Using developmental regression to reorganize the clinical importance of autistic atypicalities.

Autor: Gagnon D; Research Center of the CIUSSS-NIM, Hôpital Rivière-des-Prairies, 7070 boul. Perras, Montréal, QC, H1E 1A4, Canada.; Department of Psychiatry and Addictology, University of Montreal, 2900, boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada., Zeribi A; Department of Pediatrics, University of Montreal, 2900, boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.; Sainte-Justine Research Center, 3175, chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada., Douard É; Psychoeducation School, University of Montreal, C.P. 6128, Succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada.; Research Center of the CIUSSS-EMTL, 7331, rue Hochelaga, Montréal, QC, H1N 3V2, Canada., Courchesne V; Campbell Family Mental Health Research Institute (CAMH), 1001 Queen Street West, Toronto, M6J 1H4, ON, Canada., Huguet G; Department of Pediatrics, University of Montreal, 2900, boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.; Sainte-Justine Research Center, 3175, chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada., Jacquemont S; Department of Pediatrics, University of Montreal, 2900, boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.; Sainte-Justine Research Center, 3175, chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada., Loum MA; Department of Pediatrics, University of Montreal, 2900, boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada.; Sainte-Justine Research Center, 3175, chemin de la Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada., Mottron L; Research Center of the CIUSSS-NIM, Hôpital Rivière-des-Prairies, 7070 boul. Perras, Montréal, QC, H1E 1A4, Canada. Laurent.mottron@gmail.com.; Department of Psychiatry and Addictology, University of Montreal, 2900, boul. Édouard-Montpetit, Montreal, QC, H3T 1J4, Canada. Laurent.mottron@gmail.com.
Jazyk: angličtina
Zdroj: Translational psychiatry [Transl Psychiatry] 2022 Dec 01; Vol. 12 (1), pp. 498. Date of Electronic Publication: 2022 Dec 01.
DOI: 10.1038/s41398-022-02263-8
Abstrakt: Early regression (ER) is often reported in autistic children with a prototypical phenotype and has been proposed as a possible pathognomonic sign present in most autistic children. Despite the uncertainties attached to its definition and report, using ER to anchor the autism phenotype could help identify the signs that best contribute to an autism diagnosis. We extracted retrospective data from 1547 autistic children between the ages of 6 and 18 years from the Simons Simplex collection. Logistic regression identified the atypicalities associated with a history of ER. Stepwise variable selection using logistic regression analysis followed by a bootstrap procedure of 1000 iterations identified the cluster of atypicalities best associated with ER. Linear and logistic regressions measured the association between combinations of atypicalities within the identified cluster and adaptative behaviors, diagnostic areas of severity, and other categories. Seven atypicalities significantly increased the likelihood of having experienced ER (OR = 1.73-2.13). Four ("hand leading-ever", "pronominal reversal-ever", "never shakes head at age 4-5" and "stereotypic use of objects or interest in parts of objects-ever"), when grouped together, best characterized the phenotype of verbal autistic children with ER. This clustering of signs was associated with certain persistent language difficulties, higher summary scores on a diagnostic scale for autism, and greater odds of receiving an "autistic disorder" diagnosis instead of another pervasive developmental disorder (PDD) diagnosis. These results raise questions about using language as a clinical specifier, defining cross-sectional signs independent of their relationship with an early developmental trajectory, and relying on polythetic criteria or equivalent weighted autistic atypicalities.
(© 2022. The Author(s).)
Databáze: MEDLINE
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