Identifying Language and Cognitive Profiles in Children With ASD via a Cluster Analysis Exploration: Implications for the New ICD-11.
Verbal school-age kids with ASD split into five language-cognitive profiles—check both domains before prescribing interventions.
01Research in Context
What this study did
Silleresi et al. (2020) ran a cluster analysis on 51 verbal kids with ASD. They looked at language and cognitive scores to see if clear profiles popped out.
The goal was to check whether these profiles line up with the new ICD-11 way of grouping autism.
What they found
Five language-cognitive clusters appeared. Each cluster fits one of the ICD-11 subtypes, hinting that language sits in its own module.
Kids in the same cluster had similar strengths and bottlenecks, making the groups easy to spot on a chart.
How this fits with other research
Lee et al. (2022) also used cluster analysis, but on pragmatic language only. They found three severity groups, not five. The difference is focus: Silvia looked at both language and cognition, while K et al. zoomed in on pragmatics.
de Schipper et al. (2015) mapped 99 ICF-CY categories for ASD. Silvia’s five clusters fall inside those categories, so the new data nest neatly inside the older big-picture map.
Fombonne et al. (2020) studied autistic adults and tracked medical and mental-health comorbidities. Their work extends Silvia’s child profiles into adult life, showing that language skill level continues to matter years later.
Why it matters
You now have a quick way to sort verbal elementary kids into five clear language-cognitive buckets that match ICD-11. Picking the right cluster before you write goals keeps therapy focused and saves time. If you already use the ICF-CY list from Elles et al., just add these clusters as a shortcut to describe language-cognition combos.
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02At a glance
03Original abstract
The new version of the International Classification of Diseases (ICD-11) mentions the existence of four different profiles in the verbal part of the Autism Spectrum Disorder (ASD), describing them as combinations of either spared or impaired functional language and intellectual abilities. The aim of the present study was to put ASD heterogeneity to the forefront by exploring whether clear profiles related to language and intellectual abilities emerge when investigation is extended to the entire spectrum, focusing on verbal children. Our study proposed a systematic investigation of both language (specifically, structural language abilities) and intellectual abilities (specifically, nonverbal cognitive abilities) in 51 6- to 12-year-old verbal children with ASD based on explicitly motivated measures. For structural language abilities, sentence repetition and nonword repetition tasks were selected; for nonverbal cognitive abilities, we chose Raven's Progressive Matrices, as well as Matrix Reasoning and Block Design from the Wechsler Scales. An integrative approach based on cluster analyses revealed five distinct profiles. Among these five profiles, all four logically possible combinations of structural language and nonverbal abilities mentioned in the ICD-11 were detected. Three profiles emerged among children with normal language abilities and two emerged among language-impaired children. Crucially, the existence of discrepant profiles of abilities suggests that children with ASD can display impaired language in presence of spared nonverbal intelligence or spared language in the presence of impaired nonverbal intelligence, reinforcing the hypothesis of the existence of a separate language module in the brain. Autism Res 2020, 13: 1155-1167. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The present work put Autism Spectrum Disorder heterogeneity to the forefront by exploring whether clear profiles related to language and cognitive abilities emerge when investigation is extended to the entire spectrum (focusing on verbal children). The use of explicitly motivated measures of both language and cognitive abilities and of an unsupervised machine learning approach, the cluster analysis, (a) confirmed the existence of all four logically possible profiles evoked in the new ICD-11, (b) evoked the existence of (at least) a fifth profile of language/cognitive abilities, and (c) reinforced the hypothesis of a language module in the brain.
Autism research : official journal of the International Society for Autism Research, 2020 · doi:10.1002/aur.2268