Early adolescent outcomes of institutionally deprived and non-deprived adoptees. III. Quasi-autism.
BACKGROUND
Some young children reared in profoundly depriving institutions have been found to show autistic-like patterns, but the developmental significance of these features is unknown.


METHODS
A randomly selected, age-stratified, sample of 144 children who had experienced an institutional upbringing in Romania and who were adopted by UK families was studied at 4, 6, and 11 years, and compared with a non-institutionalised sample of 52 domestic adoptees. Twenty-eight children, all from Romanian institutions, for whom the possibility of quasi-autism had been raised, were assessed using the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) at the age of 12 years.


RESULTS
Sixteen children were found to have a quasi-autistic pattern; a rate of 9.2% in the Romanian institution-reared adoptees with an IQ of at least 50 as compared with 0% in the domestic adoptees. There were a further 12 children with some autistic-like features, but for whom the quasi-autism designation was not confirmed. The follow-up of the children showed that a quarter of the children lost their autistic-like features by 11. Disinhibited attachment and poor peer relationships were also present in over half of the children with quasi-autism.


CONCLUSIONS
The findings at age 11/12 years confirmed the reality and clinical significance of the quasi-autistic patterns seen in over 1 in 10 of the children who experienced profound institutional deprivation. Although there were important similarities with 'ordinary' autism, the dissimilarities suggest a different meaning.
Rutter
Michael
M
MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK. j.wickham@iop.kcl.ac.uk
Kreppner
Jana
J
Croft
Carla
C
Murin
Marianna
M
Colvert
Emma
E
Beckett
Celia
C
Castle
Jenny
J
Sonuga-Barke
Edmund
E
D000293:Adolescent; D000300:Adoption / Q000208:ethnology / Q000523:psychology*; D001321:Autistic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003142:Communication; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007326:Institutionalization; D008607:Intellectual Disability / Q000175:diagnosis; D007361:Intelligence Tests; D007398:Interpersonal Relations; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D000297:Psychology, Adolescent; D011610:Psychosocial Deprivation; D012383:Romania / Q000208:ethnology; D012494:Sampling Studies; D013577:Syndrome; D006113:United Kingdom / Q000453:epidemiology