Tailored Growth of A Child Measures Positive Outcomes in Autism Spectrum Disorder (ASD)

Positive outcomes for children with autism spectrum disorder (ASD) are more common than previously thought, as per one of the biggest multi-site longitudinal research studies of its kind in the world led by The Hospital for Sick Children (SickKids) and the Centre for Addiction and Mental Health (CAMH), published in the journal JAMA.

Autism Spectrum Disorder

‘Positive outcomes for children with autism spectrum disorder (ASD) are more common than previously thought when the use of growth was utilized as a measurement. This allowed for comparison of whether an individual child improved in a domain against their younger selves and it also helps support a more flexible approach to developing future interventions that are tailored to each child. ’

Autism spectrum disorder (ASD) refers to a group of neurodevelopmental conditions characterized by challenges related to communication, social understanding, and behavior. It is estimated that 1 in 100 people may have ASD. Although a person can be diagnosed at any time, ASD symptoms generally appear and are diagnosed in the first few years of life.

Historically, research literature and outcome evaluations have focused on the deficits people with ASD may experience in intellectual or skills development and less has been studied in the Canadian pediatric context.

The study team thereby followed 272 children diagnosed with ASD from clinics across Canada from the ages of 2 to 10 years old, or mid-childhood, a notable age as children transition to greater autonomy and increased social and academic demands.

They performed assessments in children with an ASD diagnosis and measured participants' proficiency (level of competency) and growth (improvement over time) in five key developmental health areas: communication, socialization, activities of daily living and emotional health (internalizing and externalizing).

Better Outcomes in ASD

It was found that growth or proficiency in at least one of the five domains was experienced by 80% of children. And 23% of children were doing well in four or more of the domains by mid-childhood.

Core to the study's strengths-based approach was shifting the definition of a 'good outcome' to 'doing well'. Unique to the approach was the use of growth as a measurement, which allowed for comparison of whether an individual child improved in a domain against their younger selves.

"It was encouraging to find that most ASD children were doing well by 10 years old by some measure. By using different criteria to track their development apart from those used to diagnose autism -- such as ASD symptoms and cognitive ability -- we were able to reframe more holistically how we conceptualized progress in the autism field. Specifying an outcome implies that there's an end point, whereas doing well relates to an individual's circumstances at a particular point in their life's journey with autism -- especially important since these kids are just at the start of a journey," says co-author Dr. Peter Szatmari, Psychiatrist in Chief, Department of Psychiatry and Senior Scientist, Neurosciences & Mental Health at SickKids, and Chief of the Child and Youth Mental Health Collaborative between SickKids, CAMH and the University of Toronto.

Positive Outcomes in ASD Related to Family Context

Since an autism diagnosis exists alongside the social context in which ASD children are growing up, the contextual factors such as household income, parent coping, and family functioning (such as positive communication and support among family members) were also examined by the study.

It was observed that higher household income and better family functioning were important predictors in several aspects of doing well - suggesting that adequate income and a well-functioning family may help improve outcomes for a child with ASD.

"There is no one way of doing well, but these findings open up a new avenue of research to assess what types of specific interventions, such as providing more income resources or alternative treatment planning for families at an earlier stage of development, may help increase the likelihood that more children with ASD will do well over time," says Szatmari.

The study thereby highlights that this strengths-based perspective on an autism diagnosis can help support a more flexible approach to developing future interventions that are tailored to each child.

Thus future research would focus on outcomes among adolescents with autism as well as ways to further incorporate the perspectives of the participants themselves in outcome definition and measurement.

Source: Medindia