Trajectories of adaptive functioning from early childhood to adolescence in autism: Identifying turning points and key correlates of chronogeneity.
Autistic kids follow one of four adaptive-skill paths, with make-or-break moments at ages five and ten.
01Research in Context
What this study did
The team tracked adaptive living skills in autistic children for many years.
They used math models to spot when growth speeds up, slows, or turns.
Kids were grouped by IQ, family income, and how often they joined peers.
What they found
Four clear paths appeared.
Most kids stayed on slow, steady gains.
Two smaller groups shot up around age five or dipped near age ten.
Cognitive scores, money stress, and peer play predicted who went which way.
How this fits with other research
Fujiura et al. (2018) first said gains "plateau" in teen years.
This new work keeps the plateau but adds two key turning points earlier.
The papers agree: keep teaching daily living skills through high school.
Heyman et al. (2019) showed warm mom-child play boosts growth.
YWilson et al. (2023) widen the lens: money and peer time matter too.
Van Hanegem et al. (2014) found four autism-severity tracks in toddlers.
Same four-group pattern now shows up in adaptive skills, just later.
Why it matters
You can watch for two risky windows: just before school entry and just before middle school.
During these years, pile on social, self-care, and community goals.
Check both family stress and peer inclusion when you write plans.
Small boosts at five or ten may keep kids on the steeper curve for life.
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02At a glance
03Original abstract
<h4>Background</h4>Previous research has demonstrated heterogeneous adaptive outcomes across the autism spectrum; however, the current literature remains limited in elucidating turning points and associated factors for longitudinal variability (chronogeneity). To address these empirical gaps, we aimed to provide a finer-grained characterization of trajectories of adaptive functioning from early childhood to adolescence in autism.<h4>Methods</h4>Our sample (<i>N</i> = 406) was drawn from an inception cohort of children diagnosed Autistic at ages 2-5. Adaptive functioning was assessed with Vineland Adaptive Behavior Scales (VABS, 2<sup>nd</sup> Edition) across 6 visits from the time of diagnosis by age 18. Parallel-process latent growth curve modeling were used to estimate domain-level VABS trajectories, followed by latent class growth analysis to identify trajectory subgroups. Child characteristics at diagnosis, family demographics, and participation outcomes at adolescence were compared across subgroups.<h4>Results</h4>Piecewise latent growth models best described VABS trajectories with two turning points identified at around ages 5-6 and 9-10, respectively reflecting transitions into school age and early adolescence. We parsed four VABS trajectory subgroups that vary by level of functioning and change rate for certain domains and periods. Around 16% of the sample exhibited overall adequate functioning (standard score >85) with notable early growth and social adaptation during adolescence. About 21% showed low adaptive functioning (standard score ≤70), with decreasing slopes by age 6 followed by improvements in communication and daily-living skills by age 10. The other two subgroups (63% in total) were characterized by adaptive functioning between low and adequate levels, with relatively stable trajectories entering school age. These subgroups differed most in their cognitive ability at diagnosis, household income, and social participation in adolescence.<h4>Conclusions</h4>We identified key individual and family characteristics and time windows associated with distinct adaptive functioning trajectories, which have important implications for providing timely and tailored supports to Autistic people across developmental stages.
, 2023 · doi:10.1002/jcv2.12212