Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010.
G N Soke, M J Maenner, D Christensen and 2 others
PMID 29524016WHAT IT FOUND
Nearly all children with autism had at least one documented co-occurring condition.
Older children had more conditions, and several behavioral and developmental problems were more common in the older group than in the younger group.
Key findings
01Nearly all children with autism had at least one documented co-occurring condition: 98% of 8-year-olds and 96% of 4-year-olds.
02Prevalence was higher in 8-year-olds for 12 of 18 conditions, but differences were significant for only eight conditions: ADHD, oppositional defiant disorder, anxiety, aggression, language disorder, sleep abnormalities, motor disability, and mood problems.
03Children with developmental regression, cognitive disability, self-injurious behaviors or temper tantrums were first evaluated for ASD at a younger age than children without those conditions; children with ADHD, anxiety, oppositional defiant disorder or aggressive behaviors were evaluated at an older age.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The study looked at records from five sites that were not chosen to represent all children with autism in the United States. It compared different children at age 4 and age 8, not the same children over time, so it cannot show how conditions change as a child grows. Conditions were only counted if documented in available records, so missed records or later evaluations could make prevalence look lower or higher. Four-year-olds were less likely to have school records, which may hide conditions first noticed in education settings. Site differences in record access may explain some findings, and the site subgroup analysis had low power. Age at first evaluation could reflect access factors such as family income or health insurance, not only co-occurring conditions.
Declared interests
All authors declared no competing interests.
The easy way to misread this
Do not read the higher prevalence at age 8 as proof that conditions develop with age. The study compared different children at two ages using records, so better documentation and school access could explain the difference.