OBJECTIVES Emotional dysregulation is a common and debilitating problem for autistic children and their families. However, we know little about early-onset patterns of dysregulation, associated risk factors, and child and family outcomes. We aimed to characterize trajectories of emotional dysregulation in an inception cohort of autistic preschoolers. METHOD Caregivers reported on the emotional dysregulation of 396 autistic children using the Aberrant Behavior Checklist (ABC) irritability and hyperactivity scales at 6 timepoints from shortly after ASD diagnosis (ages 2-4 years) to pre-adolescence (10-11 years). Covariance pattern mixture modeling was used to characterize the number and shape of latent dysregulation trajectories that best fit underlying data. Child and family correlates were measured at baseline and ages 10-11 years to characterize early risk factors and pre-adolescent profiles associated with distinct latent trajectories. RESULTS Three distinct trajectory classes best fit the data: persistently self-regulated (18% of sample); moderate and declining (54%), and persistently dysregulated (28%). Children classified in the persistently dysregulated trajectory lived with more depressed caregivers and in families reporting greater relationship problems and lower household incomes compared to lower-risk trajectories. Few associations were found with baseline child characteristics. Persistent dysregulation problems were associated with significantly worse child mental health and functional outcomes during pre-adolescent years. CONCLUSION Risk of persistent severe emotional dysregulation may be identifiable at time of early autism diagnosis. Diagnostic assessments should include contextual risk factors and links to evidence-based family supports and interventions.

中文翻译：

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自闭症儿童情绪失调的早期发作轨迹。


目标 情绪失调是自闭症儿童及其家庭的常见且使人衰弱的问题。然而，我们对失调的早发模式、相关风险因素以及儿童和家庭结局知之甚少。我们旨在描述自闭症学龄前儿童初始队列中情绪失调的轨迹。方法 照顾者使用异常行为检查表 （ABC） 易怒和多动量表报告了 396 名自闭症儿童在 ASD 诊断后不久（2-4 岁）至青春期前（10-11 岁）的 6 个时间点的情绪失调。协方差模式混合模型用于表征最适合基础数据的潜在失调轨迹的数量和形状。在基线和 10-11 岁时测量儿童和家庭相关性，以表征与不同潜在轨迹相关的早期危险因素和青春期前概况。结果三个不同的轨迹类别最适合数据：持续自我调节（占样本的 18%）;中度和下降 （54%），以及持续失调 （28%）。归类为持续失调轨迹的儿童与更抑郁的照顾者生活在一起，与低风险轨迹相比，家庭报告了更大的关系问题和较低的家庭收入。与基线儿童特征的关联很少。持续的失调问题与青春期前儿童心理健康和功能结果显着恶化相关。结论 在早期自闭症诊断时可以识别持续严重情绪失调的风险。诊断评估应包括背景危险因素以及与循证家庭支持和干预措施的联系。