Profiles of children with Down syndrome who meet screening criteria for autism spectrum disorder (ASD): a comparison with children diagnosed with ASD attending specialist schools.
Down syndrome kids who screen positive for ASD show milder social-reciprocity issues than typical ASD, so tailor intervention intensity and preserve their social strengths.
01Research in Context
What this study did
The team compared three groups of kids. Group one had Down syndrome plus a positive autism screen. Group two had a clinical ASD diagnosis and attended autism-only schools. Group three had Down syndrome with no autism concerns.
They gave each child the ADOS and the SCQ. These tools measure social skills, communication, and repetitive behaviors. All kids were matched on mental age so scores could be compared fairly.
What they found
Kids with Down syndrome who screened positive for ASD looked almost identical to the ASD-school group on communication delays and repetitive play. The big difference was social reciprocity—turn-taking, joint attention, and shared smiles were noticeably milder in the Down syndrome group.
In plain numbers, the Down-plus-screen group scored lower on social-interaction items but still above the ASD cutoff. They were not just ‘mild ASD’; they showed a unique mixed picture.
How this fits with other research
Busch et al. (2010) also compared Down syndrome and ASD using matched groups. They found more behavior problems and lower social skill in the ASD group. Amaral et al. (2017) now adds detail: the gap is smaller when you look only at kids with Down syndrome who already screen positive for autism.
Greer et al. (2013) studied three other genetic syndromes and warned that screeners can over-call ASD. G et al. echo this caution—standard cutoffs may flag Down syndrome kids who still keep better social warmth.
Root et al. (2017) showed that how you find kids matters: research-screened preschoolers looked milder than clinic-referred ones. G et al. mirror this idea inside Down syndrome—screen-positive kids are not identical to clinic ASD peers.
Why it matters
If a child with Down syndrome hits the ASD cutoff, do not assume the full autism profile. Plan extra social-reciprocity goals but keep teaching peer play and shared enjoyment—these may be relative strengths. Write goals that target joint attention without losing the warmth that is often preserved. Re-assess after six months; some kids may not need the full ASD intensity of hours.
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02At a glance
03Original abstract
BACKGROUND: Recent research suggests that around 16% to 18% of children with Down syndrome (DS) also meet diagnostic criteria for autism spectrum disorder (ASD). However, there are indications that profiles of autism symptoms in this group may vary from those typically described in children with ASD. METHOD: Rates of autism symptoms and emotional and behavioural problems among children with DS who screened positive for ASD on the Social Communication Questionnaire (SCQ) (n = 183) were compared with a group of children with clinical diagnoses of ASD (n = 189) attending specialist schools in the UK. Groups were matched for age and approximate language level (use of phrase speech). RESULTS: Profiles of autistic symptoms in the two groups were generally similar, but children with DS meeting ASD cut-off on the SCQ tended to show fewer problems in reciprocal social interaction than those in the ASD group. They also showed slightly lower rates of emotional and peer-related problems. The results mostly confirm findings from a previous study in which the original validation sample for the SCQ was used as a comparison group. CONCLUSION: Findings suggest that children with DS who meet screening criteria for ASD show similar profiles of communication and repetitive behaviours to those typically described in autism. However, they tend to have relatively milder social difficulties. It is important that clinicians are aware of this difference if children with DS and ASD are to be correctly diagnosed and eligible for specialist intervention and education services.
Journal of intellectual disability research : JIDR, 2017 · doi:10.1111/jir.12344