Epilepsy among children and adolescents with autism spectrum disorders: a population-based study.

Elina and her team pulled every child with ASD from the Finnish national health registry. They matched each kid to four same-age, same-sex peers without ASD. Then they counted who had epilepsy.

They looked at the kids with ASD and 16,000 without. They also split the ASD group by IQ to see if intellectual disability changed the numbers.

Kids with ASD were four times more likely to have epilepsy than matched controls. The rate jumped even higher when ASD came with intellectual disability.

Among children with ASD plus ID, one in five also had epilepsy. For ASD without ID, the rate was one in twenty.

Busch et al. (2010) extends these numbers into adulthood. They showed that adults who carry the triple load of ID, ASD, and epilepsy have the weakest social skills of any ID group. The child prevalence data and adult outcome data line up: the same kids who are high-risk for epilepsy stay the most impaired later.

Modabbernia et al. (2016) adds a birth clue. Their meta-analysis found that babies who needed oxygen or had low Apgar scores face double the odds of later ID and ASD. Elina’s study shows that once those kids reach school age, epilepsy is a common extra burden. The papers stitch together a life-course picture: neonatal stress → neurodevelopmental diagnosis → possible epilepsy.

Némorin et al. (2025) looks at the same ASD pool but clusters kids by behavior and adaptive scores instead of medical comorbidities. Both studies agree that DSM-5 labels alone hide important subgroups; one paper sorts by seizures, the other by daily living skills.

When you get a new ASD referral, ask about epilepsy history and request a baseline EEG if the child also has ID. Track any staring spells, morning head-aches, or sudden skill loss—these kids are four-to-five times more likely to seize. Share the numbers with parents so they know why you screen hard; early seizure control protects learning and behavior gains.