Early Developmental and Clinical Characteristics of Autism Spectrum Disorders / 대한소아신경학회지

ABSTRACT

PURPOSE: Current evidence of the benefits of early intensive behavioral intervention (EIBI) in children with autism spectrum disorders(ASD) is increasing. In order to get the benefits from EIBI, early identification of ASD is essential but a challenge for clinicians. Therefore, we designed this study to know what differs from other developmental disorders in terms of early developmental patterns and clinical and laboratory characteristics. METHODS: Among 518 children diagnosed developmental delay in Ilsan Hospital Developmental Disorder Clinic from April 2001 to January 2005, we analyzed 122 ASD patients as a study group, and 133 mentally retarded(MR) and 101 specific language impaired(SLI) patients as control groups. We used a questionnaire survey to assess past and family history. We performed various kinds of tools for the evaluation of the development, and cognitive and speech functions according to the patients' age. MRI, SPECT, EEG, genetic and metabolic studies were performed as optional tests. RESULTS: The mean age of ASD was 55.9+/-30.7 months and male was predominant in ASD(malefemale ratio was 3.21). In early developmental history, motor functions are relatively well preserved in ASD(P<0.05). In speech and social milestones, single word speech was noticeably delayed in all the 3 groups. However, there was no appreciable difference in stranger anxiety among the 3 groups. In the developmental evaluation, speech and social functions were most significantly delayed in ASD(P<0.05). There was a significant motor delay in ASD and MR than SLI(P<0.05). In physical examination, a raised rate of macrocedphaly in ASD was not noted. Abnormal EEG findings were significantly noted in ASD and MR than in SLI and MRI abnormalities were least found in these groups. The etiologic diagnosis was much less identified in ASD than MR. CONCLUSION: In an early stage, absence of stranger anxiety was not statistically significant. However, this seems to be an important risk factor for predicting ASD. Motor functions were relatively well preserved in ASD in an early stage. In the developmental evaluation, social and language areas were the most significantly delayed domains in ASD and motor functions were most delayed in MR. Routine MRI studies are not indicated for identifying the etiology in ASD. It was harder to find out the etiology in ASD than MR.