Current Literature: 5.

Background A tertiary neurodisability centre at a major London teaching hospital (Guy's and Thomas’). Aim To review the outcome after 4 years of a cohort of children with severe language delay/disorder and some features of autism, but not sufficient at the time to confirm a diagnosis of autism. Methods The notes of 227 children assessed at the centre between the age of 2 and 5 were examined to select cases. This resulted in 40 children with severe receptive language delay as the primary diagnosis and a nonverbal IQ above 70. One hundred and eight children were excluded as another diagnosis, including autism, had been made and in 79 cases original clinical notes were insufficient for re-analysis. However further exclusions due to lack of formal IQ scores, changed addresses, refusals and re-assessment delays left a total of 18 children who participated in the study. Standard measures of performance were used to assess intellectual and language functioning, in addition to clinical evaluation. Results Follow-up at a mean age of 8 years and 7 months showed that five children now showed sufficient language and social impairments for a diagnosis of childhood autism and the other 13 met criteria for atypical autism although nine of these showed some recovery in their language skills. The severity of social communication impairments and repetitive behaviours in the original notes were associated with the severity of autism when re-assessed. From parental questionnaires, none of the children was considered to have developed ‘true friendships’ with reciprocal interaction, sharing and coinitiation of activities. Some tried but didn’t succeed while others were ‘loners’ who preferred their own company. All 18 children had a statement. Ten children attended specialist educational provision (six in a language unit, two in an MLD school and two in an autism unit) and the others had help in mainstream. Conclusions The authors thought they... [ABSTRACT FROM AUTHOR]