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Sixty-two autistic patients enrolled in a prospective study an average of 12 years ago. Current retesting results are now available on 53 of the original 62 patients (85.5%). Results indicate that 36 (67.9%) achieved scores within their original IQ group. Twelve (22.6%) moved up IQ groups and five (9.4%) moved down. Of particular clinical importance is the observation that Vineland Adaptive Behavior Scores were consistently lower than cognitive scores, and maladaptive behaviors occurred with cqual frequency in the high, medium, and low IQ groups. The implications of this new data for understanding the natural history of autism, educational and vocational planning, and future research are discussed.

A scale was developed to assess effects of treatment on 47 pathognomic behaviors in patients with the syndrome of autism. It is applicable in natural settings by nonprofessional raters who can be rapidly trained to achieve significant interobserver agreement, is rapidly scored by hand, and can be repeated frequently without affecting interobserver agreement. The scale has been used successfully in over a dozen medical centers throughout the country and in several schools.

Sixty-two patients with the syndrome of autism were selected for 5-year prospective annual administrations of cognitive and linguistic scales. Results revealed that (1) the majority of subjects (77%) initially scored in the retarded ranges on cognitive tests, (2) cognitive test scores remained stable at yearly intervals for 5 years (only 8 of 62 subjects (12.9%) changed IQ groups), (3) initial scores were predictive of future educational placement (only 7 of 62 subjects (11.3%) changed classrooms after initial placement), and (4) language scores paralleled in stability and predictability cognitive scores. Implications for educational goals for autistics are discussed.

The Wechsler Intelligence Scales, Wide Range Achievement Test, and the Shipley-Hartford Test were administered to 122 parents and 153 siblings of 62 autistic probands in Utah. Scores were distributed as expected within the published normative ranges for each scale. Parents' scores correlated with those of their nonautistic children, but neither parents' nor siblings' scores correlated with the IQ level of the autistic probands. These results do not confirm prior reports from England and the United States of a high rate of cognitive and learning problems in the siblings of autistic individuals, nor the aggregation of such problems in the siblings of probands with high or low levels of cognitive function.

Fenfluramine was administered to 14 outpatient children with the syndrome of autism to determine whether previously produced decreases in blood serotonin concentrations and clinical improvements could be reinstituted. A double-blind medication-placebo crossover design was used. Each patient received fenfluramine 1.5 mg/kg daily (0.75 mg/kg twice daily) for 8 months, followed by placebo for 2 months. Blood serotonin levels promptly fell approximately 49% regardless of baseline levels. Clinical improvement returned, and on some scales gains after 8 months exceeded those noted after only 4 months of treatment. Significant correlations emerged among the amount of clinical response, initially high verbal IQs, and low blood serotonin concentrations. Compliance was excellent, and no clinically relevant side effects or weight changes occurred. It appears that fenfluramine is effective in ameliorating specific symptoms in certain autistic patients. The extent and mechanism of its action remain to be discovered.

The WISC-R and Vineland Adaptive Behavior Scale (ABS) were each administered to 27 autistic persons. Significant differences between WISC-R subtests and ABS domains were found, the socialization domain showing the largest discrepancy. The number of maladaptive behaviors was not correlated with WISC-R scores. Results are discussed in terms of their implications for diagnosis and educational planning. J. Am. Acad. Child Adolesc. Psychiatry , 1988, 27, 4:428–429.