Understanding the heterogeneity of anxiety in autistic youth: A person-centered approach.

This study looked at anxiety in 870 autistic children and teens. Researchers found three groups based on anxiety levels: mild, moderate, and severe. Children with mild anxiety were younger and had fewer autism traits but lower intellectual abilities. This research helps us understand that autistic children experience anxiety differently and may need different types of support.

This large international study used latent profile analysis to examine anxiety patterns in 870 autistic children and adolescents (mean age 11.6 years). Using the Spence Children's Anxiety Scale-Parent Version, researchers identified three distinct anxiety profiles: mild (498 participants), moderate (272), and severe (100). The mild anxiety group was significantly younger, had fewer social communication difficulties, fewer restricted and repetitive behaviors, and lower cognitive functioning compared to moderate and severe groups. No significant sex differences were found between profiles.

This person-centered approach provides preliminary evidence for anxiety-based subgroups that may inform individualized assessment and intervention strategies for autistic youth.

Results suggest anxiety assessment and intervention should be individualized based on severity profiles. Younger autistic children with milder autism traits may present with different anxiety patterns requiring tailored approaches. Person-centered assessment methods may improve intervention matching.

Single study using parent-report measures only. Cross-sectional design prevents causal inferences. Clinical validation of identified profiles needed. Sample characteristics and recruitment methods not fully described in abstract.

The present study aimed to examine anxiety profiles among children and adolescents on the autism spectrum. It further aimed to characterize the association between the identified anxiety profiles and key clinical and developmental variables. The Spence Children's Anxiety Scale-Parent Version (SCAS-P) data from a large international pooled sample of 870 caregivers of autistic children and adolescents (M = 11.6 years, SD = 2.77; 107 females) was used. Latent profile analysis identified a three-anxiety profile solution exhibiting high entropy (0.80) and high latent profile probabilities, with good classification accuracy.

Identified profiles fell along the severity spectrum and were named as the mild (n = 498), moderate (n = 272) and severe (n = 100) anxiety profiles. There were no statistically significant differences between the three anxiety profiles in terms of sex distribution. Participants in the mild profile were significantly younger than those in the severe profile, had significantly fewer social communication difficulties than youth in the moderate anxiety profile group and had significantly fewer restricted and repetitive behaviors and lower cognitive functioning scores compared to participants in moderate and severe anxiety profiles. This is the first study to move beyond identifying associations and group-level differences to exploring and identifying characteristics of anxiety-based subgroups at an individual level that differ on key clinical and developmental variables.

The subgroups identified in this study are a preliminary, yet important, first step towards informing future assessment and individualized interventions aiming to support young people on the autism spectrum to reduce and manage anxiety. LAY SUMMARY: This study tried to understand if there are subgroups of autistic young people who may have similar anxiety profiles. We found that we could meaningfully group young people into three groups based on how severe the anxiety symptoms their caregivers reported were: a group with low levels of anxiety, those with moderate anxiety, and those with more severe anxiety. We also found that the young people in the mild group were younger, had fewer autism traits and lower levels of intellectual functioning than young people in the other two groups.