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recenti pubblicazioni sull'autismo

Alcune recenti pubblicazioni sull'autismo si occupano dei bambini che 'perdono la diagnosi di autismo' (anche senza intervento ABA) ricevuta intorno ai due anni di età. Resta il dubbio che la diagnosi 'ricevuta' potesse essere un errore diagnostico, nel senso dell'incapacità a differenziare sintomi simil-autistici legati ad altre difficoltà evolutive da manifestazioni di reale malattia autistica. Il lavoro turco riconosce l'impossibilità di sapere se i bambini considerati sarebbero 'guariti' anche senza nessun intervento. Zappella usa qui il termine 'sindrome dismaturativa':
da PubMed

"Autism Res Treat. 2014; 2014: 472120.
Published online Apr 27, 2014. doi: 10.1155/2014/472120
PMCID: PMC4022169
Characteristics of Children Who Lost the Diagnosis of Autism: A Sample from Istanbul, Turkey
Nahit Motavalli Mukaddes, 1 , 2 ,* Mustafa Deniz Tutkunkardas, 1 Oktay Sari, 3 Aydan Aydin, 3 and Pınar Kozanoglu 4
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Abstract

Aim. The aim of this study was to describe a group of children who lost a diagnosis of autism following participation in early educational programs. Method. This is a descriptive study reporting the characteristics of children (n: 39) who lost their diagnosis of autism and explaining the educational programs that these children followed. The data were collected by reviewing the participants' files and through examinations. Results. All of the children were placed at regular psychiatric follow-ups. The mean age at referral was 2.39±0.75 years, whereas the mean age at the time of optimal outcome reported was 5.11 ± 1.95 years. Two of the children were in early intensive behavioral intervention (EIBI), and the rest were in a comprehensive naturalistic behavioral program. The childhood autism rating scale (CARS) total scores at baseline and final were 32.75 ± 3.15 and 18.01 ± 1.76, respectively. The mean IQ of the group at final examination was 116.70 ± 18.88. Conclusion. It could be concluded that a group of children with an autism diagnosis could lose the diagnosis of autism upon early intervention. High IQ and the development of communicative and language skills at an early age could be the most powerful factors contributing to an optimal outcome.

....
however, a study later showed lower diagnostic stability (63%) when autism was diagnosed at the age of 2 [37]. Another study reported that 18% of children with a diagnosis of ASD at age 2 lose the diagnosis of ASD by age 4. The group in that study was in an intervention program [23]. Our group was also in an intervention program and, despite the program, only 9 individuals moved off the autism spectrum prior to age 4, while 30 moved off after age 4. Taken together, it could be said that maturation may have contributed to improvements in social-communicative and cognitive areas [21]; however, we are not certain if the children in our group and other studies would have moved off the spectrum without any intervention.

...
This study documented the data of children who lost a diagnosis of autism. It could be concluded that high IQ and the development of language at an early age are the most powerful factors contributing to optimal outcomes. Additionally, early identification and intervention, relatively mild symptoms, and, finally, a high motivation of parents in the administration of home programs are other common characteristics of this group.

It is important to mention that, in settings where there is a lack of resources for intervention programs, motivating and closely supervising family members could help to improve the social communicative abilities of this group."

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Sembra da PubMed
Brain Dev. 2010 Oct;32(9):739-45. doi: 10.1016/j.braindev.2010.05.004. Epub 2010 Aug 12.
Autistic regression with and without EEG abnormalities followed by favourable outcome.
Zappella M.
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Abstract
OBJECTIVES:

To explore the relationship between autistic regression (AR) with and without EEG abnormalities and favourable outcome.
METHODS:

Follow up data on children with favourable outcome in a series of 534 cases aged below 5 years and diagnosed as ASD.
RESULTS:

Cases with regression were 167 (31.8%), usually with persistent ASD, intellectual disabilities and EEG abnormalities. Thirty nine children (7.3%) went off autism and recovered entirely their intellectual and social abilities. Few of them included examples of pharmacologically treated Landau and Kleffner syndrome and other similar complex cases with abnormal EEG. The majority was represented by 36 (6.7%) children, mostly males, with a dysmaturational syndrome: their development was initially normal up to 18 months when an autistic regression occurred accompanied by the appearance of motor and vocal tics. Relational therapies were followed by rapid improvement. By 6 years all children had lost features of ASD and their I.Q. was in most cases between 90 and 110. Convulsions were absent and EEG was normal in all cases except one. In a few of them recovery was spontaneous. Seventeen children were followed after 5 years 6 months: 12 (70%) had ADHD, 10 (56%) persistent tics. Tics were often present in parents and relatives, ASD absent, suggesting a genetic background different from cases with persistent ASD. With one exception all "off autism" children had a previous autistic regression.
CONCLUSIONS:

In this series "off autism" children had either early onset epilepsy and/or EEG abnormalities or cases of dysmaturational syndrome. Autistic regression was present in almost all.

Copyright © 2010. Published by Elsevier B.V.

PMID:
20708360
[PubMed - indexed for MEDLINE]

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