Autism in northern Sweden. A population based follow-up study: Psychopathology

A follow-up study based on a population survey of children with infantile autism from a northern Swedish county is reported. The original survey was performed during 1977-1979. In the country of Västerbottens 39 cases of "childhood psychosis" were identified in the age group 0-20 years (prevalence 5.6/10,000). According to DSM-III-R, 38 children met the criteria of "autistic disorder". The follow-up study was performed in 1987-1988, after eight to nine years. Thirty-four individuals participated (20 males and 14 females). Each child was evaluated according to the Medical Research Council's Schedule of Handicaps, Behaviours and Skills, DSM-III-R symptom check-list, Lotter's modified Questionnaire and information about the academic and social situation. Most symptoms showed stability over time. The individuals had a poor outcome. A few, mostly males, improved in function. Only one boy had "grown out of" autism without showing any autistic-like symptoms at all. Four cases, the majority being females, showed a mildly deteriorating course. In one case symptoms of schizophrenia developed. In most children language and communication had improved. The few well-functioning individuals with autism in this study were males. The proportion of severe mental retardation was greater in the female group.