Homogeneous Subgroups of Young Children with Autism Improve Phenotypic Characterization in the Study to Explore Early Development

Abstract

The objective of this study was to identify homogenous classes of young children with autism spectrum disorder (ASD) to improve phenotypic characterization. Children were enrolled in the Study to Explore Early Development between 2 and 5 years of age. 707 children were classified with ASD after a comprehensive evaluation with strict diagnostic algorithms. Four classes of children with ASD were identified from latent class analysis: mild language delay with cognitive rigidity, mild language and motor delay with dysregulation, general developmental delay, and significant developmental delay with repetitive motor behaviors. We conclude that a four-class phenotypic model of children with ASD best describes our data and improves phenotypic characterization of young children with ASD. Implications for screening, diagnosis, and research are discussed.

A Phenotype of Childhood Autism Is Associated with Preexisting Maternal Anxiety and Depression

“…Child phenotype was defined by a latent class analysis (LCA) described by Wiggins et al (2017) on the same sample of children defined herein. LCA is a statistical procedure that assumes that responses on observed variables can be explained by membership in unmeasured latent classes (Vermunt 2010).…”

“…Individuals are classified into subgroups based on similar patterns of observed data that reflect probability of class membership. Wiggins et al (2017) performed a latent class analysis with the variables in Table 1. Results showed that a four-class model best fit the data with a high precision of classification (i.e., entropy = 0.92).…”

“…Children described as Type 4 ASD had more symptoms of dysregulation (i.e., aggression, anxiety, depression, emotional reactivity, inattention, somatic complaints, and sleep problems) than those in other classes. Further details on this LCA method and results are provided elsewhere (Wiggins et al 2017). …”

“…A recent study by Wiggins et al (2017) found four subtypes of preschool children with ASD enrolled in the Study to Explore Early Development (SEED) (Schendel et al 2012): Mild Language Delay with Cognitive Rigidity (Type 1 ASD), Significant Developmental Delay with Repetitive Motor Behaviors (Type 2 ASD), General Developmental Delay (Type 3 ASD), and Mild Language and Motor Delay with Dysregulation (i.e., aggression, anxiety, depression, emotional reactivity, inattention, somatic complaints, and sleep problems) (Type 4 ASD). Characteristics of children defined as Type 4 ASD were similar to those described by Cohen and Tsiouris (2006) and Lajiness-O’Neil and Menard (2008) who were more likely to have a depressed mother: these children had average visual reception skills and increased rates of problem behaviors.…”

“…Moreover, some studies highlighted an association between maternal depression in particular and specific ASD phenotypes (Cohen and Tsiouris 2006; DeLong 2004; DeLong and Dwyer 1988; Lajiness-O’Neil and Menard 2008; Vasa et al 2012; Wiggins et al 2017). Cohen and Tsiouris (2006) found that recurrent depressive states in the mother were related to higher adaptive and cognitive functioning and increased rates of problem behaviors in the child with ASD.…”