Six Developmental Trajectories Characterize Children With Autism

Pediatrics, 05/07/2012

Fountain C et al. – Children with autism have heterogeneous developmental pathways. One group of children evidenced remarkable developmental change over time. Understanding what drives these outcomes is thus critical.


  • Children with autism who were born in California from 1992 through 2001 and enrolled with the California Department of Developmental Services were identified.
  • Subjects with <4 evaluations present in the database were excluded, resulting in a sample of 6975 children aged 2 to 14 years.
  • Score sequences were constructed based on 9 evaluative items for social, communication, and repetitive behavior functioning.
  • Typical trajectories were identified by using group-based latent trajectory modeling, and multinomial logistic regression models were used to determine the odds of classification within each trajectory varied by individual and family-level factors.


  • Six typical patterns of social, communication, and repetitive behavior functioning were identified.
  • These trajectories displayed significant heterogeneity in developmental pathways, and children whose symptoms were least severe at first diagnosis tended to improve more rapidly than those severely affected.
  • One group of -10% of children experienced rapid gains, moving from severely affected to high functioning.
  • Socioeconomic factors were correlated with trajectory outcomes; children with non-Hispanic, white, well-educated mothers were more likely to be high functioning, and minority children with less-educated mothers or intellectual disabilities were very unlikely to experience rapid gains.

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