PDF(Pubmed)
Abstract：
UNASSIGNED: Previous research has demonstrated heterogeneous adaptive outcomes across the autism spectrum; however, the current literature remains limited in elucidating turning points and associated factors for longitudinal variability (chronogeneity). To address these empirical gaps, we aimed to provide a finer-grained characterization of trajectories of adaptive functioning from early childhood to adolescence in autism.
UNASSIGNED: Our sample (N = 406) was drawn from an inception cohort of children diagnosed Autistic at ages 2-5. Adaptive functioning was assessed with Vineland Adaptive Behavior Scales (VABS, 2nd Edition) across 6 visits from the time of diagnosis by age 18. Parallel-process latent growth curve modeling were used to estimate domain-level VABS trajectories, followed by latent class growth analysis to identify trajectory subgroups. Child characteristics at diagnosis, family demographics, and participation outcomes at adolescence were compared across subgroups.
UNASSIGNED: Piecewise latent growth models best described VABS trajectories with two turning points identified at around ages 5-6 and 9-10, respectively reflecting transitions into school age and early adolescence. We parsed four VABS trajectory subgroups that vary by level of functioning and change rate for certain domains and periods. Around 16% of the sample exhibited overall adequate functioning (standard score >85) with notable early growth and social adaptation during adolescence. About 21% showed low adaptive functioning (standard score ≤70), with decreasing slopes by age 6 followed by improvements in communication and daily-living skills by age 10. The other two subgroups (63% in total) were characterized by adaptive functioning between low and adequate levels, with relatively stable trajectories entering school age. These subgroups differed most in their cognitive ability at diagnosis, household income, and social participation in adolescence.
UNASSIGNED: We identified key individual and family characteristics and time windows associated with distinct adaptive functioning trajectories, which have important implications for providing timely and tailored supports to Autistic people across developmental stages.
UNASSIGNED: Our sample (N = 406) was drawn from an inception cohort of children diagnosed Autistic at ages 2-5. Adaptive functioning was assessed with Vineland Adaptive Behavior Scales (VABS, 2nd Edition) across 6 visits from the time of diagnosis by age 18. Parallel-process latent growth curve modeling were used to estimate domain-level VABS trajectories, followed by latent class growth analysis to identify trajectory subgroups. Child characteristics at diagnosis, family demographics, and participation outcomes at adolescence were compared across subgroups.
UNASSIGNED: Piecewise latent growth models best described VABS trajectories with two turning points identified at around ages 5-6 and 9-10, respectively reflecting transitions into school age and early adolescence. We parsed four VABS trajectory subgroups that vary by level of functioning and change rate for certain domains and periods. Around 16% of the sample exhibited overall adequate functioning (standard score >85) with notable early growth and social adaptation during adolescence. About 21% showed low adaptive functioning (standard score ≤70), with decreasing slopes by age 6 followed by improvements in communication and daily-living skills by age 10. The other two subgroups (63% in total) were characterized by adaptive functioning between low and adequate levels, with relatively stable trajectories entering school age. These subgroups differed most in their cognitive ability at diagnosis, household income, and social participation in adolescence.
UNASSIGNED: We identified key individual and family characteristics and time windows associated with distinct adaptive functioning trajectories, which have important implications for providing timely and tailored supports to Autistic people across developmental stages.
摘要：
■先前的研究已经证明了自闭症谱系的异质性适应性结果；然而，目前的文献在阐明纵向变异性(慢性性)的转折点和相关因素方面仍然有限.为了解决这些经验差距，我们旨在对自闭症患者从儿童早期到青春期的适应性功能轨迹进行更细粒度的表征.
■我们的样本（N=406）来自2-5岁被诊断为自闭症儿童的初始队列。使用Vineland适应性行为量表(VABS，第2版）从诊断到18岁的6次就诊。并行过程潜在生长曲线模型用于估计领域级VABS轨迹，其次是潜在的类增长分析，以识别轨迹子群。诊断时的儿童特征，家庭人口统计，和青春期参与结局在各个亚组之间进行比较.
■分段潜在生长模型最好地描述了VABS轨迹，在5-6岁和9-10岁左右确定了两个转折点，分别反映了向学龄期和青春期早期的过渡。我们分析了四个VABS轨迹子组，这些子组根据某些域和时期的功能水平和变化率而变化。大约16%的样本在青春期表现出良好的整体功能（标准分数>85），明显的早期生长和社会适应。约21%表现出低适应功能（标准分≤70分），到6岁时坡度下降，到10岁时沟通和日常生活技能得到改善。其他两个亚组（总共63％）的特征是在低水平和适当水平之间的适应性功能。进入学龄期的轨迹相对稳定。这些亚组在诊断时的认知能力差异最大，家庭收入,青春期的社会参与。
■我们确定了与不同的自适应功能轨迹相关的关键个人和家庭特征以及时间窗口，这对于跨发育阶段为自闭症患者提供及时和量身定制的支持具有重要意义。
■我们的样本（N=406）来自2-5岁被诊断为自闭症儿童的初始队列。使用Vineland适应性行为量表(VABS，第2版）从诊断到18岁的6次就诊。并行过程潜在生长曲线模型用于估计领域级VABS轨迹，其次是潜在的类增长分析，以识别轨迹子群。诊断时的儿童特征，家庭人口统计，和青春期参与结局在各个亚组之间进行比较.
■分段潜在生长模型最好地描述了VABS轨迹，在5-6岁和9-10岁左右确定了两个转折点，分别反映了向学龄期和青春期早期的过渡。我们分析了四个VABS轨迹子组，这些子组根据某些域和时期的功能水平和变化率而变化。大约16%的样本在青春期表现出良好的整体功能（标准分数>85），明显的早期生长和社会适应。约21%表现出低适应功能（标准分≤70分），到6岁时坡度下降，到10岁时沟通和日常生活技能得到改善。其他两个亚组（总共63％）的特征是在低水平和适当水平之间的适应性功能。进入学龄期的轨迹相对稳定。这些亚组在诊断时的认知能力差异最大，家庭收入,青春期的社会参与。
■我们确定了与不同的自适应功能轨迹相关的关键个人和家庭特征以及时间窗口，这对于跨发育阶段为自闭症患者提供及时和量身定制的支持具有重要意义。
