Are kids with autism at high risk for mental health conditions? Nearly 78% suffer from one, finds study
Co-occurring mental health conditions such as anxiety, attention, mood and behavior disorders are a part of this burden, but a population-based prevalence estimate has been lacking
Autism spectrum disorder (ASD) is a complex brain development disorder that is associated with significant, typically lifelong, functional impairment and public health challenges. People with autism experience co-occurring health conditions that may adversely affect their quality of life as well as the complexity and cost of their care. Co-occurring mental health conditions such as anxiety, attention, mood and behavior disorders are a part of this burden, but a population-based prevalence estimate has been lacking.
Researchers now report that 77.7% of children with autism have at least one mental health condition and nearly half or 49.1% have two mental health conditions or more. This is in contrast to 14.1% and 6.2% of youth without ASD, respectively, reveals analysis from the University of British Columbia's department of psychology and the AJ Drexel Autism Institute at Drexel University, Pennsylvania.
The team also found that mental health conditions were present in 44.8% of pre-school age children with autism. The scope of the issue among that age group had not previously been established using a large, population-based sample, say authors.
“Research suggests that mental health conditions are common and associated with significant personal and economic costs for children with ASD and their families. However, a recent, population-based estimate of the prevalence of these conditions in US children with ASD has been lacking. This study demonstrates the outsized need for mental healthcare among children on the spectrum and further is the first population-based study to illustrate that these mental health needs arise early before some children even enter school,” Dr Connor Kerns, an assistant professor in UBC’s psychology department and lead author of the study, told MEAWW.
According to Dr Kerns, while there is greater awareness now, there are not enough people trained to provide mental health treatments to children on the autism spectrum. He suggests that it is necessary to bridge these two systems and the different sets of providers that tend to treat these children.
Autism impacts approximately 2.6% of the US population. People with autism can have difficulty communicating and interacting socially. They often demonstrate restricted, repetitive behavior patterns. The term ‘spectrum’ reflects the fact that symptoms can vary widely from one person to the next.
For their analysis, the team analyzed data from the 2016 National Survey of Children’s Health, a survey of more than 42,000 caregivers with a total of 1,131 ASD-diagnosed children in their care. These children were considered to also have a mental health condition if the parent or caregiver had reported a healthcare provider diagnosing the child with anxiety (39.5%), depression (15.7%), behavior/conduct problem (60.8%), Tourette syndrome (1.8%), and attention deficit hyperactivity disorder (ADHD) (48.4%), states the report published in the Journal of Clinical Psychiatry.
“Among children (6-11 years), 81.4% had one or more mental health conditions and 49.7% had two or more. In adolescents (12-17 years), the rate of one or more mental health conditions was similar (85.9%) to that in children, but two or more mental health conditions were more prevalent (61.7%). Young children (ages 3-5) had fewer mental health conditions overall (44.8%, 1 or more; 12.6%, 2 or more),” the findings state.
While mental health conditions became more prevalent as children with autism grew older, the prevalence among pre-school children is significant because early intervention is known to increase the effectiveness of mental health treatments, emphasize investigators.
“Most of the research we have has really focused on school-aged kids and adolescents and treating mental health conditions in that population. What we’re seeing here would suggest that really we should be working harder a lot earlier to catch mental health conditions, treat them early and prevent them before kids even get to school. The longer mental health conditions are allowed to exist and worsen, the harder they are going to be to treat,” cautioned Dr Kerns.
The authors compared the prevalence of mental health conditions in children with ASD, children with intellectual disabilities, and children with other ongoing, chronic conditions that require attention from the healthcare system. Mental health conditions were significantly more prevalent among children with autism than among the other groups. For example, anxiety was 6.3 times more prevalent among children with autism than among children with intellectual disabilities, and three times more prevalent than it was among children with other special healthcare needs.
“There’s something specific about autism that is increasing this mental health burden and it’s true not only for anxiety but also for depression, behavior problems, and attention problems. This is a special population that requires special attention,” says Dr Kerns.
The team hopes that their report will prompt changes to public policy that make it easier for mental health treatments to be approved and funded for children with autism. “If we think about ways to screen and intervene against these mental health conditions before these children even get to school, then we might be way ahead of the game,” suggests Dr Kerns.