Viewpoint

Predictors of Outcome in Autism Spectrum

Disorders: A Perspective for Clinicians and
Therapists
Ashok Mysore1,2 and Sowmyashree Mayur Kaku1

P
rofessionals working with fam-
ilies who have individuals with
Autism Spectrum Disorder (ASD)
are frequently asked about the possible
long-term outcome of their children and
the duration of intervention needed to
‘move out of the spectrum’.1,2 Clinicians
and therapists often have to predict the
subsequent outcome of an individual
child based on all the services offered.1,3
Also, families who get a diagnosis of
ASD in the Indian context for their child
typically raise the question of whether the
child will do well and recover completely.
They wish to know if the child can attend
mainstream school, be self-sufficient, be
employed, or get married like most others
in the community. This is a natural process
of exploration in the pathways to care that
most parents go through until they have
met many professionals, understood ASD,
discussed it with other parents, and started
working with their child pragmatically.
Predicting outcomes with the data avail-
able or acquired during assessments and
intervention predominantly focuses on
the short term. This can be best defined as
improvement in specified skill sets across
one-to-two-year durations. However,
parents naturally expect an understanding
of long-term outcomes across the lifespan.
In this viewpoint, we attempt to
present our viewpoint based on our
experiences working in Indian academic
institutions and hospitals and from the
literature review to summarize possible
predictors of outcomes that can be useful
for clinicians and therapists.
We recognize the view of the neuro-
diversity advocates disappointed by the
focus on therapies that work towards
normative outcomes for persons with an
ASD diagnosis. We recognize the spirit
of such advocacy. However, framing
outcome issues from that perspective
is beyond the scope of this viewpoint.
Here, we focus on the frequently noted
requests from the families.
What Is ‘Outcome’ in the
ASD Context?
In the context of ASD, it is important
to understand what ‘outcome’ means.
Is outcome (1) A set of skills the child
acquires as a natural phenomenon
when left without intervention (natu-
ralistic outcome)? (2) A phenomenon of
development of various skills, which
results as an output of intervention by
multiple stakeholders such as therapist,
individual with autism, parents, and
school (interventional outcome)? (3) A
prediction of what will happen shortly
based on the current-day assessment
and intervention with the child (pre-
dictive outcome)?4–6 Ideally, much more
research is needed to understand the
outcome of the third type. Long-term
outcome refers to outcomes beyond
5–10 years, usually focused on achieving
equivalence with normative outcomes
for the community.
What Factors Act as
Predictors?
Predictors are baseline features that can
reliably tell us how the future will be.
When the clinician assesses the child,
findings such as having good eye contact,

1
Center for Advanced Research and Excellence in Autism and Developmental Disorders (CAREADD), St. John’s Medical College Hospital, Bengaluru, Karnataka,
India. 2Dept. of Psychiatry, St. John’s Medical College Hospital, Bengaluru, Karnataka, India.

HOW TO CITE THIS ARTICLE: Mysore A and Kaku SM. Predictors of Outcome in Autism Spectrum Disorders: A Perspective for Clinicians
and Therapists. 2023;XX:1–5.
Address for correspondence: Sowmyashree Mayur Kaku, Center for Advanced
Research and Excellence in Autism and Developmental Disorders (CAREADD), St. Submitted: 08 Feb. 2022
John’s Medical College Hospital, Bengaluru 560034, Karnataka, India. Accepted: 01 Oct. 2023
E-mail: Sowmyashree.careadd@stjohns.in Published Online: xxxx

Copyright © The Author(s) 2023

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Indian Journal of Psychological Medicine | Volume XX | Issue X | XXXX-XXXX 2023 1

Mysore and Kaku
smiling once during observation, doing
a high five, pointing to the fan, or follow-
ing commands help us understand how
the child will respond to intervention.
Then, they can help predict the clinical
improvement in a year.4,7
Therefore, predictors can help in two
ways: (1) to predict the child’s clinical
outcome by measuring their skills and
(2) to predict if a particular interven-
tion results in a particular outcome in
the long term, that is, the functional
outcome connected to intervention. Pre-
dictors vary with age. The importance of
the presence of a particular skill at a par-
ticular age helps predict an outcome. We
discuss the predictors as follows.
Child Factors
Predictive factors in children are pre-
dominantly behavioral observations in
the child. These include speech, hyper-
activity, repetitive behaviors, and being
uncooperative. Apart from the observed
factors, we also infer many aspects of a
child’s behavior, such as being ‘bright/
friendly’, adhering to a task, and follow-
ing a routine. There can also be measured
factors such as the scores on severity
scales,4,8,9 sleep index,10 abilities across
domains,11 developmental or intelligence
quotient,12 adaptive behaviours,12 and
comorbidities.13 The observed, inferred,
and measured factors can all be used to
predict a given child’s outcome.2,8,14–17
A comprehensive assessment at base-
line helps make meaningful connections
for future assessment models. Systemat-
ically measuring predictors is a starting
point in predicting outcomes. We can
assess severity (e.g., Indian Scale for
Assessment of Autism—ISAA), devel-
opment (e.g., Communication DEALL
Developmental Checklist—CDDC/Intel-
lectual Quotient—IQ), sensory processing
(e.g., Sensory Profile—SP), language (e.g.,
Assessment of Language Development—
ALD/Receptive-Expressive Emergent
Language Test—REELS), carers report
vs. direct assessments by the clinician,
assessment of comorbidities such as sleep
issues, epilepsy, ADHD, tics, and self-inju-
rious behavior—SIBs.18–21
It is also important to understand
what the goal of the assessment is—
prediction, certification, or planning
intervention.
2 Indian Journal of Psychological Medicine | Volume XX | Issue X | XXXX-XXXX 2023
Parental Factors
This includes the aspects such as the
ability to co-operate, adherence to therapy
and schedules,22 home-based inter-
vention,23,24 stress levels of parents,24,25
marital discord, dysfunctional family,
single parent,24 time taken to react to the
diagnosis, and involvement with the ther-
apist26,27. A systematic review describes
the impact of cultural beliefs on parent-
ing stress, especially where ASD or related
developmental disorders are considered
a punishment to the family, resulting in
stigma, shame, marginalization, and dis-
crimination.28 A study from South Asia
highlighted parental factors such as stress
and caregiver burden in families because
of stigma and lack of resources.29
Behavioral Predictors
Age- and context-dependent factors such
as good eye contact, level of hyperactiv-
ity, imitation, and self-play can act as
behavioral predictors.30–32 However, in
developing countries, data on measuring
these specific features is usually lacking
due to a shortage of professionals.
Language- and
Communication-
Based Predictors
Presence of verbal skills by four years indi-
cate better language and communication
skills by 10 or 15 years of age.33,34 A child
with narrative abilities and back-and-
forth communication will have a better
outcome than a child with responsive
speech (responding only to questions
asked). Comprehensive spoken and
written language skills indicate a better
prognosis than in those who have poor
comprehension. A child who is also very
good with nonverbal communication
skills has a better prognosis than someone
who is verbal but cannot communicate.
A meta-analysis found that on average,
a third of children above five seemed to
pick up language.35 It also found that
the age at which you start intervention,
baseline language ability, cognitive skills
of the child, and length of follow-up
did not influence the child’s outcomes.
However, many studies that measured
outcomes had various biases. Also, the
above findings are contrary to the wider
literature and the clinical experience at
our centre.34,36 Studies have found that
baseline social and communication skills
help predict one-year outcomes after
intervention, irrespective of all other
contributing confounders.37,38 Cognitive
skills at baseline also predicted later
language production but not necessar-
ily understanding language. Where the
specialists such as speech therapists
and developmental psychologists are
unavailable, early intervention focused
on reducing core autism symptoms is
also very important to help develop later
speech and language skills.39,40
Developmental Predictors
Broad cognition of the child like IQ,12
social cognitive skills like social respon-
siveness scale (SRS),41 and adaptive
behaviors like those measured using
Vineland adaptive behavior scale (VABS)
or Vineland social maturity scale (VSMS).
Generally, better skills can point to a
positive outcome. In preschool children
with ASD, normal or near-normal per-
formance can also predict a positive ASD
outcome. The developmental trends can
inform intervention planning. However,
to predict long-term outcomes, it is
important to consider verbal and non-ver-
bal IQs, other observational measures of
severity, and other variables.
Biological Factors
Though EEG-,42–44 MRI-,9,45–50 and geno-
type-based studies51,52 have been conducted
in the last decade, current international
guidelines do not recommend using such
parameters as part of routine clinical assess-
ments in all cases. Currently, EEG, MRI, and
genotype studies help to predict autism
risk, symptom severity, language develop-
ment and differentiate them from ADHD
and other developmental disorders.53–56
However, they do not yet have individual
predictive value for each child. By and large,
biological factors contribute to understand-
ing short-term outcomes based on group
data. More research is needed to determine
if these have a translational benefit in pre-
dicting long-term outcomes.
Pharmacotherapy can be beneficial
and could impact the course of ASD,
especially in those with comorbid
ADHD, epilepsy, self-injurious behav-
iors, aggression, anxiety, depression,

sleep disorders, and so on. However, it
is important to choose the right medica-
tion at a low dose, regularly monitor for
outcomes, and withdraw as required.57
While all these factors help predict
outcomes, substantial evidence indicates
that early intervention positively impacts
the developmental trajectory. Studies
from across the globe have investigated
the efficacy of these interventions.40,41,58,59
It is well known that brain growth is rapid
in the early years of life, with a window
period during which intervention is
expected to be significantly effective.60
12–24 months of age is a critical period
for brain plasticity and development.
Intervention during this period facili-
tates better long-term outcomes.61,62 If a
child with ASD is brought later than 4 or
5 years of age, adequate evidence shows
that mainstreaming the child is com-
promised to varying extents.63,64 What
was accepted to be a good time to start
early intervention (3–4 years of age) two
decades ago has now been proven other-
wise by many longitudinal, family-based,
high-risk ASD (siblings of children with
ASD) studies. These studies opine that
early intervention has to begin as early as
18–24 months to be effective and improve
long-term outcomes.
It is important to define adequate
early intervention by answering ques-
tions such as how early the intervention
must be started; the nature, duration,
and quality of intervention, and who
is delivering the intervention (parents/
professionals/multidisciplinary team).
Duration of follow-up is also undeni-
ably important and an important factor
influencing long-term outcomes. Clin-
ical observation during multiple time
points, follow-up assessments, and
understanding the neurobehavioral path
an individual child with ASD has taken
during a few years will help better under-
stand and predict long-term outcomes.
Discussion
A variety of factors influence outcome.
When predicting outcomes, it is import-
ant to record baseline scores of cognitive
skills, adaptive behaviors, speech skills,
and severity, and look at the rate of
change in the scores over time during
the intervention. Child factors, includ-
ing social, adaptive, and language skills,
Indian Journal of Psychological Medicine | Volume XX | Issue X | XXXX-XXXX 2023
absence of comorbidities, and overlap-
ping comorbidities can predict a positive
outcome. The true test of intervention
is adequate follow-up, parental engage-
ment, and preventing dropouts, which
is the case in many research studies. It
is appropriate to look at the hierarchy
of outcomes such as self-care, adaptive
behavior, especially social skills, lan-
guage skills, academic targets, and
independent living. It is essential to
plan assessments and investigations
to predict these outcomes that help in
choosing interventions and to commu-
nicate progress to the families. It is also
necessary to consider how frequent and
well structured the assessments must be
and can be.
Some of the challenges related to ASD
are the progressive unfurling of autistic
impairments, including but not limited
to repetitive behaviors, as well as comor-
bid ADHD, anxiety, psychotic illness,
and tic disorders, which are not related
to early intervention. It is necessary to
make this information understandable
for parents and prepare them to face
these challenges. We, therefore, must be
conscious of the heterogeneities of the
condition when predicting outcomes
using our assessments and interven-
tions. Choosing an intervention is always
challenging as we do not have all facili-
ties at all centers. Whether we decide to
use an intervention based on literature,
experience, or assessments, the capa-
bility to make a statement of positive
predictability is challenging. Therefore,
clinicians and therapists often need to
decide upon outcomes that need more
attention and focus on the interventions
that are known to facilitate achieving
those outcomes. The key, however, is
to be mindful of some features which
probably will not respond well to a par-
ticular kind of intervention offered by a
therapist or a team but may benefit by
probably going to someone else who
delivers a different type of intervention.
Currently, the findings are equivocal.59,65
When we see short-term improve-
ments, it may be clinical wisdom to
expect and predict good long-term out-
comes. If skills develop in the short term,
it will set a cascade of reactions to help
the child develop other skills not directly
related to that intervention. For example,
Viewpoint
improved speech increases the likelihood
of increased social opportunities, leading
to potentially higher social skills.
Some good practices we should follow
include (1) periodic assessments—global
or specific; (2) working with a multidis-
ciplinary team of specialists who can
help with varied problem domains; (3)
involving parents and keeping them
motivated—parent/family assessments,
providing family interventions, medical
management of parents’ condition wher-
ever indicated, and keeping parents
engaged, informed, and prepared, and (4)
providing intensive interventions.
Clinicians and therapists can first
define what short-term outcomes must
be for every child, evaluate outcomes
of the intervention, and then look at
long-term, life span course, and keep
tweaking interventions along the way.
It is essential to be systematic and con-
scious with interventions and when
informing families with these pre-
dicted outcomes. Predictions, even if
negative, should intensify work with
the families.
Declaration of Conflicting Interest
The authors declared no potential conflicts of
interest with respect to the research, authorship
and/or publication of this article.
Funding
The authors received no financial support for the
research, authorship and/or publication of this
article.
ORCID iD
Sowmyashree Mayur Kaku https://orcid.
org/0000-0002-8965-8292
References
1. Zuckerman KE, Lindly OJ and Sinche BK.
Parental concerns, provider response, and
timeliness of autism spectrum disorder
diagnosis. J Pediatr 2015; 166: 1431–1439.e1.
2. Sacrey LAR, Zwaigenbaum L, Bryson S, et
al. Can parents’ concerns predict autism
spectrum disorder? A prospective study of
high-risk siblings from 6 to 36 months of
age. J Am Acad Child Adoles Psychiatry 2015;
54: 470–478.
3. Gaspar De Alba MJ and Bodfish JW.
Addressing parental concerns at the
initial diagnosis of an autism spectrum
disorder. Res Autism Spectr Disord 2011; 5:
633–639.
4. Ben Itzchak E and Zachor DA. Who
benefits from early intervention in autism
3
Mysore and Kaku
spectrum disorders? Res Autism Spectr
Disord 2011; 5: 345–350.
5. Schreibman L, Dawson G, Stahmer AC, et
al. Naturalistic developmental behavioral
interventions: Empirically validated
treatments for autism spectrum disorder.
J Autism Dev Disord 2015; 45: 2411–2428.
6. Tiede G and Walton KM. Meta-analysis
of naturalistic developmental behavioral
interventions for young children with
autism spectrum disorder. Autism 2019;
23: 2080–2095.
7. Travers BG, Tromp DPM, Adluru N, et al.
Atypical development of white matter
microstructure of the corpus callosum in
males with autism: A longitudinal investi-
gation. Mol Autism 2015; 6: 15.
8. Sutera S, Pandey J, Esser EL, et al.
Predictors of optimal outcome in toddlers
diagnosed with autism spectrum disor-
ders. J Autism Dev Disord 2007; 37: 98–107.
9. Bezgin G, Lewis JD and Evans AC.
Developmental changes of cortical white–
gray contrast as predictors of autism
diagnosis and severity. Transl Psychiatry
2018; 8: 249.
10. Schreck KA, Mulick JA and Smith AF.
Sleep problems as possible predictors of
intensified symptoms of autism. Res Dev
Disabil 2004; 25: 57–66.
11. Tiura M, Kim J, Detmers D, et al.
Predictors of longitudinal ABA treatment
outcomes for children with autism: A
growth curve analysis. Res Dev Disabil
2017; 70: 185–197.
12. Smith T, Klorman R and Mruzek DW.
Predicting outcome of community-based
early intensive behavioral intervention
for children with autism. J Abnorm Child
Psychol 2015; 43: 1271–1282.
13. Helt M, Kelley E, Kinsbourne M, et al. Can
children with autism recover? If so, how?
Neuropsychol Rev 2008; 18: 339–366.
14. Levy A and Perry A. Outcomes in adoles-
cents and adults with autism: A review of
the literature. Res Autism Spectr Disord 2011;
5: 1271–1282.
15. Anderson DK, Liang JW and Lord C.
Predicting young adult outcome among
more and less cognitively able individuals
with autism spectrum disorders. J Child
Psychol Psychiatry 2014; 55: 485–494.
16. Szatmari P, Bryson SE, Boyle MH, et
al. Predictors of outcome among high
functioning children with autism and
Asperger syndrome. J Child Psychol
Psychiatry 2003; 44: 520–528.
17. Virues-Ortega J, Rodríguez V and Yua CT.
Prediction of treatment outcomes and
longitudinal analysis in children with
autism undergoing intensive behavioral
intervention. Int J Clin Health Psychol 2013;
13: 91–100.
4 Indian Journal of Psychological Medicine | Volume XX | Issue X | XXXX-XXXX 2023
18. Mukherjee SB, Malhotra MK, Aneja S, et
al. Diagnostic accuracy of Indian Scale for
Assessment of Autism (ISAA) in children
aged 2–9 years. Indian Pediatr 2015; 52:
212–216.
19. Case-Smith J, Weaver LL and Fristad MA.
A systematic review of sensory processing
interventions for children with autism
spectrum disorders. Autism 2015; 19:
133–148.
20. Mannion A and Leader G. Comorbidity
in autism spectrum disorder: A literature
review. Res Autism Spectr Disord 2013; 7:
1595–1616.
21. Matson JL and Goldin RL. Comorbidity
and autism: Trends, topics and future
directions. Res Autism Spectr Disord 2013; 7:
1228–1233.
22. Gabriels RL, Hill DE, Pierce RA, et al.
Predictors of treatment outcome in young
children with autism: A retrospective
study. Autism 2001; 5: 407–429.
23. Green J, Pickles A, Pasco G, et al.
Randomized trial of a parent-mediated
intervention for infants at high risk for
autism: Longitudinal outcomes to age
3 years. J Child Psychol Psychiatry 2017; 58:
1330–1340.
24. Vivanti G, Prior M, Williams K, et al.
Predictors of outcomes in autism early
intervention: Why don’t we know more?
Front Pediatr 2014; 2: 58.
25. McStay RL, Trembath D and Dissanayake
C. Stress and family quality of life in
parents of children with autism spectrum
disorder: Parent gender and the double
ABCX model. J Autism Dev Disord 2014; 44:
3101–3118.
26. Strauss K, Vicari S, Valeri G, et al. Parent
inclusion in early intensive behavioral
intervention: The influence of parental
stress, parent treatment fidelity and par-
ent-mediated generalization of behavior
targets on child outcomes. Res Dev Disabil
2012; 33: 688–703.
27. Zaidman-Zait A, Mirenda P, Szatmari P, et
al. Profiles of social and coping resources
in families of children with autism spec-
trum disorder: Relations to parent and
child outcomes. J Autism Dev Disord 2018;
48: 2064–2076.
28. Enea V and Rusu DM. Raising a child
with autism spectrum disorder: A system-
atic review of the literature investigat-
ing parenting stress. J Mental Health Res
Intellect Disabil 2020; 13: 283–321.
29. Minhas A, Vajaratkar V, Divan G, et al.
Parents’ perspectives on care of children
with autistic spectrum disorder in South
Asia – Views from Pakistan and India. Int
Rev Psychiatry 2015; 27: 247–256.
30. Vivanti G, Prior M, Williams K, et al.
Predictors of outcomes in autism early
intervention: Why don’t we know more?
Front Pediatr 2014; 2: 58.
31. McTiernan A, Leader G, Healy O, et al.
Analysis of risk factors and early predic-
tors of challenging behavior for children
with autism spectrum disorder. Res Autism
Spectr Disord 2011; 5: 1215–1222.
32. Chenausky K, Norton A, Tager-Flusberg
H, et al. Behavioral predictors of
improved speech output in minimally
verbal children with autism. Autism Res
2018; 11: 1356–1365.
33. Mayo J, Chlebowski C, Fein DA, et al. Age
of first words predicts cognitive ability
and adaptive skills in children with ASD.
J Autism Dev Disord 2013; 43: 253–264.
34. Ellis Weismer S and Kover ST. Preschool
language variation, growth, and predic-
tors in children on the autism spectrum.
J Child Psychol Psychiatry 2015; 56: 1327–1337.
35. Brignell A, Morgan AT, Woolfenden S,
et al. A systematic review and meta-
analysis of the prognosis of language
outcomes for individuals with autism
spectrum disorder. Autism Dev Lang
Impairments 2018; 3: 239694151876761.
36. Ray-Subramanian CE and Ellis Weismer
S. Receptive and expressive language as
predictors of restricted and repetitive
behaviors in young children with autism
spectrum disorders. J Autism Dev Disord
2012; 42: 2113–2120.
37. Kaale A, Fagerland MW, Martinsen EW,
et al. Preschool-based social communica-
tion treatment for children with autism:
12-month follow-up of a randomized trial.
J Am Acad Child Adoles Psychiatry 2014; 53:
188–198.
38. Landa RJ, Holman KC and Garrett-Mayer
E. Social and communication develop-
ment in toddlers with early and later
diagnosis of autism spectrum disorders.
Arch Gen Psychiatry 2007; 64: 853–864.
39. Kasari C, Lawton K, Shih W, et al.
Caregiver-mediated intervention for
low-resourced preschoolers with autism:
An RCT. Pediatrics 2014; 134: e72-9.
40. Green J, Charman T, McConachie H,
et al. Parent-mediated communication-
focused treatment in children with
autism (PACT): A randomized
controlled trial. Lancet 2010; 375:
2152–2160.
41. Eapen V, Črnčec R and Walter A.
Exploring links between genotypes,
phenotypes, and clinical predictors of
response to early intensive behavioral
intervention in autism spectrum disorder.
Front Hum Neurosci 2013; 7: 567.
42. Gabard-Durnam LJ, Wilkinson C, Kapur
K, et al. Longitudinal EEG power in the
first postnatal year differentiates autism
outcomes. Nat Commun 2019; 10: 4188.

43. Grossi E, Olivieri C and Buscema M.
Diagnosis of autism through EEG
processed by advanced computational
algorithms: A pilot study. Comput Methods
Programs Biomed 2017; 142: 73–79.
44. Wilkinson CL, Gabard-Durnam LJ, Kapur
K, et al. Use of longitudinal EEG mea-
sures in estimating language develop-
ment in infants with and without familial
risk for autism spectrum disorder.
Neurobiol Lang 2020; 1: 33–53.
45. Plitt M, Barnes KA and Martin A.
Functional connectivity classification of
autism identifies highly predictive brain
features but falls short of biomarker stan-
dards. NeuroImage Clin 2015; 7: 359–366.
46. Xiao X, Fang H, Wu J, et al. Diagnostic
model generated by MRI-derived brain
features in toddlers with autism spectrum
disorder. Autism Res 2017; 10: 620–630.
47. Jiao Y, Chen R, Ke X, et al. Predictive
models of autism spectrum disorder
based on brain regional cortical thickness.
NeuroImage 2010; 50: 589–599.
48. Katuwal GJ, Cahill ND, Baum SA,
et al. The predictive power of structural
MRI in autism diagnosis. In: 2015 37th
Annual International Conference of the IEEE
Engineering in Medicine and Biology Society
(EMBC). IEEE, pp. 4270–4273.
49. Ecker C, Rocha-Rego V, Johnston P,
et al. Investigating the predictive value
of whole-brain structural MR scans in
autism: A pattern classification approach.
NeuroImage 2010; 49: 44–56.
50. Hegarty JP, Gengoux GW, Berquist KL,
et al. A pilot investigation of
Indian Journal of Psychological Medicine | Volume XX | Issue X | XXXX-XXXX 2023
neuroimaging predictors for the
benefits from pivotal response treatment
for children with autism. J Psychiatr Res
2019; 111: 140–144.
51. Arnett AB, Beighley JS, Kurtz-elson EC,
et al. Developmental predictors of
cognitive and adaptive outcomes in
genetic subtypes of autism spectrum dis-
order. Autism Res 2020; 13: 1659–1669.
52. Kong SW, Collins CD, Shimizu-Motohashi
Y, et al. Characteristics and predictive
value of blood transcriptome signature in
males with autism spectrum disorders.
PLoS One 2012; 7: e49475.
53. LaSalle JM. Epigenomic signatures reveal
mechanistic clues and predictive markers
for autism spectrum disorder. Mol
Psychiatry 2023; 1–12.
54. Krishnan A, Zhang R, Yao V, et al.
Genome-wide prediction and functional
characterization of the genetic basis of
autism spectrum disorder. Nat Neurosci
2016; 19: 1454–1462.
55. Zhang Y, Zhang S, Chen B, et al.
Predicting the symptom severity in
autism spectrum disorder based on EEG
metrics. IEEE Trans Neural Syst Rehabil Eng
2022; 30: 1898–1907.
56. Dawson G, Rieder AD and Johnson MH.
Prediction of autism in infants: Progress
and challenges. Lancet Neurol 2023; 22:
244–254.
57. Benvenuto A, Battan B, Porfirio MC, et
al. Pharmacotherapy of autism spectrum
disorders. Brain Dev 2013; 35: 119–127.
58. Karanth P, Shaista S and Srikanth N.
Efficacy of communication DEALL—An
Viewpoint
indigenous early intervention program
for children with autism spectrum
disorders. Indian J Pediatr 2010; 77:
957–962.
59. Rogers SJ, Yoder P, Estes A, et al. A
multisite randomized controlled trial
comparing the effects of intervention
intensity and intervention style on
outcomes for young children with
autism. J Am Acad Child Adolesc
Psychiatry. 60: 710–722.
60. Johnson MH. Functional brain
development in humans. Nat Rev
Neurosci 2001; 2: 475–483.
61. Rapoport JL and Gogtay N. Brain
neuroplasticity in healthy, hyperactive
and psychotic children: Insights from
neuroimaging. Neuropsychopharmacology
2008; 33: 181–197.
62. Elsabbagh M and Johnson MH.
Getting answers from babies about
autism. Trends Cogn Sci 2010; 14:
81–87.
63. Samms-Vaughan ME. The status of early
identification and early intervention in
autism spectrum disorders in lower- and
middle-income countries. Int J Speech Lan
Pathol 2014; 16: 30–35.
64. Dawson G. Early behavioral intervention,
brain plasticity, and the prevention
of autism spectrum disorder. Dev
Psychopathol 2008; 20: 775–803.
65. Rogers SJ, Estes A, Lord C, et al. A
multisite randomized controlled two-
phase trial of the early start Denver model
compared to treatment as usual. J Am Acad
Child Adolesc Psychiatry 2019; 58: 853–865.
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