Objective

For the first time, we use a longitudinal population-based autism cohort to chart the trajectories of cognition and autism symptoms from childhood to early adulthood and identify features that predict the level of function and change with development.

Method

Latent growth curve models were fitted to data from the Special Needs and Autism Project cohort at three time points: 12, 16, and 23 years. Outcome measures were IQ and parent-reported Social Responsiveness Scale autism symptoms. Of the 158 participants with an autism spectrum disorder at 12 years, 126 (80%) were reassessed at 23 years. Child, family, and contextual characteristics obtained at 12 years predicted intercept and slope of the trajectories.

Results

Both trajectories showed considerable variability. IQ increased significantly by a mean of 7.48 points from 12 to 23 years, whereas autism symptoms remained unchanged. In multivariate analysis, full-scale IQ was predicted by initial language level and school type (mainstream/specialist). Participants with a history of early language regression showed significantly greater IQ gains. Autism symptoms were predicted by Social Communication Questionnaire scores (lifetime version) and emotional and behavioral problems. Participants attending mainstream schools showed significantly fewer autism disorder symptoms at 23 years than those in specialist settings; this finding was robust to propensity score analysis for confounding.

Conclusion

Our findings suggest continued cognitive increments for many people with autism across the adolescent period, but a lack of improvement in autism symptoms. Our finding of school influences on autism symptoms requires replication in other cohorts and settings before drawing any implications for mechanisms or policy.

中文翻译：

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从童年到成年的自闭症症状和认知能力的轨迹：来自纵向流行病学队列的发现。

客观的

我们首次使用基于人群的纵向自闭症队列来绘制从儿童期到成年早期的认知和自闭症症状的轨迹，并确定预测功能水平和随发育变化的特征。

方法

潜在生长曲线模型与来自特殊需求和自闭症项目队列在三个时间点的数据拟合：12、16 和 23 年。结果指标是智商和父母报告的社会反应量表自闭症症状。在 12 年时患有自闭症谱系障碍的 158 名参与者中，126 人（80%）在 23 年时接受了重新评估。在 12 岁时获得的儿童、家庭和背景特征预测了轨迹的截距和斜率。

结果

两条轨迹都显示出相当大的可变性。从 12 岁到 23 岁，智商平均提高了 7.48 分，而自闭症症状保持不变。在多变量分析中，全面智商是通过初始语言水平和学校类型（主流/专业）来预测的。有早期语言退化史的参与者的智商显着提高。自闭症症状是通过社会交流问卷分数（终身版）和情绪和行为问题来预测的。就读于主流学校的参与者在 23 年时表现出的自闭症症状明显少于专业环境中的参与者；这一发现对于混杂的倾向评分分析是可靠的。

结论

我们的研究结果表明，许多自闭症患者在整个青春期的认知持续增加，但自闭症症状缺乏改善。我们发现学校对自闭症症状的影响需要在其他队列和环境中复制，然后才能对机制或政策产生任何影响。