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Journal of the Korean Child Neurology Society 2005;13(2):220-231.
Published online November 30, 2005.
Early Developmental and Clinical Characteristics of Autism Spectrum Disorders.
Jong Geun Song, Won Jun Kim, Seung Woo Kim, Young Key Kim, Dong Ho Song, Hee Jung Chung
1Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea.
2Department of Psychiatry, College of Medicine, Yonsei University, Seoul, Korea.
3Department of Rehabilitation Medicine, National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea.
4Department of Child Psychiatry, National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea.
5Department of Pediatrics, National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea.
6Department of Developmental Disorder Clinic, National Health Insurance Corporation, Ilsan Hospital, Goyang, Korea.
Abstract
PURPOSE
Current evidence of the benefits of early intensive behavioral intervention (EIBI) in children with autism spectrum disorders(ASD) is increasing. In order to get the benefits from EIBI, early identification of ASD is essential but a challenge for clinicians. Therefore, we designed this study to know what differs from other developmental disorders in terms of early developmental patterns and clinical and laboratory characteristics. METHODS: Among 518 children diagnosed developmental delay in Ilsan Hospital Developmental Disorder Clinic from April 2001 to January 2005, we analyzed 122 ASD patients as a study group, and 133 mentally retarded(MR) and 101 specific language impaired(SLI) patients as control groups. We used a questionnaire survey to assess past and family history. We performed various kinds of tools for the evaluation of the development, and cognitive and speech functions according to the patients' age. MRI, SPECT, EEG, genetic and metabolic studies were performed as optional tests. RESULTS: The mean age of ASD was 55.9+/-30.7 months and male was predominant in ASD(male:female ratio was 3.2:1). In early developmental history, motor functions are relatively well preserved in ASD(P<0.05). In speech and social milestones, single word speech was noticeably delayed in all the 3 groups. However, there was no appreciable difference in stranger anxiety among the 3 groups. In the developmental evaluation, speech and social functions were most significantly delayed in ASD(P<0.05). There was a significant motor delay in ASD and MR than SLI(P<0.05). In physical examination, a raised rate of macrocedphaly in ASD was not noted. Abnormal EEG findings were significantly noted in ASD and MR than in SLI and MRI abnormalities were least found in these groups. The etiologic diagnosis was much less identified in ASD than MR. CONCLUSION: In an early stage, absence of stranger anxiety was not statistically significant. However, this seems to be an important risk factor for predicting ASD. Motor functions were relatively well preserved in ASD in an early stage. In the developmental evaluation, social and language areas were the most significantly delayed domains in ASD and motor functions were most delayed in MR. Routine MRI studies are not indicated for identifying the etiology in ASD. It was harder to find out the etiology in ASD than MR.
Key Words: Autism spectrum disorders, Early developmental pattern, Etiologic yield


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