Autism Spectrum Disorder and Mental Health Problems: Patterns of Difficulties and Longitudinal Trajectories in a Population-Based Twin Sample.
Emma Colvert, Emily Simonoff, Simone J Capp and 3 others
PMID 33864558WHAT IT FOUND
Children with autism had far more emotional, behavioural and peer difficulties than their non-autistic twins or typical peers.
These problems were common, often multiple, and persisted or increased into early adolescence, rather than settling down.
Key findings
01The group with autism had significantly worse scores in all five areas of emotional and behavioural difficulty compared with both their non-autistic twins and a comparison group.
02Severity of autistic traits, whether rated by parents or by an independent observer, was the strongest factor linked to emotional and behavioural difficulties across all three groups.
03Over time, the group with autism showed significant increases in the number of children scoring above cut-off for emotional, hyperactivity and peer problems, while typical children's difficulties generally reduced.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
All mental health data came from parent report, which may miss aspects of functioning or under-estimate difficulties in non-autistic co-twins. The longitudinal analysis only included participants with data at all three time points, which resulted in the loss of some children with lower IQs, potentially biasing the trajectory findings. The sample size was too small to examine subgroups within autism, particularly by sex, despite the known differences in presentation. The study used a brief screening tool (SDQ) rather than a full diagnostic interview for psychiatric comorbidities, limiting the depth of information on specific mental health conditions.
Declared interests
The study was funded by the Medical Research Council. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that behavioural and emotional difficulties in children with autism will decrease with age. Unlike typical children, those with autism in this study showed significant increases in emotional, hyperactivity, and peer problems into early adolescence.