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Phenotypic Variability in Autism Spectrum Disorder: Clinical Considerations

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Handbook of Autism and Anxiety

Part of the book series: Autism and Child Psychopathology Series ((ACPS))

Abstract

This chapter provides an overview of the topic of high and low functioning in autism spectrum disorder (ASD). High and low functioning are relative terms and typically defined by an IQ above or below 70, the cutoff used to define intellectual disability (ID). The distinction between high and low functioning is used by clinicians and researchers alike and rests on the premise that a better understanding of the heterogeneity in ASD will likely generate useful information for studying the etiology and treatment of the disorder. In the following pages, the topic is discussed in terms of prevalence, etiology, diagnostic and clinical features, and outcome. Changes in the conceptualization of ASD to include high-functioning individuals have significantly impacted the epidemiology of ASD. It is well known that ASD and ID often co-occur; what remains unclear is the strength and origin of the association between ASD and ID. Intelligence quotient (IQ) impacts a host of clinical variables such as core diagnostic features, as well as adaptive and problem behavior. Finally, there is a relationship between level of functioning and the natural course and response to treatment.

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References

  • Aman, M. G., Tassé, M. J., Rojahn, J., & Hammer, D. (1996). The Nisonger CBRF: A child behavior rating form for children with developmental disabilities. Research in Developmental Disabilities, 17, 41–57. doi:10.1016/0891-4222(95)00039-9.

    Article  PubMed  Google Scholar 

  • Aman, M. G., Buican, B., & Arnold, L. E. (2003). Methylphenidate treatment in children with borderline IQ and mental retardation: Analysis of three aggregate studies. Journal of Child and Adolescent Psychopharmacology, 13, 29–40. doi:10.1089/104454603321666171.

    Article  PubMed  Google Scholar 

  • Amaral, D. G., Schumann, C. M., & Nordahl, C. W. (2008). Neuroanatomy of autism. Trends in Neurosciences, 31, 137–145. doi:10.1016/j.tins.2007.12.005.

    Article  PubMed  Google Scholar 

  • AAIDD. (2010). Intellectual disability: Definition, classification, and systems of supports (11th ed.). Washington, DC: American Association on Intellectual and Developmental Disabilities.

    Google Scholar 

  • APA. (2000). Diagnostic and statistical manual of mental disorders (4th ed. text revised). Washington, DC: American Psychiatric Association. doi:10.1176/appi.books.9780890423349.

    Google Scholar 

  • APA. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington: American Psychiatric Association.

    Google Scholar 

  • Ameis, S. H., & Szatmari, P. (2012). Imaging-genetics in autism spectrum disorder: Advances, translational impact, and future directions. Frontiers in Psychiatry, 3, 46. doi:10.3389/fpsyt.2012.00046.

    Article  PubMed Central  PubMed  Google Scholar 

  • Amiet, C., Gourfinkel-An, I., Bouzamondo, A., Tordjman, S., Baulac, M., Lechat, P., et al. (2008). Epilepsy in autism is associated with intellectual disability and gender: Evidence from a meta-analysis. Biological Psychiatry, 64, 577–582. doi:10.1016/j.biopsych.2008.04.030.

    Article  PubMed  Google Scholar 

  • Arnold, L. E., Farmer, C., Kraemer, H. C., Davies, M., Witwer, A. N., Chang, S., et al. (2010). Moderators, mediators, and other predictors of risperidone response in children with autistic disorder and irritability. Journal of Child and Adolescent Psychopharmacology, 20, 83–93. doi:10.1089/cap.2009.0022.

    Article  PubMed Central  PubMed  Google Scholar 

  • Baghdadli, A., Picot, M. C., Michelon, C., Bodet, J., Pernon, E., Burstezjn, C., et al. (2007). What happens to children with PDD when they grow up? Prospective follow-up of 219 children from preschool age to mid-childhood. Acta Psychiatrica Scandinavica, 115, 403–412. doi:10.1111/j.1600-0447.2006.00898.x.

    Article  PubMed  Google Scholar 

  • Banach, R., Thompson, A., Szatmari, P., Goldberg, J., Tuff, L., Zwaigenbaum, L., & Mahoney, W. (2009). Brief report: Relationship between non-verbal IQ and gender in autism. Journal of Autism and Developmental Disorders, 39, 188–193. doi:10.1007/s10803-008-0612-4.

    Article  PubMed  Google Scholar 

  • Ben Itzchak, E., & Zachor, A. D. (2007). The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism. Research in Developmental Disabilities, 28, 287–303. doi:10.1016/j.ridd.2006.03.002.

    Article  PubMed  Google Scholar 

  • Ben Itzchak, E., Lahat, E., Burgin, R., & Zachor, A. D. (2008). Cognitive, behavior, and intervention outcome in young children with autism. Research in Developmental Disabilities, 29, 447–458. doi:10.1016/j.ridd.2007.08.003.

    Article  PubMed  Google Scholar 

  • Bishop, S. L., Richler, J., & Lord, C. (2006). Association between restricted and repetitive behaviors and nonverbal IQ in children with autism spectrum disorders. Clinical Neuropsychology, 12, 247–267. doi:10.1080/09297040600630288.

    Google Scholar 

  • Bishop, S. L., Hus, V., Duncan, A., Huerta, M., Gotham, K., Pickles, A., et al. (2013). Subcategories of restricted and repetitive behaviors in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43, 1287–1297. doi:10.1007/s10803-012-1671-0.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237–243. doi:10.1023/A:1005596502855.

    Article  PubMed  Google Scholar 

  • Bolte, S., & Poustka, F. (2002). The relation between general cognitive level and adaptive behavior domains in individuals with autism with and without co-morbid mental retardation. Child Psychiatry and Human Development, 33, 165–172. doi:10.1023/A:1020734325815.

    Article  PubMed  Google Scholar 

  • Brereton, A. V., Tonge, B. J., & Einfeld, S. L. (2006). Psychopathology in children and adolescents with autism compared to young people with intellectual disability. Journal of Autism and Developmental Disorders, 36, 863–870. doi:10.1007/s10803-006-0125-y.

    Article  PubMed  Google Scholar 

  • Caniato, R. (2007). Epilepsy in autism spectrum disorders. European Child and Adolescent Psychiatry, 16, 61–66. doi:10.1007/s00787-006-0563-2.

    Article  Google Scholar 

  • Cantwell, D. P. (1996). Classification of child and adolescent psychopathology. Journal of Child Psychology and Psychiatry, 37, 3–12. doi:10.1111/j.1469-7610.1996.tb01377.x.

    Article  PubMed  Google Scholar 

  • Cuccaro, M. L., Shao, Y., Grubber, J., Slifer, M., Wolpert, C. M., Donnelly, S. L., et al. (2003). Factor analysis of restricted and repetitive behaviors in autism using the Autism Diagnostic Interview-Revised. Child Psychiatry and Human Development, 34, 3–17. doi:10.1023/A:1025321707947.

    Article  PubMed  Google Scholar 

  • Dodds, L., Fell, D. B., Shea, S., Armson, B. A., Allen, A. C., & Bryson, S. (2011). The role of prenatal, obstetric and neonatal factors in the development of autism. Journal of Autism and Developmental Disorders, 41, 891–902. doi:10.1007/s10803-010-1114-8.

    Article  PubMed  Google Scholar 

  • Dominick, K. C., Davis, N. O., Lainhart, J., Tager-Flusberg, H., & Folstein, S. (2007). Atypical behaviors in children with autism and children with a history of language impairment. Research in Developmental Disabilities, 28, 145–162. doi:10.1016/j.ridd.2006.02.003.

    Article  PubMed  Google Scholar 

  • Duerden, E. G., Oatley, H. K., Mak-Fan, M. K., McGrath, P. A., Taylor, M. J., Szatmari, P., & Roberts, S. W. (2012). Risk factors associated with self-injurious behaviors in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 2460–2470. doi:10.1007/s10803-012-1497-9.

    Article  PubMed  Google Scholar 

  • Estes, A. M., Dawson, G., Sterling, L., & Munson, J. (2007). Level of intellectual functioning predicts patterns of associated symptoms in school-age children with autism spectrum disorder. American Journal on Mental Retardation, 112, 439–449.

    Article  PubMed  Google Scholar 

  • Fein, D., Barton, M., Eigsti, I.-M., Kelly, E., Naigles, L., Schultz, R., et al. (2013). Optimal outcome in individuals with a history of autism. Journal of Child Psychology and Psychiatry, 54, 195–205. doi:10.1111/jcpp.12037.

    Article  PubMed Central  PubMed  Google Scholar 

  • Fenton, G., D’Ardia, C., Valente, D., Vecchio, I. D. V., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism: The International Journal of Research and Practice, 7, 269–287. doi:10.1177/1362361303007003004.

    Article  Google Scholar 

  • Fombonne, E. (2009). The epidemiology of pervasive developmental disorders. Pediatric Research, 65, 591–598. doi:10.1203/PDR.0b013e31819e7203.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., & Sprafkin, J. (1997). Adolescent symptom inventory-4 screening manual. Stony Brook: Checkmate Plus.

    Google Scholar 

  • Gadow, K. D., & Sprafkin, J. (2002). Child symptom inventory-4 screening and norms manual. Stony Brook: Checkmate Plus.

    Google Scholar 

  • Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2005). Comparison of DSM-IV symptoms in elementary school-age children with PDD versus clinic and community. Autism: The International Journal of Research and Practice, 9, 392–415. doi:10.1177/1362361305056079.

    Article  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2006). ADHD symptom subtypes in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 36, 271–283. doi:10.1007/s10803-005-0060-3.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., & Drabick, D. A. G. (2008a). Oppositional defiant disorder as a clinical phenotype in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 38, 1302–1310. doi:10.1007/s10803-007-0516-8.

    Article  Google Scholar 

  • Gadow, K. D., DeVincent, C., & Schneider, J. (2008b). Predictors of psychiatric symptoms in children with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 38, 1710–1720. doi:10.1007/s10803-008-0556-8.

    Article  Google Scholar 

  • Gadow, K. D., Roohi, J., DeVincent, C. J., & Hatchwell, E. (2008c). Association of ADHD, tics, and anxiey with dopamine transporter (DAT1) genotype in autism spectrum disorder. Journal of Child Psychology and Psychiatry, 49, 1331–1338. doi:10.1111/j.1469-7610.2008.01952.x.

    Article  Google Scholar 

  • Gadow, K. D., Guttmann-Steinmetz, S., Rieffe, C., & DeVincent, C. J. (2012). Depression symptoms in boys with autism spectrum disorder and comparison samples. Journal of Autism and Developmental Disorders, 42, 1353–1363. doi:10.1007/s10803-011-1367-x.

    Article  PubMed  Google Scholar 

  • Geschwind, D. H. (2011). Genetics of autism spectrum disorders. Trends in Cognitive Sciences, 15, 409–416. doi:10.1016/j.tics.2011.07.003.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 693–705. doi:10.1007/s10803-008-0674-3.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gotham, K., Bishop, S. L., Hus, V., Huerta, M., Lund, S., Buja, A., Krieger, A., & Lord, C. (2013). Exploring the relationship between anxiety and insistence on sameness in autism spectrum disorders. Autism Research, 6, 33–41. doi:10.1002/aur.1263.

    Article  PubMed  Google Scholar 

  • Grafodatskaya, D., Chung, B., Szatmari, P., & Weksberg, P. (2010). Autism spectrum disorders and epigenetics. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 794–809. doi:10.1016/j.jaac.2010.05.005.

    Article  PubMed  Google Scholar 

  • Hallett, V., Lecavalier, L., Sukhodolsky, D. G., Cipriano, N., McCracken, J. T., et al. (2013). Exploring anxiety in children with pervasive developmental disorders across a broad range of functioning. Journal of Autism and Developmental Disorders, 43(10), 2341–2352. doi:10.1007/s10803-013-1775-1.

    Article  PubMed  Google Scholar 

  • Helt, M., Kelley, E., Kinsbourne, M., Pandey, J., Boorstein, H., Herbert, M., & Fein, D. (2008). Can children with autism recover? If so, how? Neuropsychology Review, 18, 339–366. doi:10.1007/s11065-008-9075-9.

    Article  PubMed  Google Scholar 

  • Hoekstra, R. A., Happé, F., Baron-Cohen, S., & Ronald, A. (2009). Association between extreme autistic traits and intellectual disability. British Journal of Psychiatry, 195, 531–536. doi:10.1192/bjp.bp.108.060889.

    Article  PubMed  Google Scholar 

  • Howlin, P., Goode, S., Hutton, J., & Rutter, M. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45, 212–229. doi:10.1111/j.1469-7610.2004.00215.x.

    Article  PubMed  Google Scholar 

  • Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114, 23–41. doi:10.1352/2009.114:23;nd41.

    Article  PubMed  Google Scholar 

  • Hus, V., Bishop, S., Gotham, K., & Huerta, M., & Lord, C. (2013). Factors influencing scores on the social responsiveness scale. Journal of Child Psychiatry and Psychology, 54, 216–224. doi:10.1111/j.1469-7610.2012.02589.x.

    Article  Google Scholar 

  • Jacobson, J. W., Mulick, J. A., & Rojahn, J. (Eds.). (2007). Handbook of intellectual and developmental disabilities. New York: Springer. doi:10.1007/0-387-32931-5.

    Google Scholar 

  • Jang, J., Dixon, D. R., Tarbox, J., & Granpeesheh, D. (2010). Symptom severity and challenging behavior in children with ASD. Research in Autism Spectrum Disorders, 5, 1028–1032. doi:10.1016/j.rasd.2010.11.008.

    Article  Google Scholar 

  • Kaat, A. J., & Lecavalier, L. (2014). Group-based social skills treatment: A methodological review. Research in Autism Spectrum Disorders, 8, 15–24.

    Google Scholar 

  • Kaat, A. J., Gadow, K. D., & Lecavalier, L. (2013). Psychiatric symptom impairment in children with autism spectrum disorders. Journal of Abnormal Child Psychology, 41, 959–969. doi:10.1007/s10802-013-9739-7.

    Article  PubMed  Google Scholar 

  • Kanne, S., & Mazurek, M. (2011). Aggression in children and adolescents with ASD: Prevalence and risk factors. Journal of Autism and Developmental Disorders, 41, 926–937. doi:10.1007/s10803-010-1118-4.

    Article  PubMed  Google Scholar 

  • Kanne, S. M., Gerber, A. J., Quirmbach, L. M., Sparrow, S. S., Cicchetti, D. V., & Saulnier, C. A. (2011). The role of adaptive behavior in autism spectrum disorders: Implications for functional outcome. Journal of Autism and Developmental Disorders, 41, 1007–1018. doi:10.1007/s10803-010-1126-4.

    Article  PubMed  Google Scholar 

  • King, B. H., Hollander, E., Sikich, L., McCracken, J. T., Scahill, L., Bregman, J. D., et al. (2009). Lack of efficacy of cilaopram in children with autism spectrum disorders and high levels of repetitive behavior. Archives of General Psychiatry, 66, 583–590. doi:10.1001/archgenpsychiatry.2009.30.

    Article  PubMed Central  PubMed  Google Scholar 

  • King, M., & Bearman, P. (2009). Diagnostic change and the increased prevalence of autism. International Journal of Epidemiology, 38, 1224–1234. doi:10.1093/ije/dyp261.

    Article  PubMed Central  PubMed  Google Scholar 

  • Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F. R., & Lord, C. (2007). Communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: The Vineland and ADOS. Journal of Autism and Developmental Disorders, 37, 748–759. doi:10.1007/s10803-006-0229-4.

    Article  PubMed  Google Scholar 

  • Lam, K. S. L., Bodfish, J. W., & Piven, J. (2008). Evidence for three subtypes of repetitive behavior in autism that differ in familiality and association with other symptoms. Journal of Child Psychology and Psychiatry, 49, 1193–2000. doi:10.1111/j.1469-7610.2008.01944.x.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lang, R., Regester, A., Lauderdale, S., Ashbaugh, K., & Haring, A. (2010). Treatment of anxiety in autism spectrum disorders using cognitive behavior therapy: A systematic review. Developmental Neurorehabilitation, 13, 53–63. doi:10.3109/17518420903236288.

    Article  PubMed  Google Scholar 

  • Lecavalier, L. (2006). Behavior and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. Journal of Autism and Developmental Disorders, 36, 1101–1114. doi:10.1007/s10803-006-0147-5.

    Article  PubMed  Google Scholar 

  • Lecavalier, L., & Gadow, K. D. (2008). Pharmacology effects and side effects. In J. L. Matson (Ed.), Clinical assessment and intervention for autism spectrum disorders (pp. 221–263). New York: Elsevier.

    Chapter  Google Scholar 

  • Lecavalier, L., Gadow, K., DeVincent, C. J., & Edwards, M. C. (2009). Validation of DSM-IV model of psychiatric syndromes in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 278–289. doi:10.1007/s10803-008-0622-2.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., Pickles, A., & Rutter, M. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223. doi:10.1023/A:1005592401947.

    Article  PubMed  Google Scholar 

  • Lord, C., Petkova, E., Hus, V., Gan, W., Lu, F., Martin, D. M., et al. (2012). A multisite study of the clinical diagnosis of different autism spectrum disorders. Archives of General Psychiatry, 69, 306–313. doi:10.1001/archgenpsychiatry.2011.148.

    Article  Google Scholar 

  • MacMillan, D. L., & Speece, D. L. (1999). Utility of current diagnostic categories for research and practice. In R. Gallimore, L. P. Bernheimer, D. L. MacMillan, D. L. Speece & S. Vaughn (Eds.), Developmental perspectives on children with high-incidence disabilities (pp. 111–113). Mahwah: Erlbaum.

    Google Scholar 

  • Magiati, I., Moss, J., Charman, T., & Howlin, P. (2011). Patterns of change in children with autism spectrum disorders who received community based comprehensive interventions in their pre-school years: A seven year follow-up study. Research in Autism Spectrum Disorders, 5, 1016–1027. doi:10.1016/j.rasd.2010.11.007.

    Article  Google Scholar 

  • Norris, M., & Lecavalier, L. (2010). Screening accuracy of Level 2 autism spectrum disorder rating scales: A review of selected instruments. Autism: The International Journal of Research and Practice, 14, 263–284. doi:10.1177/1362361309348071.

    Article  Google Scholar 

  • Ozonoff, S., & Cathcart, K. (1998). Effectiveness of a home program intervention for young children with autism. Journal of Autism and Developmental Disorders, 28, 25–32. doi:10.1023/A:1026006818310.

    Article  PubMed  Google Scholar 

  • Palmer, R. F., Blanchard, S., Jean, C. R., & Mandell, D. S. (2005). School district resources and identification of children with autistic disorder. American Journal of Public Health, 95, 125–130. doi:10.2105/AJPH.2003.023077.

    Article  PubMed Central  PubMed  Google Scholar 

  • Perry, A., Flanagan, H. E., Geier, J. D., & Freeman, N. L. (2009). Brief report: The Vineland Adaptive Behavior Scales in young children with autism spectrum disorders at different cognitive levels. Journal of Autism and Developmental Disorders, 39, 1066–1078. doi:10.1007/s10803-009-0704-9.

    Article  PubMed  Google Scholar 

  • Remington, B., Hastings, R. P., Kovshoff, H., degli Espinosa, F., Jahr, E., Brown, T., et al. (2007). Early intensive behavioral intervention: Outcomes for children with autism and their parents after two years. American Journal on Mental Retardation, 112, 418–438.

    Article  PubMed  Google Scholar 

  • Research Units on Pediatric Psychopharmacology (RUPP) Autism Network (2005). Randomized, controlled, crossover trial of methylphenidate in pervasive developmental disorders with hyperactivity. Archives of General Psychiatry, 62, 1266–1274. doi:10.1001/archpsyc.62.11.1266.

    Article  Google Scholar 

  • Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126, 983–987.

    PubMed  Google Scholar 

  • Rosenberg, R. E., Mandell, D. S., Farmer, J. E., Law, J. K., Marvin, A. R., & Law, P. A. (2010). Psychotropic medication use among children with autism spectrum disorders enrolled in a national registry, 2007-2008. Journal of Autism and Developmental Disorders, 40, 342–351. doi:10.1007/s10803-009-0878-1.

    Article  PubMed  Google Scholar 

  • Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview—Revised. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110, 417–438.

    Article  PubMed  Google Scholar 

  • Schroeder, S. R., Oster-Granite, M. L., Berkson, G., Bodfish, J. W., Breese, G. R., Cataldo, M. F., et al. (2001). Self-injurious behavior: Gene-brain-behavior relationships. Mental Retardation and Developmental Disabilities, 7, 3–12.

    Article  Google Scholar 

  • Seltzer, M. M., Shattuck, P., Abbeduto, L., & Greenberg, J. S. (2004). Trajectory of development in adolescents and adults with autism. Mental Retardation and Developmental Disabilities Research Reviews, 10, 234–247. doi:10.1002/mrdd.20038.

    Article  PubMed  Google Scholar 

  • Shattuck, P. T. (2006). The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education. Pediatrics, 117, 1028–1037. doi:10.1442/peds.2005-1516.

    Article  PubMed  Google Scholar 

  • Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Bolt, D., Kring, S., Lounds, J., & Lord, C. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747. doi:10.1007/s10803-006-0307-7.

    Article  PubMed Central  PubMed  Google Scholar 

  • Shattuck, P. T., Durkin, M., Maenner, M., Newschaffer, C., Mandell, D. S., Wiggins, L., et al. (2009). Timing of identification among children with an autism spectrum disorder: Findings from a population-based surveillance study. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 474–483. doi:10.1097/CHI.0b013e31819b3848.

    Article  PubMed Central  PubMed  Google Scholar 

  • Siegel, M., & Beaulieu, A. A. (2012). Psychotropic medications in children with autism spectrum disorders: A systematic review and synthesis for evidence-based practice. Journal of Autism and Developmental Disorders, 42, 1592–1605. doi:10.1007/s10803-011-1399-2.

    Article  PubMed  Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adoelscent Psychiatry, 47, 921–929. doi:10.1097/CHI.0b013e318179964f.

    Article  Google Scholar 

  • Skuse, D. H. (2007). Rethinking the nature of genetic vulnerability to autistic spectrum disorders. Trends in Genetics, 8, 387–395. doi:10.1016/j.tig.2007.06.003.

    Article  Google Scholar 

  • Sparrow, S. S., Cicchetti, D., & Balla, D. A. (2005). Vineland adaptive behavior scales (2nd ed. manual). Minneapolis: NCS Pearson.

    Google Scholar 

  • Spiker, D., Lotspeich, L. J., Dimiceli, S., Myers, R. M., & Risch, N. (2002). Behavioral phenotypic variation in autism multiplex familes: Evidence for a continuous severity gradient. American Journal of Medical Genetics (Neuropsychiatric Genetics), 114, 129–136. doi:10.1002/ajmg.10188.

    Article  Google Scholar 

  • Sukhodolsky, D. G., Scahill, L., Gadow, K. D., Arnold, E., Aman, M. G., McDougle, C. J., et al. (2008). Parent-rated anxiety symptoms in children with pervasive developmental disorders: Frequency, distribution, and association with the core autism symptoms and cognitive functioning. Journal of Abnormal Child Psychology, 36, 117–128. doi:10.1007/s10802-007-9165-9.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Bryson, S. E., Boyle, M. H., Streiner, D. L., & Duku, E. (2003). Predictors of outcome among high functioning children with autism and Asperger syndrome. Journal of Child Psychology and Psychiatry, 44, 520–528. doi:10.1111/1469-7610.00141.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Georgiades, S., Bryson, S., Zwaigenbaum, L., Roberts, W., Mahoney, W., Goldberg, J., & Tuff, L. (2006). Investigating the structure of the restricted, repetitive behaviors and interests domain of autism. Journal of Child Psychology and Psychiatry, 47, 582–590. doi:10.1111/j.1469-7610.2005.01537.x.

    Article  PubMed  Google Scholar 

  • van Bokhoven, H. (2011). Genetic and epigenetic networks in intellectual disabilities. Annual Review of Genetics, 45, 81–104. doi:10.1146/annurev-genet-110410-132512.

    Article  PubMed  Google Scholar 

  • van Steensel, F. J., Bogels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14, 302–317. doi:10.1007/s10567-011-0097-0.

    Article  PubMed Central  PubMed  Google Scholar 

  • Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15, 477–496. doi:10.1089/cap.2005.15.477.

    Article  PubMed  Google Scholar 

  • White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229. doi:10.1016/j.cpr.2009.01.003.

    Article  PubMed Central  PubMed  Google Scholar 

  • Witwer, A., & Lecavalier, L. (2005). Treatment incidence and patterns in children and adolescents with autism spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 15, 671–681. doi:10.1089/cap.2005.15.671.

    Article  PubMed  Google Scholar 

  • Witwer, A. N., & Lecavalier, L. (2008). Examining the validity of autism spectrum disorder subtypes. Journal of Autism and Developmental Disorders, 38, 1611–1624. doi:10.1007/s10803-008-0541-2.

    Article  PubMed  Google Scholar 

  • Witwer, A. N., & Lecavalier, L. (2010). Validity of comorbid psychiatric disorders in children with autism spectrum disorders. Journal of Developmental and Physical Disabilities, 22, 367–380. doi:10.1007/s10882-010-9194-0.

    Article  Google Scholar 

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Authors and Affiliations

  1. Nisonger Center and Departments of Psychology and Psychiatry, The Ohio State University, 371-D McCampbell Hall, 1581 Dodd Drive, Columbus, OH, 43210, USA

    Luc Lecavalier Ph.D.

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  1. Luc Lecavalier Ph.D.
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Correspondence to Luc Lecavalier Ph.D. .

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Editors and Affiliations

  1. Louisiana State University Department of Psychology, Baton Rouge, Louisiana, USA

    Thompson E. Davis III

  2. Virginia Tech, Blacksburg, Virginia, USA

    Susan W. White

  3. Department of Psychology, Virginia Tech Child Study Center, Blacksburg, Virginia, USA

    Thomas H. Ollendick

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Lecavalier, L. (2014). Phenotypic Variability in Autism Spectrum Disorder: Clinical Considerations. In: Davis III, T., White, S., Ollendick, T. (eds) Handbook of Autism and Anxiety. Autism and Child Psychopathology Series. Springer, Cham. https://doi.org/10.1007/978-3-319-06796-4_2

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