Utilising Behavioural and Sensory Profiles and Associated Perinatal Factors to Identify Meaningful Subgroups in Autism Spectrum Disorder

Jane Shirley; James Rufus John; Alicia Montgomery; Andrew Whitehouse; Valsamma Eapen

doi:10.1007/s10803-024-06421-3

Utilising Behavioural and Sensory Profiles and Associated Perinatal Factors to Identify Meaningful Subgroups in Autism Spectrum Disorder

J Autism Dev Disord. 2024 Jun 6. doi: 10.1007/s10803-024-06421-3. Online ahead of print.

Authors

Jane Shirley¹, James Rufus John^{1

2}, Alicia Montgomery¹, Andrew Whitehouse³, Valsamma Eapen^{4

5

6}

Affiliations

¹ School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.
² Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia.
³ Telethon Kids Institute, The University of Western Australia, Nedlands, WA, Australia.
⁴ School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia. v.eapen@unsw.edu.au.
⁵ Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia. v.eapen@unsw.edu.au.
⁶ Academic Unit of Child Psychiatry, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW, Australia. v.eapen@unsw.edu.au.

PMID: 38842670
DOI: 10.1007/s10803-024-06421-3

Abstract

The heterogeneity of autism spectrum disorder (ASD) clinically and aetiologically hinders intervention matching and prediction of outcomes. This study investigated if the behavioural, sensory, and perinatal factor profiles of autistic children could be used to identify distinct subgroups. Participants on the autism spectrum aged 2 to 17 years and their families were sourced via the Australian Autism Biobank (AAB). Latent class analysis was used to identify subgroups within this cohort, utilising twenty-six latent variables representing child's behavioural and sensory features and perinatal factors. Four distinct subgroups within the sample (n = 1168) distinguished by sensory and behavioural autism traits and exposure to perinatal determinants were identified. Class 2 and Class 4, which displayed the greatest behavioural and sensory impairment respectively, were associated with the highest perinatal factor exposure. Class 1, labelled "Most behavioural concerns and moderate sensory and behavioural skills concerns" had mixed exposure to perinatal determinants while Class 3, named "Least sensory and behavioural skills concerns" had the least perinatal determinant exposure, indicating a directly proportional correlation between severity of clinical features and perinatal factor exposure. Additionally, association between specific exposures such as maternal mental illness in Class 1 and significant behavioural concerns was recognised. Identifying distinct subgroups among autistic children can lead to development of targeted interventions and supports. Close monitoring of children exposed to specific perinatal determinants for developmental differences could assist early intervention and supports.

Keywords: Autism spectrum disorder; Latent class analysis; Paediatrics; Subgroups.