Autism Spectrum Disorder (ASD) Diagnostics: Part 2
This is Part 2 of a 5-part series about the prevalence of autism spectrum disorders and the issues commonly associated with it. It is important to be aware of these issues for best practice in treating and supporting people with the diagnosis and their families. All parts within the series are as follows:
Part 1: ASD-Early Identification
Part 2: ASD-Prevalence and Comorbid Issues (this article)
Part 3: ASD-Support (upcoming article)
Part 4: ASD-Treatment (upcoming article)
Part 5: ASD-Communicating with People Diagnosed with ASD (upcoming article)
Autism Spectrum Disorder (ASD) Prevalence
According to the Centers for Disease Control and Prevention Disabilities Monitoring (ADDM) Network, prevalence for ASD is identified in 1 in 59 children and 4 times more common in boys than girls. It is reported to occur in all racial, ethnic, and socioeconomic groups and is without a medical test or cure. Overall, it is more common than childhood cancer, juvenile diabetes, and pediatric AIDS combined.
Comorbidity Issues
Below are common issues associated with ASD which are important to be aware about when evaluating, treating, supporting, and making referrals for this population. Continued screening is necessary for several comorbidities as they can occur spontaneously throughout the lifespan of a person with autism spectrum disorder. (Note: Issues in the table below are listed alphabetically.)
Additional mental disorder (70%); 40% with 2+ disorders | Drowning leading cause of death (90-91% those under 14 years) | Obsessive-compulsive disorder (OCD) (~30% with range 1.8-81%) |
Aggressive behavior (68% toward caregiver and 49% toward non caregivers; 33% self-injurious behaviors) | Elopement: wandering/bolting (92% reported by parents) | Other mental disorders (as high as 90%) |
Anxiety (11-84%) | Epilepsy/seizures (as high as 77.5%) | Phobias (10-64%) |
ADHD (29-83%) | Food sensitivity (twice as likely) | Premature or Low Birth Weight (small percentage at greater risk) |
Auditory Disorders and Infections (87.8%) | Fragile X (2-5%) | Psychosis and psychiatric disorders (as high as 33%) |
Autoimmune Disorders (high incidence) | Gender dysphoria (more likely) | Schizophrenia (4-35% in adults) |
Behavioral issues (increase with age) and may indicate an underlying medical condition | Genetic, familial, chromosomal conditions (identical twins diagnosed 36-95%; non-identical twins 0-31%; one child with ASD then risk of another increased by 2-18%; risk increased with parent age; 10-15% with single-gene condition, chromosomal abnormality, or other genetic or chromosomal disorder | Tourette Syndrome (~6.5%) |
Bipolar disorder (6-21% in adults diagnosed with Asperger Syndrome; 10% of Asperger Syndrome relatives) | Healthcare issues (0-50% of teens with ASD receive transition services) | Sensory problems (42-88%) |
Bowel disease (up to 50% with persistent gastrointestinal tract problems) | Intellectual disability or cognitive delay (20-70%) | Tuberous sclerosis (1-4%) |
Bullied (67%) | Language disorder (33% nonverbal) | Sleep disorders (53-78%) |
Depression (2-30%) | Learning disorder/disability (25-75%) | Vision and Hearing concerns (reported by parents in the first year of life) |
Developmental differences (evident from 6 months of age with social, communication, and fine motor skills) | Mitochondrial diseases (5-80%) | Weight issues (32% of 2-5 year olds were overweight and 16% were obese) |
Developmental Coordination Disorder | Mood disorder (25%) |
|
Developmental regression with language and social interests between 1-3 years of age affects one in five with ASD
| Mortality (3-10 times higher than the general population) |
|
Comorbidity Issues
Below are common issues associated with ASD which are important to be aware about when evaluating, treating, supporting, and making referrals for this population. Continued screening is necessary for several comorbidities as they can occur spontaneously throughout the lifespan of a person with autism spectrum disorder.
REFERENCES:
-Wikipedia “Conditions Comorbid to Autism Spectrum Disorders” https://en.wikipedia.org/wiki/Conditions_comorbid_to_autism_spectrum_disorders
-Autism Spectrum Disorders and Co-Occurring Mental Health Conditions, Slides by Sydney Rice, MD, MS, University of Arizona and Erika Ryst, MD, University of Nevada
-Autism Spectrum Disorders and Comorbid Conditions by Judith Miller, PhD through the Center for Autism Research at The Children’s Hospital of Philadelphia Research Institute slides https://www.cigna.com/assets/docs/behavioral-health-series/autism/2012/autismSpectrumDisordersAndComorbidConditions.pdf
-National Institute of Neurological Disorders and Stroke Autism Spectrum Disorder Fact Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Autism-Spectrum-Disorder-Fact-Sheet
-Medical Comorbidities in Autism Spectrum Disorders: A Primer for Health Care Professionals and Policy Makers prepared by Treating Autism and Autism Treatment Trust http://nationalautismassociation.org/pdf/MedicalComorbiditiesinASD2013.pdf
-Centers for Disease Control and Prevention Data & Statistics on Autism Spectrum Disorder https://www.cdc.gov/ncbddd/autism/data.html
-Comorbid Psychopathology with Autism Spectrum Disorder in Children: An Overview by Johnny Matson and Marie Nebel-Schwalm, Louisiana State University http://www.vcuautismcenter.org/foundations/comorbidity.pdf
-Comorbidity Clusters in Autism Spectrum Disorders: An Electronic Health Record Time-Series Analysis by Finale Doshi-Velez, PhD, Yaorong Ge, PhD, and Isaac Kohane, MD, PhD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3876178/
-ADHD, Anxiety, and Autism? By Marina Sarris, Interactive Autism Network at Kennedy Krieger Institute https://iancommunity.org/ssc/autism-plus-another-diagnosis
-Autism Speaks Autism Statistics and Facts https://www.autismspeaks.org/autism-facts-and-figures
-Applied Behavior Analysis Edu.org “What is Elopement? https://www.appliedbehavioranalysisedu.org/what-is-elopement/
-Caring For Children With Autism Spectrum Disorders: A Resource Toolkit For Clinicians, 2nd Edition “Wandering Off (Elopement) http://nationalautismassociation.org/docs/AAPElopement.F0419.pdf
-Centers for Disease Control and Prevention “Disability and Safety: Information on Wandering (Elopement)” https://www.cdc.gov/ncbddd/disabilityandsafety/wandering.html
-The American Journal of Psychiatry Residents’ Journal, “Elopement in Children With Autism Spectrum Disorder” by Veeraraghaan J Iyer, MBBS, MD https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp-rj.2017.120206
-Child Mind Institute “Autism Plus Wandering” by Beth Arky https://childmind.org/article/autism-plus-wandering/
-Autism Speaks “Study Confirms: Autism Wandering Common & Scary” https://www.autismspeaks.org/news/study-confirms-autism-wandering-common-scary
-National Autism Association “Wandering” http://www.autismsafety.org/wandering.php
-“VERIFY: Are Kids With Autism Attracted To Water?” through WFMYNEWS2 https://www.wfmynews2.com/article/news/local/verify/verify-are-kids-with-autism-attracted-to-water/83-598270720
-National Autism Association “Wandering” http://nationalautismassociation.org/resources/awaare-wandering/
-National Center For Missing & exploited Children “The Issues: Autism & Wandering”
https://www.missingkids.org/theissues/autism
-“Bullying And Students on the Autism Spectrum” Indiana University Bloomington
https://www.iidc.indiana.edu/pages/bullying-and-students-on-the-autism-spectrum
-PACER’S National Bullying Prevention Center “Bullying Statistics” https://www.pacer.org/bullying/resources/stats.asp