Some etiologic and prognostic factors in early infantile autism and psychosis

Fifty infants and young preschool children seen in a pediatric developmental service and diagnosed as having "autism" all had evidence of organic disease of the brain and three fourths had mental deficiency of varying degrees. They did not differ in any respect from a comparison group of patients with central nervous system dysfunction unassociated with the symptom complex of autism. Both groups of patients had a high incidence of low birthweight, complications of pregnancy and the neonatal period, seizure disorders, and a variety of specific disease entities associated with developmental defects. Follow-up of 40 of the 45 survivors for a mean of five years showed that none of the patients had had treatment directed to their psychotic symptoms. However, three fourths had established social responses appropriate to their level of function; those who did not generally were over 3 years of age at the time of their first examination or had initial DQs of 35 or less. The degree of mental deficiency was as great or greater at follow-up than it was initially.