Developmental trajectories of hierarchical visuo-spatial processing in fragile X syndrome and ASD: Within- and cross-syndrome variability

Background/aims: Despite the advances in understanding visuo-spatial processing in developmental disorders such as ASD and fragile X syndrome (FXS), less is known about the profile of those with a comorbid diagnosis, or the role of within-disorder disparities between individuals across the ASD spectrum.

Methods and procedures: Using a developmental trajectory approach, we tested 5 groups of children: Typically developing, FXS, FXS + ASD, ASD individuals who had low-moderate symptoms (HFA) and ASD individuals who had severe symptoms (LFA). Symptoms of ASD were assessed using the Childhood Autism Rating Scale: CARS and hierarchical visuo-spatial processing was assessed using the Navon task.

Outcomes and results: Crucially, results differed between HFA and LFA participants. Furthermore, the pattern of results differed between those who had a diagnosis of FXS only and FXS + ASD. Poorer performance within the FXS groups and the group who are low functioning on the ASD spectrum indicated a delayed developmental rate compared to typical controls.

Conclusions and implications: This study showed that diagnosis and severity of symptoms are indicative of differences in visuo-spatial processing styles. It is important that heterogeneity within FXS and ASD populations are considered in subsequent studies and look beyond diagnostic group differences.