Impact of multiple co‐occurring emotional and behavioural conditions on children with autism and their families

Dovgan, Kristen; Mazurek, Micah O.

doi:10.1111/jar.12590

Cited by 18 publications

(13 citation statements)

References 62 publications

(76 reference statements)

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“…ID was defined by an IQ score below 70 in all studies. Prevalence of ID in ASD children ranged from 0.00% in children aged 3–4y ( 35 ) to 91.70% in female ASD aged 0-18y ( Figure 9 and Supplementary Material 6 ) ( 49 ). Prevalence of ID in Dovgan and Mazurek ( 49 ) was estimated based on telephone surveys aimed at parents of children with ASD and asked the following question: ‘have “a doctor or other health care provider ever told [him/her] that [the child] had” other specific co-occurring conditions?’.…”

Section: Resultsmentioning

confidence: 99%

“…Prevalence of ID in ASD children ranged from 0.00% in children aged 3–4y ( 35 ) to 91.70% in female ASD aged 0-18y ( Figure 9 and Supplementary Material 6 ) ( 49 ). Prevalence of ID in Dovgan and Mazurek ( 49 ) was estimated based on telephone surveys aimed at parents of children with ASD and asked the following question: ‘have “a doctor or other health care provider ever told [him/her] that [the child] had” other specific co-occurring conditions?’. The study population was stratified by the number of co-morbidities, and the prevalence of 91.7% corresponded to the subpopulation of children who had ASD associated with three co-morbidities.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review

Bougeard¹,

et al. 2021

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Objective: Individuals with autism spectrum disorder often present somatic and/or psychiatric co-morbid disorders. The DSM-5 allows for consideration of additional diagnoses besides ASD and may have impacted the prevalence of co-morbidities as well as being limited in capturing the true differences in prevalence observed between males and females. We describe the prevalence of ASD and frequently observed co-morbidities in children and adolescents (<18 years) in the United States and five European countries.Methods: Two systematic literature reviews were conducted in PubMed and Embase for the period 2014–2019 and focusing on the prevalence of ASD and nine co-morbidities of interest based on their frequency and/or severity: Attention Deficit Hyperactivity Disorder (ADHD), anxiety, depressive disorders, epilepsy, intellectual disability (ID), sleep disorders, sight/hearing impairment/loss, and gastro-intestinal syndromes (GI).Results: Thirteen studies on prevalence of ASD and 33 on prevalence of co-morbidities were included. Prevalence of ASD was 1.70 and 1.85% in US children aged 4 and 8 years respectively, while prevalence in Europe ranged between 0.38 and 1.55%. Additionally, current evidence is supportive of a global increase in ASD prevalence over the past years. Substantial heterogeneity in prevalence of co-morbidities was observed: ADHD (0.00–86.00%), anxiety (0.00–82.20%), depressive disorders (0.00–74.80%), epilepsy (2.80–77.50%), ID (0.00–91.70%), sleep disorders (2.08–72.50%), sight/hearing impairment/loss (0.00–14.90%/0.00–4.90%), and GI syndromes (0.00–67.80%). Studies were heterogeneous in terms of design and method to estimate prevalence. Gender appears to represent a risk factor for co-morbid ADHD (higher in males) and epilepsy/seizure (higher in females) while age is also associated with ADHD and anxiety (increasing until adolescence).Conclusion: Our results provide a descriptive review of the prevalence of ASD and its co-morbidities in children and adolescents. These insights can be valuable for clinicians and parents/guardians of autistic children. Prevalence of ASD has increased over time while co-morbidities bring additional heterogeneity to the clinical presentation, which further advocates for personalized approaches to treatment and support. Having a clear understanding of the prevalence of ASD and its co-morbidities is important to raise awareness among stakeholders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review

Bougeard¹,

et al. 2021

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“…However, relatively little attention in the subgrouping literature has been given to co-occurring psychiatric symptoms, which have been recognized as an area of importance (Lombardo et al, 2019). The few studies that have considered co-occurring psychiatric symptoms when subgrouping samples of autistic children are limited in that they either focused on older, school-aged children (≥ 15 years) and aggregated all psychiatric symptoms into a single large category (Doshi-Velez et al, 2014) or focused on younger, preschool-aged children and kept psychiatric symptoms separated, even though multiple, co-occurring conditions are more common in older children (Wiggins et al, 2017;Dovgan & Mazurek, 2019;Nordahl et al, 2020). Additionally, all these studies included other child-level indicator variables (e.g., adaptive functioning, cognitive development) in their models along with psychiatric symptoms.…”

Section: Introductionmentioning

confidence: 99%

Subgrouping School-Aged Children on the Autism Spectrum Based on Co-Occurring Psychiatric Symptoms

Piergies¹,

Hirota²,

Monden

et al. 2021

Preprint

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Background: Symptom heterogeneity within autism spectrum disorder (ASD) is compounded by co-occurring psychopathology. Considering that some psychiatric disorders present together more often than others, deriving subgroups of individuals with ASD based on co-occurring psychopathology could better our understanding of symptom patterns existing within this population. This study's purpose was to derive subgroups of school-aged children with ASD based on co-occurring psychopathology while controlling for age and sex and to examine correlates of subgroup membership. Method: Six latent class models were estimated with a sample from the Simons Simplex Collection (n = 2,092), using dichotomized categories (borderline/clinical versus normal range) from five of the DSM-Oriented Scales of the Child Behavior Checklist for Ages 6 to 18 as indicator variables. We evaluated the predictive value of intellectual disability and three groups of medical conditions (allergies/autoimmune disorders, gastrointestinal disorders, and neurological disorders) on subgroup membership using multinomial logistic regression. Results: Four subgroups emerged based on the combined presence/absence of psychiatric symptoms: "Low Psychopathology," "Externalizing Problems," "Internalizing Problems," and "High Psychopathology." Gastrointestinal disorders, the strongest predictor, was associated with increased odds of belonging to the "Externalizing Problems," "Internalizing Problems," and "High Psychopathology" subgroups over the "Low Psychopathology" subgroup, whereas intellectual disability was associated with decreased odds. Neurological disorders was also associated with increased odds of belonging to the "Internalizing Problems" and "High Psychopathology" subgroups. Conclusion: Patterns of psychopathology exist within school-aged children with ASD and are correlated with intellectual disability as well as specific medical conditions, providing guidance for clinical practice and etiology-driven research.

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“…Co-occurring social-emotional and behavioural problems are common in autistic children (Dovgan & Mazurek, 2019; Totsika et al, 2011). In one group of school-aged autistic children (Mage = 10.91 years, standard deviation (SD) = 3.34), Hoffmann et al (2016) found clinically significant internalising and externalising behaviours in 70.8% and 41.5% of children, respectively.…”

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confidence: 99%

Relative predictive utility of the original and Autism-Specific Five-Minute Speech Samples for child behaviour problems in autistic preschoolers: A preliminary study

Smith

Sulek

Green

et al. 2021

Autism

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Many autistic children have co-occurring behavioural problems influencing core autism symptomology potentially relevant for intervention planning. Parental Expressed Emotion – reflecting critical, hostile and overprotective comments – contributes to understanding and predicting behaviour in autistic school-aged children, adolescents and adults and is typically measured using the Five-Minute Speech Sample. However, limitations exist for its use with parents of younger autistic children and so the Autism-Specific Five-Minute Speech Sample was adapted with the goal of better measuring parent Expressed Emotion in the context of childhood autism. The Autism-Specific Five-Minute Speech Sample has not yet been used to explore Expressed Emotion in parents of autistic preschoolers, nor has the relative predictive utility of the Autism-Specific Five-Minute Speech Sample and Five-Minute Speech Sample been evaluated in the same sample. We compared the two measures from speech samples provided by 51 Australian parents with newly diagnosed autistic preschoolers, including investigating their predictive value for concurrent and subsequent child internalising and externalising behaviour problems. While Autism-Specific Five-Minute Speech Sample Expressed Emotion and Five-Minute Speech Sample Expressed Emotion were associated in this sample, only Autism-Specific Five-Minute Speech Sample codes contributed significant predictive value for concurrent and subsequent child problem behaviour. These preliminary data strengthen the position that the Autism-Specific Five-Minute Speech Sample may better capture Expressed Emotion, than the Five-Minute Speech Sample, among parents of autistic preschool-aged children. Lay abstract Parental Expressed Emotion refers to the intensity and nature of emotion shown when a parent talks about their child, and has been linked to child behaviour outcomes. Parental Expressed Emotion has typically been measured using the Five-Minute Speech Sample; however, the Autism-Specific Five-Minute Speech Sample was developed to better capture Expressed Emotion for parents of children on the autism spectrum. In each case, parents are asked to talk for 5 min about their child and how they get along with their child. Parents’ statements are then coded for features such as number of positive and critical comments, or statements reflecting strong emotional involvement. While both the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample have been used with parents of autistic school-aged children, their relative usefulness for measuring Expressed Emotion in parents of preschool-aged children – including their links to child behaviour problems in this group – is unclear. We collected speech samples from 51 parents of newly diagnosed autistic preschoolers to investigate similarities and differences in results from the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample coding schemes. This included exploring the extent to which the Five-Minute Speech Sample and Autism-Specific Five-Minute Speech Sample, separately, or together, predicted current and future child behaviour problems. While the two measures were related, we found only the Autism-Specific Five-Minute Speech Sample – but not the Five-Minute Speech Sample – was related to child behavioural challenges. This adds support to the suggestion that the Autism-Specific Five-Minute Speech Sample may be a more useful measure of parental Expressed Emotion in this group, and provides a first step towards understanding how autistic children might be better supported by targeting parental Expressed Emotion.

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Impact of multiple co‐occurring emotional and behavioural conditions on children with autism and their families

Cited by 18 publications

References 62 publications

Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review

Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review

Subgrouping School-Aged Children on the Autism Spectrum Based on Co-Occurring Psychiatric Symptoms

Relative predictive utility of the original and Autism-Specific Five-Minute Speech Samples for child behaviour problems in autistic preschoolers: A preliminary study

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