Mental health aspects of autistic spectrum disorders in children.
Half of school-age children with autism land in the clinical range for anxiety or ADHD—so screen for both at every intake.
01Research in Context
What this study did
The team gave parents of children with autism a common checklist. They also gave the same checklist to parents of children with the same IQ but without autism.
They wanted to see which group showed more signs of anxiety, ADHD, and other internalizing problems.
What they found
Almost half of the autism group landed in the clinical range for anxiety or ADHD. Their parents also reported higher stress than the comparison parents.
How this fits with other research
Koegel et al. (2014) looked at every past study and found the same trio—anxiety, depression, ADHD—gets most of the attention.
Hanson et al. (2013) surveyed over 1,800 children with autism. Parent-only reports gave a high ADHD rate, but adding teacher reports dropped the rate sharply. This warns us that single-checklist numbers can look scarier than they are.
McGonigle et al. (2014) showed that high ADHD symptoms in preschoolers with autism boost later signs of depression and somatic complaints. Together these papers say: expect overlap, and start screening early.
Why it matters
You already watch for social and communication goals. Add a quick anxiety and ADHD screen to every autism intake. If both parent and teacher agree on high scores, plan treatment for the combo, not just autism. This small step can catch the problems that fuel meltdowns and parent burnout before they grow.
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02At a glance
03Original abstract
BACKGROUND: Previous studies have reported variable and at times opposite findings on comorbid psychiatric problems in children with autistic spectrum disorders (ASD). AIMS: This study aimed to examine patterns of comorbid psychiatric problems in children with ASD and their parents compared with IQ matched controls and their parents. METHODS: Behavioural/emotional problems were evaluated in a sample of children with ASD [a diagnosis of ASD was given if they met criteria for ASD on both of the ADI-R (Autism Diagnostic Interview-Revised) and ADOS (Autism Diagnostic Observational Schedule)] and an age and IQ matched control group using the Child Behavior Checklist (CBCL/6-18). Parental psychological distress for both groups was evaluated with the Brief Symptom Inventory (BSI). RESULTS: There were 59 (88%) boys and 8 (12%) girls in the ASD group. Similarly, 57 (85%) of the control group were male and 10 (15%) were female. The groups did not differ significantly on mean age, mean IQ scores, gender and parents mean age. Results of the CBCL/6-18 revealed that the majority of parents reported their child with ASD as having either internalising (clinical range: 47.8%; borderline range: 16.4%) or externalising problems (clinical range: 10.4%; borderline range: 20.9%). In the control group more parents reported their children having externalising (clinical range: 46.3%; borderline range: 16.4%) than internalising problems (clinical range: 35.8%; borderline range: 11.9%). Almost a half of the ASD group met CBCL DSM criteria for clinically significant attention deficit hyperactivity disorder (44.78%) and anxiety (46.2%) problems. Based on the Brief Symptom Inventory Global Severity Index 22.4% of fathers and 23.8% of mothers of ASD children produced scores that were indicative of possible psychopathology. CONCLUSIONS: High rates of clinically significant psychiatric problems were detected in ASD children, with anxiety and attention deficit hyperactivity disorder being the most frequently detected syndromes.
Journal of intellectual disability research : JIDR, 2012 · doi:10.1111/j.1365-2788.2011.01423.x