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Prospective Long-Term Follow- Up of Patients With Pervasive Development Disorders Larry Burd, PhD; Jacob Kerbeshian, MD; Alyssia Westerland; Janelle Labine,

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Presentation on theme: "Prospective Long-Term Follow- Up of Patients With Pervasive Development Disorders Larry Burd, PhD; Jacob Kerbeshian, MD; Alyssia Westerland; Janelle Labine,"— Presentation transcript:

1 Prospective Long-Term Follow- Up of Patients With Pervasive Development Disorders Larry Burd, PhD; Jacob Kerbeshian, MD; Alyssia Westerland; Janelle Labine, MD; Amy Barth, BS; Marilyn G. Klug, PhD; Kay Wagner, MD

2 Abstract We conducted a 12-year prospective study of children with pervasive development disorders from North Dakota. In a prospective longitudinal follow-up study, of 59 patients, we found 52 patients with pervasive developmental disorders (88%). Ten (17%) declined to participate. We collected data on 42 (71%) of the original cohort. Of the 42 subjects, 1 died (1.7%). The other 41 were followed up for 492 person-years. (J Child Neurol 2002; 17:681-688)

3 North Dakota Autism Follow-Up Project The purpose of the project was to conduct a prospective follow-up on the cohort of children identified in the North Dakota prevalence study of autism and pervasive developmental disorders.

4 Age of Accomplishment in Months of Three Early Developmental Milestones for 42 Patients With Pervasive Developmental Disorders from North Dakota. _______________________________________________________________________________________________________ MilestoneMeanSDRange ________________________________________________________________________________________________________ Walked Total(n=36)21.517.49-96 Male(n=23)19.918.09-96 Female(n=13)24.316.611-72 Talked Total(n=28)24.818.78-72 Male(n=17)22.217.08-72 Female(n=11)28.921.38-72 Toilet trained Total(n=31)52.332.218-168 Male(n=21)58.433.724-168 Female(n=10)39.626.018-96

5 Percent Change in Severity Measures at Initial Evaluation (Age 7.7 yr) and Follow-Up Evaluation (Age 20.2 yr) for 41 Patients With Pervasive Developmental Disorders From North Dakota. ________ ________________________________________________________________________________________________________ Initial EvaluationFollow-Up Mean MeanChange (%) _______________________________________________________________________________________________________________ DSM-III Total 7.4 5.91.5 (20) Male 8.2 6.51.7 (21) Female 5.9 4.81.1 (19) DSM-IV Total 26.1 20.06.1 (23) Male 30.3 22.97.3 (24) Female 18.1 14.43.8 (21)

6 Percent Change in Severity Measures at Initial Evaluation (Age 7.7 yr) and Follow-Up Evaluation (Age 20.2 yr) for 41 Patients With Pervasive Developmental Disorders From North Dakota. ________ __________________________________________________________________________________________________ Initial EvaluationFollow-Up Mean Mean Change (%) _________________________________________________________________________________________________________ Comorbidity Total 4.7 2.62.1 (45) Male 4.4 2.61.8 (41) Female 5.3 2.62.7 (51) Reversed GAF Total 65.0 52.312.6 (19) Male 65.1 49.215.9 (24) Female 64.5 58.46.2 (10) __________________________________________________________________________________________ DSM = Diagnostic and Statistical Manual of Mental Disorders; GAF = Global Assessment of Functioning.

7 Most Common Comorbid Diagnosis at Initial Evaluation (Age 20.2 yr, n = 41) in Patients With Pervasive Developmental Disorders From North Dakota. __________________________________________________________________________________________________________ Initial EvaluationFollow-Up Diagnosis n (%) n (%) _______________________________________________________________________________________________________________________________ Mental Retardation Mild/moderate 22 (52)10 (24) Severe/profound 14 (33)10 (24) Attention-deficit hyperactivity 19 (45)8 (20) disorder (ADHD) Tourette syndrome/ 11 (26)7 (17) tic disorders Seizure disorders 11 (26)5 (12) Developmental language disorder 16 (38)1 (2)

8 Austism Ratings at Follow-Up (Age 20.2 yr) and IQ Scores at Intake (Age 7.7 yr) of Patients With Pervasive Developmental Disorders From North Dakota. ____________________________________________________________________________________________________________________________ MeanSDRange ____________________________________________________________________________________________________________________________ ABC score Total(n=41)37.832.40-135 Male(n=27)34.625.95-98 Female(n=14)44.042.70-135 Number of symptoms Total(n=41)14.912.40-44 Male(n=27)14.511.32-43 Female(n=14)15.514.60-44 IQ at intake Total(n=40)46.219.120-95 Male(n=26)46.818.920-95 Female(n=14)45.220.025-90

9

10 ________________________________________________________ Summary of Change in 71% of 1986 Cohort ________________________________________________________ DSM-III Severity 20% DSM-IV Severity23% Comorbility45%

11 Summary of Change in 1986 Cohort Composite Severity score over 12.4 years28.7%

12 PDD in a Geographically Defined Cohort A Gradual Improvement of 2.2% per year

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