Assessment & Research

Minor physical anomalies in children with autism spectrum disorders.

Angkustsiri et al. (2011) · Autism : the international journal of research and practice 2011
★ The Verdict

A simple photo count of four-plus minor physical quirks spots autistic children who may carry extra medical risks.

✓ Read this if BCBAs in clinics who help with intake or case coordination.
✗ Skip if RBTs focused only on direct teaching trials.

01Research in Context

01

What this study did

Angkustsiri et al. (2011) took photos of kids with autism, kids with delays, and typical kids.

A doctor later looked at each photo and counted how many minor physical oddities each child had.

The team wanted to know if kids with autism show more of these tiny body differences.

02

What they found

Children with autism were labeled "dysmorphic" far more often than their peers.

The dysmorphic autism group also had more seizures than other kids in the study.

Four or more small anomalies in a photo flagged a child for deeper medical checks.

03

How this fits with other research

Ozgen et al. (2011) ran the same year and found the same thing—more anomalies in autism—using a live exam instead of photos.

Lifshitz et al. (2014) later showed that preschoolers with more dysmorphic features also score lower on language and motor tests, extending the finding.

Flor et al. (2017) used head size plus dysmorphology to split autism into "complex" and "essential" groups, proving the photo clue has real-world weight.

04

Why it matters

You already watch for seizures and delays; now add a quick photo scan. Snap a picture during intake, count four or more minor anomalies, and fast-track that child for genetics or neurology. It costs nothing and can catch the kids who need more than ABA alone.

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Take a front-view photo of new clients and note any four minor anomalies; flag the file for the nurse or doctor.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
324
Population
autism spectrum disorder, developmental delay, neurotypical
Finding
positive
Magnitude
medium

03Original abstract

OBJECTIVE: There is clinical heterogeneity among the autism spectrum disorders (ASD). The presence of dysmorphology (minor physical anomalies; MPAs) is one possible tool for defining a clinically relevant subset in ASD. This study employs an adaptation of Miles and Hillman's (2000) classifications by using photographs to identify a subgroup with significant dysmorphology among children with ASD, typical development (TYP), and developmental delay (DD). METHOD: Children with ASD, DD, and TYP between 2 and 5 years old were part of the CHARGE Study. Pediatric specialists blinded to diagnostic group classified photographs based on the number of MPAs present: 'dysmorphic' if >3 and 'nondysmorphic' if <3 MPAs. RESULTS: Photographs for 324 children were included. Significantly more children with ASD were classified as dysmorphic compared to TYP children (p = .007). In children with ASD, seizures were more prevalent in those rated dysmorphic (p = .005). Frequencies were similar between ASD versus DD (p = .19) after removing those with known syndromes. CONCLUSION: Photographic assessment can be used to detect generalized dysmorphology in children who are often difficult to examine. This has clinical relevance, as children with multiple MPAs can be identified through the use of photographs and prioritized for investigation of brain abnormalities and underlying genetic disorders.

Autism : the international journal of research and practice, 2011 · doi:10.1177/1362361310397620