Patterns of autism spectrum symptomatology in individuals with Down syndrome without comorbid autism spectrum disorder.
Marie Moore Channell, B Allyson Phillips, Susan J Loveall, Frances A Conners, Paige M Bussanich, Laura Grofer Klinger
Author Information
Marie Moore Channell: University of Alabama, Box 870348, Tuscaloosa, AL 35487 USA ; MIND Institute, University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA.
B Allyson Phillips: University of Alabama, Box 870348, Tuscaloosa, AL 35487 USA ; Ouachita Baptist University, 410 Ouachita St, OBU Box 3734, Arkadelphia, AR 71998 USA.
Susan J Loveall: University of Alabama, Box 870348, Tuscaloosa, AL 35487 USA ; Life Span Institute, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045 USA.
Frances A Conners: University of Alabama, Box 870348, Tuscaloosa, AL 35487 USA.
Paige M Bussanich: Waisman Center, University of Wisconsin-Madison, 1500 Highland Ave, Madison, WI 53705 USA.
Laura Grofer Klinger: TEACCH Autism Program; Department of Psychiatry, University of North Carolina at Chapel Hill, CB# 7180, Chapel Hill, NC 27599 USA.
BACKGROUND: Prevalence estimates of autism spectrum disorder (ASD) in Down syndrome (DS) are highly varied. This variation is partly due to the difficulty of screening for and diagnosing comorbid ASD in individuals with a syndrome that carries its own set of social communicative and behavioral difficulties that are not well documented. The aim of this study was to identify the typical range of social communicative impairments observed in children, adolescents, and young adults with DS who do not have comorbid ASD. METHODS: We examined patterns of scores from the five subscales of the Social Responsiveness Scale (SRS) in 46 individuals with DS (ages 10-21 years) without comorbid ASD relative to the published normative sample. We also explored the correlations between SRS symptomatology and age, nonverbal cognition, and receptive language. RESULTS: SRS scores were elevated (i.e., more ASD symptoms endorsed), with mean scores falling into the clinically significant range. Analysis by subscale revealed a specific pattern, with Autistic Mannerisms and Social Cognition scores significantly more elevated than Social Communication scores, which were significantly more elevated than Social Awareness and Social Motivation scores. Correlations between SRS scores and the other measures varied by subscale. CONCLUSIONS: General elevated ASD symptomatology on the SRS indicates the need for developing population-based norms specific to DS. The pattern of scores across subscales should inform clinicians of the typical range of behaviors observed in DS so that individuals with atypical patterns of behavior can be more easily identified and considered for a full ASD evaluation.
