Assessment & Research

Neurological disorders in autism: A systematic review and meta-analysis.

Pan et al. (2021) · Autism : the international journal of research and practice 2021
★ The Verdict

Autism travels with more epilepsy, macrocephaly, and cerebral palsy—track these at every age.

✓ Read this if BCBAs doing intake or yearly reviews for autistic clients in clinic, school, or home programs.
✗ Skip if Practitioners who only serve adults with autism and no access to medical charts.

01Research in Context

01

What this study did

The team pulled 58 studies on autism and neurological problems. They ran a meta-analysis to see how often epilepsy, big heads, cerebral palsy, and other brain issues show up.

Over 5 million kids and adults with autism were counted. They compared each condition to rates in the general population.

02

What they found

Epilepsy was the clear leader: 12 out of every 100 people with autism had it. That is 20 times the usual rate.

Big heads (macrocephaly) came next at a large share. Cerebral palsy, hydrocephalus, and migraine also ran higher than normal.

03

How this fits with other research

Cederlund et al. (2014) looked only at preschoolers and found just a large share had big heads, the same as typical kids. The clash disappears when you see age matters: little kids rarely show it, older groups do.

Supekar et al. (2017) adds a time lens. They show epilepsy peaks in autistic youth and fades after adolescence, backing the meta numbers but warning rates are not flat across life.

Jennett et al. (2003) first linked big heads to a high non-verbal IQ profile. Pan et al. (2021) now pools many studies to say the head-size signal is real, just not present at age three.

04

Why it matters

Screen every client with autism for epilepsy, big heads, cerebral palsy, and migraine. Ask about seizures at each visit and measure head circumference even in teens. Track changes over years, not just at intake. These simple checks catch treatable brain issues early and guide referrals to neurology.

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Add head-circumference measurement and two epilepsy questions to your baseline checklist.

02At a glance

Intervention
not applicable
Design
systematic review
Population
autism spectrum disorder
Finding
positive

03Original abstract

Neurological disorders, such as epilepsy and cerebral palsy, have been reported to occur among individuals with autism beyond chance and may have an impact on daily living across the lifespan. Although there has been research investigating neurological disorders in autism, the findings are not always conclusive. Previous summaries of existing studies have not evaluated the full range of neurological disorders. This study aimed to comprehensively explore the neurological problems appearing in autism to provide updated information that is needed for better healthcare and support in this population. We looked at already published studies focusing on risk or frequency of neurological disorders in autism. Our results suggest that individuals with autism are more likely than the general population to have a range of neurological disorders, including epilepsy, macrocephaly, hydrocephalus, cerebral palsy, migraine/headache, and inborn abnormalities of the nervous system. In order to provide individualized healthcare and support of high quality to individuals diagnosed with autism, health care professionals and other support providers need to be attentive to neurological complications. To further improve our understanding about the link between autism and neurological disorders, future research should follow the neurological health of children who are diagnosed with or are at increased likelihood of autism.

Autism : the international journal of research and practice, 2021 · doi:10.1177/1362361320951370