Co-occurring Neurodevelopmental Conditions in Children: Advocating for Transdiagnostic Approach to Assessments.
Symptoms group into four skill domains that ignore traditional labels—assess all kids on these domains, not by diagnosis.
01Research in Context
What this study did
The team looked at two big clinic files of kids. Some had autism, some ADHD, some delays, some several labels at once.
They ran math models that group symptoms into clusters. The goal was to see if the clusters follow the old boxes of ASD, ADHD, or something else.
What they found
The clusters did not stay inside one diagnosis. Instead, four clear domains popped up: communication, social, emotional, and thinking skills.
A child could score high in one domain and low in another, no matter the original label.
How this fits with other research
Dworzynski et al. (2009) already saw autism symptoms split into loose pieces in twins. The new study widens the lens and shows the same splitting happens across ASD, ADHD, and delays together.
Seiverling et al. (2012) warned that brain scans only partly back the DSM-5 two-domain autism model. Ishra et al. now give fresh data saying we should step even further away from diagnosis-bound checklists.
Lee et al. (2024) found irritability and autism symptoms live in separate networks. Ishra’s four-domain map lines up with that view: different symptom groups can be tackled on their own.
Why it matters
Stop letting the file folder name drive your assessment. Pick tools that rate communication, social, emotional, and thinking domains for every child. One score can guide goals no matter if the referral says ASD, ADHD, or “mixed.”
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02At a glance
03Original abstract
Approximately 8% of all children experience developmental and mental health conditions. Similarities in characteristics across neurodevelopmental conditions-such as difficulties in communication and language, social interaction, motor coordination, attention, activity regulation, behavior, mood, and sleep-make it challenging to attribute these characteristics exclusively to specific diagnoses and assessments. The purpose of this study was to identify symptomatic domains across neurodevelopmental conditions in children and to explore dimension reduction for transdiagnostic assessment. Cluster and factor analyses were conducted on two datasets to determine the co-occurrence of conditions in children. Deidentified data were sourced from two data repositories, the Australian Autism Biobank and the Child Behavior Research Clinic. Four clusters were identified in the behavior clinic dataset based on emotional, behavioral, and social characteristics. The autism biobank dataset revealed three distinct clusters categorized by cognitive skills, adaptive skills, and autistic traits. Factor analysis was subsequently used to explore which characteristics could be grouped into domains. The study aimed to characterize and capture the complexities of co-occurring conditions within neurodevelopmental conditions by identifying distinct domains derived from both cluster and factor analysis. By integrating findings from two clinical datasets with children having both behavioral and neurodevelopmental conditions, we highlighted how clusters of comorbidity and behavioral profiles align with factors. Thus, the findings emphasizes the importances of adopting a transdiagnostic approach to diagnosis, rather than viewing neurodevelopmental conditions in isolation.
Journal of autism and developmental disorders, 2025 · doi:10.18637/jss.v045.i03