Evaluating the characteristics of patients with a history of autism spectrum disorders WHO did not meet diagnostic criteria after receiving treatment and special education

Objective: The aim of this study is to evluate optimal outcome and current clinical characteristics in a group of cases with Autism Spectrum Disorder followed up in Dokuz Eylul University Hospital Child and Adolescent Psychiatry Department Outpatient Clinic and to compare sociodemographic and clinical features with the cases still being followed up with the diagnosis of High Functioning Autism (HFA). Method: This study consists of 60 cases aged 4-18 years who were diagnosed with Autism Spectrum Disorder according to DSM-IV (before 2013) or DSM-5 criteria by clinicians in Dokuz Eylul University Faculty of Medinice Hospital Child and Adolescent Psychiatry Department Outpatient Clinic and during follow-up considered optimal outcome and cases who still meet the diagnosis of High Functioning Autism. The necessary data were collected through retrospective examination of the medical records and during clinical interviews. Comorbid psychopathologies were assessed with the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) semi-structured interview. Childhood Autism Rating Scale (CARS), Strenghts and Difficulties Questionnaire (SDQ), Aberrant Behaviour Checklist (ABC) and Social Communication Questionnaire (SCQ) were applied to evaluate the severity of the symptoms and clinical features. Intelligence and developmental test results were recorded if available in the medical records for cognitive assessment. Results: The optimal outcome (OO) group was diagnosed and started special education at a significantly earlier age than the HFA group (p=0.001). The duration of pre-school education was also significantly higher in the optimal outcome group (p=0,023). Symptom severity assessed by CARS at both the time of diagnosis and the current situation was significantly lower in the optimal outcome group (p<0.001, p<0.001). There was no significant difference between the two groups in terms of early verbalization skills and WISC-R scores. At least one psychiatric diagnosis was present in 80% of the optimal outcome group. Total SCQ and ABC scores were significantly higher in the HFA group (p<0.001, p=0.001). SDQ Peer Problems subscale and total difficulty score were significantly higher in the HFA group (p=0.001, p=0.014). A moderate positive correlation was found between total SCQ score and the time to optimal outcome (p=0.004, r=0.507). Conclusion: In out study we defined a group of children who lost their diagnosis of autism after special education. Even if the diagnosis is lost, subthreshold psychiatric symptoms and non-ASD diagnosis continued at a high rate. Early diagnosis and initiation of special education and less severe ASD symptoms at the time of diagnosis were found to be important factors contributing to optimal outcome.