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

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Abstract

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, JW Goethe University Hospital, Deutschordenstraße 50, 60528, Frankfurt Am Main, Germany

    Hannah Cholemkery, Juliane Medda, Thomas Lempp & Christine M. Freitag

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  1. Hannah Cholemkery
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  2. Juliane Medda
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Correspondence to Hannah Cholemkery.

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Cholemkery, H., Medda, J., Lempp, T. et al. Classifying Autism Spectrum Disorders by ADI-R: Subtypes or Severity Gradient?. J Autism Dev Disord 46, 2327–2339 (2016). https://doi.org/10.1007/s10803-016-2760-2

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