title: Can biological components predict short-term evolution in Autism Spectrum Disorders? A proof-of-concept study.
abstract: BACKGROUND
  The clinical and pathogenetic heterogeneity of Autism Spectrum Disorders (ASD) limits our ability to predict its short- and long-term evolution. Aim of this naturalistic study was to observe the clinical evolution of very young children with ASD for 12 months after first diagnosis, in order to identify those children who might develop a more positive trajectory and understand how a wide range of biological, clinical and familial factors can influence prognosis.
  
  
  METHODS
  Ninety-two children were characterized in terms of family history, prenatal and perinatal variables, and clinical conditions. The sample was divided into four subgroups based on the association of 22 biological, clinical and family history variables. Developmental Quotient (DQ), determined using the Psychoeducational Profile Revised (PEP-R), and symptoms severity, measured by means of the Autism Diagnostic Observation Schedule (ADOS), were evaluated at baseline (T0) and after one year (T1), while receiving treatment as usual. Changes in DQ and ADOS between baseline and follow-up and differences in the short-term evolution of the four subgroups were analyzed.
  
  
  RESULTS
  At T1, 55.4 % of the children demonstrated some gains either of autistic symptomatology or of developmental skills. Mean ADOS score was 13.63 ± 3.67 at T0 and 10.85 ± 4.10 at T1 and mean DQ was 0.64 ± 0.14 at T0 and 0.66 ± 0.15 at T1. At follow-up, 33.7 % of the children showed an improvement in DQ and 37 % presented a less severe symptomatology, measured by means of ADOS. Overall, 15.2 % of the sample displayed major improvements both on developmental quotient and ADOS severity score; these children presented less EEG abnormalities and familial psychiatric disorders. The four subgroups, based on biological, clinical and familial variables, showed differing trends in terms of evolution.
  
  
  CONCLUSIONS
  Categorizing very young children with ASD in terms of biological, clinical and familial variables can be instrumental in predicting short-term evolution. This exploratory study highlights the importance of a precise characterization and thorough analysis of interactions among biological and clinical variables, in order to predict the developmental evolution in children with ASD.
authors.affiliation: Department of Biomedicine and Prevention, University of Rome "Tor Vergata", via Montpellier 1, 00133, Rome, Italy.|Centre for Communication and Neurorehabilitation Research-CNAPP, via Marcantonio Boldetti 12, 00162, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Emberti Gialloreti
authors.affiliation: Department of Neuroscience, Pediatric Neurology Unit, University of Rome "Tor Vergata", via Montpellier 1, 00133, Rome, Italy.|Centre for Communication and Neurorehabilitation Research-CNAPP, via Marcantonio Boldetti 12, 00162, Rome, Italy.
authors.forename: Arianna
authors.initials: A
authors.lastname: Benvenuto
authors.affiliation: Department of Neuroscience, Pediatric Neurology Unit, University of Rome "Tor Vergata", via Montpellier 1, 00133, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Battan
authors.affiliation: Centre for Communication and Neurorehabilitation Research-CNAPP, via Marcantonio Boldetti 12, 00162, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Benassi
authors.affiliation: Department of Neuroscience, Pediatric Neurology Unit, University of Rome "Tor Vergata", via Montpellier 1, 00133, Rome, Italy. curatolo@uniroma2.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Curatolo
mesh_terms: D000367:Age Factors; D000067877:Autism Spectrum Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D005075:Biological Evolution; D002675:Child, Preschool; D018450:Disease Progression; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors
keywords: Autism Spectrum Disorders; Autistic symptoms; Biological subtypes; Developmental profiles; Predicting factors