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. 2014 Jul;18(5):571-82.
doi: 10.1177/1362361313481506. Epub 2013 Oct 8.

Demographic and clinical correlates of autism symptom domains and autism spectrum diagnosis

Affiliations

Demographic and clinical correlates of autism symptom domains and autism spectrum diagnosis

Thomas W Frazier et al. Autism. 2014 Jul.

Abstract

Demographic and clinical factors may influence assessment of autism symptoms. This study evaluated these correlates and also examined whether social communication and interaction and restricted/repetitive behavior provided unique prediction of autism spectrum disorder diagnosis. We analyzed data from 7352 siblings included in the Interactive Autism Network registry. Social communication and interaction and restricted/repetitive behavior symptoms were obtained using caregiver-reports on the Social Responsiveness Scale. Demographic and clinical correlates were covariates in regression models predicting social communication and interaction and restricted/repetitive behavior symptoms. Logistic regression and receiver operating characteristic curve analyses evaluated the incremental validity of social communication and interaction and restricted/repetitive behavior domains over and above global autism symptoms. Autism spectrum disorder diagnosis was the strongest correlate of caregiver-reported social communication and interaction and restricted/repetitive behavior symptoms. The presence of comorbid diagnoses also increased symptom levels. Social communication and interaction and restricted/repetitive behavior symptoms provided significant, but modest, incremental validity in predicting diagnosis beyond global autism symptoms. These findings suggest that autism spectrum disorder diagnosis is by far the largest determinant of quantitatively measured autism symptoms. Externalizing (attention deficit hyperactivity disorder) and internalizing (anxiety) behavior, low cognitive ability, and demographic factors may confound caregiver-report of autism symptoms, potentially necessitating a continuous norming approach to the revision of symptom measures. Social communication and interaction and restricted/repetitive behavior symptoms may provide incremental validity in the diagnosis of autism spectrum disorder.

Keywords: autism spectrum disorder; autism symptoms; diagnosis; prediction.

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Conflict of interest statement

Declaration of conflicting interests

Dr Paul Law has no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Magnitude (r) of unique predictive effects for SCI, with and without ASD diagnosis as a covariate. SCI: social communication and interaction; CI: confidence interval; ASD: autism spectrum disorder; ADHD: attention deficit hyperactivity disorder. All 95% CIs are <±0.01 (not shown).
Figure 2
Figure 2
Magnitude (r) of unique predictive effects for RRB, with and without ASD diagnosis as a covariate. RRB: restricted/repetitive behavior; CI: confidence interval; ASD: autism spectrum disorder; ADHD: attention deficit hyperactivity disorder. All 95% CIs are <±0.01 (not shown).
Figure 3
Figure 3
Receiver operating characteristic curves for SRS total raw, SCI raw, and RRB raw scores show close overlap in the prediction of ASD diagnosis. RRB: restricted/repetitive behavior; SRS: Social Responsiveness Scale; SCI: social communication and interaction; ASD: autism spectrum disorder.

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