Objective
Aside from features associated with risk of neurogenetic syndromes in general (e.g., cognitive impairment), limited progress has been made in identifying phenotype-genotype relationships in autism spectrum disorder (ASD).
Method
This study extends work in the Simons Simplex Collection (SSC) by comparing the phenotypic profiles of ASD probands with or without identified de novo loss of function mutations (LoF) or Copy Number Variants (CNV) in high confidence ASD-associated genes/loci (Sanders et al., 2015). Analyses pre-emptively accounted for documented differences in sex and IQ in affected individuals with de novo mutations, by matching probands with and without these genetic events on sex, IQ, and age before comparing them on multiple behavioral domains.
Results
Children with de novo mutations (n=112) showed greater likelihood of motor delays during early development (i.e., later age of walking), but less impairment in certain measures of ASD core symptoms (parent-rated social-communication impairment and clinician-rated diagnostic certainty) in later childhood. These children also showed relative strengths in verbal and language abilities, including a smaller discrepancy between nonverbal and verbal IQ and a greater likelihood of having achieved fluent language.
Conclusions
Children with ASD with de novo mutations may exhibit a “muted” symptom profile with respect to social-communication and language deficits, relative to those with ASD with no identified genetic abnormalities. Such findings suggest that examining early milestone differences and standardized testing results may be helpful in etiologic efforts, and potentially in clinical differentiation of various subtypes of ASD, but only if developmental/demographic variables are properly accounted for first.