The Structure and Individual Patterns of Emotional and Behavioral Problems in Preschool Children With Autism Spectrum...

This study explored the interactions between emotional and behavioral symptoms in preschool children with autism spectrum disorder (ASD) and identified potential clinical subtypes based on these interrelationships. A total of 1886 preschool children with ASD and 285 age-matched typically developing (TD) children were assessed using the Child Behavior Checklist for ages 1.5-5. Symptom networks were estimated using the EBICglasso algorithm, and group differences were evaluated via network comparison tests. Subgroups within the ASD sample were identified using Individual Difference Symptom Networks (IDSN) with k-means clustering. The results revealed distinct network structures between the ASD and TD groups, with emotional reactivity demonstrating the highest centrality in the ASD network. Two distinct ASD subgroups (ASD-A and ASD-B) were identified, which showed significant differences from the TD group across all emotional and behavioral dimensionsin the CBCL 1.5-5. The subgroups differed significantly in overall network strength and specific edge connections, particularly between aggressive behavior and withdrawal problems. The findings indicate that emotional reactivity may play a central role in the symptom network of preschool children with ASD. The identification of two clinical subgroups with distinct symptom connectivity patterns provides valuable insights for developing more individualized and targeted intervention strategies. ASD-A subgroup points to the potential value of comprehensive early intervention programs, whereas ASD-B subgroup highlights the need for functional communication training and social engagement strategies.