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Joint trajectories of internalizing and externalizing problems in preschool children with autism spectrum disorder

  • Tracy Vaillancourt (a1), John D. Haltigan (a1), Isabel Smith (a2), Lonnie Zwaigenbaum (a3), Peter Szatmari (a4), Eric Fombonne (a5), Charlotte Waddell (a6), Eric Duku (a7), Pat Mirenda (a8), Stelios Georgiades (a7), Teresa Bennett (a7), Joanne Volden (a9), Mayada Elsabbagh (a10), Wendy Roberts (a4) and Susan Bryson (a11)...


The co-occurring development of internalizing and externalizing problems were examined in an inception cohort of 392 children diagnosed with autism spectrum disorder at age 3 who were assessed on four occasions. Results indicated that internalizing and externalizing problems were stable over time and highly comorbid. Joint trajectory analysis suggested that 13% of the sample followed a dual high-risk trajectory. High risk was not found to be associated with intellectual ability or autism spectrum disorder symptom severity but was linked to lower income and gender: more girls than boys were found in the high/stable internalizing problems trajectory. The results suggest that 1 in 4 preschoolers followed a trajectory of internalizing or externalizing problems (or a combination of the two) that could be characterized as clinically elevated.


Corresponding author

Address correspondence and reprint requests to: Tracy Vaillancourt, Department of Education and Psychology, University of Ottawa, 145 Jean-Jacques-Lussier, Ottawa, ON K1N 6N5, Canada; E-mail:


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