Abstract
The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.
Highlights
Youth with autism spectrum disorders (ASD) are characterized by deficits in social communication and by the presence of restricted interests and repetitive behaviors (APA 2013) and frequently endorse comorbid symptoms of anxiety, depression, attention and behavior problems (e.g., Gadow et al 2005; Goldin et al 2014)
Anxiety disorders seem to be one of the most common conditions and are meta-analytically estimated to be prevalent in about 40% of youth with ASD. This prevalence rate is thought to be higher compared to typically developing children in which prevalence rates up to 27% are reported (Costello et al 2005)
Most important findings are that: (1) anxiety levels of youth with ASD are much higher compared to typically developing children; (2) anxiety levels of children with ASD seem elevated compared to clinically referred children in general; (3) the type of comparison group seems to matter in the direction that anxiety levels in youth with ASD were found to be higher compared to youth with externalizing or developmental problems, but compared to children with internalizing problems results were inconsistent for the fixed and random model; (4) as IQ increases, so does the difference in anxiety levels between ASD and typically developing children, and (5) as age increases, so does the difference in anxiety levels between ASD and clinically referred children
Summary
Youth with autism spectrum disorders (ASD) are characterized by deficits in social communication and by the presence of restricted interests and repetitive behaviors (APA 2013) and frequently endorse comorbid symptoms of anxiety, depression, attention and behavior problems (e.g., Gadow et al 2005; Goldin et al 2014). Comorbid disorders are commonly observed in youth with ASD (e.g., de Bruin et al 2007; Leyfer et al 2006; Simonoff et al 2008). Anxiety disorders seem to be one of the most common conditions and are meta-analytically estimated to be prevalent in about 40% of youth with ASD (van Steensel et al 2011). This prevalence rate is thought to be higher compared to typically developing children in which prevalence rates up to 27% are reported (Costello et al 2005). There are suggestions that youth with ASD are more prone to anxiety than youth from (some) other clinical groups (e.g., see review of MacNeil et al 2009), but, again, the size of the possible difference is unknown
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