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Subgrouping Autism Based on Symptom Severity Leads to Differences in the Degree of Convergence Between Core Feature Domains

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Abstract

Existing models of autism spectrum disorder (ASD) disagree as to whether the core features should be conceptualized as convergent (related) or divergent (unrelated), and the few previous studies addressing this question have found conflicting results. We examined standardized parent ratings of symptoms from three domains (social, communication, repetitive behaviors) in large samples of typically developing children, children with ASD, and ASD subgroups. Our results suggest that the most evidence for divergence lies in typically developing children and lower severity ASD cases, while more evidence for convergence is found in a subset of cases with more severe impairment on any core feature. These results highlight the importance of subgrouping ASD given the degree of phenotypic heterogeneity present across the autism spectrum.

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Acknowledgments

Assistance for this study was provided by Division TEACCH and also by the Subject Registry and Behavioral Measurement Research Cores of the UNC Neurodevelopmental Disorders Research Center (P30 HD03110). We thank Dr. Daniel Ashmead and Dr. Stephen Camarata for their guidance, and the participants and their families for their participation in this study

Funding

This study was funded by the National Institute of Mental Health R01 MH073402 and the National Institute of Child Health and Human Development R01 HD 082127.

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Author notes

  1. Kathryn E. Unruh

    Present address: University of Kansas Lifespan Institute, Lawrence, KS, USA

Authors and Affiliations

  1. Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, South Tower, Nashville, TN, 37232, USA

    Allison Whitten & James W. Bodfish

  2. Vanderbilt Neuroscience Graduate Program, Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, 37232-2050, USA

    Kathryn E. Unruh, Robin L. Shafer & James W. Bodfish

  3. Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA

    James W. Bodfish

Authors
  1. Allison Whitten
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  2. Kathryn E. Unruh
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  3. Robin L. Shafer
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  4. James W. Bodfish
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Contributions

Each author (AW, KU, RS, JB) was involved in revising the work critically for important intellectual content, gave his or her final approval of this version of the paper, and agrees to be accountable for all aspects of the work. JB conceived of the idea and with AW, designed the work. AW drafted the manuscript. AW, KU, RS, and JB contributed to the analysis and interpretation of data.

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Correspondence to Allison Whitten.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all participants included in this study.

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Whitten, A., Unruh, K.E., Shafer, R.L. et al. Subgrouping Autism Based on Symptom Severity Leads to Differences in the Degree of Convergence Between Core Feature Domains. J Autism Dev Disord 48, 1908–1919 (2018). https://doi.org/10.1007/s10803-017-3451-3

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  • DOI: https://doi.org/10.1007/s10803-017-3451-3

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