Autism Spectrum Disorder and Head Circumference in children under 5 years of age attending a public clinic in Johannesburg, South Africa

Abstract

Introduction: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that is increasing in prevalence globally. There is an emerging field of research investigating the association between head circumference and ASD but there is a marked paucity of such data from Southern Africa. Aim: To describe the head circumference (HC) measurement of children diagnosed with ASD and to investigate associations between HC, ASD severity levels and associated comorbidities. Methods: A retrospective record review of children diagnosed with ASD attending a neurodevelopmental clinic at a large public hospital in South Africa was conducted. Demographic data and HC measurements from the first clinic visit were collected. The World Health Organization data set of head circumference norms were used as the comparator reference population. Statistical analysis was conducted using parametric, descriptive and inferential methods. Results: Data from 135 children diagnosed with ASD were included. The sample population had a mean age of 43 months (range 13-61 months) and 107 (79%) were males. Thirty (22.2%) patients in the cohort had a HC which was classified as macrocephalic. Almost half (46.7%) had an ASD severity level of three and 94 (69.6%), had been diagnosed with a comorbidity. In this study no significant association was found between macrocephaly and ASD severity. Conclusions: Measuring the HC during childhood is a cost-effective, simple and non-invasive procedure that may well assist professionals in raising suspicion of ASD at an early age. Early detection and intervention could optimise participation and integration for the individual living with this life-long neurodevelopmental disability.