di Renzo, Magda
di Castelbianco, Federico Bianchi
Alberto, Villani
Antonio, Del Vecchio
Giovanni, Corsello
Vanadia, Elena
Petrillo, Massimiliano
Davide, Trapolino
Racinaro, Lidia
Rea, Monica
author_facet Di Renzo, Magda
di Castelbianco, Federico Bianchi
Alberto, Villani
Antonio, Del Vecchio
Giovanni, Corsello
Vanadia, Elena
Petrillo, Massimiliano
Davide, Trapolino
Racinaro, Lidia
Rea, Monica
author_sort Di Renzo, Magda
collection PubMed
description BACKGROUND: Autism spectrum disorder is a complex condition with wide variation in type and severity that involves persistent challenges in social interaction, speech and nonverbal communication, restricted/repetitive behaviours and adaptive behaviours. In recent years, research has deepened the study of the predictive factors of optimal outcome, intended as indicators of positive trajectory in children with a previous diagnosis of autism who, after a therapeutic path, show a significant reduction in the “core” symptoms of autism and a positive evolution in social, adaptive, affective, and relational skills. METHODS: The study included 40 children aged 21 to 66 months, enrolled between 2015 and 2016 for an autism spectrum disorder clinical suspicious. Children were re-evaluated after at least 2 years of therapy and they were divided into two groups: the ASD-ASD group included children with a confirmed diagnosis of ASD, and the ASD-OO comparison group included children who no longer met the criteria for an autism classification. The aim of this retrospective study was to investigate the presence of cognitive, emotional and relational predictors capable of predicting the presence of optimal outcome in with a diagnosis of autism; the predictors taken into consideration were the intelligence quotient, the play, the emotional contagion and the understanding of other’s intentions. In this way, it is possible to support clinicians in defining a more complete diagnostic framework of autism, using assessment tools that can be administered quickly and therefore suitable for short observation sessions in paediatric patients. RESULTS: The findings showed that 15 out of 40 children, after at least for 2 years, no longer fell into the diagnostic ASD category based on the ADOS-2, DSM-5 and clinical criteria. The children in the ASD-OO group initially had a higher IQ than those in the ASD-ASD group, lower severity of autistic symptoms, greater understanding of intentions, more emotional contagion, and better quality of play. The results suggest that the initial coexistence of skills in these areas at the time of the first diagnostic assessment may allow us to predict the possibility of achieving optimal outcome after 2 years of therapy. CONCLUSIONS: The data of this study highlight the importance of considering, during assessment, intelligence quotient, play, emotional contagion, and understanding of the intentions of others as potential prognostic predictors that can become useful tools for clinicians and paediatricians. This allows us to focus attention, in both the diagnostic and prognostic phases, on emotional-relational variables that can support the clinician in defining a more complete diagnostic framework and in planning a more personalized therapeutic path.
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spelling pubmed-79776042021-03-22 Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician Di Renzo, Magda di Castelbianco, Federico Bianchi Alberto, Villani Antonio, Del Vecchio Giovanni, Corsello Vanadia, Elena Petrillo, Massimiliano Davide, Trapolino Racinaro, Lidia Rea, Monica Ital J Pediatr Research BACKGROUND: Autism spectrum disorder is a complex condition with wide variation in type and severity that involves persistent challenges in social interaction, speech and nonverbal communication, restricted/repetitive behaviours and adaptive behaviours. In recent years, research has deepened the study of the predictive factors of optimal outcome, intended as indicators of positive trajectory in children with a previous diagnosis of autism who, after a therapeutic path, show a significant reduction in the “core” symptoms of autism and a positive evolution in social, adaptive, affective, and relational skills. METHODS: The study included 40 children aged 21 to 66 months, enrolled between 2015 and 2016 for an autism spectrum disorder clinical suspicious. Children were re-evaluated after at least 2 years of therapy and they were divided into two groups: the ASD-ASD group included children with a confirmed diagnosis of ASD, and the ASD-OO comparison group included children who no longer met the criteria for an autism classification. The aim of this retrospective study was to investigate the presence of cognitive, emotional and relational predictors capable of predicting the presence of optimal outcome in with a diagnosis of autism; the predictors taken into consideration were the intelligence quotient, the play, the emotional contagion and the understanding of other’s intentions. In this way, it is possible to support clinicians in defining a more complete diagnostic framework of autism, using assessment tools that can be administered quickly and therefore suitable for short observation sessions in paediatric patients. RESULTS: The findings showed that 15 out of 40 children, after at least for 2 years, no longer fell into the diagnostic ASD category based on the ADOS-2, DSM-5 and clinical criteria. The children in the ASD-OO group initially had a higher IQ than those in the ASD-ASD group, lower severity of autistic symptoms, greater understanding of intentions, more emotional contagion, and better quality of play. The results suggest that the initial coexistence of skills in these areas at the time of the first diagnostic assessment may allow us to predict the possibility of achieving optimal outcome after 2 years of therapy. CONCLUSIONS: The data of this study highlight the importance of considering, during assessment, intelligence quotient, play, emotional contagion, and understanding of the intentions of others as potential prognostic predictors that can become useful tools for clinicians and paediatricians. This allows us to focus attention, in both the diagnostic and prognostic phases, on emotional-relational variables that can support the clinician in defining a more complete diagnostic framework and in planning a more personalized therapeutic path. BioMed Central 2021-03-18 /pmc/articles/PMC7977604/ /pubmed/33736673 http://dx.doi.org/10.1186/s13052-021-01008-5 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Di Renzo, Magda
di Castelbianco, Federico Bianchi
Alberto, Villani
Antonio, Del Vecchio
Giovanni, Corsello
Vanadia, Elena
Petrillo, Massimiliano
Davide, Trapolino
Racinaro, Lidia
Rea, Monica
Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
title Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
title_full Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
title_fullStr Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
title_full_unstemmed Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
title_short Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
title_sort prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977604/
https://www.ncbi.nlm.nih.gov/pubmed/33736673
http://dx.doi.org/10.1186/s13052-021-01008-5
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