Background and intelligence predict more pathology in children with autism and in their siblings

What is it about?

Children and adolescents with high-functioning autism spectrum disorder (HF-ASD) often have many other psychiatric disorders. Their siblings are also at higher risk of developing ASD themselves, but little is known about their risk of having other mental health conditions. We examined 50 children and adolescents with HF-ASD and 24 of their siblings, and we compared these with 32 children and adolescents from general population (who did not have HF-ASD) and their siblings (n=22). Our aim was to identify all mental health conditions each group had, to see if there were any differences between the groups. Our results showed that children and adolescents with HF-ASD and their siblings had more psychiatric diagnoses than participants from the general population and their siblings. Attention Deficit and Hyperactivity Disorder (ADHD) was the most common disorder found in both HF-ASD individuals and their siblings. Furthermore, anxiety disorders were more frequent in the HF-ASD group. The highest rates of additional mental health disorders were found in those HF-ASD children and adolescents with lower socioeconomic status (SES) and lower levels of intelligence (IQ). Among siblings of those with HF-ASD, those with lower IQ were more likely to have higher rates of psychiatric disorders. The higher rates of ADHD in individuals with HF-ASD and in their siblings suggest that genetics play a role. Our findings emphasize that it is important to evaluate other mental health conditions in children and adolescents with HF-ASD, especially in those with lower IQ and from disadvantaged backgrounds. Such individuals may need tailored interventions that are developed to address their specific associated symptoms. Standard assessment of individuals who have a brother or sister with ASD should include screening for ASD and additional screening for other mental health conditions.

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Why is it important?

Our findings reinforce the importance of careful screening of children with ASD for comorbidities that contribute to poor response to treatment and worse outcomes. Assessment of siblings and more attention to those from disadvantaged families is becomes principal in clinical practice and could guide prevention tasks into the community.

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