Trajectories of autism severity in early childhood.

The team tracked the toddlers who got an autism diagnosis before age three. They gave each child the ADOS every 9-12 months until age five and a half.

They used the ADOS Calibrated Severity Score to sort kids into groups that shared the same growth pattern.

Four clear paths showed up. About half the kids stayed in the moderate range. One third stayed high. Small groups either slid from high to moderate or climbed from moderate to low.

Kids who stayed severe had the lowest IQ and daily-living scores at the start.

Giserman-Kiss et al. (2020) ran a similar study with more diverse families and found the same thing: a large share kept the diagnosis and most stayed in the same severity band.

Jónsdóttir et al. (2007) used an older rating scale and saw symptoms drop a little over the preschool years. The new ADOS scores are more precise, so the 2014 results refine the older picture rather than clash with it.

Fujiura et al. (2018) followed the same kids longer and found that daily-living scores stop climbing in the teen years. Together, the papers say: severity paths lock in early, but skill teaching must keep going.

You can tell families that autism severity at age three is a strong hint of where a child will stay. Use the first ADOS score to plan intensity: kids who start severe need more hours up front. Re-check yearly, but do not expect big jumps. Shift goals to daily-living and communication skills early, because gains slow down later.