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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*
University of Ottawa
John D. Haltigan
University of Ottawa
Isabel Smith
Dalhousie University
Lonnie Zwaigenbaum
University of Alberta
Peter Szatmari
University of Toronto
Eric Fombonne
Oregon Health and Science University
Charlotte Waddell
Simon Fraser University
Eric Duku
McMaster University
Pat Mirenda
University of British Columbia
Stelios Georgiades
McMaster University
Teresa Bennett
McMaster University
Joanne Volden
University of Alberta
Mayada Elsabbagh
Independent Scholar
Wendy Roberts
University of Toronto
Susan Bryson
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:


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.

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