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Trajectories of Autism Severity in Early Childhood

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Abstract

Relatively little is known about trajectories of autism severity using calibrated severity scores (CSS) from the Autism Diagnostic Observation Schedule, but characterizing these trajectories has important theoretical and clinical implications. This study examined CSS trajectories during early childhood. Participants were 129 children with autism spectrum disorder evaluated annually from ages 2½ to 5½. The four severity trajectory classes that emerged—Persistent High (n = 47), Persistent Moderate (n = 54), Worsening (n = 10), and Improving (n = 18)—were strikingly similar to those identified by Gotham et al. (Pediatrics 130(5):e1278–e1284, 2012). Children in the Persistent High trajectory class had the most severe functional skill deficits in baseline nonverbal cognition and daily living skills and in receptive and expressive language growth.

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Notes

  1. AIC is calculated as: −2 log likelihood +2p, where p is the number of parameters in the model. SSBIC is calculated as: −2 log likelihood +p ln([N + 2]/24), where p is the number of parameters in the model and N is the sample size. SSBIC takes sample size into account and is more appropriate than unadjusted BIC for limited sample sizes.

  2. Αlpha level for the pairwise contrasts was controlled using the Bonferroni-Holm method as follows. First, α was set at a standard level of α = 0.05. The contrast with the lowest p value was tested against α/6, or α = 0.008, since there was a total of six planned contrasts among classes. If the first contrast was significant, the contrast with the next lowest p value was tested at α/5, or α = 0.01, since there were five remaining contrasts. This process continued until a contrast was non-significant.

  3. The effect size variant of Cohen’s d used for the pairwise comparisons was calculated as the difference in the intercepts (or slopes) between classes, divided by the residual standard deviation of the random intercept (or slope), as estimated using the HLM software. Following Cohen’s classification, effect sizes of d > 0.8 are considered indicative of large effects.

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Acknowledgments

We would first and foremost like to thank the children and families who participated in this study. Without them, this study would not have been possible. We would also like to thank the members of Language Processes Lab for their assistance in data collection and data management. This work was supported by NIH R01DC007223-05 (Ellis Weismer, PI; Gernsbacher, co-PI); T32DC005359-10 (Ellis Weismer, PI); P30HD003352-46 (Seltzer, PI).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Communication Sciences and Disorders and Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Waisman Center Room 475, Madison, WI, 53705, USA

    Courtney E. Venker

  2. Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Room 441, Madison, WI, 53705, USA

    Corey E. Ray-Subramanian

  3. Department of Educational Psychology and Waisman Center, University of Wisconsin-Madison, 1082a Educational Sciences, 1025 W. Johnson St., Madison, WI, 53706, USA

    Daniel M. Bolt

  4. Department of Communication Sciences and Disorders and Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue, Room 473, Madison, WI, 53705, USA

    Susan Ellis Weismer

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  1. Courtney E. Venker
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Correspondence to Courtney E. Venker.

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Venker, C.E., Ray-Subramanian, C.E., Bolt, D.M. et al. Trajectories of Autism Severity in Early Childhood. J Autism Dev Disord 44, 546–563 (2014). https://doi.org/10.1007/s10803-013-1903-y

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