Features that best define the heterogeneity and homogeneity of autism in preschool-age children: A multisite case–control analysis replicated across two independent samples

Details

• Alternative Title:
  Autism Res
• Personal Author:
  Wiggins, Lisa D. ; Tian, Lin H. ; Rubenstein, Eric ; Schieve, Laura ; Daniels, Julie ; Pazol, Karen ; DiGuiseppi, Carolyn ; Barger, Brian ; Moody, Eric ; Rosenberg, Steven ; Bradley, Chyrise ; Hsu, Melanie ; Rosenberg, Cordelia Robinson ; Christensen, Deborah ; Crume, Tessa ; Pandey, Juhi ; Levy, Susan E.
• Description:
  The heterogeneous nature of children with symptoms of autism spectrum disorder (ASD) makes it difficult to identify risk factors and effective treatment options. We sought to identify behavioral and developmental features that best define the heterogeneity and homogeneity in 2-5-year-old children classified with ASD and subthreshold ASD characteristics. Children were enrolled in a multisite case-control study of ASD. Detailed behavioral and developmental data were gathered by maternal telephone interview, parent-administered questionnaires, child cognitive evaluation, and ASD diagnostic measures. Participants with a positive ASD screen score or prior ASD diagnosis were referred for comprehensive evaluation. Children in the ASD group met study criteria based on this evaluation; children who did not meet study criteria were categorized as having subthreshold ASD characteristics. There were 1480 children classified as ASD (81.6% boys) and 594 children classified as having subthreshold ASD characteristics (70.2% boys) in the sample. Factors associated with dysregulation (e.g., aggression, anxiety/depression, sleep problems) followed by developmental abilities (e.g., expressive and receptive language skills) most contributed to heterogeneity in both groups of children. Atypical sensory response contributed to homogeneity in children classified as ASD but not those with subthreshold characteristics. These findings suggest that dysregulation and developmental abilities are clinical features that can impact functioning in children with ASD and other DD, and that documenting these features in pediatric records may help meet the needs of the individual child. Sensory dysfunction could be considered a core feature of ASD and thus used to inform more targeted screening, evaluation, treatment, and research efforts. LAY SUMMARY: The diverse nature of autism spectrum disorder (ASD) makes it difficult to find risk factors and treatment options. We identified the most dissimilar and most similar symptom(s) in children classified as ASD and as having subthreshold ASD characteristics. Factors associated with dysregulation and developmental abilities contributed to diversity in both groups of children. Sensory dysfunction was the most common symptom in children with ASD but not those with subthreshold characteristics. Findings can inform clinical practice and research.
• Keywords:
  Autism Autism Spectrum Disorder Autistic Disorder Case-Control Studies Characteristics Child Child, Preschool Female Heterogeneity Homogeneity Humans Male Parents Phenotypes Surveys And Questionnaires

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• Source:
  Autism Res. 15(3):539-550
• Pubmed ID:
  34967132
• Pubmed Central ID:
  PMC9048225
• Document Type:
  Journal Article
• Funding:
  U01000750/CC/CDC HHSUnited States/ ; P50 HD105354/HD/NICHD NIH HHSUnited States/ ; U10 DD000901/DD/NCBDD CDC HHSUnited States/ ; U01000747/CC/CDC HHSUnited States/ ; T32 HD007489/HD/NICHD NIH HHSUnited States/ ; U10 DD000184/DD/NCBDD CDC HHSUnited States/ ; U01 DD001210/DD/NCBDD CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U10 DD000183/DD/NCBDD CDC HHSUnited States/ ; U01000746/CC/CDC HHSUnited States/ ; U01000749/CC/CDC HHSUnited States/ ; U10 DD000180/DD/NCBDD CDC HHSUnited States/ ; U10 DD000181/DD/NCBDD CDC HHSUnited States/ ; U01000748/CC/CDC HHSUnited States/ ; U54 HD086984/HD/NICHD NIH HHSUnited States/ ; U10 DD000182/DD/NCBDD CDC HHSUnited States/ ; U54 HD090256/HD/NICHD NIH HHSUnited States/ ; U01 DD001290/DD/NCBDD CDC HHSUnited States/
• Volume:
  15
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:07b08ab52666c8080f77ce5cb48a8a502576ca5ab985cdd1766e9376a541e22c
• Download URL:
  https://stacks.cdc.gov/view/cdc/116879/cdc_116879_DS1.pdf
• File Type:
  [PDF - 450.34 KB ]