- 主题:关于谱系跟踪，诊断1年和3年后的结果两篇论文
这个论文是2021年的非常新，主要探讨早期诊断靠谱型，文章对于147个18-48个月确诊ASD谱系一年后跟踪，用ADOS判断程度，基本大部分还有谱系症状，但非常大部分(Significant percentage)程度降低，其中25%（也就是1/4，相当于“摘帽”了，所以X爸访谈里面3个月1年摘帽挺正常，不是个非常小概率事件）不再符合ASD诊断标准，但是这些不符合诊断标准的儿童都还是有一到两个领域的发育迟缓
One-Year Follow-Up Diagnostic Stability of Autism Spectrum Disorder Diagnosis in a Clinical Sample of Children and Toddlers
Some studies show that the diagnosis of Autism Spectrum Disorder could be considered reliable and stable in children aged 18 to 24 months. Nevertheless, the diagnostic stability of early ASD diagnosis has not yet been fully demonstrated. This observational study examines the one-year diagnostic stability of autism spectrum disorder diagnosis in a clinical sample of 147 children diagnosed between 18 and 48 months of age. The ADOS-2 scores were used in order to stratify children in three levels of symptom severity: Autism (AD; comparison score 5-7), Autism Spectrum Disorder (ASD; comparison score 3-4), and Sub-Threshold Symptoms; (STS; comparison score 1-2). Results: Overall, the largest part of children and toddlers diagnosed with autism spectrum disorder between 18 and 48 months continued to show autistic symptoms at one-year follow-up evaluation. Nevertheless, a significant percentage of children with higher ADOS severity scores exhibited a reduction of symptom severity and, therefore, moved towards a milder severity class one year later. Conversely, the number of subjects of the STS group meaningfully increased. Therefore, at one-year follow-up a statistically significant (χ2(2) = 181.46, p < 0.0001) percentage of subjects (25.2% of the total) who had received a categorical diagnosis of Autistic Disorder or Autism Spectrum Disorder in baseline no longer met the criteria for a categorical diagnosis. Furthermore, children who no longer met the criteria for autism spectrum disorder continue to show delays in one or more neurodevelopmental areas, possibly related to the emergence of other neurodevelopmental/neuropsychiatric disorders. Overall, the comprehensive results of the study account for a high sensibility but a moderate stability of ASD early diagnosis.
这个是Stephen教授引述的那篇，就是在PDD定义下的症状稳定性研究，跟踪了322个AD的儿童和122个PDD的儿童，结论是36个月之前诊断PDD的儿童三年之后的稳定性只有35%，即只有大概1/3儿童仍然诊断为PDD，而AD诊断稳定性是接近80%
Is pervasive developmental disorder not otherwise specified less stable than autistic disorder? A meta-analysis
We reviewed the stability of the diagnosis of pervasive developmental disorder not otherwise specified (PDD-NOS). A Medline search found eight studies reiterating a diagnostic assessment for PDD-NOS. The pooled group included 322 autistic disorder (AD) and 122 PDD-NOS cases. We used percentage of individuals with same diagnose at Times 1 and 2 as response criterion. The pooled Relative Risk was 1.95 (p < 0.001) showing that AD diagnostic stability was higher than PDD-NOS. When diagnosed before 36 months PDD-NOS bore a 3-year stability rate of 35%. Examining the developmental trajectories showed that PDD-NOS corresponded to a group of heterogeneous pathological conditions including prodromic forms of later AD, remitted or less severe forms of AD, and developmental delays in interaction and communication.
不过还是要说，虽然稳定性不高，但确实不能保证任何人落在lucky的那个范围，但至少证明症状改善可能性很大，即使从1年的那个维度来看
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修改:sdali FROM 27.125.156.*
FROM 27.125.156.*
ad 和odd分别是啥意思？
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FROM 124.127.145.*
3年太短，参考意义不大啊！应该写个5年到10年的更有意义
【 在 sdali 的大作中提到: 】
: 这个论文是2021年的非常新，主要探讨早期诊断靠谱型，文章对于147个18-48个月确诊ASD谱系一年后跟踪，用ADOS判断程度，基本大部分还有谱系症状，但非常大部分(Significant percentage)程度降低，其中25%（也就是1/4，相当于“摘帽”了，所以X爸访谈里面3个月1年摘帽挺正常，不是个非常小概率事件）不再符合ASD诊断标准，但是这些不符合诊断标准的儿童都还是有一到两个领域的发育迟缓
: One-Year Follow-Up Diagnostic Stability of Autism Spectrum Disorder Diagnosis in a Clinical Sample of Children and Toddlers
: Some studies show that the diagnosis of Autism Spectrum Disorder could be considered reliable and stable in children aged 18 to 24 months. Nevertheless, the diagnostic stability of early ASD diagnosis has not yet been fully demonstrated. This observational study examines the one-year diagnostic stability of autism spectrum disorder diagnosis in a clinical sample of 147 children diagnosed between 18 and 48 months of age. The ADOS-2 scores were used in order to stratify children in three levels of symptom severity: Autism (AD; comparison score 5-7), Autism Spectrum Disorder (ASD; comparison score 3-4), and Sub-Threshold Symptoms; (STS; comparison score 1-2). Results: Overall, the largest part of children and toddlers diagnosed with autism spectrum disorder between 18 and 48 months continued to show autistic symptoms at one-year follow-up evaluation. Nevertheless, a significant percentage of children with higher ADOS severity scores exhibited a reduction of symptom severity and, therefore, moved towards a milder severity class one year later. Conversely, the number of subjects of the STS group meaningfully increased. Therefore, at one-year follow-up a statistically significant (χ2(2) = 181.46, p < 0.0001) percentage of subjects (25.2% of the total) who had received a categorical diagnosis of Autistic Disorder or Autism Spectrum Disorder in baseline no longer met the criteria for a categorical diagnosis. Furthermore, children who no longer met the criteria for autism spectrum disorder continue to show delays in one or more neurodevelopmental areas, possibly related to the emergence of other neurodevelopmental/neuropsychiatric disorders. Overall, the comprehensive results of the study account for a high sensibility but a moderate stability of ASD early diagnosis.
: ...................
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FROM 221.223.193.*
ad是以前的经典自闭症，现在估计对应重度自闭症
pdd叫做未分类广泛性发育障碍，虽然看起来好像是发育迟缓，但实际是满足一些自闭症特征，但是又不是经典自闭症和阿斯伯格的那一部分，可以理解为现在的自闭症谱系
【 在 yyhn1959 的大作中提到: 】
: ad 和odd分别是啥意思？
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FROM 27.125.156.*
有没有调查久一点的文章？
比如pdd6岁以上的现状
【 在 sdali 的大作中提到: 】
ad是以前的经典自闭症，现在估计对应重度自闭症
pdd叫做未分类广泛性发育障碍，虽然看起来好像是发育迟缓，但实际是满足一
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FROM 114.251.211.*
我还真看了很多篇，一般90年代和这个世纪初的都偏悲观，因为可能诊断比较严格
这篇是2014年的，结果比较乐观，他统计了所有曾经诊断过ASD的，包括“痊愈”（OO）和高功能（HFA）结果都算乐观，OO的组和TD（就是完全nt）的组在很多社交领域没有明显差异，只是有3个OO的人还是很难识别面部表情
他的样本构成，34个ASD和OO，44个高功能和34个nt，年龄从8岁到21岁
Thirty-four individuals with a history of ASD and OO, 44 high-functioning individuals with a current ASD diagnosis (HFA), and 34 typically developing peers (TD) were tested. Participants ranged from 8 years, 1 month to 21 years, 8 months.
Optimal Outcome in Individuals with a History of Autism
Background
Although Autism Spectrum Disorders (ASDs) are generally considered lifelong disabilities, literature suggests that a minority of individuals with an ASD will lose the diagnosis. However, the existence of this phenomenon, as well as its frequency and interpretation, is still controversial: were they misdiagnosed initially, is this a rare event, did they lose the full diagnosis but still suffer significant social and communication impairments or did they lose all symptoms of ASD and function socially within the normal range?
Methods
The present study documents a group of these optimal outcome individuals (OO group, n=34) by comparing their functioning on standardized measures to age, sex, and nonverbal IQ matched individuals with high-functioning autism (HFA group, n=44) or typical development (TD group, n=34). For this study, ‘optimal outcome’ requires losing all symptoms of ASD in addition to the diagnosis, and functioning within the non-autistic range of social interaction and communication. Domains explored include language, face recognition, socialization, communication, and autism symptoms.
Results
OO and TD groups’ mean scores did not differ on socialization, communication, face recognition, or most language subscales, although three OO individuals showed below-average scores on face recognition. Early in their development, the OO group displayed milder symptoms than the HFA group in the social domain, but had equally severe difficulties with communication and repetitive behaviors.
Conclusions
Although possible deficits in more subtle aspects of social interaction or cognition are not ruled out, the results substantiate the possibility of optimal outcome from autism spectrum disorders and demonstrate an overall level of functioning within normal limits for this group.
【 在 whitelie 的大作中提到: 】
: 有没有调查久一点的文章？
: 比如pdd6岁以上的现状
: ad是以前的经典自闭症，现在估计对应重度自闭症
: ...................
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FROM 27.125.156.*
赞分享，版面需要您这样的分享者
【 在 sdali 的大作中提到: 】
我还真看了很多篇，一般90年代和这个世纪初的都偏悲观，因为可能诊断比较严格
这篇是2014年的，结果比较乐观，他统计了所
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FROM 120.244.236.*
不到成年，都难以有定论
整个成长期间变数太多了，尤其是青春期。
就算核心能力有极大提升，但仍然会伴有性格，心理，抑郁等问题。
【 在 sdali 的大作中提到: 】
: 这个论文是2021年的非常新，主要探讨早期诊断靠谱型，文章对于147个18-48个月确诊ASD谱系一年后跟踪，用ADOS判断程度，基本大部分还有谱系症状，但非常大部分(Significant percentage)程度降低，其中25%（也就是1/4，相当于“摘帽”了，所以X爸访谈里面3个月1年摘帽挺正常，不是个非常小概率事件）不再符合ASD诊断标准，但是这些不符合诊断标准的儿童都还是有一到两个领域的发育迟缓
: One-Year Follow-Up Diagnostic Stability of Autism Spectrum Disorder Diagnosis in a Clinical Sample of Children and Toddlers
: Some studies show that the diagnosis of Autism Spectrum Disorder could be considered reliable and stable in children aged 18 to 24 months. Nevertheless, the diagnostic stability of early ASD diagnosis has not yet been fully demonstrated. This observational study examines the one-year diagnostic stability of autism spectrum disorder diagnosis in a clinical sample of 147 children diagnosed between 18 and 48 months of age. The ADOS-2 scores were used in order to stratify children in three levels of symptom severity: Autism (AD; comparison score 5-7), Autism Spectrum Disorder (ASD; comparison score 3-4), and Sub-Threshold Symptoms; (STS; comparison score 1-2). Results: Overall, the largest part of children and toddlers diagnosed with autism spectrum disorder between 18 and 48 months continued to show autistic symptoms at one-year follow-up evaluation. Nevertheless, a significant percentage of children with higher ADOS severity scores exhibited a reduction of symptom severity and, therefore, moved towards a milder severity class one year later. Conversely, the number of subjects of the STS group meaningfully increased. Therefore, at one-year follow-up a statistically significant (χ2(2) = 181.46, p < 0.0001) percentage of subjects (25.2% of the total) who had received a categorical diagnosis of Autistic Disorder or Autism Spectrum Disorder in baseline no longer met the criteria for a categorical diagnosis. Furthermore, children who no longer met the criteria for autism spectrum disorder continue to show delays in one or more neurodevelopmental areas, possibly related to the emergence of other neurodevelopmental/neuropsychiatric disorders. Overall, the comprehensive results of the study account for a high sensibility but a moderate stability of ASD early diagnosis.
: ...................
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FROM 183.215.78.*
所谓普通小孩也会有青春期，也会碰到性格、心理、抑郁问题
这些还是在家庭的教育和每个孩子的发展，每个人一生中都会碰到困境，谱系和发育迟缓的小孩学业上肯定面临更多挑战，一个成绩有可能不是很好小孩，肯定心理问题就会多一些，普通小孩要是成绩垫底也会很多问题，还是找到他们的优势，有些小孩就是数学好，能够找到自己的位置，发展就会不错
其实我觉得这个帽子最大不好就是啥都可以归根于这个帽子，其实对于轻度和发育迟缓的小孩，大部分行为都和这个帽子没有啥关系
另外我下面那篇论文也说了，“脱帽”的大部分在成年跟踪研究中其实和普通人差距不大了，那个论文选择脱帽的标准是必须要有自然发展的朋友，不是简单的医学意义上的脱帽
【 在 hfyx 的大作中提到: 】
: 不到成年，都难以有定论
: 整个成长期间变数太多了，尤其是青春期。
: 就算核心能力有极大提升，但仍然会伴有性格，心理，抑郁等问题。
: ...................
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修改:sdali FROM 27.125.156.*
FROM 27.125.156.*
自然发展的朋友是啥意思？
- 来自 水木社区APP v3.5.5
【 在 sdali 的大作中提到: 】
所谓普通小孩也会有青春期，也会碰到性格、心理、抑郁问题
这些还是在家庭的教育和每个孩子的发展，每个人一生中都会碰到困境，
- 来自 水木社区APP v3.5.5
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FROM 218.30.113.*