Evaluation of additional diagnoses, functionality and factors affecting prognosis of patients diagnosed with autism spectrum disorder in our clinic between 2-6 years of age after 5 years of follow-up

Objective: In this thesis, we aim to evaluate the correlation between the age at diagnosis, the way of arrival, the symptoms at that time, the level of development, language development of children diagnosed with ASD in the past, and their functionality in daily life in their current situation, quality of life, and the severity of the disease. Method: After the approval of the ethics committee, the sociodemographic characteristics, age of diagnosis, reason for admission, symptoms at the time of admission, clinical features, developmental level of the patients at the age of 2-6, at the first application to the Department of Child and Adolescent Psychiatry, Ankara University Faculty of Medicine. The information is taken from the file. The developmental stages, clinical features, additional diagnoses, interventions, and medical treatments were examined in the 5-year period of the patients. In the clinical evaluation to be made today, K-SADS (Interview Schedule for Affective Disorders and Schizophrenia for School-Age Children) was applied to the patients. Current symptoms, autism severity, treatments, education programs, comorbid diagnoses, quality of life and functionality were evaluated. In order to evaluate these characteristics of the patients more concretely, CARS (Childhood Autism Assessment Scale), ODKL (Autism Behavior Checklist), SCQ (Social Communication Scale), Repetitive Behaviors in Autism Spectrum Disorder Scale, Dunn Sensory Profile Scale, , Quality of Life Scale for Children, Quality of Life in Autism Questionnaire-Parent Edition scales were used. Results: In our study, the age of diagnosis of autism and the age of onset of special education in patients with loss of diagnosis were found to be statistically significantly lower(p=0.033, p=0.003). There was no difference in age at diagnosis between genders. There is a statistically significant moderate and negative correlation between WISC-R Score and ODKL Score and CARS-TF Score. Patients with diagnosis loss had significantly higher WISC-R scores than those without diagnosis loss (p=0.030), and those with a Global Functioning score of 60 and above had significantly higher SB Verbal and Performance scores (p=0.033, p=0.044). Those with a Global Functioning score below 60 had a significantly higher Repetitive Behavior Scale-Revised (RBS-R-TV) score (p=0.003). There is a statistically significant and negative correlation between CARS-TF score and Global Functioning Score (p<0.001). No relationship could be established between special education hours and functionality. In our sample, 96% of the patients had comorbidities. The Quality of Life in Autism A(QOL-A) Scores were found to be higher in those whose mothers had a university education and whose mothers were working (p=0.004). The Quality of Life in Autism B (QOL-B) Scores of the participants whose fathers did not have a psychiatric disorder were found to be statistically significantly higher (p=0.040). ).With RBS-R-TV score score; There was a statistically significant high level correlation between all Sensory Profile scores (p<0.001). Conclusion: As far as we know, we think that our study will contribute to the literature since it is the first study in which the clinical features of children with autism at the time of first diagnosis and during the follow-up period, current disease severity, sensory profiles and repetitive behaviors, functionality, and quality of life of both individuals and their families are evaluated together. In our study, the prognostic importance of IQ and early diagnosis and initiation of early special education was emphasized again. In our study, sensory differences and repetitive behaviors were found to be correlated with disease severity. The inverse relationship of these factors with functionality indicates that these factors may have prognostic significance. Cognitive level, disease severity, comorbidities, sensory differences and repetitive behaviors should be well evaluated to predict the process. Prospective studies with larger sample sizes can be recommended to elucidate the causality and treatment processes of autism spectrum disorder.