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Looking for subgroups in the autistic spectrum

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Subgroups within the autistic spectrum disorders may be definable on clinical, physiological, genetic, and pharmacological grounds. One possible subgroup has been suggested by a study in North Carolina (

They assessed response to the selective serotonin reuptake inhibitor, fluoxetine in 129 children aged 2–8 years with idiopathic autistic spectrum disorder. Twenty-two children (17%) had an excellent response (no longer autistic, able to participate in mainstream education though usually with special help). Sixty-seven (52%) had a good response (substantial benefit but still autistic and unable to participate in mainstream education) and 40 (31%) had a fair or poor response. Treatment response was analysed in relation to the child’s clinical features and aspects of the family history in first or second degree relatives. Three features correlated strongly with an excellent or good response to fluoxetine; family history of major affective disorder (especially bipolar disorder), family history of high achievement (usually in science, mathematics, or computer science), and hyperlexia in the child.

These researchers propose that the combination of fluoxetine responsiveness, family history of major affective disorder, family history of high achievement, and hyperlexia in the child may define a subgroup within the autistic spectrum, possibly with a distinct genetic basis.

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