Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Soke, Gnakub N.; Maenner, Matthew J.; Christensen, Deborah; Kurzius-Spencer, Margaret; Schieve, Laura A.

doi:10.1007/s10803-018-3521-1

Cited by 163 publications

(167 citation statements)

References 48 publications

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“…Paquet et al [] reported motor difficulties in 41% of children with ASD ( N = 34, 4–11 years, 44% with ID), Dewey et al [] reported 59% ( N = 49, 5–18 years, 10% with ID), Liu and Breslin [] reported 77% ( N = 30, 3–16 years, no ID), and Green et al [] reported 79% ( N = 101, 10–14 years, 35% with ID). While studies evaluating prevalence based on the review of clinical records have reported a lower prevalence than we identified in our standardized parent‐report measure, with Soke, Maenner, Christensen, Kurzius‐Spencer, and Schieve [] reporting motor difficulties in 24% of children aged 4 years ( N = 607, 20% with ID) and 29% aged 8 years ( N = 749, 15.6% with ID). The inconsistency between studies likely reflects varying sample sizes and age ranges, core and/or co‐occurring symptomology of samples, and method of evaluation.…”

Section: Discussionmentioning

confidence: 85%

Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population‐Based Cohort

et al. 2019

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Motor impairment is not currently included in the diagnostic criteria or evaluation of autism. This reflects the lack of large‐scale studies demonstrating its prominence to advocate for change. We examined the prevalence of motor difficulties at the time of diagnosis in a large sample of children with autism utilizing standardized assessment, and the relationship between motor difficulties, core autism symptomology, and other prominent clinical features. Vineland Adaptive Behavior Scales were administered to children from the Western Australian Register for Autism Spectrum Disorders aged ≤6 years (N = 2,084; 81.2% males, 18.8% females). Prevalence of motor difficulties was quantified based on scores from the motor domain of the Vineland and then compared to other domains of functioning within the Vineland (communication, daily living, and socialization), the DSM criteria, intellectual level, age, and gender. Scores on the Vineland indicated that 35.4% of the sample met criteria for motor difficulties (standard score <70), a rate almost as common as intellectual impairment (37.7%). Motor difficulties were reported by diagnosing clinicians in only 1.34% of cases. Motor difficulties were common in those cases meeting diagnostic criteria for impairments in nonverbal behavior and the presence of restricted and repetitive behaviors. The prevalence of motor difficulties also increased with increasing age of diagnosis (P < 0.001). Findings from the present study highlight the need for further consideration of motor difficulties as a distinct specifier within the diagnostic criteria for ASD. Autism Res 2020, 13: 298–306. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary In this population‐based cohort that included 2,084 children with autism aged ≤6 years, over one‐third met the criteria for motor difficulties, a rate almost as common as intellectual disability. This study demonstrates that motor difficulties are a prominent feature of the autism phenotype requiring further consideration in both the diagnostic criteria and evaluation of autism.

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Section: Discussionmentioning

confidence: 85%

Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population‐Based Cohort

et al. 2019

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“…Medical and psychiatric co‐occurring conditions represent a sizable burden on participants and their families [Croen et al, ; Jokiranta‐Olkoniemi et al, ; Soke, Maenner, Christensen, Kurzius‐Spencer, & Schieve, ]. Information reported was as follows: 74% with at least one co‐occurring neurodevelopmental, psychiatric, or neurological condition and 93% with at least one general medical condition.…”

Section: Discussionmentioning

confidence: 99%

Autism Heterogeneity in a Densely Sampled U.S. Population: Results From the First 1,000 Participants in the RI‐CART Study

et al. 2020

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The objective of this study was to establish a large, densely sampled, U.S. population‐based cohort of people with autism spectrum disorder (ASD). The Rhode Island Consortium for Autism Research and Treatment (RI‐CART) represents a unique public‐private‐academic collaboration involving all major points of service for families in Rhode Island affected by ASD. Diagnosis was based on direct behavioral observation via the Autism Diagnostic Observation Schedule, Second Edition. For the first 1,000 participants, ages ranged from 21 months to 64 years. Using Geographic Information System and published prevalence rates, the overall cohort is estimated to represent between 20% and 49% of pediatric age persons in Rhode Island with ASD, with demographics representative of U.S. Census. We observed a high rate of co‐occurring medical and psychiatric conditions in affected individuals. Among the most prominent findings of immediate clinical importance, we found that females received a first diagnosis of ASD at a later age than males, potentially due to more advanced language abilities in females with ASD. In summary, this is the first analysis of a large, population‐based U.S. cohort with ASD. Given the depth of sampling, the RI‐CART study reflects an important new resource for studying ASD in a representative U.S. population. Psychiatric and medical comorbidities in ASD constitute a substantial burden and warrant adequate attention as part of overall treatment. Our study also suggests that new strategies for earlier diagnosis of ASD in females may be warranted. Autism Res 2020, 13: 474–488. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary The Rhode Island Consortium for Autism Research and Treatment (RI‐CART) represents a unique public‐private‐academic collaboration involving all major points of service for families in Rhode Island affected by autism spectrum disorder (ASD). In this article, we provide results from the first 1,000 participants, estimated to represent >20% of affected families in the state. Importantly, we find a later age at first diagnosis of ASD in females, which potentially calls attention to the need for improved early diagnosis in girls. Also, we report a high rate of co‐occurring medical and psychiatric conditions in affected individuals.

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“…Despite the fact that ASD is defined by behavior, it is now recognized as being associated with a large number of co‐occurring medical conditions (COCs) beyond the core behavioral symptoms [Tye, Runicles, Whitehouse, & Alvares, ]. A recent study from the Autism and Developmental Disabilities Monitoring Network found over 95% of children with ASD to be affected by at least one COC [Soke, Maenner, Christensen, Kurzius‐Spencer, & Schieve, ]. Although the economic costs of caring for a child with ASD are already elevated compared to those for a typically developing child, these costs are further increased by the presence of COCs [Buescher, Cidav, Knapp, & Mandell, ; Horlin, Falkmer, Parsons, Albrecht, & Falkmer, ; Lavelle et al, ].…”

Section: Introductionmentioning

confidence: 99%

“…This highlights the need for timely diagnosis of COCs, which is made difficult by substantial variation in their occurrence with age. One study reported a higher prevalence of most evaluated COCs in 8‐year‐old children with ASD compared to 4‐year‐olds [Soke et al, ]. Changes in prevalence of GI symptoms and sleep problems over 2 years of follow‐up have also been observed in individuals with ASD [Mannion & Leader, ], although it is unclear whether this difference in prevalence simply results from difficulty diagnosing COCs early in life.…”

Section: Introductionmentioning

confidence: 99%

Clustering of co‐occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data

et al. 2019

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Individuals with autism spectrum disorder (ASD) are frequently affected by co-occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k-means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% (n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% (n = 870) of the cohort. Children in the third cluster, making up 49.8% (n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD.Lay Summary: Medical conditions that co-occur with autism spectrum disorder (ASD) vary significantly from person to person. This study analyzed patterns in diagnosis of co-occurring conditions from medical claims data and observed three subtypes of children with ASD. These results may aid with screening for co-occurring conditions in children with ASD and with understanding ASD subtypes.

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Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Cited by 163 publications

References 48 publications

Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population‐Based Cohort

Prevalence of Motor Difficulties in Autism Spectrum Disorder: Analysis of a Population‐Based Cohort

Autism Heterogeneity in a Densely Sampled U.S. Population: Results From the First 1,000 Participants in the RI‐CART Study

Clustering of co‐occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data

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