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Six Developmental Trajectories Characterize Children With Autism

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Fountain, Christine, Winter, Alix S., Bearman, Peter S.·2012·Pediatrics
DOI 10.1542/peds.2011-1601PMC PMC3340586
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Abstract

OBJECTIVE: The goal of this study was to describe the typical longitudinal developmental trajectories of social and communication functioning in children with autism and to determine the correlates of these trajectories. METHODS: Children with autism who were born in California from 1992 through 2001 and enrolled with the California Department of Developmental Services were identified. Subjects with <4 evaluations present in the database were excluded, resulting in a sample of 6975 children aged 2 to 14 years. Score sequences were constructed based on 9 evaluative items for social, communication, and repetitive behavior functioning. Typical trajectories were identified by using group-based latent trajectory modeling, and multinomial logistic regression models were used to determine the odds of classification within each trajectory varied by individual and family-level factors. RESULTS: Six typical patterns of social, communication, and repetitive behavior functioning were identified. These trajectories displayed significant heterogeneity in developmental pathways, and children whose symptoms were least severe at first diagnosis tended to improve more rapidly than those severely affected. One group of ∼10% of children experienced rapid gains, moving from severely affected to high functioning. Socioeconomic factors were correlated with trajectory outcomes; children with non-Hispanic, white, well-educated mothers were more likely to be high functioning, and minority children with less-educated mothers or intellectual disabilities were very unlikely to experience rapid gains. CONCLUSIONS: Children with autism have heterogeneous developmental pathways. One group of children evidenced remarkable developmental change over time. Understanding what drives these outcomes is thus critical.

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  • Some individuals diagnosed as children have no clinically meaningful (or even detectable) impairment later in life (so-called 'optimal outcome').

    “Some individuals diagnosed as children have no clinically meaningful (or even detectable) impairment later in life (socalled 'optimal outcome' 141,142 )”

    From Autism spectrum disorder (2020) · cites this paper as [142]

    The Discussion (page not available in our copy) reports that some children with autism may improve substantially and even lose their diagnosis over time. It does not establish that they have no clinically meaningful or detectable impairment later in life; this study followed children only through age 14. (LLM, conf=0.86)

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  • Primary and secondary disorders and disadvantage can accumulate through development in people with ASD.

    “Primary and secondary disorders and disadvantage can accumulate through development in people with autism spectrum disorder (ASD).”

    From Autism spectrum disorder (2020) · cites this paper as [142]

    The Abstract and Discussion (page unavailable in our copy) link socioeconomic disadvantage to less favorable developmental trajectories in children with autism. They do not show that primary and secondary disorders, or disadvantage itself, accumulate over development. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Most of the trajectories remained stable from 4 to 14 years, but with different levels of severity.

    “Most of the trajectories remained stable from 4 to 14 years, but with different levels of severity.”

    From Progress toward treatments for synaptic defects in autism (2013) · cites this paper as [6]

  • About one in ten children with ASD experienced rapid gains in communication and social abilities, moving from severely affected to high functioning ('bloomers').

    “Interestingly, about one in ten of children with ASD experienced rapid gains in communication and social abilities, moving from severely affected to high functioning ('bloomers').”

    From Progress toward treatments for synaptic defects in autism (2013) · cites this paper as [6]

  • 21.4% of the subjects never showed repetitive behaviors.

    “For example, 21.4% of the subjects never showed repetitive behaviors, and 8.1% presented with repetitive behaviors at age 3 but improved as they grew older ( Fig. 1 ).”

    From Progress toward treatments for synaptic defects in autism (2013) · cites this paper as [6]

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Authors
Fountain, C., Winter, A. S., & Bearman, P. S.
Affiliations
Columbia University (US)
ORCID
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
2012-05-01
Volume
129
Issue
5
Pages
e1112-e1120
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.2011-1601
PMC
PMC3340586
OpenAlex
W2145095299
Cited by
372
References
43
Citations by year
2026: 13 · 2025: 23 · 2024: 24 · 2023: 23 · 2022: 32 · 2021: 43 · 2020: 30 · 2019: 38 · 2018: 30 · 2017: 26 · 2016: 23 · 2015: 22 · 2014: 20 · 2013: 22 · 2012: 3
FWCI
10.83
Type
journal article
Language
en
Open access
Locations
  • PEDIATRICS (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Columbia Academic Commons (Columbia University)
Funders
  • National Institutes of Health (DP1OD003635)
  • National Institute of Mental Health (R21MH096122)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
Keywords
autism spectrum disorder, developmental trajectories, social functioning, repetitive behavior, developmental heterogeneity, trajectory classification, socioeconomic factors, maternal education, intellectual disability, developmental changes
MeSH terms
Adolescent, California, Child, Developmental Disabilities, Child Development Disorders, Pervasive, Child, Preschool, Communication, Female, Hispanic or Latino, Humans, Intelligence, Longitudinal Studies, Male, Social Behavior, Socioeconomic Factors, Statistics as Topic, Stereotyped Behavior, Models, Statistical, White People

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