Skip to main content Accessibility help
×
Home
Hostname: page-component-59b7f5684b-8dvf2 Total loading time: 0.378 Render date: 2022-09-26T17:02:44.385Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

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

Published online by Cambridge University Press:  05 February 2016

Tracy Vaillancourt*
Affiliation:
University of Ottawa
John D. Haltigan
Affiliation:
University of Ottawa
Isabel Smith
Affiliation:
Dalhousie University
Lonnie Zwaigenbaum
Affiliation:
University of Alberta
Peter Szatmari
Affiliation:
University of Toronto
Eric Fombonne
Affiliation:
Oregon Health and Science University
Charlotte Waddell
Affiliation:
Simon Fraser University
Eric Duku
Affiliation:
McMaster University
Pat Mirenda
Affiliation:
University of British Columbia
Stelios Georgiades
Affiliation:
McMaster University
Teresa Bennett
Affiliation:
McMaster University
Joanne Volden
Affiliation:
University of Alberta
Mayada Elsabbagh
Affiliation:
Independent Scholar
Wendy Roberts
Affiliation:
University of Toronto
Susan Bryson
Affiliation:
Autism Research Centre, Halifax
*
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: tracy.vaillancourt@uottawa.ca.

Abstract

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.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Achenbach, T. M., & Rescorla, L. A. (2000). Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
Aman, M. G., McDougle, C. J., Scahill, L., Handen, B., Arnold, L. E., Johnson, C., et al. (2009). Medication and parent training in children with pervasive developmental disorders and serious behavior problems: Results from a randomized control trail. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 11431154. doi:10.1097/CHI.0b013e3181bfd669 CrossRefGoogle Scholar
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.Google ScholarPubMed
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google ScholarPubMed
Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 5787.CrossRefGoogle Scholar
Angold, A., Costello, E. J., & Worthman, C. M. (1998). Puberty and depression: The roles of age, pubertal status and pubertal timing. Psychological Medicine, 28, 5161.CrossRefGoogle ScholarPubMed
Angold, A., Erkanli, A., Silberg, J., Eaves, L., & Costello, E. J. (2002). Depression scale scores in 8-17-year-olds: Effects of age and gender. Journal of Child Psychology and Psychiatry, 43, 10521063. doi:10.1111/1469-7610.00232 CrossRefGoogle ScholarPubMed
Ballaban-Gil, K., Rapin, I., Tuchman, R., & Shinnar, S. (1996). Longitudinal examination of the behavioral, language, and social changes in a population of adolescents and young adults with autistic disorder. Pediatric Neurology, 15, 217223. doi:10.1016/S0887-8994(96)00219-6 CrossRefGoogle Scholar
Biederman, J., Mick, E., & Faraone, S. V. (2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: Impact of remission definition and symptom type. American Journal of Psychiatry, 157, 816818. doi:10.1176/appi.ajp.157.5.816 CrossRefGoogle Scholar
Bongers, I. L., Koot, H. M., Van der Ende, J., & Verhulst, F. C. (2003). The normative development of child and adolescent problem behavior. Journal of Abnormal Psychology, 112, 179. doi:10.1037/0021-843X.112.2.179 CrossRefGoogle ScholarPubMed
Bongers, I. L., Koot, H. M., Van Der Ende, J., & Verhulst, F. C. (2004). Developmental trajectories of externalizing behaviors in childhood and adolescence. Child Development, 75, 15231537. doi:10.1111/j.1467-8624.2004.00755.x CrossRefGoogle Scholar
Boylan, K., Vaillancourt, T., & Szatmari, P. (2012). Linking oppositional behaviour trajectories to the development of depressive symptoms in childhood. Child Psychiatry & Human Development, 43, 484497. doi:10.1007/s10578-011-0277-7 CrossRefGoogle ScholarPubMed
Capaldi, D. M., & Stoolmiller, M. (1999). Co-occurrence of conduct problems and depressive symptoms in early adolescent boys: III. Prediction to young-adult adjustment. Development and Psychopathology, 11, 5984. doi:10.1017/S0954579400005605 CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2010. Atlanta, GA: US Department of Health and Human Services.Google Scholar
Cicchetti, D. (1984). The emergence of developmental psychopathology. Child Development, 55, 17. doi:10.2307/1129830 CrossRefGoogle ScholarPubMed
Cicchetti, D., & Rogosch, F. A. (1996). Equfinality and multifinality in developmental psychopathology. Development and Psychopathology, 8, 597600. doi:10.1017/S0954579400007318 CrossRefGoogle Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155159. doi:10.1037/0033-2909.112.1.155 CrossRefGoogle Scholar
Copeland, W. E., Shanahan, L., Costello, E. J., & Angold, A. (2009). Childhood and adolescent psychiatric disorders as predictors of young adult disorders. Archives of General Psychiatry, 66, 764772. doi:10.1001/archgenpsychiatry.2009.85 CrossRefGoogle ScholarPubMed
Côté, S., Vaillancourt, T., LeBlanc, J. C., Nagin, D. S., & Tremblay, R. E. (2006). The development of physical aggression from toddlerhood to pre-adolescence: A nation-wide longitudinal study of Canadian children. Journal of Abnormal Child Psychology, 34, 6882. doi:10.1007/s10802-005-9001-z CrossRefGoogle ScholarPubMed
Daniels, A. M., & Mandell, D. S. (2013). Explaining differences in age at autism spectrum disorder diagnosis: A critical review. Autism, 18, 583597. doi:10.1177/1362361313480277 CrossRefGoogle ScholarPubMed
Dearing, E., McCartney, K., & Taylor, B. A. (2006). Within-child associations between family income and externalizing and internalizing problems. Developmental Psychology, 42, 237252. doi:10.1037/0012-1649.42.2.237 CrossRefGoogle ScholarPubMed
De Giacomo, A., & Fombonne, E. (1998). Parental recognition of developmental abnormalities in autism. European Child & Adolescent Psychiatry, 7, 131136. doi:10.1007/s007870050058 CrossRefGoogle ScholarPubMed
Dekker, M. C., Ferdinand, R. F., Van Lang, N. D., Bongers, I. L., Van Der Ende, J., & Verhulst, F. C. (2007). Developmental trajectories of depressive symptoms from early childhood to late adolescence: Gender differences and adult outcome. Journal of Child Psychology and Psychiatry, 48, 657666. doi:10.1111/j.1469-7610.2007.01742.x CrossRefGoogle ScholarPubMed
Eisenberg, N., Cumberland, A., Spinrad, T. L., Fabes, R. A., Shepard, S. A., Reiser, M., et al. (2001). The relations of regulation and emotionality to children's externalizing and internalizing problem behavior. Child Development, 72, 11121134. doi:10.1111/1467-8624.00337 CrossRefGoogle ScholarPubMed
Eisenberg, N., Valiente, C., Spinrad, T. L., Cumberland, A., Liew, J., Reiser, M., et al. (2009). Longitudinal relations of children's effortful control, impulsivity, and negative emotionality to their externalizing, internalizing, and co-occurring behavior problems. Developmental Psychology, 45, 988. doi:10.1037/a0016213 CrossRefGoogle ScholarPubMed
Fanti, K. A., & Henrich, C. C. (2010). Trajectories of pure and co-occurring internalizing and externalizing problems from age 2 to age 12: Findings from the National Institute of Child Health and Human Development Study of Early Child Care. Developmental Psychology, 46, 11591175. doi:10.1037/a0020659 CrossRefGoogle ScholarPubMed
Fanti, K. A., Henrich, C. C., Brookmeyer, K. A., & Kuperminc, G. P. (2008). Toward a transactional model of parent-adolescent relationship quality and adolescent psychological adjustment. Journal of Early Adolescence, 28, 252276. doi:10.1037/a0020659 CrossRefGoogle Scholar
Galambos, N. L., Barker, E. T., & Almeida, D. M. (2003). Parents do matter: Trajectories of change in externalizing and internalizing problems in early adolescence. Child Development, 74, 578594. doi:10.1111/1467-8624.7402017 CrossRefGoogle Scholar
Gillion, M., & Shaw, D. S. (2004). Codevelopment of externalizing and internalizing problems in early childhood. Development and Psychopathology, 16, 313333. doi:10.10170S0954579404044530 Google Scholar
Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 693705.CrossRefGoogle Scholar
Gray, K., Keating, C., Taffe, J., Brereton, A., Einfeld, S., & Tonge, B. (2012). Trajectory of behavior and emotional problems in autism. American Journal on Intellectual and Developmental Disabilities, 117, 121133. doi:10.1352/1944-7588-117-2.121 CrossRefGoogle ScholarPubMed
Hunter, J., Rivero-Arias, O., Angelov, A., Kim, E., Fotheringham, I., & Leal, J. (2014). Epidemiology of fragile X syndrome: A systematic review and meta-analysis. American Journal of Genetics, 164A, 16481658. doi:10.1002/ajmg.a.36511 CrossRefGoogle Scholar
Joshi, G., Petty, C., Wozniak, J., Henin, A., Fried, R., Galdo, M., et al. (2010). The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: A large comparative study of a psychiatrically referred population. Journal of Autism and Developmental Disorders, 40, 13611370. doi:10.1007/s10803-010-0996-9 CrossRefGoogle ScholarPubMed
Keiley, M. K., Bates, J. E., Dodge, K. A., & Pettit, G. S. (2000). A cross-domain growth analysis: Externalizing and internalizing behaviors during 8 years of childhood. Journal of Abnormal Child Psychology, 28, 161179. doi:10.1023/A:1005122814723 CrossRefGoogle Scholar
Keiley, M. K., Lofthouse, N., Bates, J. E., Dodge, K. A., & Pettit, G. S. (2003). Differential risks of covarying and pure components in mother and teacher reports of externalizing and internalizing behavior across ages 5 to 14. Journal of Abnormal Child Psychology, 31, 267283. doi:10.1023/A:1023277413027 CrossRefGoogle Scholar
Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4, 117132. doi:10.1177/1362361300004002002 CrossRefGoogle Scholar
Kim, K. J., Conger, R. D., Elder, G. H. Jr., & Lorenz, F. O. (2003). Reciprocal influences between stressful life events and adolescent internalizing and externalizing problems. Child Development, 74, 127143. doi:10.1111/1467-8624.00525 CrossRefGoogle ScholarPubMed
Kovacs, M., Paulauskas, S., Gatsonis, C., & Richards, C. (1988). Depressive disorders in childhood: III. A longitudinal study of comorbidity with and risk for conduct disorders. Journal of Affective Disorders, 15, 205217. doi:10.1016/0165-0327(88)90018-3 CrossRefGoogle Scholar
Lee, E. J., & Bukowski, W. M. (2012). Co-development of internalizing and externalizing problem behaviors: Causal direction and common vulnerability. Journal of Adolescence, 35, 713729. doi:10.1016/j.adolescence.2011.10.008 CrossRefGoogle ScholarPubMed
Leve, L. D., Kim, H. K., & Pears, K. C. (2005). Childhood temperament and family environment as predictors of internalizing and externalizing trajectories from ages 5 to 17. Journal of Abnormal Child Psychology, 33, 505520. doi:10.1007/s10802-005-6734-7 CrossRefGoogle ScholarPubMed
Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36, 849861. doi:10.1007/s10803-006-0123-0 CrossRefGoogle ScholarPubMed
Lord, C., Risi, S., Lambrecht, L., Cook, E. H. Jr., Leventhal, B. L., DiLavore, P. C., et al. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205223. doi:10.1023/A:1005592401947 CrossRefGoogle ScholarPubMed
Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2002). Autism Diagnostic Observation Schedule manual. Los Angeles: WPS.Google Scholar
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism Diagnostic Interview—Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659685.CrossRefGoogle ScholarPubMed
Maggi, S., Hertzman, C., & Vaillancourt, T. (2007). Changes in smoking behaviors from late childhood to adolescence: Insights from the Canadian National Longitudinal Survey of Children and Youth. Health Psychology, 26, 232240. doi:10.1037/0278-6133.26.2.232 CrossRefGoogle ScholarPubMed
Matson, J. L., & Goldin, R. L. (2013). Comorbidity and autism: Trends, topics and future directions. Research in Autism Spectrum Disorders, 7, 12281233. doi:10.1016/j.rasd.2013.07.003 CrossRefGoogle Scholar
Mayes, S. D., & Calhoun, S. L. (2011). Impact of IQ, age, SES, gender, and race on autistic symptoms. Research in Autism Spectrum Disorders, 5, 749757. doi:10.1016/j.rasd.2010.09.002 CrossRefGoogle Scholar
Mazurek, M. O., & Kanne, S. M. (2010). Friendship and internalizing symptoms among children and adolescents with ASD. Journal of Autism and Developmental Disorders, 40, 15121520. doi:10.1007/s10803-010-1014-y CrossRefGoogle Scholar
Measelle, J. R., Stice, E., & Hogansen, J. M. (2006). Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents. Journal of Abnormal Psychology, 115, 524538. doi:10.1037/0021-843X.115.3.524 CrossRefGoogle Scholar
Merikangas, K. R., He, J. P., Brody, D., Fisher, P. W., Bourdon, K., & Koretz, D. S. (2010). Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics, 125, 7581. doi:10.1542/peds.2008-2598 CrossRefGoogle ScholarPubMed
Mesman, J., Bongers, I. L., & Koot, H. M. (2001). Preschool developmental pathways to preadolescent internalizing and externalizing problems. Journal of Child Psychology and Psychiatry, 42, 679689. doi:10.1017/S0021963001007351 CrossRefGoogle ScholarPubMed
Miner, J. L., & Clarke-Stewart, K. A. (2008). Trajectories of externalizing behavior from age 2 to age 9: Relations with gender, temperament, ethnicity, parenting, and rater. Developmental Psychology, 44, 771786. doi:10.1037/0012-1649.44.3.771 CrossRefGoogle ScholarPubMed
Muthén, K., & Muthén, B. O. (1998–2012). Mplus user's guide (7th ed.). Los Angeles: Author.Google Scholar
Nagin, D. (1999). Analyzing developmental trajectories: Semiparametric, group-based approach. Psychological Methods, 4, 139157. doi:10.1037/1082-989X.4.2.139 CrossRefGoogle Scholar
Nagin, D., & Tremblay, R. E. (1999). Trajectories of boys’ physical aggression, opposition, and hyperactivity on the path to physically violent and nonviolent juvenile delinquency. Child Development, 70, 11811196. doi:10.1111/1467-8624.00086 CrossRefGoogle ScholarPubMed
Oldehinkel, A. J., Hartman, C. A., De Winter, A. F., Veenstra, R., & Ormel, J. (2004). Temperament profiles associated with internalizing and externalizing problems in preadolescence. Development and Psychopathology, 16, 421440. doi:10.1017/S0954579404044591 CrossRefGoogle ScholarPubMed
Panak, W. F., & Garber, J. (1992). Role of aggression, rejection, and attributions in the prediction of depression in children. Development and Psychopathology, 4, 145165. doi:10.1017/S0954579400005617 CrossRefGoogle Scholar
Reiss, F. (2013). Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Social Science & Medicine, 90, 2431. doi:org/10.1016/j.socscimed.2013.04.026 CrossRefGoogle ScholarPubMed
Ritakallio, M., Koivisto, A. M., von der Pahlen, B., Pelkonen, M., Marttunen, M., & Kaltiala-Heino, R. (2008). Continuity, comorbidity and longitudinal associations between depression and antisocial behavior in middle adolescence: A 2-year prospective follow-up study. Journal of Adolescence, 31, 355370. doi:10.1016/j.adolescence.2007.06.006 CrossRefGoogle ScholarPubMed
Roeder, K., Lynch, K. G., & Nagin, D. S. (1999). Modeling uncertainty in latent class membership: A case study in criminology. Journal of the American Statistical Association, 94, 766776. doi:10.1080/01621459.1999.10474179 CrossRefGoogle Scholar
Rogers, S. J., & DiLalla, D. L. (1990). Age of symptom onset in young children with pervasive developmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 29, 863872. doi:10.1097/00004583-199011000-00004 CrossRefGoogle ScholarPubMed
Roid, G. H., & Sampers, J. (2004). Merrill–Palmer Developmental Scale—Revised manual. Wood Dale, IL: Stoelting.Google Scholar
Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Bolt, D., Kring, S., et al. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 17351747. doi:10.1007/s10803-006-0307-7 CrossRefGoogle ScholarPubMed
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 921929. doi:10.1097/CHI.0b013e318179964f CrossRefGoogle Scholar
Solomon, M., Miller, M., Taylor, S. L., Hinshaw, S. P., & Carter, C. S. (2012). Autism symptoms and internalizing psychopathology in girls and boys with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42, 4859 doi:10.1007/s10803-011-1215-z CrossRefGoogle ScholarPubMed
Sroufe, L. A. (2013). The promise of developmental psychopathology: Past and present. Development and Psychopathology, 25, 12151224. doi:10.1017/S0954579413000576 CrossRefGoogle ScholarPubMed
Sroufe, L. A., & Rutter, M. (1984). The domain of developmental psychopathology. Child Development, 55, 1729. doi:10.2307/1129832 CrossRefGoogle ScholarPubMed
Sterba, S. K., Prinstein, M. J., & Cox, M. J. (2007). Trajectories of internalizing problems across childhood: Heterogeneity, external validity, and gender differences. Development and Psychopathology, 19, 345366. doi:10.10170S0954579407070174 CrossRefGoogle ScholarPubMed
Strang, J. F., Kenworthy, L., Daniolos, P., Case, L., Wills, M. C., Martin, A., et al. (2012). Depression and anxiety symptoms in children and adolescents with autism spectrum disorders without intellectual disability. Research in Autism Spectrum Disorders, 6, 406412. doi:10.1016/j.rasd.2011.06.015 CrossRefGoogle Scholar
Sukhodolsky, D. G., Bloch, M. H., Panza, K. E., & Reichow, B. (2013). Cognitive-behavioral therapy for anxiety in children with high functioning autism: A meta-analysis. Pediatrics, 132, e1314e1350. doi:10.1542/peds.2013-1193 CrossRefGoogle Scholar
Vaillancourt, T., & Boylan, K. (2015). Behavioural and emotional disorders of childhood and adolescence. In Dozois, D. (Ed.), Abnormal psychology: Perspectives, DSM-5 update edition (5th ed.). Toronto: Pearson Education.Google Scholar
Vaillancourt, T., Brittain, H. L., McDougall, P., & Duku, E. (2013). Longitudinal links between childhood peer victimization, internalizing and externalizing problems, and academic functioning: Developmental cascades. Journal of Abnormal Child Psychology, 41, 12031215. doi:10.1007/s10802-013-9781-5 CrossRefGoogle Scholar
Vaillancourt, T., Brittain, H. L., McDougall, P., Krygsman, A., Boylan, K., Duku, E., et al. (2014). Predicting borderline personality disorder symptoms in adolescents from childhood physical and relational aggression, depression, and attention-deficit/hyperactivity disorder. Development and Psychopathology, 26, 817830. doi:10.1017/S0954579414000418 CrossRefGoogle ScholarPubMed
Wiesner, M., & Kim, H. K. (2006). Co-occurring delinquency and depressive symptoms of adolescent boys and girls: A dual trajectory modeling approach. Developmental Psychology, 42, 12201235. doi:10.1037/0012-1649.42.6.1220 CrossRefGoogle ScholarPubMed
Wing, L. (1992). Manifestations of social problems in high-functioning autistic people. In Schopler, E. & Mesibov, G. B. (Eds.), High-functioning individuals with autism (pp. 129142). New York: Springer.CrossRefGoogle Scholar
Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2003). Who are the comorbid adolescents? Agreement between psychiatric diagnosis, youth, parent, and teacher report. Journal of Abnormal Child Psychology, 31, 231245. doi:10.1023/A:1023244512119 CrossRefGoogle ScholarPubMed
29
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

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

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

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

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

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

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *