Autism Characteristics and Behavioural Disturbances in ∼ 500 Children with Down's Syndrome in England and Wales

Abstract

Recent research shows that a significant minority of children with Down's syndrome (DS) also meet diagnostic criteria for an autism spectrum disorder (ASD). The present study investigated what proportion of children aged 6-15 years with a confirmed diagnosis of DS in England and Wales display autistic-type behaviours, and explored the characteristics of this group of children. The Social Communication Questionnaire (SCQ) was used to screen for autism characteristics and the Strengths and Difficulties Questionnaire (SDQ) to explore behavioural difficulties. The proportion of children who met the cut-off score for ASD on the SCQ (total score ≥ 15) was 37.7% (95% CI: 33.4-42.0%); for autism (total score ≥ 22) the proportion was 16.5% (95% CI: 13.2-19.8%). Children who met the cut-off for ASD were significantly more likely to be reported as having emotional symptoms, conduct problems and hyperactivity on the SDQ than children who scored well below cut-off (total score < 10). However, the profile of their autism characteristics on the SCQ was atypical compared with individuals with idiopathic ASD. The pervasiveness of ASD in children with DS in England and Wales is substantially higher than in the general population. These children also experience significantly greater behavioural problems than children with DS only. Early detection of autism characteristics is important for appropriate intervention. However, the unusual profile of autism characteristics in this group may affect the recognition of the disorder and hinder the implementation of appropriate interventions.

Prevalence of autism and attention‐deficit–hyperactivity disorder in Down syndrome: a population‐based study

“…Each item is scored ‘1=symptom present’ or ‘0=symptom absent’. A cut‐off of 15 has been found to be reliable and to discriminate accurately between groups of children with Down syndrome alone versus children with Down syndrome and ASD …”

“…In a large study from England and Wales, children with Down syndrome, aged 6 to 15 years, were assessed according to the Social Communication Questionnaire (SCQ) . The proportion of children meeting the SCQ cut‐off criteria for ASD was 37.7%.…”

“…These children experienced greater behavioural problems according to the Strengths and Difficulties Questionnaire (SDQ) than children with Down syndrome without ASD. The authors emphasized that early detection of autism characteristics is important for appropriate intervention, but the unusual profile of autism characteristics and a distinct phenotypic presentation may influence the recognition of the disorder and hinder the implementation of appropriate interventions …”

Correlates of early cognition in infants with Down syndrome

“…; Warner et al . ), attention deficit and hyperactivity disorder (Ekstein et al . ) and Alzheimer's disease (Zigman and Lott ; Lott and Dierssen ; Esbensen et al .…”

Language and Speech in Autism

“…For example, in a sample of 500 children with Down syndrome, the number of parents who reported that their children had at some time during development reversed their pronouns was nearly double the number of parents of a reference sample of autistic children (Warner et al 2014). …”