Autism and common co-existing medical conditions

Autism spectrum disorders (ASD) are a group of complex neurodevelopmental conditions with a diverse set of causes and outcomes. ASD is characterised by the presence of deficits in social communication and social interaction, as well as repetitive behaviours or activities and limited range of interests (1)(2).

Many medical and psychiatric conditions have been reported to be more prevalent in children and adolescents with ASD. These include (2)(3):

  • seizures
  • sleep disorders
  • allergic disorders (asthma, nasal allergies, food intolerances)
  • gastrointestinal problems (constipation, abdominal pain, bloating, diarrhoea, and/or nausea lasting three or more months)
  • nutritional deficiencies
  • diabetes and obesity
  • hormonal imbalances
  • thyroid disease
  • cardiovascular diseases
  • anxiety
  • depression
  • attention deficit hyperactivity disorder (ADHD)
co-exisiting conditions in autism

Table 1. Co-existing conditions among adults with ASD vs general population (based on Croen L., et al. 2012)

The importance of treatment

“Clinically, it is important to provide children with ASD the correct adequate treatment and support, because we know that this is essential for their further development and wellbeing. Treatment of comorbid medical conditions may result in a substantial improvement in the quality of life both of the child and their parents. What investigations should be implemented can vary both within the autism spectrum and individually.”

Isaksen, et al.,2012, ‘Children with autism spectrum disorders–the importance of medical investigations.’

Without intervention, adults with ASD have a higher risk of developing many medical conditions such as diabetes, coronary heart disease, and cancer (4). Moreover, there is an increased mortality risk in ASD which appears to be related to the presence of co-existing medical conditions, such as epilepsy, respiratory and cardiac disorders, not with ASD itself (5).

The co-existing conditions can be more difficult to recognise in children and adults with ASD due to a variety of potential reasons (6).

  • Nonverbal or intellectual disability may result in the inability to inform the carer or healthcare provider about the pain or the pain location.
  • Symptoms can be dismissed as being “a part autism”.
  • Challenging behaviours, which can be a sign of illness, can be attributed to autism due to the lack of awareness on the part of healthcare providers, teachers and parents.
  • Atypical symptoms may result in undiagnosed medical conditions.

“Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders.”

Buie, et al., 2010a, ‘Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report’.

Behaviours to look out for

The table below lists vocal and motor behaviours that may be present when there is an abdominal pain or discomfort present in children and adults with ASD (7).

Recognising, assessing and managing the co-existing medical conditions in children and adults diagnosed with ASD is crucial in order to provide those individuals with appropriate medical care. This, as a result, can have a positive impact on challenging behaviours and improve the quality of life of individuals with ASD and their families.

This article was inspired by reading a publication written by Treating Autism, ESPA Research and Autism Treatment Plus called “Medical Comorbidities in Autism Spectrum Disorder – A Primer for Healthcare Professionals and Policy Makers“.

References

  1. Isaksen J., et al. (2012). ‘Children with autism spectrum disorders–the importance of medical investigations’. European Journal of Paediatric Neurology, 2013 Jan;17(1):68-76.
  2. Croen, L., at al. (2015). ‘The health status of adults on the autism spectrum.’, University of California San Francisco.
  3. Mazurek, M., et al. (2012).Anxiety, Sensory over-responsivity, and Gastrointestinal problems in children with Autism Spectrum Disorders’. Journal of abnormal child psychology, Volume 41, Issue 1, pp 165–17.
  4. Tyler, C., et al. (2011). ‘Chronic Disease Risks in Young Adults With Autism Spectrum Disorder: Forewarned Is Forearmed’. American Journal on Intellectual and Developmental Disabilities: September 2011, Vol. 116, No. 5, pp. 371-380.
  5. Bilder, D., et al. (2013). ‘Excess Mortality and Causes of Death in Autism Spectrum Disorders: A Follow up of the 1980s Utah/UCLA Autism Epidemiologic Study’. Journal of autism and developmental disorders. 2013;43(5):1196-1204. 
  6. Willis, J. and Evans, Y. (2016). ‘Health and service provision for people with Autism Spectrum Disorder: A survey of parents in the United Kingdom, 2014’.
  7. Buie,T., et al. (2010a) . ‘Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report’. Pediatrics, 125: (Supplement 1): S1-S18.
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