Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 1 , Pages 28-40.e3 , January 2012

Validation of Proposed DSM-5 Criteria for Autism Spectrum Disorder

  • Thomas W. Frazier, Ph.D.

      Affiliations

    • Center for Pediatric Behavioral Health and Center for Autism, Cleveland Clinic
    • Corresponding Author InformationCorrespondence to Thomas W. Frazier, Ph.D., Center for Autism, Cleveland Clinic, 2801 Martin Luther King Jr. Drive CRS10, Cleveland, OH 44104
    • ,
  • Eric A. Youngstrom, Ph.D.

      Affiliations

    • University of North Carolina at Chapel Hill
    • ,
  • Leslie Speer, Ph.D.

      Affiliations

    • Center for Pediatric Behavioral Health and Center for Autism, Cleveland Clinic
    • ,
  • Rebecca Embacher, B.S.

      Affiliations

    • Center for Autism, Cleveland Clinic
    • ,
  • Paul Law, M.D., M.P.H.

      Affiliations

    • Kennedy Krieger Institute
    • ,
  • John Constantino, M.D.

      Affiliations

    • Washington University in St. Louis
    • ,
  • Robert L. Findling, M.D.

      Affiliations

    • Case Western Reserve University
    • ,
  • Antonio Y. Hardan, M.D.

      Affiliations

    • Stanford University, Stanford, CA
    • ,
  • Charis Eng, M.D., Ph.D.

      Affiliations

    • Genomic Medicine Institute, Taussig Cancer Institute, and Stanley Shalom Zielony Institute of Nursing Excellence, Cleveland Clinic

,Accepted 29 September 2011.

  • Image Result

    Two-factor/two-class model using the Social Responsiveness Scale in the total available sample (N = 6,949) and sibling subsample without autism spectrum disorder (ASD) (N = 2,701). Note: The ASD class

    Two-factor/two-class model using the Social Responsiveness Scale in the total available sample (N = 6,949) and sibling subsample without autism spectrum disorder (ASD) (N = 2,701). Note: The ASD class had substantially higher symptom levels (T scores) than the non-ASD class in both the total sample and non-ASD sibling subsample (p < .001). Non-ASD siblings designate model results for the non-ASD sibling subsample. SC 1-4 = social communication/interaction scales from the Social Responsiveness Scale. AM 1-4 = autism mannerisms item packets from the Social Responsiveness Scale. Horizontal black line separates results for the empirically derived ASD and non-ASD classes. Curved double-headed arrows represent factor correlations in the ASD and non-ASD classes.

  • Image Result
    Social Responsiveness Scale (SRS) social and autism mannerism T scores cluster within autism spectrum disorder (ASD) and non-ASD classes in the total available sample (N = 6,949; left panel) and non-A

    Social Responsiveness Scale (SRS) social and autism mannerism T scores cluster within autism spectrum disorder (ASD) and non-ASD classes in the total available sample (N = 6,949; left panel) and non-ASD sibling subsample (N = 2,701; right panel). Note: SRS social T scores are the average of the four social subscales. Higher scores indicate greater impairment. Each figure is based upon a random subsample (n = 500).

  • Image Result
    Age of reported developmental milestones (mean ± 95% confidence interval) for siblings without autism spectrum disorder (ASD) empirically classified into the ASD and non-ASD classes.

    Age of reported developmental milestones (mean ± 95% confidence interval) for siblings without autism spectrum disorder (ASD) empirically classified into the ASD and non-ASD classes.

 This publication was made possible by the Case Western Reserve University/Cleveland Clinic Clinical and Translational Grant Number UL1 RR024989 from the National Center for Research Resources. Autism Speaks provided support for the Interactive Autism Network project and Dr. Law. Funding from the National Institute of Child Health and Human Development Grant Number HD42541 supported Dr. Constantino's involvement. Dr. Eng is a Doris Duke Distinguished Clinical Scientist and holds the Sondra J. and Stephen R. Hardis Chair of Cancer Genomic Medicine at the Cleveland Clinic.

 Dr. Law designed and maintains the Interactive Autism Network registry. Drs. Frazier, Youngstrom, and Eng designed the present study. Dr. Frazier obtained funding to support analyses. Drs. Frazier, Youngstrom, Speer, Constantino, Findling, and Hardan, and Ms. Embacher supervised data interpretation of the study. Drs. Frazier and Ms. Embacher conducted data management and data analyses. All authors contributed to writing and revision.

 The authors gratefully acknowledge the efforts of families contributing to the Interactive Autism Network. Drs. Frazier and Youngstrom served as the statistical experts.

 Disclosure: Dr. Frazier has received federal funding or research support from, acted as a consultant to, or received travel support from Shire Development, Inc., Bristol-Myers Squibb, Integragen, the National Institutes of Health (NIH), and the Brain and Behavior Research Foundation. Dr. Youngstrom has received travel support from Bristol-Myers Squibb. Dr. Findling receives or has received research support, acted as a consultant to and/or served on a speakers' bureau for Abbott, Addrenex, AstraZeneca, Biovail, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Johnson and Johnson, KemPharm, Eli Lilly and Co., Lundbeck, Merck, Neuropharm, Novartis, Noven, Organon, Otsuka, Pfizer, Rhodes Pharmaceuticals, Sanofi-Aventis, Schering-Plough, Seaside Therapeutics, Sepracore, Shire, Solvay, Sunovion, Supernus Pharmaceuticals, Transcept, Validus, and Wyeth. Dr. Constantino receives grant or research support from NIH, National Institute of Child Health and Human Development, the National Institute of Mental Health, the Department of Health and Human Services, Autism Speaks, and the Centers for Disease Control and Prevention. He receives royalties from Western Psychological Services for the commercial distribution of the Social Responsiveness Scale, one of the metrics used in this study; no royalties were generated by any of the assessments performed in the present research. Drs. Law, Speer, Eng, and Hardan, and Ms. Embacher report no biomedical financial interests or potential conflicts of interest.

 This article is discussed in an editorial by Dr. Bennett L. Leventhal on page 6.

 Supplemental material cited in this article is available online.

PII: S0890-8567(11)00890-2

doi: 10.1016/j.jaac.2011.09.021

Journal of the American Academy of Child & Adolescent Psychiatry
Volume 51, Issue 1 , Pages 28-40.e3 , January 2012

Article Tools

* Image Usage & Resolution