Clinical Features in Children With Loss of Autism Diagnosis and Persistent Autism: A Comparative Study

The aim of this study was to evaluate the loss of autism diagnosis (LAD) in individuals with Autism Spectrum Disorder (ASD) and to compare the clinical features of LAD cases with those who continued to meet criteria for ASD without Intellectual Disability (ID).

This study included 60 children aged 5-18 years who were previously diagnosed with ASD and were classified either as having lost the diagnosis (LAD) or as continuing to meet criteria for ASD without ID. Data were obtained through clinical interviews and retrospective review of medical records. Comorbidities were evaluated using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Symptom severity and clinical characteristics were assessed using the Childhood Autism Rating Scale (CARS), Strengths and Difficulties Questionnaire (SDQ), Aberrant Behavior Checklist (ABC), and Social Communication Questionnaire (SCQ).

The LAD group had an earlier age at ASD diagnosis, earlier initiation of special education, and a longer duration of preschool education. Symptom severity measured by CARS and SCQ was lower in the LAD group. At least one comorbid psychiatric diagnosis was present in 80% of the LAD group, with Attention-Deficit/Hyperactivity Disorder, Anxiety Disorders/Specific Phobia, and Specific Learning Disorder being the most common. A moderate positive association was observed between SCQ-Lifetime scores and the time required to achieve LAD.

Early diagnosis, earlier initiation of special education, and lower ASD symptom severity at diagnosis were associated with LAD. Despite loss of the ASD diagnosis, subthreshold psychiatric symptoms and non-ASD psychiatric diagnoses remained highly prevalent.