Understanding the heterogeneity of anxiety in autistic youth: A person-centered approach.
Autistic youth split into three caregiver-rated anxiety bands that link to clear developmental patterns, so treat the profile, not the total score.
01Research in Context
What this study did
Spackman et al. (2022) asked caregivers to rate anxiety in their autistic kids. They used a math tool called latent profile analysis to see if the kids fell into clear groups.
The study pulled out three steady groups: mild, moderate, and severe anxiety. Each group also differed in age, social skills, repetitive actions, and thinking scores.
What they found
Caregiver answers lined up into three anxiety levels that stayed stable across checks. Kids in the severe group were older, had more social trouble, more repetitive behaviors, and lower cognitive scores.
The mild group was younger with stronger skills. The moderate group sat in the middle on every measure.
How this fits with other research
Ozsivadjian et al. (2012) first showed parents notice big anxiety-driven behavior swings. Emily’s work now gives those parent voices numbers and clear buckets.
Waldron et al. (2023) later used the same person-centered idea on preschoolers and found intolerance of uncertainty as the key thread. Together the papers say anxiety clusters start early and stay organized.
Noordenbos et al. (2012) warned that high-functioning teens under-report anxiety. Emily keeps the caregiver view front and center, matching that advice to trust parent data.
Why it matters
Stop using one total anxiety score. Look for which profile—mild, moderate, severe—best fits your learner, then plan from there. Severe-profile kids may need social and repetitive-behavior targets along with anxiety care. Mild-profile kids might just need brief coping skills. Match treatment depth to the profile, not the single number.
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02At a glance
03Original abstract
The present study aimed to examine anxiety profiles among children and adolescents on the autism spectrum. It further aimed to characterize the association between the identified anxiety profiles and key clinical and developmental variables. The Spence Children's Anxiety Scale-Parent Version (SCAS-P) data from a large international pooled sample of 870 caregivers of autistic children and adolescents (Mage = 11.6 years, SDage = 2.77; 107 females) was used. Latent profile analysis identified a three-anxiety profile solution exhibiting high entropy (0.80) and high latent profile probabilities, with good classification accuracy. Identified profiles fell along the severity spectrum and were named as the mild (n = 498), moderate (n = 272) and severe (n = 100) anxiety profiles. There were no statistically significant differences between the three anxiety profiles in terms of sex distribution. Participants in the mild profile were significantly younger than those in the severe profile, had significantly fewer social communication difficulties than youth in the moderate anxiety profile group and had significantly fewer restricted and repetitive behaviors and lower cognitive functioning scores compared to participants in moderate and severe anxiety profiles. This is the first study to move beyond identifying associations and group-level differences to exploring and identifying characteristics of anxiety-based subgroups at an individual level that differ on key clinical and developmental variables. The subgroups identified in this study are a preliminary, yet important, first step towards informing future assessment and individualized interventions aiming to support young people on the autism spectrum to reduce and manage anxiety. LAY SUMMARY: This study tried to understand if there are subgroups of autistic young people who may have similar anxiety profiles. We found that we could meaningfully group young people into three groups based on how severe the anxiety symptoms their caregivers reported were: a group with low levels of anxiety, those with moderate anxiety, and those with more severe anxiety. We also found that the young people in the mild group were younger, had fewer autism traits and lower levels of intellectual functioning than young people in the other two groups.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1002/aur.2744