ARE Patterns of Aberrant Behaviors Associated to Developmental Trajectories of Adolescents with Autism Spectrum Disorders (ASD) ?

Background:

Challenging behaviors are a critical issue for individuals with Autism Spectrum Disorders (ASD) and their proxy, with a negative impact on their quality of life and outcome. They are related to several clinical characteristics, such as intellectual disability, speech deficits or autism severity (Baghdadli et al, 2008; Matson & Nebel-Schwam, 2007), and may be particularly severe during adolescence. These data are part of the EpiTED cohort, a 10-year follow-up of 152 children with ASD from childhood to adolescence.

Objectives:

The aim of this study was to identify aberrant behavior patterns in adolescents with Autism Spectrum Disorders and to examine if these patterns were associated to their developmental trajectories.

Methods:

Aberrant behaviors were assessed using 4 behavioral domains of the Aberrant Behavior Checklist or ABC (Aman et al, 1985): (I) irritability / aggressiveness, (II) lethargy / withdrawal, (III) stereotypy / self-injury, (IV) hyperactivity / lack of cooperation. Scores are reduced to a scale of 100 in order to make comparisons between domains. The adolescents' developmental trajectories were described using Vineland communication and socialization scores changes over a ten year follow-up (Baghdadli et al, 2012).

Results:

Median scores of aberrant behaviors in the four domains were highly correlated and there was an important heterogeneity among adolescents: (I) irritability = 15.6 (IntQ: 6.7-37.8), (II) lethargy = 25 (IntQ: 14.6-37.5), (III) stereotypy = 23.8 (IntQ: 9.5-42.9), (IV) hyperactivity = 22.9 (IntQ: 8.3-41.7). A cluster analysis allowed us to identify four patterns of aberrant behaviors: a) low score in the ABC four domains, b) high score in irritability and hyperactivity, c) mean score in the four domains and d) very high score in stereotypy, high score in withdrawal and hyperactivity. These four patterns were significantly linked to the adolescents' developmental trajectories, p < .01. Most adolescents with a high trajectory (87%) were found in clusters a) and c), whereas adolescents with a low trajectory were equally distributed in the four clusters.

Conclusions:

Those results suggest that, if a high trajectory seems associated with a low level of aberrant behaviors, low trajectory is not necessarily associated with a high level of aberrant behaviors. The impact of an early treatment of behavioral problems for improving individuals with ASD's quality of life and outcome is discussed.