Abstract
Within the autistic spectrum, there is remarkable variability in the etiology, presentation, and treatment response. This prospective study was designed to identify, through cluster analysis, subgroups of individuals with ASD without intellectual disability (ID) based on the severity of the core symptoms in childhood. The secondary aim was to explore whether these subgroups and a group with typical development (TD) differ in cognitive, adaptive, and social aspects measured in adolescence. The sample at baseline was comprised of 52 children with ASD without ID and 37 children with TD, aged 7–11. Among the ASD group, three clusters were identified. Cluster 1 (40%), ‘high severity’, presented high symptom severity on the DSM-5 criteria and the Social Communication Questionnaire. Cluster 2 (34%) showed ‘moderate severity’ on most of the scores. Cluster 3 (25%) corresponded to ‘low severity’, showing moderate social impairment and low restrictive, repetitive patterns of behavior, interests and activities. At 5-year follow-up, 45 adolescents with ASD without ID and 27 adolescents with TD were assessed. All clusters had significantly more difficulties in EF, ToM, socialization and adaptive behavior compared to TD. Social and adaptive trajectories between the ASD subgroups were relatively different; Cluster 3 showed poorer socialization and daily living skills than the other two subgroups. These findings highlight the importance of fully assessing social, cognitive, and adaptive profiles to develop care plans tailored to specific needs.
Highlights
The identification of clusters in groups of children with Autism spectrum disorder (ASD) has mainly been based on the severity of the core symptoms, assessed with the Autism Diagnostic Observation
The present study was designed to address the following objectives: (1) to identify empirically, through cluster analysis, subgroups of individuals with ASD without intellectual disability (ID) based on the severity of the core symptoms in childhood; (2) to explore whether these subgroups of ASD without ID and a group with typical development differ in cognitive, adaptive, and social aspects measured in adolescence
The two groups of children were between 7 and 11 years old, and their intellectual functioning was within the normal range as per the scores on the Kaufman Brief Intelligence Test (K-BIT) [34]
Summary
Autism spectrum disorder (ASD) is conceptualized in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) [1] as a single diagnostic category with impairments in two dimensions, social communication and restricted, repetitive patterns of behavior, interests, and activities (RRBI). Within the autistic spectrum, there is remarkable variability in the etiology, presentation, and treatment response. In order to enhance phenotypic homogeneity, previous research has used cluster analysis to develop meaningful ASD subgroups based on empirical characteristics that may reflect clinical phenotypes. Cluster Studies in Children with ASD, with and without Intellectual Disability. The identification of clusters in groups of children with ASD has mainly been based on the severity of the core symptoms, assessed with the Autism Diagnostic Observation
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