397 - Characterizing Communication Outcomes in School-Aged Children Diagnosed with Autism Spectrum Disorder as Toddlers

Poster Number: 397
Publication Number: 397.118

Background: Little is known about predictors of communication outcomes for children diagnosed with Autism Spectrum Disorder (ASD) at a young age. Several studies found that ASD may not persist at school age for all children diagnosed as toddlers. There may be important differences in the trajectory of communication development between those whose ASD does vs. does not persist.

Objective: To: 1) determine predictors of communication outcomes at age 5-7-years in children who received a DSM-5 ASD diagnosis at 12-36 months and 2) understand differences in rate of change of communication scores over time among children with persistent and non-persistent ASD.

Design/Methods: We conducted a secondary analysis of a cohort study of 5-7-year-olds who were clinically diagnosed with DSM-5 ASD between 12-36 months in a multidisciplinary evaluation. Data from initial diagnosis (Time 1) were abstracted from medical records and included the Bayley-3, ADOS, and Vineland Adaptive Behavior Scales. At age 5-7 years, participants completed a research assessment (Time 2), including the ADI-R, ADOS-2, and Vineland Adaptive Behavior Scales-3rd Edition. Participants were given an overall best estimate of DSM-5 ASD, which was dichotomized to “persistent ASD” and “non-persistent ASD” based on the child’s current functioning. We used multiple regression analysis to evaluate the association between predictor variables (baseline cognitive, language, adaptive functioning, gender, maternal education, insurance) and Time 2 Vineland Communication Standard Scores (SS) (Aim 1). We used Hierarchical Linear Modeling (HLM) to compare slopes of Vineland Communication SS scores over time (Aim 2).

Results: In this cohort of 213 children diagnosed with ASD as toddlers (36 females [16.9%] and 177 males [83.1%]), 134 [62.9%] had persistent ASD, and 79 [37.1%] had non-persistent ASD at ages 5-7 years. Higher baseline adaptive functioning and having private insurance predicted later Vineland Communication SS (b=0.485, p< 0.05 and b=16.485, p< 0.05, respectively; Table 1). The non-persistent ASD group had higher baseline Vineland Communication SS and a steeper trajectory of growth compared with the persistent ASD group (p < 0.001 for differences in both slope and intercept).

Conclusion(s): Higher baseline adaptive functioning and private insurance were associated with higher communication at age 5-7 among children diagnosed with ASD as toddlers, suggesting that both child-specific factors and socio-economic status may influence communication outcomes. The developmental trajectory of communication skills was more favorable for children with non-persistent ASD.