The DOI matches its Crossref record; 37 of the 39 references it cites were found in a registry or an index.
Developmental Trajectories of Symptom Severity and Adaptive Functioning in an Inception Cohort of Preschool Children With Autism Spectrum Disorder
Abstract
IMPORTANCE: Symptom severity and adaptive functioning are fundamental domains of the autism spectrum disorder (ASD) phenotype. To date, the longitudinal association between these 2 domains has not been examined. OBJECTIVE: To describe the developmental trajectories of autistic symptom severity and adaptive functioning in a large inception cohort of preschool children with ASD. DESIGN, SETTING, AND PARTICIPANTS: The sample consisted of 421 newly diagnosed preschool children with ASD 2 to 4 years old (355 boys; mean age at study enrollment, 39.87 months) participating in a large Canadian multisite longitudinal study (Pathways in ASD Study). Prospective data collected at 4 points from time of diagnosis to age 6 years were used to track the developmental trajectories of children. MAIN OUTCOMES AND MEASURES: Autistic symptom severity was indexed using the Autism Diagnostic Observation Schedule. Adaptive functioning was indexed using the Vineland Adaptive Behavior Scales, Second Edition. RESULTS: Two distinct trajectory groups provided the best fit to the autistic symptom severity data. Group 1 (11.4% of the sample) had less severe symptoms and an improving trajectory (P < .05), whereas group 2 (88.6% of the sample) had more severe symptoms and a stable trajectory. Three distinct trajectory groups provided the best fit to the adaptive functioning data. Group 1 (29.2% of the sample) showed lower functioning and a worsening trajectory, group 2 (49.9% of the sample) had moderate functioning and a stable trajectory, and group 3 (20.9% of the sample) had higher functioning and an improving trajectory (P < .05). Cross-trajectory overlap between the autistic symptom severity and adaptive functioning groups was low (φ = 0.13, P < .05). Sex was a significant predictor of autistic symptom severity group membership and age at diagnosis, and language and cognitive scores at baseline predicted membership in adaptive functioning trajectories. Trajectories of both symptom severity and adaptive functioning predicted several different outcomes at age 6 years. CONCLUSIONS AND RELEVANCE: Findings confirm the heterogeneous nature of developmental trajectories in ASD. Change in adaptive functioning suggests that improvement is possible in roughly 20% of the sample. Autistic symptom severity appears to be more stable, with roughly 11% of the sample showing a marked decrease in symptom severity. During the preschool years, there appears to be only a small amount of "yoking" of developmental trajectories in autistic symptom severity and adaptive functioning. It is imperative that a flexible suite of interventions that target both autistic symptom severity and adaptive functioning should be implemented and tailored to each child's strengths and difficulties.
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In the citing paper
“ASD manifests with broad phenotypic variability and evolves along heterogeneous developmental trajectories (1).”
From Genetics and genomics of autism spectrum disorder: embracing complexity (2015) · cites this paper as [1]
In the citing paper
“These differences overlapped substantially with the differences observed between ASD and controls (Figure 5A), suggesting that normal variation in mechanisms that are also affected by ASD may cause variation in how ASD may manifest 1,91.”
From Subtyping cognitive profiles in Autism Spectrum Disorder using a Functional Random Forest algorithm (2018) · cites this paper as [91]
In the citing paper
“it is possible that variation within the ASD subgroups identified here may actually be “nested” within the normal variation found in brain networks across typical children 1,71,91”
From Subtyping cognitive profiles in Autism Spectrum Disorder using a Functional Random Forest algorithm (2018) · cites this paper as [91]
In the citing paper
“Because we are confident in the ASD diagnosis, we suspect that the variation between these three subgroups reflects typical variation in cognitive mechanisms, which may be independent of autism symptom severity but influence ASD presentation14,91.”
From Subtyping cognitive profiles in Autism Spectrum Disorder using a Functional Random Forest algorithm (2018) · cites this paper as [91]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Diagnostic and Statistical Manual of Mental Disorders
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Group-Based Modeling of Development
NAGIN, D. (2005) · doi:10.4159/9780674041318 · Cited by 4,164
Standardizing ADOS Scores for a Measure of Severity in Autism Spectrum Disorders
Gotham, K., Pickles, A., & Lord, C. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-008-0674-3 · Cited by 1,605
Vineland Adaptive Behavior Scales, Second Edition
Sparrow, S. S., Cicchetti, D. V., & Balla, D. (2005) · PsycTESTS Dataset · doi:10.1037/t15164-000 · Cited by 983
Autism From 2 to 9 Years of Age
Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.6.694 · Cited by 973
Lyons, M. (2021) · Springer eBooks · doi:10.1007/978-3-319-91280-6_979 · Cited by 964
Young Adult Outcome of Autism Spectrum Disorders
Eaves, L. C., & Ho, H. H. (2008) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-007-0441-x · Cited by 683
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An Overview of Autism Spectrum Disorder, Heterogeneity and Treatment Options
Masi, A., DeMayo, M. M., Glozier, N., & Guastella, A. J. (2017) · Neuroscience Bulletin · doi:10.1007/s12264-017-0100-y · Cited by 987
Big data approaches to decomposing heterogeneity across the autism spectrum
Lombardo, M. V., Lai, M.-C., & Baron-Cohen, S. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0321-0 · Cited by 537
Autism spectrum heterogeneity: fact or artifact?
Mottron, L., & Bzdok, D. (2020) · Molecular Psychiatry · doi:10.1038/s41380-020-0748-y · Cited by 332
Alvares, G. A., Bebbington, K., Cleary, D., Evans, K., Glasson, E. J., Maybery, M. T., Pillar, S., Uljarević, M., Varcin, K., Wray, J., et al. (2020) · Autism · doi:10.1177/1362361319852831 · Cited by 331
Constantino, J. N., & Charman, T. (2016) · The Lancet Neurology · doi:10.1016/s1474-4422(15)00151-9 · Cited by 294
Metadata
- Authors
- Szatmari, P., Georgiades, S., Duku, E., Bennett, T. A., Bryson, S., Fombonne, E., Mirenda, P., Roberts, W., Smith, I. M., Vaillancourt, T., Volden, J., Waddell, C., Zwaigenbaum, L., Elsabbagh, M., & Thompson, A.
- Affiliations
- Centre for Addiction and Mental Health, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- McMaster University (CA)
- Dalhousie University (CA)
- Oregon Health & Science University (US)
- University of British Columbia (CA)
- University of Toronto (CA)
- University of Ottawa (CA)
- University of Alberta (CA)
- Simon Fraser University (CA)
- McGill University (CA)
- ORCID
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2015-03-01
- Volume
- 72
- Issue
- 3
- Pages
- 276
- ISSN
- 2168-622X (ISSN-L)
- OpenAlex
- W2120646369
- Cited by
- 322
- References
- 39
- Citations by year
- 2026: 26 · 2025: 23 · 2024: 26 · 2023: 33 · 2022: 29 · 2021: 36 · 2020: 38 · 2019: 36 · 2018: 26 · 2017: 27 · 2016: 11 · 2015: 10
- FWCI
- 14.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Autism Speaks
- Sinneave Family Foundation
- Alberta Innovates
- Canadian Institutes of Health Research
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, preschool children, symptom severity, adaptive behavior, developmental trajectories, trajectory heterogeneity, autism phenotype, sex differences, developmental outcomes
- MeSH terms
- Adaptation, Psychological, Canada, Child, Child Development, Child Development Disorders, Pervasive, Child, Preschool, Female, Humans, Longitudinal Studies, Male, Severity of Illness Index
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