A cluster analysis exploration of autism spectrum disorder subgroups in children without intellectual disability / Felicity KLOPPER in Research in Autism Spectrum Disorders, 36 (April 2017)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 36 (April 2017) . - p.66-78 Titre : A cluster analysis exploration of autism spectrum disorder subgroups in children without intellectual disability Type de document : Texte imprimé et/ou numérique Auteurs : Felicity KLOPPER, Auteur ; Renee TESTA, Auteur ; Christos PANTELIS, Auteur ; Efstratios SKAFIDAS, Auteur Article en page(s) : p.66-78 Langues : Anglais (eng) Mots-clés : Autism spectrum disorders  Asperger disorder  Autistic disorder  Classification  Subgroups Index. décimale : PER Périodiques Résumé : The heterogeneity in autism spectrum disorder (ASD) remains poorly understood, particularly in individuals without intellectual disability (ID), where phenotypic variability can be most pronounced. The presence of phenotypic subgroups continues to be questioned. This study investigated whether children with ASD without ID are differentiable into clinically meaningful subgroups. Method Data from the ‘gold standard’ ASD diagnostic instruments for 61 children (5–14 years) with ASD without ID were subjected to exploratory cluster analysis. Cognition, language, pragmatic communication, and behaviour were used to explore subgroups. Results Children with ASD without ID could be differentiated into Moderate and Severe Social Impairment subgroups when core ASD symptoms were more closely examined. The Moderate Social Impairment subgroup showed less severe social interaction and communication impairments but greater lifetime severity of restricted/repetitive behaviours. In contrast, the Severe Social Impairment subgroup, with poorer social interaction and communication skills, had lower lifetime severity of restricted/repetitive behaviours. This subgroup also had greater cognitive and language difficulties, and poorer adaptive functioning. Importantly, however, these neurocognitive and functional differences showed only small to moderate associations with the differentiated ASD clinical profiles. Conclusions Evidence of dissociated levels of severity across core ASD dimensions supports the idea that clinically meaningful subgroups within ASD without ID can be identified. The dissociated profiles of ASD features could represent different underlying neurobiological mechanisms for each subgroup. Identifying such subgroups in practice can improve the clinical utility of diagnostic labels in this population. Thus, both categorical and dimensional approaches may be useful in classifying ASD, with neither alone being adequate. En ligne : http://dx.doi.org/10.1016/j.rasd.2017.01.006 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=304 [article] A cluster analysis exploration of autism spectrum disorder subgroups in children without intellectual disability [Texte imprimé et/ou numérique] / Felicity KLOPPER, Auteur ; Renee TESTA, Auteur ; Christos PANTELIS, Auteur ; Efstratios SKAFIDAS, Auteur . - p.66-78. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 36 (April 2017) . - p.66-78 Mots-clés : Autism spectrum disorders  Asperger disorder  Autistic disorder  Classification  Subgroups Index. décimale : PER Périodiques Résumé : The heterogeneity in autism spectrum disorder (ASD) remains poorly understood, particularly in individuals without intellectual disability (ID), where phenotypic variability can be most pronounced. The presence of phenotypic subgroups continues to be questioned. This study investigated whether children with ASD without ID are differentiable into clinically meaningful subgroups. Method Data from the ‘gold standard’ ASD diagnostic instruments for 61 children (5–14 years) with ASD without ID were subjected to exploratory cluster analysis. Cognition, language, pragmatic communication, and behaviour were used to explore subgroups. Results Children with ASD without ID could be differentiated into Moderate and Severe Social Impairment subgroups when core ASD symptoms were more closely examined. The Moderate Social Impairment subgroup showed less severe social interaction and communication impairments but greater lifetime severity of restricted/repetitive behaviours. In contrast, the Severe Social Impairment subgroup, with poorer social interaction and communication skills, had lower lifetime severity of restricted/repetitive behaviours. This subgroup also had greater cognitive and language difficulties, and poorer adaptive functioning. Importantly, however, these neurocognitive and functional differences showed only small to moderate associations with the differentiated ASD clinical profiles. Conclusions Evidence of dissociated levels of severity across core ASD dimensions supports the idea that clinically meaningful subgroups within ASD without ID can be identified. The dissociated profiles of ASD features could represent different underlying neurobiological mechanisms for each subgroup. Identifying such subgroups in practice can improve the clinical utility of diagnostic labels in this population. Thus, both categorical and dimensional approaches may be useful in classifying ASD, with neither alone being adequate. En ligne : http://dx.doi.org/10.1016/j.rasd.2017.01.006 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=304

A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder / Amanda BRIGNELL in Autism & Developmental Language Impairments, 3 (January-December 2018)  

Public ISBD [article]  inAutism & Developmental Language Impairments > 3 (January-December 2018) Titre : A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Amanda BRIGNELL, Auteur ; Angela T. MORGAN, Auteur ; Susan WOOLFENDEN, Auteur ; Felicity KLOPPER, Auteur ; Tamara MAY, Auteur ; Vanessa SARKOZY, Auteur ; Katrina WILLIAMS, Auteur Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : BackgroundLanguage difficulties are common in autism spectrum disorder, yet little is known about the prognosis of language in children with autism spectrum disorder. The aim of this study was to systematically review studies reporting language outcomes in individuals with autism spectrum disorder.MethodA comprehensive search strategy with a well-established sensitive prognosis filter for Medline, adapted for five other databases, was used. Included studies observed individuals diagnosed with autism spectrum disorder for ?12 months and had ?30 participants. Risk of bias was assessed.ResultsFifty-four studies (N=5064) met inclusion criteria. Language outcomes were standardised assessments (n=35), notation of presence/absence of verbal language (n=11) or both (n=8). Age at baseline ranged from 17 months to 26 years, duration of follow-up from 1 to 38 years. Most publications (92%) were rated medium to high risk of bias. In all but one study individuals had below-average scores at baseline and follow-up. However, in most (n=24/25; 96%) studies reporting standard scores, individuals (aged???11 years at follow-up) progressed at a comparable rate to age-expected norms or demonstrated some ?catch up? over time. Meta-analyses found mean standard scores increased over time in three language domains (composite receptive language, composite expressive language and adaptive language). Nineteen to thirty percent of children aged five years and under gained verbal language. For children aged over five years 5?32% gained verbal language over the course of study. Age, baseline language scores, IQ and length of follow-up did not moderate between study differences in composite language or adaptive language growth or the acquisition of verbal language.ConclusionDespite variability in study methods, findings were consistent, with the majority of studies reporting children under 11 years on average progressed at a comparable rate to age-expected norms or with some ?catchup? over time.ImplicationsThis review provides synthesised information for families and clinicians on language development over time and on language outcomes for individuals with autism spectrum disorder. Such information can be useful for prognostic counselling and may assist planning around future resources and support needs. This review also makes recommendations regarding methodology for future studies so that prognosis can become more fine-tuned at an individual level. En ligne : https://doi.org/10.1177/2396941518767610 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387 [article] A systematic review and meta-analysis of the prognosis of language outcomes for individuals with autism spectrum disorder [Texte imprimé et/ou numérique] / Amanda BRIGNELL, Auteur ; Angela T. MORGAN, Auteur ; Susan WOOLFENDEN, Auteur ; Felicity KLOPPER, Auteur ; Tamara MAY, Auteur ; Vanessa SARKOZY, Auteur ; Katrina WILLIAMS, Auteur. Langues : Anglais (eng) in Autism & Developmental Language Impairments > 3 (January-December 2018) Index. décimale : PER Périodiques Résumé : BackgroundLanguage difficulties are common in autism spectrum disorder, yet little is known about the prognosis of language in children with autism spectrum disorder. The aim of this study was to systematically review studies reporting language outcomes in individuals with autism spectrum disorder.MethodA comprehensive search strategy with a well-established sensitive prognosis filter for Medline, adapted for five other databases, was used. Included studies observed individuals diagnosed with autism spectrum disorder for ?12 months and had ?30 participants. Risk of bias was assessed.ResultsFifty-four studies (N=5064) met inclusion criteria. Language outcomes were standardised assessments (n=35), notation of presence/absence of verbal language (n=11) or both (n=8). Age at baseline ranged from 17 months to 26 years, duration of follow-up from 1 to 38 years. Most publications (92%) were rated medium to high risk of bias. In all but one study individuals had below-average scores at baseline and follow-up. However, in most (n=24/25; 96%) studies reporting standard scores, individuals (aged???11 years at follow-up) progressed at a comparable rate to age-expected norms or demonstrated some ?catch up? over time. Meta-analyses found mean standard scores increased over time in three language domains (composite receptive language, composite expressive language and adaptive language). Nineteen to thirty percent of children aged five years and under gained verbal language. For children aged over five years 5?32% gained verbal language over the course of study. Age, baseline language scores, IQ and length of follow-up did not moderate between study differences in composite language or adaptive language growth or the acquisition of verbal language.ConclusionDespite variability in study methods, findings were consistent, with the majority of studies reporting children under 11 years on average progressed at a comparable rate to age-expected norms or with some ?catchup? over time.ImplicationsThis review provides synthesised information for families and clinicians on language development over time and on language outcomes for individuals with autism spectrum disorder. Such information can be useful for prognostic counselling and may assist planning around future resources and support needs. This review also makes recommendations regarding methodology for future studies so that prognosis can become more fine-tuned at an individual level. En ligne : https://doi.org/10.1177/2396941518767610 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387

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