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A Review of Subtyping in Autism and Proposed Dimensional Classification Model

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Abstract

Autism has been divided into subtypes based on social interaction/communication, developmental level, or both. The validity of subtyping systems and the extent to which they overlap were examined. According to this review, a single subtyping system capable of accounting for the symptom heterogeneity in autism has not yet been proposed; however, evidence supports the presence of a three-factor continuum containing at least four subgroups. Foremost among directions for future research is the need for comprehensive studies in which medical screening, careful selection of measures, and longitudinal data collection are included.

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REFERENCES

  • Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, VT: University of Vermont, Department of Psychiatry.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., Rev.) Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington DC: Author.

    Google Scholar 

  • Bailey, A., Phillips, W., & Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. Journal of Child Psychology and Psychiatry, 37, 89-126.

    Google Scholar 

  • Birnbrauer, J. S., & Leach, D. J. (1993). The Murdoch Early Intervention Program after two years. Behaviour Change, 10, 63-74.

    Google Scholar 

  • Bonde, E. (2000). Comorbidity and subgroups in childhood autism. European Child and Adolescent Psychiatry, 9, 7-10.

    Google Scholar 

  • Borden, M. C., & Ollendick, T. H. (1994). An examination of the validity of social subtypes in autism. Journal of Autism and Developmental Disorders, 24, 23-38.

    Google Scholar 

  • 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, 229-241.

    Google Scholar 

  • Dawson, G., Klinger, L., Panagiotides, H., Lewy, A., & Castelloe, P. (1995). Subgroups of autistic children based on social behavior display distinct patterns of brain activity. Journal of Abnormal Child Psychology, 23, 569-583.

    Google Scholar 

  • Donnelly, J. (1997). Subtypes of autism by cluster analysis. Dissertation Abstracts International Section A: Humanities and Social Sciences, 58, 2159.

    Google Scholar 

  • Eaves, L., Ho, H., & Eaves D. (1994). Subtypes of autism by cluster analysis. Journal of Autism and Developmental Disorders, 24, 3-22.

    Google Scholar 

  • Fein, D., Stevens, M., Dunn, M., Waterhouse, L., Allen, D., Rapin, I., & Feinstein, C. (1999). Subtypes of pervasive developmental disorder: Clinical characteristics. Child Neuropsychology, 5, 1-23.

    Google Scholar 

  • Folstein, S., Haines, J., & Santangelo, S. (1998). The genetics of autism. Neuroscience News, 1, 14-17.

    Google Scholar 

  • Ghaziuddin, M., & Burmeister, M. (1999). Deletion of chromosome 2 q37 and autism: A distinct subtype? Journal of Autism and Developmental Disorders, 29, 259-263.

    Google Scholar 

  • Gillberg, C. (1992). Subgroups in autism: are there behavioral phenotypes typical of underlying medical conditions? Journal of Intellectual Disability Research, 36, 201-214.

    Google Scholar 

  • Gillberg, C., Ehlers, Schaumann, H., Jakobsson, G., Dahlgren, S., Lindblom, R., Bagenholm, A., Tjuus, T., & Blinder, E. (1990). Autism under age 3 years: A clinical study of 28 cases referred for autistic symptoms in infancy. Journal of Child Psychology and Psychiatry, 31, 921-934.

    Google Scholar 

  • Harris, N., Courchesne, E., Townsend, J., Carper, R., & Lord, C. (1999). Neuroanatomic contributions to slowed orienting of attention in children with autism. Cognitive Brain Research, 8, 61-71.

    Google Scholar 

  • Klinger, L., & Dawson, G. (1996). Autistic disorder. In E. Mash & R. Barkley (Eds.), Child Psychopathology (pp. 311-339). New York: Guilford.

    Google Scholar 

  • Konstantareas, M., & Homatidis, S. (1999). Chromosomal abnormalities in a series of children with autistic disorder. Journal of Autism and Developmental Disorders, 29, 275-285.

    Google Scholar 

  • Leekam, S., Libby, S., Wing, L., Gould, J., & Gillberg, C. (2000). Comparison of the ICD-10 and Gillberg's criteria for Asperger syndrome. Autism, 4, 11-28.

    Google Scholar 

  • Lord, C. (1995). Follow-up of two year-olds referred for possible autism. Journal of Child Psychology and Psychiatry, 36, 1365-1382.

    Google Scholar 

  • Lord, C., Pickles, A., McLennan, J., Rutter, M., Bregman, J., Folstein, S., Fombonne, E., Leboyer, M., & Minshew, N. (1997). Diagnosing autism: Analyses of data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27, 501-517.

    Google Scholar 

  • Lord, C., Rutter, M., Goode, S., Heemsberge, J., Jordan, H., Mawhood, L., & Schopler, E. (1989). Autism Diagnostic Observation Schedule: A standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders, 19, 185-212.

    Google Scholar 

  • Mahoney, W., Szatmari, P., Maclean, J., Bryson, S., Bartolucci, G., Walter, S., Jones, M., & Zwaigenbaum, L. (1998). Reliability and accuracy of differentiating pervasive developmental disorder subtypes. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 278-285.

    Google Scholar 

  • McEachin, J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97, 359-372.

    Google Scholar 

  • Modahl, C., Green, L., Fein, D., Morris, M., Waterhouse, L., Feinstein, C., & Levin, H. (1998). Plasma oxytocin levels in autistic children. Biological Psychiatry, 43, 270-277.

    Google Scholar 

  • Myhr, G. (1998). Autism and other pervasive developmental disorders: Exploring the dimensional view. Canadian Journal of Psychiatry, 43, 589-595.

    Google Scholar 

  • Newsom, C., & Hovanitz, C. (1997). Autistic disorder, In E. Mash & L. Terdal (Eds.), Assessment of childhood disorders (3rd ed., pp. 408-444). New York: Guilford.

    Google Scholar 

  • O'Brien, S. K. (1996). The validity and reliability of the Wing subgroups questionnaire. Journal of Autism and Developmental Disorders, 26, 321-335.

    Google Scholar 

  • Perry, A., Veleno, P., & Factor, D. (1998). Inter-rater agreement between direct care staff and psychologists for the diagnosis of autism according to DSM-III, DSM-III-R, and DSM-IV. Journal of Developmental Disabilities, 6, 32-43.

    Google Scholar 

  • Piven, J., Harper, J., Palmer, P., & Arndt, S. (1996). Course of behavioral change in autism: a retrospective study of high-IQ adolescents and adults. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 523-529.

    Google Scholar 

  • Prior, M., Boulton, D., Gajzago, C., & Perry, D. (1975). The classification of childhood psychoses by numerical taxonomy. Journal of Child Psychology and Psychiatry, 16, 321-330.

    Google Scholar 

  • Prior, M., Eisenmajer, R., Leekam, S., Wing, L., Gould, J., Ong, B., & Dowe, D. (1998). Are there subgroups within the autism spectrum? A cluster analysis of a group of children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 39, 893-902.

    Google Scholar 

  • Rapin, I. (1996). Preschool children with inadequate communication: Developmental language disorders, autism, or low IQ. Clinics in developmental medicine, No. 139. London: Mac Keith.

    Google Scholar 

  • Rescorla, L. (1988). Cluster analytic identification of autistic preschoolers. Journal of Autism and Developmental Disorders, 18, 475-492.

    Google Scholar 

  • Rutter, M., Bailey, A., Bolton, P., & Le Couter, A. (1994). Autism and known medical conditions: Myth and substance. Journal of Child Psychology and Psychiatry, 35, 311-322.

    Google Scholar 

  • Rutter, M., & Schopler, E. (1992). Classification of pervasive developmental disorders: Some concepts and practical considerations. Journal of Autism and Developmental Disorders, 22, 459-482.

    Google Scholar 

  • Sandman, C., Spence, A., & Smith, M. (1999). Proopiomelanocortin (POMC) disregulation and response to opiate blockers. Mental Retardation and Developmental Disabilities Research Reviews, 5, 314-321.

    Google Scholar 

  • Siegel, B., Anders, T. F., Ciarenello, R. D., Bienenstock, B., & Kraemer, H. C. (1986). Empirically derived subclassification of the autistic syndrome. Journal of Autism and Developmental Disorders, 16, 275-294.

    Google Scholar 

  • Siegel, B., Pliner, C., Eschler, J., & Elliott, G. (1988). How children with autism are diagnosed: Difficulties in identification of children with multiple developmental delays. Journal of Developmental and Behavioral Pediatrics, 9, 199-204.

    Google Scholar 

  • Sparrow, S., Balla, D., & Cicchetti, D. (1984). Vineland Adaptive Behavior Scales. Circle Pines, MN: American Guidance Services.

    Google Scholar 

  • Sponheim, E. (1996). Changing criteria of autistic disorders: A comparison of the ICD-10 research criteria, and DSM-IV with DSMIII-R, CARS, and ABC. Journal of Autism and Developmental Disorders, 26, 513-525.

    Google Scholar 

  • Stevens, M., Fein, D., Dunn, M., Allen, D., Waterhouse, L., Feinstein, C., & Rapin, I. (2000). Subgroups of children with autism by cluster analysis: A longitudinal examination. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 346-352.

    Google Scholar 

  • Stone, W., Ousley, O., Hepburn, S., Hogan, K., & Brown, C. (1999). Patterns of adaptive behavior in very young children with autism. American Journal on Mental Retardation, 104, 187-199.

    Google Scholar 

  • Stone, W. L., Hoffman, E. L., Lewis, S. E., & Ousley, O. Y. (1994). Early recognition of autism: Parental reports vs. clinical observation. Archives of Pediatric and Adolescent Medicine, 148, 174-179.

    Google Scholar 

  • Tanguay, P., Robertson, J., & Derrick, A. (1998). A dimensional classification of autism spectrum disorder by social communication domains. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 271-277.

    Google Scholar 

  • Volkmar, F., Cohen, D., Bregman, J., Hooks, M., & Stevenson, J. (1989). An examination of social typologies in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 82-86.

    Google Scholar 

  • Volkmar, F., Klin, A., & Cohen, D. (1997). Diagnosis and classification of autism and related conditions: Consensus and issues. In D. Cohen & F. Volkmar (Eds.), Handbook of autism and pervasive developmental disorders (2nd ed.; pp. 5-40). New York: Wiley.

    Google Scholar 

  • Waterhouse, L. (1996). Classification of autistic disorder (AD). In I. Rapin (Ed.), Preschool children with inadequate communication (pp. 21-30). London: MacKeith.

    Google Scholar 

  • Waterhouse, L., & Fein, D. (1984). Developmental trends in cognitive skills for children diagnosed as autistic and schizophrenic. Child Development, 55, 236-248.

    Google Scholar 

  • Waterhouse, L., Morris, R., Allen, D., Dunn, M., Fein, D., Feinstein, C., Rapin, I., & Wing, L. (1996). Diagnosis and classification in autism. Journal of Autism and Developmental Disorders, 26, 59-85.

    Google Scholar 

  • Wing, L. (1981). Language, social, and cognitive impairments in autism and severe mental retardation. Journal of Autism and Developmental Disorders, 11, 31-44.

    Google Scholar 

  • Wing, L. (1991). The relationship between Asperger's syndrome and Kanner's autism. In U. Frith (Ed.), Autism and Asperger syndrome (pp. 93-121). Cambridge, England: Cambridge University Press.

    Google Scholar 

  • Wing, L. (1992). Manifestations of social problems in high-functioning autistic people. In Schopler, E., & Mesibov, G. (Eds.), High-functioning individuals with autism: current issues in autism (pp. 129-142). New York: Plenum.

    Google Scholar 

  • Wing, L. (1997). Syndromes of autism and atypical development. In D. Cohen & F. Volkmar (Eds.), Handbook of autism and pervasive developmental disorders (2nd ed.; pp. 148-172). New York: Wiley.

    Google Scholar 

  • 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, 11-29.

    Google Scholar 

  • World Health Organization. (1992). The ICD-10 classification of mental and behavioral disorders: Clinical descriptions and diagnostic guidelines. Geneva: Author.

    Google Scholar 

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Authors and Affiliations

  1. Washington State University, Pullman, Washington, 99164

    Leigh J. Beglinger & Tristram H. Smith

  2. University of Rochester, Rochester, New York

    Tristram H. Smith

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  1. Leigh J. Beglinger
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Beglinger, L.J., Smith, T.H. A Review of Subtyping in Autism and Proposed Dimensional Classification Model. J Autism Dev Disord 31, 411–422 (2001). https://doi.org/10.1023/A:1010616719877

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