Abstract
This study compared four systems for the diagnosis of autism (DSM-III, DSM-III-R, DSM-IV, and ICD-10) with two empirically derived taxa of autism, and with three social subgroups of autism (Aloof, Passive, and Active-but-Odd) in 194 preschool children with salient social impairment. There were significant behavior and IQ differences between autistic and other-PDD groups for all four diagnostic systems, and a significant association was found (a) for Taxon B, diagnoses of autism, and the Aloof subgroup, and (b) for Taxon A, other-PDD, and the Active-but-Odd subgroup. Findings offer support for two major overlapping continua within idiopathic Pervasive Developmental Disorder.
Similar content being viewed by others
References
American Psychiatric Association. (1980).Diagnostic and statistical manual of mental disorders (3rd ed.), Washington, DC: Author.
American Psychiatric Association. (1987).Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
American Psychiatric Association (1994).Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Bailey, A., Le Couteur, A., Gottesman, I., Bolton, P., Simonoff, E., Yuzda, E., & Rutter, M. (1995). Autism as a strongly genetic disorder:evidence from a British twin study.Psychological Medicine, 25, 63–77.
Bayley, N. (1969).Bayley Scales of Infant Development—Mental Scale. Berkeley, CA: Psychological Corp.
Bolton, P., MacDonald, H., Pickles, A., Rios, P., Goode, S., Crowson, M., Bailey, A., & Rutter, M. (1994). A case-control family history study of autism.Journal of Child Psychology and Psychiatry, 35, 877–900.
Borden, M. C., & Ollendick, T. H. (1994). An examination of the validity of social subtypes in autism.Journal of Autism and Developmental Disorders, 24, 23–37.
Castelloe, P., & Dawson, G. (1993). Subclassification of children with Autism and Pervasive Developmental Disorder: A questionnaire based on Wing's subgrouping scheme.Journal of Autism and Developmental Disorders, 23, 225–237.
Cohen, D. J., Paul, R., & Volkmar, F. R. (1986). Issues in the classification of pervasive and other developmental disorders: Toward DSM-IV.Journal of the American Academy of Child Psychiatry, 25, 213–220.
Cohen, D. J., Paul, R., & Volkmar, F. R. (1987). Issues in the classification of pervasive developmental disorders and associated conditions. In D. J. Cohen, A. M. Donnellan, & R. Paul (Eds.),Handbook of autism and pervasive developmental disorders (pp. 20–40), New York: Wiley.
Dahl, K., Cohen, D. J., & Provence, S. (1986). Clinical and multivariate approaches to nosology of PDD.Journal of the American Academy of Child Psychiatry, 25, 170–180.
Eaves, L. C., Ho, H. H., & Eaves, D. M. (1984). Subtypes of autism by cluster analysis.Journal of Autism and Developmental Disorders, 24, 3–22.
Erlenmeyer-Kimling, L., Golden, R. R., & Cornblatt, B. (1989). Taxometric analysis of cognitive and neuromotor variables in children at risk for schizophrenia.Journal of Abnormal Psychology, 98, 203–208.
Fein, D., Golden, R., Allen, D., Dunn, M., Rapin, R., and Waterhouse, L. (1996).Taxa in autism. Manuscript in preparation.
Fein, D., Waterhouse, L., Lucci, D., & Snyder, D. (1985). Cognitive subtypes in developmentally disabled children: A pilot study.Journal of Autism and Developmental Disorders, 15, 77–96.
Filipek, P. A., Richelme, C., Kennedy, D. N., Rademacher, J., Pitcher, D. A., Zidel, S. Y., & Caviness, V. S., Jr. (1992). Morphometric analysis of the brain in developmental language disorders and autism.Annals of Neurology, 32, 475.
Fleiss, J. L., Spitzer, R. L., Endicott, J., & Cohen. (1972). Quantification of agreement in multiple psychiatric diagnosis.Archives of General Psychiatry, 26, 168–171.
Freeman, B. J., Ritvo, E. R., Schroth, P. C., Tonick, I., Guthrie, D., & Wake, L. (1981). Behavioral characteristics of high- and low-IQ autistic children.American Journal of Psychiatry, 138, 25–29.
Gaffney, G. R., & Tsai, L. Y. (1987). Magnetic resonance imaging of high level autism.Journal of Autism and Developmental Disorders, 17, 433–438.
Golden, R. R. (1991). Bootstrapping taxometrics: on the development of a method for detection of a single major gene. In D. Cicchetti & W. Grove (Eds.),Thinking clearly about psychology. Minneapolis: University of Minnesota Press.
Golden, R. R., Campbell, M., & Perry, R. (1987). A taxometric method for diagnosis of tardive dyskinesia.Journal of Psychiatric Research, 21, 101–109.
Golden, R. R., Dunn, M., Rapin, I., & Morris, R. (1996).Using neuropsychological indicators for the detection of autism and language taxa in preschool children with communication disorders. Manuscript in preparation.
Golden, R. R., & Mayer, M. J. (1995). A model of pseudo-taxonicity. In R. V. Dawls & D. Lubinski (Eds.),Assessing individual differences in human behavior: New concepts, methods, and findings (pp. 93–115). Palo Alto, CA: Davies-Black Publishing.
Golden, R. R., & Sliwinski, M. J. (1996).A regression mixture model for the early detection of dementia. Manuscript in preparation.
Hedrick, D. L., Prather, E. M., & Tobin, A. R. (1984).Sequenced inventory of communication development—Revised (SICD-R). Seattle: University of Washington Press.
Horowitz, B., & Rumsey, J. (1994). Positron emission tomography: Implications for cerebral dysfunction in autism. In M. L. Bauman & T. L. Kemper. (Eds.),The neurobiology of autism (pp. 102–118). Baltimore, MD: Johns Hopkins University Press.
Hresko, W. P., Reid, D. K., & Hammill, D. D. (1981).The test of early language development (TELD). Austin, TX: Pro-Ed.
Kanner, L. (1943). Autistic disturbances of affective contact.Nervous Child, 2, 217–250.
Kanner, L., & Eisenberg, L. (1956). Early infantile autism 1943-1955.American Journal of Orthopsychiatry, 26, 55–65.
Krippendorff, K. (1970). Bivariate agreement coefficients for reliability of data. In E. F. Borgatta (Ed.)Sociological methodology (pp. 139–150). San Francisco: Jossey Bass.
Meehl, P. (1986). Diagnostic taxa as open concepts: Metatheoretical and statistical questions about reliability and construct validity in the grand strategy of nosological revision. In T. Millon & G. L. Klerman (Eds.),Contemporary directions in psychopathology: Toward the DSM-IV (pp. 215–232). New York: Guilford.
Ozonoff, S., Pennington, B. F., & Rogers, S. J. (1991). Executive function deficits in highfunctioning autistic individuals: Relationship to theory of mind.Journal of Child Psychology and Psychiatry, 32, 1081–1105.
Parks, S. (1983). The assessment of autistic children: A selective review of available instruments.Journal of Autism and Developmental Disorders, 13, 255–267.
Piven, J., & Folstein, S. (1994). The genetics of autism. In M. L. Bauman & T. L. Kemper (Eds.),The neurobiology of autism (pp. 18–44). Baltimore, MD: Johns Hopkins University Press.
Provence, S., & Dahl, K. (1987). Disorders of atypical development: diagnostic issues raised by a spectrum disorder. In D. Cohen, A. Donnellan, & R. Paul (Eds.),Handbook of autism and pervasive developmental disorders (pp. 677–689). New York: Wiley.
Rapin, I. (1991). Autistic children: Diagnosis and clinical features.Pediatrics 87 (Suppl.), 751–760.
Rapin, I. (Ed.) (in press). Preschool children with inadequate communication: Developmental language disorder, autism, mental retardation.Clinics in Developmental Medicine.
Reichler, R. J., & Lee, M. C. L. (1987). Overview of biomedical issues in autism. In E. Schopler & G. B. Mesibov (Eds.),Neurobiological issues in autism (pp. 14–43). New York: Plenum Press.
Rutter, M., & Schopler, E. (1992). Classification of pervasive developmental disorders: Some concepts and practical considerations.Journal of Autism and Developmental Disorders, 22, 459–482.
Siegel, B., Anders, T., Ciarenello, R., Bienenstock, B. & Kraemer, H. (1986). Empirically derived subclassification of the autistic syndrome.Journal of Autism and Developmental Disorders, 16, 275–294.
Sparrow, S. S., Balla, D. A., & Cicchetti, D. V. (1984).Vineland Adaptive Behavior Scales—Interview edition. Circle Pines, MN: American Guidance Service.
Szatmari, P. (1992). Review of DSM-III-R criteria for autistic disorder.Journal of Autism and Developmental Disorders, 22, 507–523.
Szatmari, P., Volkmar, F., & Walter, S. (1995). Evaluation of diagnostic criteria for autism using latent class models.Journal of the American Academy of Child and Adolescent Psychiatry, 34, 216–222.
Thorndike, R. L., Hagen, E. P., & Sattler, J. M. (1986).Stanford-Binet Intelligence Test—4th edition. Chicago, IL: Riverside.
Tsai, L. (1992). Diagnostic issues in high functioning autism. In E. Schopler & G. Mesibov (Eds.),High functioning individuals with autism (pp. 11–40). New York: Plenum Press.
Tsai, L., & Ghaziuddin, M. (1992). Biomedical research in autism. In D. E. Berkell (Ed.),Autism: Identification, education and treatment (pp. 53–74). Hillsdale, NJ: Erlbaum.
Volkmar, F. R., Cicchetti, D., Bregman, J. D., & Cohen, D. J. (1992). Three diagnostic systems for autism: DSM-III, DSM-IIIR, and ICD-10.Journal of Autism and Developmental Disorders, 22, 483–492.
Volkmar, F. R., Cohen, D. J. Bregman, J. D., Hooks, M. Y., & Stevenson, J. M. (1989). An examination of social typologies found in autism.Journal of the American Academy of Child and Adolescent Psychiatry, 28, 82–86.
Wainwright-Sharp, J. A., & Bryson, S. E. (1993). Visual orienting deficits in high-functioning people with autism.Journal of Autism and Developmental Disorders, 23, 1–13.
Waterhouse, L. (1986, January).Report on PDD for DSM-IIIR on the 21 Wing Checklist Items. Working Group on PDD.
Waterhouse, L. (1994). Severity of impairment in autism. In S. H. Broman & J. Grafman (Eds.)Atypical cognitive deficits in developmental disorders: Implications for brain function (pp. 159–180). Hillsdale, NJ: Erlbaum.
Waterhouse, L., Wing, L., & Fein, D. (1989). Reevaluating the syndrome of autism in the light of empirical research. In G. Dawson & S. Segalowitz (Eds.),Autism: Perspectives on diagnosis, nature and treatment (pp. 263–281). New York: Guilford.
Waterhouse, L., Wing, L., Spitzer, R., & Siegel, B. (1992). PDD: From DSM-III to DSM-III-R.Journal of Autism and Developmental Disorders, 22, 525–549.
Waterhouse, L., Feinstein, C., Allen, D., & Morris, R. (1993, February). Behavior in high and low functioning autistic spectrum preschool children. In I. Rapin (Organizer),Autism and language disorder collaborative project: Preschool study. Symposium conducted at the meeting of the International Neuropsychological Society, Galveston, Tx.
Wing, L. (1985).Autistic Disorder Interview. London: MRC Social Psychiatry Unit, Institute of Psychiatry.
Wing, L. (1988). The continuum of autistic characteristics. In E. Schopler & G. Mesibov (Eds.),Diagnosis and assessment in autism (pp. 91–110). New York: Plenum Press.
Wing, L., & Attwood, A. (1987). Syndromes of autism and atypical development. In D. Cohen, A. Donnellan, & R. Paul (Eds.),Handbook of autism and pervasive developmental disorders (pp. 3–19). New York: Wiley.
Wing, L., & Gould, J. (1978). Systematic recording of behaviors and skills of retarded and psychotic children.Journal of Autism and Childhood Schizophrenia, 8, 79–97.
Wing, L., & Gould, J. (1979). Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification.Journal of Autism and Developmental Disorders, 9, 11–30.
World Health Organization. (1993).Mental disorders: The ICD-10 classification of mental and behavioural disorders. Diagnostic criteria for research. Geneva, Switzerland: Author.
Author information
Authors and Affiliations
Additional information
This study was supported in part by National Institutes of Health grant NS 20489 to the Autism and Language Disorders Collaborative Project: Preschool Study Group. The authors gratefully acknowledge the contributions of Robert Golden, Dorothy Aram, and Barbara Wilson to this study. The authors thank Dolores Drake and Maura McGovern Graber for assistance in the preparation of this paper, and thank Cathy Lord and several anonymous reviewers for their help in developing the structure of this paper.
Rights and permissions
About this article
Cite this article
Waterhouse, L., Morris, R., Allen, D. et al. Diagnosis and classification in autism. J Autism Dev Disord 26, 59–86 (1996). https://doi.org/10.1007/BF02276235
Issue Date:
DOI: https://doi.org/10.1007/BF02276235