Suivi de la stabilité temporelle du diagnostic et de la sévérité du trouble du spectre de l’autisme mesurés par l’Autism Diagnostic Observation Schedule : revue systématique et méta-analyse

Titre original en anglais : Tracing the temporal stability of autism spectrum diagnosis and severity as measured by the Autism Diagnostic Observation Schedule: A systematic review and meta-analysis

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Bieleninik, Ł., Posserud, M., Geretsegger, M., Thompson, G., Elefant, C., & Gold, C. (2017). Tracing the temporal stability of autism spectrum diagnosis and severity as measured by the Autism Diagnostic Observation Schedule: A systematic review and meta-analysis. PLOS ONE, 12(9), e0183160. https://doi.org/10.1371/journal.pone.0183160

Date de publication: 21/09/2017 Ajout dans AutiHub: 06/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
6
Auteur·ices de la publication identifié·es comme autistes
1 / 6 (16,7 %)
  1. Łucja Bieleninik
  2. Maj‐Britt Posserud
  3. Monika Geretsegger
  1. Grace Thompson *
  2. Cochavit Elefant
  3. Christian Gold

Résumé

CONTEXTE : L’exploration des moyens d’améliorer la trajectoire et les symptômes du trouble du spectre de l’autisme est fréquente dans la recherche, mais le pronostic naturel du trouble du spectre de l’autisme et l’évolution des symptômes sont moins bien connus. L’objectif de cette étude était d’examiner la stabilité temporelle du trouble du spectre de l’autisme et du diagnostic d’autisme, ainsi que les trajectoires longitudinales de la sévérité des symptômes centraux de l’autisme. Nous avons en outre cherché à identifier d’éventuels prédicteurs du changement. MÉTHODES : Nous avons effectué des recherches dans PubMed, PsycInfo, EMBASE, Web of Science et la Cochrane Library jusqu’en octobre 2015 afin d’identifier des études de cohorte prospectives portant sur la stabilité diagnostique du trouble du spectre de l’autisme/de l’autisme, ainsi que des études prospectives sur les effets des interventions. Nous avons inclus des personnes de tous âges présentant un trouble du spectre de l’autisme/de l’autisme ou à risque de présenter un trouble du spectre de l’autisme, qui avaient reçu un diagnostic et avaient été suivies pendant au moins 12 mois à l’aide de l’Autism Diagnostic Observation Schedule (ADOS). Les scores ADOS continus et les catégories diagnostiques dichotomiques ont été regroupés dans une méta-analyse à effets aléatoires et une méta-régression. RÉSULTATS : Parmi les 1443 résumés examinés, 44 étaient admissibles, dont 40 études contenaient des données appropriées pour la méta-analyse. Au total, 5771 participants âgés de 7 mois à 16,5 ans ont été inclus. Nos analyses n’ont montré aucun changement des scores ADOS au fil du temps, mesurés par les Calibrated Severity Scores (différence moyenne [DM] = 0,05, IC à 95 % : -0,26 à 0,36). Nous avons observé un changement mineur mais statistiquement significatif des scores bruts totaux ADOS (DM = -1,51, IC à 95 % : -2,70 à -0,32). Aucune amélioration n’a été observée concernant les comportements restreints et répétitifs (DM standardisée [DMS] = -0,04, IC à 95 % : -0,19 à 0,11), mais une légère amélioration de l’affect social au fil du temps a été constatée (DMS = -0,31, IC à 95 % : -0,50 à -0,12). Aucun changement n’a été observé concernant le respect des critères du trouble du spectre de l’autisme au fil du temps (différence de risque [DR] = -0,01, IC à 95 % : -0,03 à 0,01), mais un changement significatif a été observé concernant le respect des critères de l’autisme au fil du temps (DR = -0,18, IC à 95 % : -0,29 à -0,07). En moyenne, l’hétérogénéité entre les études était élevée (intervalle de I2 : 65,3 % à 93,1 %). DISCUSSION : Bien que 18 % des participants soient passés d’un diagnostic d’autisme à un diagnostic de trouble du spectre de l’autisme, la prévalence globale du trouble du spectre de l’autisme est restée inchangée. Dans l’ensemble, les symptômes centraux de l’autisme étaient remarquablement stables au fil du temps pendant l’enfance, ce qui indique que les études d’intervention devraient se concentrer sur d’autres domaines, tels que la qualité de vie et le fonctionnement adaptatif. Toutefois, en raison de l’hétérogénéité élevée entre les études et d’un certain nombre de limites dans les études, les résultats doivent être interprétés avec prudence.

BACKGROUND: Exploring ways to improve the trajectory and symptoms of autism spectrum disorder is prevalent in research, but less is known about the natural prognosis of autism spectrum disorder and course of symptoms. The objective of this study was to examine the temporal stability of autism spectrum disorder and autism diagnosis, and the longitudinal trajectories of autism core symptom severity. We furthermore sought to identify possible predictors for change. METHODS: We searched PubMed, PsycInfo, EMBASE, Web of Science, Cochrane Library up to October 2015 for prospective cohort studies addressing the autism spectrum disorder/autism diagnostic stability, and prospective studies of intervention effects. We included people of all ages with autism spectrum disorder/autism or at risk of having autism spectrum disorder, who were diagnosed and followed up for at least 12 months using the Autism Diagnostic Observation Schedule (ADOS). Both continuous ADOS scores and dichotomous diagnostic categories were pooled in random-effects meta-analysis and meta-regression. RESULTS: Of 1443 abstracts screened, 44 were eligible of which 40 studies contained appropriate data for meta-analysis. A total of 5771 participants from 7 months of age to 16.5 years were included. Our analyses showed no change in ADOS scores across time as measured by Calibrated Severity Scores (mean difference [MD] = 0.05, 95% CI -0.26 to 0.36). We observed a minor but statistically significant change in ADOS total raw scores (MD = -1.51, 95% CI -2.70 to -0.32). There was no improvement in restricted and repetitive behaviours (standardised MD [SMD] = -0.04, 95% CI -0.19 to 0.11), but a minor improvement in social affect over time (SMD = -0.31, 95% CI -0.50 to -0.12). No changes were observed for meeting the autism spectrum disorder criteria over time (risk difference [RD] = -0.01, 95% CI -0.03 to 0.01), but a significant change for meeting autism criteria over time (RD = -0.18, 95% CI -0.29 to -0.07). On average, there was a high heterogeneity between studies (I2 range: 65.3% to 93.1%). DISCUSSION: While 18% of participants shifted from autism to autism spectrum disorder diagnosis, the overall autism spectrum disorder prevalence was unchanged. Overall autism core symptoms were remarkably stable over time across childhood indicating that intervention studies should focus on other areas, such as quality of life and adaptive functioning. However, due to high heterogeneity between studies and a number of limitations in the studies, the results need to be interpreted with caution.

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Références citées
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Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 82 / 377 (21,8 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 43 / 43 (100,0 %).
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