Rethinking Measurement Standards of Autism Symptomology in Adolescents with Fragile X Syndrome

J Autism Dev Disord. 2021 Dec;51(12):4520-4533. doi: 10.1007/s10803-021-04892-2. Epub 2021 Feb 6.

Abstract

Accurate representation of autism spectrum disorder (ASD) in fragile X syndrome (FXS) is necessary for the field. We examined classifications of ASD using three approaches-Autism Diagnostic Observation Schedule (ADOS-2; Lord et al. 2012), Childhood Autism Rating Scale (CARS2-ST; Schopler et al. 2010), and Vineland Adaptive Behavior Scales (VABS-II; Sparrow et al. 2005)-in 45 adolescents with FXS. Maladaptive items from the VABS-II plus a maternal interview were matched with Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5; American Psychiatric Association 2013) criteria for ASD. Results indicated discrepant classifications. The ADOS-2 yielded the highest rate of comorbid autism (71%); CARS2-ST and VABS-II/DSM-5 yielded lower rates (38% and 42%, respectively). A singular measure of autism symptomology is insufficient to characterize autism in FXS.

Keywords: Autism; Fragile X syndrome; Measurement.

MeSH terms

  • Adolescent
  • Autism Spectrum Disorder* / diagnosis
  • Autistic Disorder*
  • Child
  • Diagnostic and Statistical Manual of Mental Disorders
  • Fragile X Syndrome* / diagnosis
  • Humans