PEDIATRICS Vol. 105 No. 5 May 2000, p. e65
Received Oct 25, 1999; accepted Dec 10, 1999.
From the Department of Pediatrics, University of Pennsylvania School of Medicine, Children's Seashore House of The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
A triaxial model for autistic spectrum disorder
(ASD) is presented, incorporating age, degree of intelligence, and
severity of autistic features. As the name implies, ASD can vary in
degree of expression from minimal to profound. Furthermore, the
symptoms of ASD change in predictable ways with the passage of time.
For example, echolalia during early childhood may be replaced by verbal literalism and difficulty with verbal humor during later childhood or
adolescence. The prognosis for children with ASD is governed by the
joint impact of the degree of expression of ASD and the degree of
developmental delay, if any. All combinations of ASD and intellect are
possible (ie, severe ASD plus severe mental retardation, severe ASD
plus normal general intelligence, and so forth). The relationship among
these 3 parameters
severity of ASD, level of general intelligence, and
change in symptom expression over time, is represented schematically as
a 3-dimensional graph. The utility of this graph as a counseling tool,
and as the basis for future research on the prognosis of ASD are
discussed.