A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children

N. Wright; V. Courchesne; A. Pickles; R. Bedford; E. Duku; C. M. Kerns; T. Bennett; S. Georgiades; J. Hill; A. Richard; H. Sharp; I. M. Smith; T. Vaillancourt; A. Zaidman-Zait; L. Zwaigenbaum; P. Szatmari; M. Elsabbagh

doi:10.1017/S0033291723001599

A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children

N. Wright, V. Courchesne, A. Pickles, R. Bedford, E. Duku, C. M. Kerns, T. Bennett, S. Georgiades, J. Hill, A. Richard, H. Sharp, I. M. Smith, T. Vaillancourt, A. Zaidman-Zait, L. Zwaigenbaum, P. Szatmari, M. Elsabbagh

Research output: Contribution to journal › Article › peer-review

7 Citations (SciVal)

Abstract

Background: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort.

Methods: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children.

Results: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers.

Conclusions: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.

Original language	English
Pages (from-to)	7707-7719
Number of pages	13
Journal	Psychological Medicine
Volume	53
Issue number	16
Early online date	29 Jun 2023
DOIs	https://doi.org/10.1017/S0033291723001599
Publication status	Published - 29 Dec 2023

Bibliographical note

Funding Information:
The WCHADS was funded by the Medical Research Council (grant number: G0400577, G0900654; MR/L022257/1). The Pathways study was supported by: Canadian Institutes of Health Research, Fonds de Recherche du Québec, Kids Brain Health Network (formerly NeuroDevNet), Autism Speaks (US), Government of British Columbia, Alberta Innovates Health Solutions, and the Sinneave Family Foundation. AP and NW were partially supported by NIHR grant NF-SI-0617-10120 and NIHR Maudsley Biomedical Research Centre. VC is supported by CIHR. RB is supported by a King's Prize Fellowship (204823/Z/16/Z).

Funding

The authors are grateful to all participating families in WCHADS and Pathways and to the research staff who contributed to this work. The Pathways authors acknowledge the past and present members of the Pathways in ASD study team, who made equal contributions to the study. The WCHADS authors acknowledge the Wirral University Teaching Hospital NHS Foundation Trust, Wirral Community NHS Foundation Trust, Cheshire and Wirral Partnership NHS Foundation Trust who supported the recruitment into the study in pregnancy and to the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The Pathways authors acknowledge support from the Azrieli Centre for Autism Research (ACAR), The Canadian Institutes of Health Research, Fonds de Recherche du Québec, Kids Brain Health Network (formerly NeuroDevNet), Autism Speaks (US), Government of British Columbia, Alberta Innovates Health Solutions, and the Sinneave Family Foundation. The WCHADS was funded by the Medical Research Council (grant number: G0400577, G0900654; MR/L022257/1). The Pathways study was supported by: Canadian Institutes of Health Research, Fonds de Recherche du Québec, Kids Brain Health Network (formerly NeuroDevNet), Autism Speaks (US), Government of British Columbia, Alberta Innovates Health Solutions, and the Sinneave Family Foundation. AP and NW were partially supported by NIHR grant NF-SI-0617-10120 and NIHR Maudsley Biomedical Research Centre. VC is supported by CIHR. RB is supported by a King's Prize Fellowship (204823/Z/16/Z).

Keywords

attention problems
Autism
behavioral problems
emotional problems
longitudinal
trajectories

ASJC Scopus subject areas

Applied Psychology
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1017/S0033291723001599Licence: CC BY

Cite this

Wright, N., Courchesne, V., Pickles, A., Bedford, R., Duku, E., Kerns, C. M., Bennett, T., Georgiades, S., Hill, J., Richard, A., Sharp, H., Smith, I. M., Vaillancourt, T., Zaidman-Zait, A., Zwaigenbaum, L., Szatmari, P., & Elsabbagh, M. (2023). A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children. Psychological Medicine, 53(16), 7707-7719. https://doi.org/10.1017/S0033291723001599

Wright, N, Courchesne, V, Pickles, A, Bedford, R, Duku, E, Kerns, CM, Bennett, T, Georgiades, S, Hill, J, Richard, A, Sharp, H, Smith, IM, Vaillancourt, T, Zaidman-Zait, A, Zwaigenbaum, L, Szatmari, P & Elsabbagh, M 2023, 'A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children', Psychological Medicine, vol. 53, no. 16, pp. 7707-7719. https://doi.org/10.1017/S0033291723001599

@article{62486879fd21485aa555a74312dc45ad,

title = "A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children",

abstract = "Background: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. Methods: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. Results: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. Conclusions: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.",

keywords = "attention problems, Autism, behavioral problems, emotional problems, longitudinal, trajectories",

author = "N. Wright and V. Courchesne and A. Pickles and R. Bedford and E. Duku and Kerns, {C. M.} and T. Bennett and S. Georgiades and J. Hill and A. Richard and H. Sharp and Smith, {I. M.} and T. Vaillancourt and A. Zaidman-Zait and L. Zwaigenbaum and P. Szatmari and M. Elsabbagh",

note = "Funding Information: The WCHADS was funded by the Medical Research Council (grant number: G0400577, G0900654; MR/L022257/1). The Pathways study was supported by: Canadian Institutes of Health Research, Fonds de Recherche du Qu{\'e}bec, Kids Brain Health Network (formerly NeuroDevNet), Autism Speaks (US), Government of British Columbia, Alberta Innovates Health Solutions, and the Sinneave Family Foundation. AP and NW were partially supported by NIHR grant NF-SI-0617-10120 and NIHR Maudsley Biomedical Research Centre. VC is supported by CIHR. RB is supported by a King's Prize Fellowship (204823/Z/16/Z). ",

year = "2023",

month = dec,

day = "29",

doi = "10.1017/S0033291723001599",

language = "English",

volume = "53",

pages = "7707--7719",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

number = "16",

}

TY - JOUR

T1 - A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children

AU - Wright, N.

AU - Courchesne, V.

AU - Pickles, A.

AU - Bedford, R.

AU - Duku, E.

AU - Kerns, C. M.

AU - Bennett, T.

AU - Georgiades, S.

AU - Hill, J.

AU - Richard, A.

AU - Sharp, H.

AU - Smith, I. M.

AU - Vaillancourt, T.

AU - Zaidman-Zait, A.

AU - Zwaigenbaum, L.

AU - Szatmari, P.

AU - Elsabbagh, M.

N1 - Funding Information: The WCHADS was funded by the Medical Research Council (grant number: G0400577, G0900654; MR/L022257/1). The Pathways study was supported by: Canadian Institutes of Health Research, Fonds de Recherche du Québec, Kids Brain Health Network (formerly NeuroDevNet), Autism Speaks (US), Government of British Columbia, Alberta Innovates Health Solutions, and the Sinneave Family Foundation. AP and NW were partially supported by NIHR grant NF-SI-0617-10120 and NIHR Maudsley Biomedical Research Centre. VC is supported by CIHR. RB is supported by a King's Prize Fellowship (204823/Z/16/Z).

PY - 2023/12/29

Y1 - 2023/12/29

N2 - Background: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. Methods: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. Results: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. Conclusions: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.

AB - Background: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. Methods: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. Results: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. Conclusions: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.

KW - attention problems

KW - Autism

KW - behavioral problems

KW - emotional problems

KW - longitudinal

KW - trajectories

UR - http://www.scopus.com/inward/record.url?scp=85164346800&partnerID=8YFLogxK

U2 - 10.1017/S0033291723001599

DO - 10.1017/S0033291723001599

M3 - Article

AN - SCOPUS:85164346800

SN - 0033-2917

VL - 53

SP - 7707

EP - 7719

JO - Psychological Medicine

JF - Psychological Medicine

IS - 16

ER -

A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this