Screening for autism spectrum disorders in children with epilepsy: where to begin … and where to go?

Fodstad, Jill C.; Dunn, David W.

doi:10.1111/dmcn.12516

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…Specifically, numerous studies used early screening questionnaires over formal diagnostic measures, which increase the risk of false positives for ASD in individuals with epilepsy. 53 For example, Eom et al 33 reported a 54% risk of ASD using an early ASD screening measure; however, only 6% proceeded to receive a formal ASD diagnosis using later diagnostic measures. It is possible that early ASD screening measures are confounded by intellectual disability or developmental delay, which are common among individuals with epilepsy.…”

Section: Epidemiologymentioning

confidence: 99%

Prevalence and risk factors for autism spectrum disorder in epilepsy: a systematic review and meta‐analysis

Strasser

Downes

Kung

et al. 2017

Develop Med Child Neuro

124

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Critical evaluation of previous studies examining the prevalence of autism spectrum disorder (ASD) in individuals with epilepsy. A meta-analysis of 19 studies showed a pooled ASD prevalence of 6.3% in individuals with epilepsy. Studies that included a majority of individuals with intellectual disability or younger population age had a higher prevalence of autism. Risk factors reported in studies included presence of intellectual disability, sex, age, and symptomatic epilepsy origin.

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Section: Epidemiologymentioning

confidence: 99%

Prevalence and risk factors for autism spectrum disorder in epilepsy: a systematic review and meta‐analysis

Strasser

Downes

Kung

et al. 2017

Develop Med Child Neuro

124

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“…Positive screening results were associated with ASD diagnosis in only 8% of patients with a positive M-CHAT and 57% of children with a positive SCQ, but a much higher percentage (20% of all children with positive screens) warranted referral for other services such as psychiatric, psychological, or educational services [193]. The frequency of referrals for services confirms the importance of developmental screening, but the high rate of false positive screens for ASD suggests that routine screening for ASD in all children with epilepsy may not be optimal [194]. …”

Section: Asd Screening and Diagnosismentioning

confidence: 99%

Autism spectrum disorder and epilepsy: Disorders with a shared biology

Lee

Smith

Paciorkowski

2015

Epilepsy & Behavior

141

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There is an increasing recognition of clinical overlap in patients presenting with epilepsy and autism spectrum disorder (ASD), and a great deal of new information is available regarding the genetic causes of both disorders. Several biological pathways appear to be involved in both disease processes, including gene transcription regulation, cellular growth, synaptic channel function, and maintenance of synaptic structure. We review several genetic disorders where ASD and epilepsy frequently co-occur, and we discuss the screening tools available to practicing neurologists and epileptologists to help determine which patients should be referred for formal ASD diagnostic evaluation. Finally, we make recommendations regarding the workflow of genetic diagnostic testing available for children with both ASD and epilepsy.

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“…Thus, the findings in the current study indicate that young children with epilepsy are a particular high-risk group with respect to behavioural difficulties. It has previously been suggested that given the very high level of risk in this group, screening for broad -based behavioural difficulties using instruments such as SDQ is unnecessary 29 but that these children require disorder specific screening as part of comprehensive multidisciplinary assessment. Our data support this view given the very high rates of children who scored in the at-risk zone.…”

Section: Discussionmentioning

confidence: 99%

Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy

Reilly

Atkinson

Memon

et al. 2019

Seizure

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To provide data on the prevalence of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and parent reported behaviour difficulties in young children with epilepsy, and to compare results with children with neurodisability (neurodevelopmental/neurological difficulties) without epilepsy. Method: Children with epilepsy (1-7 years, n=48) and children with neurodisability (1-7 years, n=48) matched for gender, chronological and developmental age underwent psychological assessment. Parents completed measures of behaviour including the Strengths and Difficulties Questionnaire (SDQ). DSM-5 diagnoses of ASD and ADHD were made at consensus case conferences. Factors associated with child behaviour were analysed using linear regression. Results: Of the children with epilepsy, 18% met ASD criteria and 40% met ADHD criteria (corresponding figures in the non-epilepsy group were 33% and 27%). A large proportion (76%-78%) in both groups scored in the at-risk range on the SDQ and frequently had difficulties across multiple behavioural domains. Children with epilepsy had more concerns expressed regarding attention and mood. None of the epilepsy factors were significantly associated with scores on the behavioural measures. Significance: Young children with epilepsy had a very high level of parent reported behavioural difficulties and a high risk for ADHD and ASD highlighting the need for comprehensive multidisciplinary assessment. Behavioural concerns were not greater than for other children with non-epilepsy related neurodisability with the exception of attention and mood. Epilepsy related factors were not associated with child behaviour, suggesting that seizures per se do not confer a unique risk for behavioural difficulties.

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Screening for autism spectrum disorders in children with epilepsy: where to begin … and where to go?

Abstract: This commentary is on the original article by Eom et al. on pages 1110–1105 of this issue.

Cited by 4 publications

References 4 publications

Prevalence and risk factors for autism spectrum disorder in epilepsy: a systematic review and meta‐analysis

Prevalence and risk factors for autism spectrum disorder in epilepsy: a systematic review and meta‐analysis

Autism spectrum disorder and epilepsy: Disorders with a shared biology

Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy

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