Journal of Autism and Developmental Disorders

, Volume 46, Issue 7, pp 2327–2339 | Cite as

Classifying Autism Spectrum Disorders by ADI-R: Subtypes or Severity Gradient?

  • Hannah CholemkeryEmail author
  • Juliane Medda
  • Thomas Lempp
  • Christine M. Freitag
Original Paper


To reduce phenotypic heterogeneity of Autism spectrum disorders (ASD) and add to the current diagnostic discussion this study aimed at identifying clinically meaningful ASD subgroups. Cluster analyses were used to describe empirically derived groups based on the Autism Diagnostic Interview-revised (ADI-R) in a large sample of n = 463 individuals with ASD aged 3–21. Three clusters were observed. Most severely affected individuals regarding all core symptoms were allocated to cluster 2. Cluster 3 comprised moderate symptom severity of social communication impairments (SCI) and less stereotyped repetitive behavior (RRB). Minor SCI and relatively more RRB characterized cluster 1. This study offers support for both, a symptom profile, and a gradient model of ASD within the spectrum due to the sample included.


Autism Diagnostic Interview-revised Psychometric assessment Diagnosis Autism spectrum disorder Cluster analysis DSM-5 



Our gratitude goes to the children, adolescents, and families we are allowed to work with, who took part in our study, and thus made our research possible. We are also indepted to our clinician colleagues who refer the families to our projects. The authors address special thanks to Heiko Zerlaut for data preparation, and Dana Probst for first working with parts of the data due to her diploma thesis. This work was supported by the European Union and the Bundesministerium für Bildung und Forschung (ERA-NET NEURON project: EUHF-AUTISM-01EW1105 to CMF), the Landes-Offensive zur Entwicklung wissenschaftlich ökonomischer Exzellenz (LOEWE): Neuronal Coordination Research Focus Frankfurt (NeFF to CMF), and the Deutsche Forschungsgemeinschaft DFG (FR2069/2-1 to CMF).

Author Contributions

HC and CMF designed and planned the study. JM and TL were involved in the study process. HC did the statistics and was together with CMF primarily responsible for the present article. All authors read and corrected the first draft, and approved the final manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Hannah Cholemkery
    • 1
    Email author
  • Juliane Medda
    • 1
  • Thomas Lempp
    • 1
  • Christine M. Freitag
    • 1
  1. 1.Department of Child and Adolescent Psychiatry, Psychosomatics and PsychotherapyJW Goethe University HospitalFrankfurt Am MainGermany

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