The analysis and interpretation of trajectories and patterns of autism symptom development in children

Background. Due to the high prevalence of autism spectrum disorders (ASD) and the dependence of prognosis on intervention time, the development of factor models for autistic symptoms in preschool childhood is an urgent area of research. Comparing autism symptoms multifactorial models obtained using structural equation modeling for preschoolers with autism of different age groups is valuable because it provides information that cannot be covered by studying a single age group.

Objective: To compare the factor patterns for ASD symptoms in children aged 3–4 and 5–7 years to identify autism development trajectories.

Material and methods. Since autism symptoms pattern changes as children develop, comparing factor models allows to identify age-related indicators and use more accurate diagnostic criteria adapted to each age group for improving sensitivity and specificity of early autism diagnosis and optimize corrective interventions. Within the years 2023–2024, 7-factor and 8-factor models for autism symptoms, respectively, were obtained in 3–4-year-old (n=294) and 5–6-year-old (n=374) ASD children. The data in both studies were collected by specialists who worked with the patients on a regular basis by filling out the online questionnaires.

Results. When comparing two autism factor models, it was found that the identified factor pattern, which includes three groups of symptoms for young children, was dramatically changed in older children. With age, the relationship between specific symptoms and the underlying factors has significantly increased and become more complex. For younger children, the identified 7-factor pattern consists of three unrelated groups of symptoms: communication problems (including factors such as emotional dysregulation, speech understanding, echolalia, alienation), persistence on sameness with sensory disintegration and hyperactivity/disinhibition. For older children, the 8-factor pattern has developed into three other groups of relatively independent but related symptoms: the verbal group (including factors of speech understanding and empathy), praxis disorders (including factors such as hyperactivity, emotional dysregulation, motor disorders) and sensory disintegration (including factors such as persistence on sameness, sensory disintegration and echolalia).

Conclusion. Speech and motor development are two lead symptoms that deserve special attention from specialists. By understanding how the pattern of ASD symptoms and factor load change throughout preschool age, researchers can improve existing diagnostic tools to increase their accuracy and effectiveness in detecting autism at different ages and develop targeted intervention strategies.

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