Use of dysmorphology for subgroup classification on autism spectrum disorder in Chinese children.
More unusual facial and body features predict lower test scores in preschoolers with autism, especially when ID is also present.
01Research in Context
What this study did
Doctors took photos of preschoolers with autism, kids with autism plus intellectual disability, and typical kids.
They counted minor physical anomalies like low-set ears or wide-spaced eyes to give each child a dysmorphology score.
Then they compared the scores to language, motor, and visual tests.
What they found
Children with more dysmorphic features scored lower on every test.
The link was strongest for children who had both autism and intellectual disability.
Typical children showed no link between looks and test scores.
How this fits with other research
Angkustsiri et al. (2011) saw the same thing: more anomalies in autistic preschoolers.
Flor et al. (2017) later named the high-anomaly group "complex autism" and also found lower IQ and more stomach problems.
Mukherjee et al. (2021) tried the same checklist in India but ancestry and age muddled the results, so the tool may not travel well.
Why it matters
When you see a preschooler with autism who has many minor physical differences, expect lower language, motor, and visual scores.
Plan simpler instructions, shorter trials, and medical screening for seizures or GI issues.
Share the photo checklist with your team so everyone watches for the same markers.
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02At a glance
03Original abstract
Previous studies investigating the association between dysmorphology and cognitive, behavioral, and developmental outcomes among individuals with autism spectrum disorder (ASD) have been limited by the binary classification of dysmorphology and lack of comparison groups. We assessed the association using a continuous measure of dysmorphology severity (DS) in preschool children aged 2-5 years (322 with ASD and intellectual disability [ID], 188 with ASD without ID, and 371 without ASD from the general population [POP]). In bivariate analyses, an inverse association between DS and expressive language, receptive language, fine motor, and visual reception skills was observed in children with ASD and ID. An inverse association of DS with fine motor and visual reception skills, but not expressive language and receptive language, was found in children with ASD without ID. No associations were observed in POP children. These results persisted after exclusion of children with known genetic syndromes or major morphologic anomalies. Quantile regression models showed that the inverse relationships remained significant after adjustment for sex, race/ethnicity, maternal education, family income, study site, and preterm birth. DS was not associated with autistic traits or autism symptom severity, behaviors, or regression among children with ASD with or without ID. Thus, DS was associated with a global impairment of cognitive functioning in children with ASD and ID, but only with fine motor and visual reception deficits in children with ASD without ID. A better understanding is needed for mechanisms that explain the association between DS and cognitive impairment in children with different disorders. Autism Res 2020, 13: 1227-1238. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We examined whether having more dysmorphic features (DFs) was related to developmental problems among children with autism spectrum disorder (ASD) with or without intellectual disability (ID), and children without ASD from the general population (POP). Children with ASD and ID had more language, movement, and learning issues as the number of DFs increased. Children with ASD without ID had more movement and learning issues as the number of DFs increased. These relationships were not observed in the POP group. Implications are discussed.
Journal of autism and developmental disorders, 2014 · doi:10.1007/s10803-013-1846-3