Identification of subgroups of children in the Australian Autism Biobank using latent class analysis.

Autism spectrum Latent class analysis Subgroups

Journal

Child and adolescent psychiatry and mental health
ISSN: 1753-2000
Titre abrégé: Child Adolesc Psychiatry Ment Health
Pays: England
ID NLM: 101297974

Informations de publication

Date de publication:
20 Feb 2023
Historique:
received: 22 01 2023
accepted: 26 01 2023
entrez: 22 2 2023
pubmed: 23 2 2023
medline: 23 2 2023
Statut: epublish

Résumé

The identification of reproducible subtypes within autistic populations is a priority research area in the context of neurodevelopment, to pave the way for identification of biomarkers and targeted treatment recommendations. Few previous studies have considered medical comorbidity alongside behavioural, cognitive, and psychiatric data in subgrouping analyses. This study sought to determine whether differing behavioural, cognitive, medical, and psychiatric profiles could be used to distinguish subgroups of children on the autism spectrum in the Australian Autism Biobank (AAB). Latent profile analysis was used to identify subgroups of children on the autism spectrum within the AAB (n = 1151), utilising data on social communication profiles and restricted, repetitive, and stereotyped behaviours (RRBs), in addition to their cognitive, medical, and psychiatric profiles. Our study identified four subgroups of children on the autism spectrum with differing profiles of autism traits and associated comorbidities. Two subgroups had more severe clinical and cognitive phenotype, suggesting higher support needs. For the 'Higher Support Needs with Prominent Language and Cognitive Challenges' subgroup, social communication, language and cognitive challenges were prominent, with prominent sensory seeking behaviours. The 'Higher Support Needs with Prominent Medical and Psychiatric and Comorbidity' subgroup had the highest mean scores of challenges relating to social communication and RRBs, with the highest probability of medical and psychiatric comorbidity, and cognitive scores similar to the overall group mean. Individuals within the 'Moderate Support Needs with Emotional Challenges' subgroup, had moderate mean scores of core traits of autism, and the highest probability of depression and/or suicidality. A fourth subgroup contained individuals with fewer challenges across domains (the 'Fewer Support Needs Group'). Data utilised to identify subgroups within this study was cross-sectional as longitudinal data was not available. Our findings support the holistic appraisal of support needs for children on the autism spectrum, with assessment of the impact of co-occurring medical and psychiatric conditions in addition to core autism traits, adaptive functioning, and cognitive functioning. Replication of our analysis in other cohorts of children on the autism spectrum is warranted, to assess whether the subgroup structure we identified is applicable in a broader context beyond our specific dataset.

Sections du résumé

BACKGROUND BACKGROUND
The identification of reproducible subtypes within autistic populations is a priority research area in the context of neurodevelopment, to pave the way for identification of biomarkers and targeted treatment recommendations. Few previous studies have considered medical comorbidity alongside behavioural, cognitive, and psychiatric data in subgrouping analyses. This study sought to determine whether differing behavioural, cognitive, medical, and psychiatric profiles could be used to distinguish subgroups of children on the autism spectrum in the Australian Autism Biobank (AAB).
METHODS METHODS
Latent profile analysis was used to identify subgroups of children on the autism spectrum within the AAB (n = 1151), utilising data on social communication profiles and restricted, repetitive, and stereotyped behaviours (RRBs), in addition to their cognitive, medical, and psychiatric profiles.
RESULTS RESULTS
Our study identified four subgroups of children on the autism spectrum with differing profiles of autism traits and associated comorbidities. Two subgroups had more severe clinical and cognitive phenotype, suggesting higher support needs. For the 'Higher Support Needs with Prominent Language and Cognitive Challenges' subgroup, social communication, language and cognitive challenges were prominent, with prominent sensory seeking behaviours. The 'Higher Support Needs with Prominent Medical and Psychiatric and Comorbidity' subgroup had the highest mean scores of challenges relating to social communication and RRBs, with the highest probability of medical and psychiatric comorbidity, and cognitive scores similar to the overall group mean. Individuals within the 'Moderate Support Needs with Emotional Challenges' subgroup, had moderate mean scores of core traits of autism, and the highest probability of depression and/or suicidality. A fourth subgroup contained individuals with fewer challenges across domains (the 'Fewer Support Needs Group').
LIMITATIONS CONCLUSIONS
Data utilised to identify subgroups within this study was cross-sectional as longitudinal data was not available.
CONCLUSIONS CONCLUSIONS
Our findings support the holistic appraisal of support needs for children on the autism spectrum, with assessment of the impact of co-occurring medical and psychiatric conditions in addition to core autism traits, adaptive functioning, and cognitive functioning. Replication of our analysis in other cohorts of children on the autism spectrum is warranted, to assess whether the subgroup structure we identified is applicable in a broader context beyond our specific dataset.

Identifiants

pubmed: 36805686
doi: 10.1186/s13034-023-00565-3
pii: 10.1186/s13034-023-00565-3
pmc: PMC9940381
doi:

Types de publication

Journal Article

Langues

eng

Pagination

27

Subventions

Organisme : Cooperative Research Centre for Living with Autism
ID : 1.073RU
Organisme : Royal Australasian College of Physicians
ID : 2020 NHMRC RACP Fellows Research Entry Scholarship

Informations de copyright

© 2023. The Author(s).

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Auteurs

Alicia Montgomery (A)

University of New South Wales, Sydney, Australia. a.k.montgomery@unsw.edu.au.

Anne Masi (A)

University of New South Wales, Sydney, Australia.

Andrew Whitehouse (A)

University of Western Australia, Perth, Australia.

Jeremy Veenstra-VanderWeele (J)

Columbia University, New York, USA.

Lauren Shuffrey (L)

Columbia University, New York, USA.

Mark D Shen (MD)

University of North Carolina, Chapel Hill, USA.

Lisa Karlov (L)

University of New South Wales, Sydney, Australia.

Mirko Uljarevic (M)

University of Melbourne, Melbourne, Australia.

Gail Alvares (G)

University of Western Australia, Perth, Australia.

Sue Woolfenden (S)

University of New South Wales, Sydney, Australia.

Natalie Silove (N)

Sydney Children's Hospital Network, Randwick, Sydney, Australia.

Valsamma Eapen (V)

University of New South Wales, Sydney, Australia.

Classifications MeSH