Dissecting the phenotypic heterogeneity in sensory features in autism spectrum disorder: a factor mixture modelling appr
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RESEARCH
Open Access
Dissecting the phenotypic heterogeneity in sensory features in autism spectrum disorder: a factor mixture modelling approach J. Tillmann1,2*† , M. Uljarevic3,4,5†, D. Crawley6, G. Dumas7, E. Loth6,8, D. Murphy6,8,9, J. Buitelaar10,11,12, T. Charman1,9 and the AIMS-2-TRIALS LEAP group
Abstract Background: Heterogeneity in the phenotypic presentation of autism spectrum disorder (ASD) is apparent in the profile and the severity of sensory features. Here, we applied factor mixture modelling (FMM) to test a multidimensional factor model of sensory processing in ASD. We aimed to identify homogeneous sensory subgroups in ASD that differ intrinsically in their severity along continuous factor scores. We also investigated sensory subgroups in relation to clinical variables: sex, age, IQ, social-communication symptoms, restricted and repetitive behaviours, adaptive functioning and symptoms of anxiety and attention-deficit/hyperactivity disorder. Methods: Three hundred thirty-two children and adults with ASD between the ages of 6 and 30 years with IQs varying between 40 and 148 were included. First, three different confirmatory factor models were fit to the 38 items of the Short Sensory Profile (SSP). Then, latent class models (with two-to-six subgroups) were evaluated. The best performing factor model, the 7-factor structure, was subsequently used in two FMMs that varied in the number of subgroups: a two-subgroup, seven-factor model and a three-subgroup and seven-factor model. Results: The ‘three-subgroup/seven-factor’ FMM was superior to all other models based on different fit criteria. Identified subgroups differed in sensory severity from severe, moderate to low. Accounting for the potential confounding effects of age and IQ, participants in these sensory subgroups had different levels of social-communicative symptoms, restricted and repetitive behaviours, adaptive functioning skills and symptoms of inattention and anxiety. Limitations: Results were derived using a single parent-report measure of sensory features, the SSP, which limits the generalisability of findings. (Continued on next page)
* Correspondence: [email protected] † J. Tillmann and M. Uljarevic are first co-author. 1 Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, Denmark Hill, London SE5 8AF, UK 2 Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Crea
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