The clinical relevance of subgroups of autistic adults: Stability and predictive value.
Two adult autism subgroups stay put for years and forecast later cognitive, mood, and life-quality outcomes.
01Research in Context
What this study did
The team followed autistic adults for two to five years.
They checked if two data-based subgroups stayed the same over time.
They also asked if today’s group membership predicts later thinking skills, mood, and quality of life.
What they found
Most adults stayed in the same subgroup years later.
The group you were in at the start forecast later cognitive scores, mental-health symptoms, and life satisfaction.
How this fits with other research
Fusar-Poli et al. (2017) watched similar adults for ten years and saw flat adaptive scores. McQuaid et al. (2024) now show that subgroup labels, not just skills, also stay stable.
Johnson et al. (2009) found that cognitively able clients can gain IQ and half reach good independence. The new study adds that subgroup membership gives an extra early warning flag for who will do well.
Yu-Wen et al. (2023) used toddler pointing and joint-attention to predict teen outcomes. McQuaid et al. (2024) move the timeline forward: adult subgroups predict mid-life outcomes, so you can plan services long after early childhood.
Why it matters
You can sort adult clients into these two subgroups during intake. The label tells you who may need stronger mental-health supports and who may aim for higher independence. Re-check every few years; the group rarely changes, so your long-term plans stay on track.
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02At a glance
03Original abstract
Autism in adulthood is characterized by heterogeneity, complicating the provision of tailored support. In previous work, we aimed to capture this heterogeneity by determining subgroups of autistic adults that differed in clinical outcomes: cognitive failures, psychological difficulties, and quality of life (QoL). Two subgroups were identified: a "Feelings of Low Grip" subgroup characterized by experiencing a lower sense of mastery and a higher susceptibility to difficulties in daily life, and a "Feelings of High Grip" subgroup characterized by a higher sense of mastery and lower susceptibility to difficulties in daily life. The current pre-registered study involves a longitudinal extension to determine (a) stability and (b) predictive value of the previously identified two subgroups. Subgroups were identified using community detection based on 14 self-report measures related to demographic, psychological, and lifestyle characteristics in two samples (aged 31-86 years) that were analyzed separately: Sample 1 (NAutism = 80) measured 5 years after baseline and Sample 2 (NAutism = 241, NComparison = 211) measured 2 years after baseline. The stability over time was assessed based on (a) the number of subgroups, (b) subgroup profiles, and (c) subgroup membership. Predictive validity was assessed for cognitive failures, psychological difficulties, and QoL. Results indicated that autistic and non-autistic adults formed distinct subgroups. Within both autism samples, the two previously identified autism subgroups were replicated at follow-up. Subgroup profiles were similar for >50% of the variables at two-year follow-up, and 21% at five-year follow-up. Moreover, ≥76% remained in the same subgroup at two-year follow-up, and ≥ 57% after 5 years. Subgroup membership was predictive of external clinical outcomes up to 5 years. Thus, this study demonstrated the stability and predictive value of the autism subgroups, especially for the two-year follow-up. A further focus on their clinical utility might increase the aptness of support, and may provide more insight into the aging process when being autistic.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3116