Longitudinal Stability of Intellectual Functioning in Autism Spectrum Disorder: From Age 3 Through Mid-adulthood

Prigge, Molly B.D.; Bigler, Erin D.; Lange, Nicholas; Morgan, Jubel; Froehlich, Alyson; Freeman, Abigail; Kellett, Kristina A.; Kane, Karen; King, Carolyn K.; Taylor, Judy; Dean, Douglas C.; King, Jace B.; Anderson, Jeff S.; Zielinski, Brandon A.; Alexander, Andrew L.; Lainhart, Janet E.

doi:10.1007/s10803-021-05227-x

Cited by 11 publications

(8 citation statements)

References 84 publications

(113 reference statements)

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“…Our longitudinal data show that these patterns of group differences remain remarkably stable over serial assessments (i.e., 2–3 evaluations over a 2-year time frame) on all cognitive and behavioral measures examined. It should be noted that, while the present data suggest that the neurocognitive functions remain fairly stable in patients with PHTS (with and without ASD), this differs from studies of IQ in an idiopathic ASD population where IQ tended to increase from early childhood to adulthood and remained more variable than expected [ 10 ]. It is possible that this difference is simply due to the short observation period of the present study.…”

Section: Discussioncontrasting

confidence: 97%

Longitudinal neurobehavioral profiles in children and young adults with PTEN hamartoma tumor syndrome and reliable methods for assessing neurobehavioral change

Busch

Frazier

Sonneborn

et al. 2023

J Neurodevelop Disord

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Background Individuals with PTEN hamartoma tumor syndrome (PHTS) demonstrate a distinct neurobehavioral profile suggesting primary disruption of frontal lobe symptoms, with more severe cognitive deficits in those with associated autism spectrum disorder (ASD) that extend to other areas of neurobehavioral function as well (e.g., adaptive behavior, sensory deficits). The current study sought to characterize longitudinal neurobehavioral profiles in individuals with PHTS who completed serial assessments (2–3 evaluations) over a 2-year time period. Methods Comprehensive neurobehavioral evaluations were conducted on 92 participants (age range 6–21) with PHTS and/or ASD. Spaghetti plots and linear mixed effects models were used to visualize the individual patient profiles and group trends and examine the group differences in cognitive/behavioral test scores over time. Practice-adjusted reliable change indices (RCIs) and standardized regression-based change scores (SRBs) were calculated for those measures in the battery with adequate sample sizes and test–retest reliabilities for future use in assessing neurobehavioral change in children and young adults with PHTS. Results Wide individual differences were observed at baseline across all measures. Encouragingly, baseline differences between patient groups persisted at the same magnitude over a 2-year time period with no differences in longitudinal neurobehavioral profiles within any one group. Test–retest reliabilities were generally high, ranging from 0.62 to 0.97, and group mean change from baseline to 12 months was small (range − 3.8 to 3.7). A Microsoft Excel calculator was created that clinicians and researchers can use to automatically calculate RCI and SRB thresholds at both 80% and 90% confidence intervals using test scores from a given child or young adult with PHTS. Conclusions Our results suggest that the neurobehavioral phenotypes observed in individuals with PHTS remain relatively stable over time, even in those with ASD. The RCIs and SRBs provided can be used in future research to examine patient outcomes at the individual level as well as to detect negative deviations from the expected trajectory that can be used to inform intervention strategies.

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Section: Discussioncontrasting

confidence: 97%

Longitudinal neurobehavioral profiles in children and young adults with PTEN hamartoma tumor syndrome and reliable methods for assessing neurobehavioral change

Busch

Frazier

Sonneborn

et al. 2023

J Neurodevelop Disord

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“…The rapid IQ gains in the CHG group we found in prior work slowed after middle childhood. While this is not consistent with two recent studies that report average mean IQ improvements through adolescence (Prigge et al, 2021;Simonoff et al, 2020), these studies examined mean differences versus trajectories, and Prigge et al…”

Section: Discussioncontrasting

confidence: 57%

IQ trajectories in autistic children through preadolescence

et al. 2023

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Background We extended our study of trajectories of intellectual development of autistic individuals in early (mean age 3 years; T1), and middle childhood (mean age 5 years, 7 months; T2) into later middle childhood/preadolescence (mean age 11 years, 6 months; T3) in the longitudinal Autism Phenome Project cohort. Participants included 373 autistic children (115 females). Methods Multivariate latent class growth analysis was used to identify distinct IQ trajectory subgroups. Baseline and developmental course group differences and predictors of trajectory membership were assessed using linear mixed effects models for repeated measures with pairwise testing, multinomial logistic regression models, and sensitivity analyses. Results We isolated three IQ trajectory groups between T1 and T3 for autistic youth that were similar to those found in our prior work. These included a group with persistent intellectual disability (ID; 45%), a group with substantial increases in IQ (CHG; 39%), and a group with persistently average or above IQs (P‐High; 16%). By T3, the groups did not differ in ADOS‐2 calibrated severity scores (CSS), and there were no group differences between Vineland (VABS) communication scores in CHG and P‐High. T1‐T3 externalizing behaviors declined significantly for CHG, however, there were no significant T3 group differences between internalizing or externalizing symptoms. T1 correlates for CHG and P‐High versus ID group membership included higher VABS communication and lower ADOS‐2 CSS. A T1 to T2 increase in VABS communication scores and a decline in externalizing predicted CHG versus ID group membership, while T1 to T2 improvement in VABS communication and reduction in ADOS‐2 CSS predicted P‐High versus ID group membership. Conclusions Autistic youth exhibit consistent IQ developmental trajectories from early childhood through preadolescence. Factors associated with trajectory group membership may provide clues about prognosis, and the need for treatments that improve adaptive communication and externalizing symptoms.

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“…Shumway & Wetherby, 2009). Lower IQ is detected in ASD relative to typically developing (TD) individuals in a sample with a wide range of age at first visit (~3 to 39 years of age, initial non‐verbal IQ > 70), with the differences diminishing in an adults‐only (18 years and above at first visit) between‐group comparison (Prigge et al, 2021). This analysis suggests that participants below 18 years are contributing to the overall finding of lower IQ.…”

Section: Introductionmentioning

confidence: 99%

The importance of low IQ to early diagnosis of autism

Denisova

Lin

2022

Autism Research

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Some individuals can flexibly adapt to life's changing demands while others, in particular those with Autism Spectrum Disorder (ASD), find it challenging. The origin of early individual differences in cognitive abilities, the putative tools with which to navigate novel information in life, including in infants later diagnosed with ASD remains unexplored. Moreover, the role of intelligence quotient (IQ) vis-à-vis core features of autism remains debated. We systematically investigate the contribution of early IQ in future autism outcomes in an extremely large, population-based study of 8000 newborns, infants, and toddlers from the US between 2 and 68 months with over 15,000 cross-sectional and longitudinal assessments, and for whom autism outcomes are ascertained or ruled out by about 2-4 years. This population is representative of subjects involved in the National Institutes of Health (NIH)-funded research, mainly on atypical development, in the US. Analyses using predetermined age bins showed that IQ scores are consistently lower in ASD relative to typically developing (TD) children at all ages (p < 0.001), and IQ significantly correlates with social, non-social, and total Calibrated Severity Scores (CSS) on the Autism Diagnostic Observation Schedule (ADOS) (p<0.01). Lower IQ is associated with greater autistic impairments. Note, verbal IQ (VIQ) is no better than the full-scale IQ to predict ASD cases. These findings raise new, compelling questions about potential atypical brain circuitry affecting performance in both verbal and nonverbal abilities and preceding an ASD diagnosis. This study is the first to establish prospectively that low early IQ is a major feature of ASD in early childhood. Lay SummaryThe role of IQ scores in autism remains debated. We systematically investigate the contribution of early IQ in an extremely large study of 8,000 children between 2 and 68 months with autism outcomes by about 2-4 years. We show that IQ scores are consistently lower in ASD relative to TD children. This study is the first to establish prospectively that low early IQ is a predictor for ASD diagnosis in early childhood.

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Longitudinal Stability of Intellectual Functioning in Autism Spectrum Disorder: From Age 3 Through Mid-adulthood

Cited by 11 publications

References 84 publications

Longitudinal neurobehavioral profiles in children and young adults with PTEN hamartoma tumor syndrome and reliable methods for assessing neurobehavioral change

Longitudinal neurobehavioral profiles in children and young adults with PTEN hamartoma tumor syndrome and reliable methods for assessing neurobehavioral change

IQ trajectories in autistic children through preadolescence

The importance of low IQ to early diagnosis of autism

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