Characteristics and Co-morbidities of Autism Spectrum Disorder as Risk Factors for Severity: A National Survey in the United States

Abstract

Abstract Background Autism spectrum disorder (ASD) consists of heterogeneous neurodevelopmental disorders with impairments in social communication, repetitive behaviors, and restricted interests. This condition is associated with several co-morbidities which significantly affect the quality of life. Therefore, individuals with ASD should undergo screening for common co-morbidities to enable early diagnosis and treatment. This study aimed to assess the prevalence and common socio-demographic characteristics of ASD as well as both medical and psychiatric co-morbidities and their effects on the severity of ASD. Methods Data from the National Survey of Children’s Health (NSCH) in the US from 2020 to 2021 were used in this study. We included 79,182 children and adolescents aged between 3 to 17 years for the analysis. The mean age of these individuals was 10.1 (standard deviation: 4.6), and 2,568 (3.2%) had ASD diagnosis. Results Our analysis showed that ASD is more common in males (78.7%) than females (21.3%). Additionally, ASD was associated with lower family income and a higher level of education in the family. We found that 96.4% of patients developed at least one co-morbid condition. The most common neuropsychiatric co-morbidities included developmental delay (64%), behavioral and conduct problems (57.8%), and anxiety (45.7%). While the most common medical co-morbidities were allergies (32.4%), genetic disorders (26.2%), and asthma (12.6%). The odds of intellectual disability (odds ratio, OR: 5.8), developmental delay (OR: 5.0), Down syndrome (OR: 4.5), epilepsy (OR: 3.4), cerebral palsy (OR: 3.0), vision problems (OR: 2.5), and genetic disorders (OR: 2.3) were significantly higher among severe cases. Conclusions The presence of numerous co-morbidities in individuals with ASD, often linked to increased ASD severity, underscores the critical importance of comprehensive screening, early diagnosis, and targeted treatment strategies to enhance the overall health and well-being of these individuals.