Top

Journal of Autism and Developmental Disorders

19-03-2025 | Original Article

Is There a Core Deficit in Autism Spectrum Disorder? An Analysis of CPEP-3 Assessment Data from 543 Children With Autism

Auteurs: Yunqiang Lin, Chenglong Wang, Rongdi Chen, Hongxia Zhang, Dingwei Zhao

Gepubliceerd in: Journal of Autism and Developmental Disorders

Abstract

Identifying a “core deficit” is essential for early detection and intervention in developmental disorders among children. However, the presence of a core deficit within autism spectrum disorder (ASD) continues to be unclear. Therefore, the purpose of this study was to examine the possibility of the core deficit in autism spectrum disorders. This study evaluated 543 children diagnosed with ASD by using Chinese version of the Psychoeducational Profile-Third Edition (CPEP-3). Structural equation modeling (SEM) was used to construct single-factor models (assuming the presence of a core deficit) and a multi-factor model (assuming the absence of core deficits) based on the assessed data, and then to compare the fit of the two types of models. Assessments revealed developmental delays and adaptive challenges among the children with ASD. The single-factor model assuming the “motor” domain as the “core deficit” showed a superior fit (CFI = 0.86, AIC = 356.47, ECVI = 0.66) than other single-factor models. The multi-factor model, which assumes no core deficit, provided a better fit and greater predictive accuracy (CFI = 0.87, AIC = 351.94, ECVI = 0.65) than all single-factor models. ASD is characterized by widespread developmental delays and adaptive challenges. While motor impairment may serve as an effective predictor of these issues, it does not fully account for the diverse and complex symptomatology observed in children with ASD. The symptoms in these children likely arise from multiple factors, which are not adequately explained by a single core deficit model.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5, 5th ed). American Psychiatric Association.

Astle, D. E., & Fletcher-Watson, S. (2020). Beyond the core-deficit hypothesis in developmental disorders. Current Directions in Psychological Science, 29(5), 431–437. https://doi.org/10.1177/0963721420925518CrossRefPubMedPubMedCentral

Baron-Cohen, S. (1989). Do autistic children have obsessions and compulsions? British Journal of Clinical Psychology, 28(3), 193–200. https://doi.org/10.1111/j.2044-8260.1989.tb01369.xCrossRefPubMed

Bhat, A. N. (2020). Is motor impairment in autism spectrum disorder distinct from developmental coordination disorder? A report from the spark study. Physical Therapy, 100(4), 633–644. https://doi.org/10.1093/ptj/pzz190CrossRefPubMedPubMedCentral

Bhat, A. N. (2021). Motor impairment increases in children with autism spectrum disorder as a function of social communication, cognitive and functional impairment, repetitive behavior severity, and comorbid diagnoses: A SPARK study report. Autism Research, 14(1), 202–219. https://doi.org/10.1002/aur.2453CrossRefPubMed

Bhat, A. N., Galloway, J. C., & Landa, R. J. (2012). Relation between early motor delay and later communication delay in infants at risk for autism. Infant Behavior and Development, 35(4), 838–846. https://doi.org/10.1016/j.infbeh.2012.07.019CrossRefPubMed

Bishop, S. L., Wickstrom, J., & Thurm, A. (2022). Insufficient evidence for inclusion of motor deficits in the ASD diagnostic criteria: A response to Bhat (2021). Autism Research, 15(8), 1374–1375. https://doi.org/10.1002/aur.2775CrossRefPubMed

Boomsma, A., Van Lang, N. D. J., De Jonge, M. V., De Bildt, A. A., Van Engeland, H., & Minderaa, R. B. (2008). A new symptom model for autism cross-validated in an independent sample. Journal of Child Psychology and Psychiatry, 49(8), 809–816. https://doi.org/10.1111/j.1469-7610.2008.01897.xCrossRefPubMed

Bralten, J., van Hulzen, K. J., Martens, M. B., Galesloot, T. E., Arias Vasquez, A., Kiemeney, L. A., Buitelaar, J. K., Muntjewerff, J. W., Franke, B., & Poelmans, G. (2018). Autism spectrum disorders and autistic traits share genetics and biology. Molecular Psychiatry, 23(5), 1205–1212. https://doi.org/10.1038/mp.2017.98CrossRefPubMed

Brick, C., Hood, B., Ekroll, V., & de-Wit, L. (2022). Illusory essences: A bias holding back theorizing in psychological science. Perspectives on Psychological Science, 17(2), 491–506. https://doi.org/10.1177/1745691621991838CrossRefPubMed

Byrne, B. M. (2016). Structural equation modeling with Amos: Basic concepts, applications, and programming, third edition (3rd ed.). Routledge. https://doi.org/10.4324/9781315757421

Chetcuti, L., Hudry, K., Grant, M., & Vivanti, G. (2019). Object-directed imitation in autism spectrum disorder is differentially influenced by motoric task complexity, but not social contextual cues. Autism, 23(1), 199–211. https://doi.org/10.1177/1362361317734063CrossRefPubMed

Chevallier, C., Kohls, G., Troiani, V., Brodkin, E. S., & Schultz, R. T. (2012). The social motivation theory of autism. Trends in Cognitive Sciences, 16(4), 231–239. https://doi.org/10.1016/j.tics.2012.02.007CrossRefPubMedPubMedCentral

Choi, Y. B., Mentch, J., Haskins, A. J., Van Wicklin, C., & Robertson, C. E. (2023). Visual processing in genetic conditions linked to autism: A behavioral study of binocular rivalry in individuals with 16p11.2 deletions and age-matched controls. Autism Research, 1–10. https://doi.org/10.1002/aur.2901

De la Marche, W., Noens, I., Boets, B., Kuppens, S., & Steyaert, J. (2015). The underlying symptom structure of autism spectrum disorders: A factor analytic approach using the developmental, dimensional and diagnostic interview. Research in Autism Spectrum Disorders, 12, 40–51. https://doi.org/10.1016/j.rasd.2014.11.002CrossRef

Fu, C. P., Hsieh, C. L., Tseng, M. H., Chen, Y. L., Huang, W. T., Wu, P. C., & Chiang, F. M. (2010). Inter-rater reliability and smallest real difference of the Chinese psychoeducational Profile-third edition for children with autism spectrum disorder. Research in Autism Spectrum Disorders, 4(1), 89–94. https://doi.org/10.1016/j.rasd.2009.09.002CrossRef

Gelman, S. A., Heyman, G. D., & Legare, C. H. (2007). Developmental changes in the coherence of essentialist beliefs about psychological characteristics. Child Development, 78(3), 757–774. https://doi.org/10.1111/j.1467-8624.2007.01031.xCrossRefPubMed

Gong, L., Liu, Y., Yi, L., Fang, J., Yang, Y., & Wei, K. (2020). Abnormal gait patterns in autism spectrum disorder and their correlations with social impairments. Autism Research, 13(7), 1215–1226. https://doi.org/10.1002/aur.2302CrossRefPubMed

Happé, F., & Frith, U. (2020). Annual research review: Looking back to look forward– changes in the concept of autism and implications for future research. Journal of Child Psychology and Psychiatry, 61(3), 218–232. https://doi.org/10.1111/jcpp.13176CrossRefPubMed

Happé, F., Ronald, A., & Plomin, R. (2006). Time to give up on a single explanation for autism. Nature Neuroscience, 9(10), 1218–1220.CrossRefPubMed

Hellendoorn, A., Wijnroks, L., Van Daalen, E., Dietz, C., Buitelaar, J. K., & Leseman, P. (2015). Motor functioning, exploration, visuospatial cognition and Language development in preschool children with autism. Research in Developmental Disabilities, 39, 32–42. https://doi.org/10.1016/j.ridd.2014.12.033CrossRefPubMed

Hudry, K., Chetcuti, L., & Hocking, D. R. (2020). Motor functioning in developmental psychopathology: A review of autism as an example context. Research in Developmental Disabilities, 105, 103739. https://doi.org/10.1016/j.ridd.2020.103739CrossRefPubMed

Hus, Y., & Segal, O. (2021). Challenges surrounding the diagnosis of autism in children. Neuropsychiatric Disease and Treatment, 17, 3509–3529. https://doi.org/10.2147/NDT.S282569CrossRefPubMedPubMedCentral

Jaswal, V. K., & Akhtar, N. (2019). Being versus appearing socially uninterested: Challenging assumptions about social motivation in autism. Behavioral and Brain Sciences, 42, e82. https://doi.org/10.1017/S0140525X18001826CrossRef

Kangarani-Farahani, M., Malik, M. A., & Zwicker, J. G. (2023). Motor impairments in children with autism spectrum disorder: A systematic review and meta-analysis. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-023-05948-1CrossRefPubMed

Kaur, M., Srinivasan, M., S., & Bhat, N., A (2018). Comparing motor performance, praxis, coordination, and interpersonal synchrony between children with and without autism spectrum disorder (ASD). Research in Developmental Disabilities, 72, 79–95. https://doi.org/10.1016/j.ridd.2017.10.025CrossRefPubMed

Ketcheson, L. R., Pitchford, E. A., & Wentz, C. F. (2021). The relationship between developmental coordination disorder and concurrent deficits in social communication and repetitive behaviors among children with autism spectrum disorder. Autism Research, 14(4), 804–816. https://doi.org/10.1002/aur.2469CrossRefPubMed

Kim, H., Keifer, C. M., Rodriguez-Seijas, C., Eaton, N. R., Lerner, M. D., & Gadow, K. D. (2018). Structural hierarchy of autism spectrum disorder symptoms: An integrative framework. Journal of Child Psychology and Psychiatry, 59(1), 30–38. https://doi.org/10.1111/jcpp.12698CrossRefPubMed

Lee, J., Mayall, L. A., Bates, K. E., Hill, E. L., Leonard, H. C., & Farran, E. K. (2021). The relationship between motor milestone achievement and childhood motor deficits in children with attention deficit hyperactivity disorder (ADHD) and children with developmental coordination disorder. Research in Developmental Disabilities, 113, 103920. https://doi.org/10.1016/j.ridd.2021.103920CrossRefPubMed

Leonard, H. C., & Hill, E. L. (2014). Review: The impact of motor development on typical and atypical social cognition and Language: A systematic review. Child and Adolescent Mental Health, n/a-n/a https://doi.org/10.1111/camh.12055.CrossRefPubMed

Lim, Y. H., Licari, M., Spittle, A. J., Watkins, R. E., Zwicker, J. G., Downs, J., & Finlay-Jones, A. (2021). Early motor function of children with autism spectrum disorder: A systematic review. Pediatrics, 147(2). https://doi.org/10.1542/peds.2020-011270. Scopus.

Moulton, E., Bradbury, K., Barton, M., & Fein, D. (2019). Factor analysis of the childhood autism rating scale in a sample of two year olds with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 49(7), 2733–2746. https://doi.org/10.1007/s10803-016-2936-9CrossRefPubMedPubMedCentral

Myers, S. M., Challman, T. D., Bernier, R., Bourgeron, T., Chung, W. K., Constantino, J. N., Eichler, E. E., Jacquemont, S., Miller, D. T., Mitchell, K. J., Zoghbi, H. Y., Martin, C. L., & Ledbetter, D. H. (2020). Insufficient evidence for autism-specific genes. The American Journal of Human Genetics, 106(5), 587–595. https://doi.org/10.1016/j.ajhg.2020.04.004CrossRefPubMed

Norris, M., Lecavalier, L., & Edwards, M. C. (2012). The structure of autism symptoms as measured by the autism diagnostic observation schedule. Journal of Autism and Developmental Disorders, 42(6), 1075–1086. https://doi.org/10.1007/s10803-011-1348-0CrossRefPubMed

Paquet, A., Olliac, B., Bouvard, M. P., Golse, B., & Vaivre-Douret, L. (2016). The semiology of motor disorders in autism spectrum disorders as highlighted from a standardized neuro-psychomotor assessment. Frontiers in Psychology, 7. https://www.frontiersin.org/articles/https://doi.org/10.3389/fpsyg.2016.01292

Pieters, S., De Block, K., Scheiris, J., Eyssen, M., Desoete, A., Deboutte, D., Van Waelvelde, H., & Roeyers, H. (2012). How common are motor problems in children with a developmental disorder: Rule or exception? Child Care Health and Development, 38(1), 139–145. https://doi.org/10.1111/j.1365-2214.2011.01225.xCrossRefPubMed

Raykov, T., & Marcoulides, G. A. (2000). A first course in structural equation modeling. (pp. viii, 205). Lawrence Erlbaum Associates Publishers.

Ronald, A., Happé, F., Price, T. S., Baron-Cohen, S., & Plomin, R. (2006). Phenotypic and genetic overlap between autistic traits at the extremes of the general population. Journal of the American Academy of Child & Adolescent Psychiatry, 45(10), 1206–1214. https://doi.org/10.1097/01.chi.0000230165.54117.41CrossRef

Rong, Y., Yang, C. J., Jin, Y., & Wang, Y. (2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83, 101759. https://doi.org/10.1016/j.rasd.2021.101759CrossRef

Satterstrom, F. K., Kosmicki, J. A., Wang, J., Breen, M. S., Rubeis, S. D., An, J. Y., Peng, M., Collins, R., Grove, J., Klei, L., Stevens, C., Reichert, J., Mulhern, M. S., Artomov, M., Gerges, S., Sheppard, B., Xu, X., Bhaduri, A., Norman, U., & Buxbaum, J. D. (2020). Large-scale exome sequencing study implicates both developmental and functional changes in the neurobiology of autism. Cell, 180(3), 568–584e23. https://doi.org/10.1016/j.cell.2019.12.036CrossRefPubMedPubMedCentral

Schopler, E., Lansing, M. D., Reichler, R. J., & Marcus, L. M. (2009). The Chinese edition of psychoeducational profile—Third edition. Commercial. (Hong Kong).

Schreibman, L. E. (2007). Are there core deficits in autism? The science and fiction of autism (pp. 109–131). Harvard Univ. Press.

Shek, D. T. L., & Yu, L. (2014). Construct validity of the Chinese version of the psycho-educational profile-3rd edition (CPEP-3). Journal of Autism and Developmental Disorders, 44(11), 2832–2843. https://doi.org/10.1007/s10803-014-2143-5CrossRefPubMedPubMedCentral

Stallworthy, I. C., Berry, D., Davis, S., Wolff, J. J., Burrows, C. A., Swanson, M. R., Grzadzinski, R. L., Botteron, K., Dager, S. R., Estes, A. M., Schultz, R. T., Piven, J., Elison, J. T., Pruett, J. R., Marrus, N., & Network, I. (2022). Quantifying latent social motivation and its associations with joint attention and Language in infants at high and low likelihood for autism spectrum disorder. Developmental Science, e13336. https://doi.org/10.1111/desc.13336

Sullivan, P. F., & Geschwind, D. H. (2019). Defining the genetic, genomic, cellular, and diagnostic architectures of psychiatric disorders. Cell, 177(1), 162–183. https://doi.org/10.1016/j.cell.2019.01.015CrossRefPubMedPubMedCentral

van Lang, N. D. J., Boomsma, A., Sytema, S., Bildt, A. A., Kraijer, D. W., Ketelaars, C., & Minderaa, R. B. (2006). Structural equation analysis of a hypothesised symptom model in the autism spectrum. Journal of Child Psychology and Psychiatry, 47(1), 37–44. https://doi.org/10.1111/j.1469-7610.2005.01434.xCrossRefPubMed

Wang, J., Wang, X., & Jiang, B. (2011). Structural equation models: Methods and applications. Higher Education Press.

Wang, L., He, H., Bi, X., Zhou, L., & Fan, X. (2021). Social deficits in autism spectrum disorder: A perspective from the social motivation theory. Advances in Psychological Science, 29(12), 2209–2223. https://doi.org/10.3724/SP.J.1042.2021.02209CrossRef

Warrier, V., Toro, R., Won, H., Leblond, C. S., Cliquet, F., Delorme, R., De Witte, W., Bralten, J., Chakrabarti, B., Børglum, A. D., Grove, J., Poelmans, G., Hinds, D. A., Bourgeron, T., & Baron-Cohen, S. (2019). Social and non-social autism symptoms and trait domains are genetically dissociable. Communications Biology, 2(1), 328. https://doi.org/10.1038/s42003-019-0558-4CrossRefPubMedPubMedCentral

West, K. L. (2019). Infant motor development in autism spectrum disorder: A synthesis and meta-analysis. Child Development, 90(6), 2053–2070. https://doi.org/10.1111/cdev.13086CrossRefPubMed

Williams, J. H. G., Whiten, A., Suddendorf, T., & Perrett, D. I. (2001). Imitation, mirror neurons and autism. Neuroscience & Biobehavioral Reviews, 25(4), 287–295. https://doi.org/10.1016/S0149-7634(01)00014-8CrossRef

Wuang, Y. P., Wang, C., ‐C., Huang, M., ‐H., Su, C., & ‐Y (2008). Profiles and cognitive predictors of motor functions among early school‐age children with mild intellectual disabilities. Journal of Intellectual Disability Research, 52(12), 1048–1060. https://doi.org/10.1111/j.1365-2788.2008.01096.xCrossRefPubMed

Yates, L., & Hobson, H. (2020). Continuing to look in the mirror: A review of neuroscientific evidence for the broken mirror hypothesis, EP-M model and STORM model of autism spectrum conditions. Autism, 24(8), 1945–1959. https://doi.org/10.1177/1362361320936945CrossRefPubMedPubMedCentral

Young, G. S., Rogers, S. J., Hutman, T., Rozga, A., Sigman, M., & Ozonoff, S. (2011). Imitation from 12 to 24 months in autism and typical development: A longitudinal Rasch analysis. Developmental Psychology, 47(6), 1565–1578. https://doi.org/10.1037/a0025418CrossRefPubMedPubMedCentral

Yu, L., & Shek, D. T. L. (2020). Simplified Chinese Psychoeducational Profile Third Edition. In F. R. Volkmar (Ed.), Encyclopedia of Autism Spectrum Disorders (pp. 1–5). Springer. https://doi.org/10.1007/978-1-4614-6435-8_102349-1

Yu, L., Zhu, X., Shek, D. T. L., Zou, X. B., Deng, H. Z., & Au Yeung, P. W. H. (2019). Validation of the simplified Chinese psychoeducational profile third edition in Mainland China. Journal of Autism and Developmental Disorders, 49(4), 1599–1612. https://doi.org/10.1007/s10803-018-3827-zCrossRefPubMed

Titel: Is There a Core Deficit in Autism Spectrum Disorder? An Analysis of CPEP-3 Assessment Data from 543 Children With Autism
Auteurs: Yunqiang Lin
Chenglong Wang
Rongdi Chen
Hongxia Zhang
Dingwei Zhao
Publicatiedatum: 19-03-2025
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-025-06796-x

Bohn Stafleu van Loghum

Welkom bij St. Antonius Academie & Bohn Stafleu van Loghum

Registreer

Login

Is There a Core Deficit in Autism Spectrum Disorder? An Analysis of CPEP-3 Assessment Data from 543 Children With Autism

Abstract

Bohn Stafleu van Loghum

Welkom bij St. Antonius Academie & Bohn Stafleu van Loghum

Registreer

Login

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Log in om toegang te krijgen