Changes in the severity of autism symptom domains are related to mental health challenges during middle childhood.
Einat Waizbard-Bartov, Emilio Ferrer, Brianna Heath and 6 others
PMID 37691349WHAT IT FOUND
Children whose social communication symptoms worsened had increasing anxiety and ADHD.
Those whose repetitive behaviors decreased had higher anxiety at age 11. Worsening social symptoms and reducing repetitive behaviors were both linked to more mental health challenges.
Key findings
01Children who increased in social-communication severity showed greater symptoms of anxiety, ADHD, and overall psychopathology over time.
02Children who decreased in restricted/repetitive behavior severity had higher anxiety levels and a greater proportion meeting criteria for an anxiety disorder at the end of middle childhood.
03Changes in the two core autism domains were often independent, and evaluating them separately revealed stronger associations with mental health than looking at total autism severity.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was small (75 participants), limiting the ability to analyze subgroups. The structured anxiety interview (ADIS/ASA) was only administered at the end of the study, so it could not track changes in anxiety over time. Mental health measures relied on parent report, which can be subject to bias. The study did not correct for multiple statistical comparisons, increasing the risk of chance findings. The study found associations but cannot prove causation; it is unclear if symptom changes cause mental health issues or vice versa. The sample included only 15 girls, limiting conclusions about sex differences.
Declared interests
One author (D. Amaral) serves on the Scientific Advisory Boards of Stemina Biomarkers Discovery, Inc. and Axial Therapeutics. Other authors declared no potential conflicts of interest.
The easy way to misread this
Do not assume that reducing restricted/repetitive behaviors is always beneficial for mental health. This study found that children whose repetitive behaviors decreased had higher anxiety levels, suggesting these behaviors may serve a self-regulatory function.