Latent trajectories in autistic individuals: A systematic review.

The review used the GRoLTS checklist for risk of bias, which is not an established standard like ROBINS-I, potentially affecting the consistency of study quality assessment. Multiple included analyses were based on the same cohorts, which may introduce bias and reduce the independence of the findings. Autistic individuals over the age of 30 are underrepresented, so these trajectories cannot be generalized to older adults. Studies used different measures and age ranges for the same domains, making direct comparison of trajectory shapes and proportions difficult. Participants with lower cognitive levels are less likely to join research, meaning the identified trajectories may not represent the full spectrum of autistic individuals.

The project was funded by the Sophia Children’s Hospital Fund and the Erasmus MC Fellowship. The authors declared no potential conflicts of interest.

Do not assume that stable core autism traits mean a lack of change in other areas. The review found that while overall severity may remain stable, repetitive behaviors often worsen and adaptive skills may improve or decline independently. Clinical decisions should not rely on a single domain's trajectory.