ESSENCE: Child and Adult Studies of Verbal and Nonverbal Skills in ASD and ADHD

Aim: Longitudinal analysis of verbal and nonverbal deficits and skills and their contribution to clinical presentation in children and adults with ESSENCE/Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations. Methods: Forty school children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) or both were contrasted with 21 similarly aged children from the community who had screened positive for language disorder (LD) at 30 months. Also, 69 young adult males with ASD (Asperger syndrome) were followed longitudinally neuropsychologically, psychiatrically and according to self/parent report for an average of almost 10 years. Results: Clinic children with ASD and/or ADHD and community children with early LD had very similar verbal/nonverbal test and developmental profiles. Retelling of a story was linked both to verbal and nonverbal factors in the collapsed group with ADHD/ASD/LD. Nonverbal learning problems, persisting from childhood to adult age, in ASD, were associated with reduced tested and perceived executive functioning (EF). Good and superior verbal skills predicted better EF even in the presence of less good nonverbal skills. Conclusion: Young school age children seen in clinics with ASD/ADHD have almost identical verbal and nonverbal test profiles and problems as those screening positive for LD already at 2.5 years. Narrative skills at young school age were linked both to verbal and nonverbal test results. Boys with ASD (Asperger syndrome) become men with ASD, and their functioning in adulthood is linked to verbal skills and nonverbal deficits in childhood. – These longitudinal studies demonstrate the importance of full neuropsychological and psychiatric assessments in ESSENCE. These conditions are often lifelong. Many of them should be recognisable or at least broadly categorisable as ESSENCE already at 2.5 years. Follow-up assessment, both in school and in young adult age, is clearly important. Realistic prognosis and individual intervention plans based on such assessments are needed in ESSENCE.