Medical Conditions in the First Years of Life Associated with Future Diagnosis of ASD in Children

Stacey E Alexeeff,Phillip Crawford,Frances Lynch,Robert Davis,Vincent Yau,Meghan Davignon,Yinge Qian,Lisa A Croen

doi:10.1007/s10803-017-3130-4

Abstract

This study examines medical conditions diagnosed prior to the diagnosis of autism spectrum disorder (ASD). Using a matched case control design with 3911 ASD cases and 38,609 controls, we found that 38 out of 79 medical conditions were associated with increased ASD risk. Developmental delay, mental health, and neurology conditions had the strongest associations (ORs 2.0–23.3). Moderately strong associations were observed for nutrition, genetic, ear nose and throat, and sleep conditions (ORs 2.1–3.2). Using machine learning methods, we clustered children based on their medical conditions prior to ASD diagnosis and demonstrated ASD risk stratification. Our findings provide new evidence indicating that children with ASD have a disproportionate burden of certain medical conditions preceding ASD diagnosis.

Highlights

Autism spectrum disorders (ASD) are neurodevelopmental disorders defined by impaired social interaction and repetitive behaviors
Our study provides new evidence indicating that children who are diagnosed with ASD experience a higher burden of 38 medical conditions in the years preceding ASD diagnosis, including GI conditions, developmental delays, mental health disorders, musculoskeletal abnormalities, neurological conditions, and sleep disorders
Our highly-powered study found no evidence that children who are diagnosed with ASD experience a higher burden of the other 41 medical conditions in the years preceding ASD diagnosis, even though the conditions were all hypothesized to be more common in children with ASD based on previous studies

Summary

Introduction

Autism spectrum disorders (ASD) are neurodevelopmental disorders defined by impaired social interaction and repetitive behaviors. Experienced clinicians can diagnose ASD in children as young as age 2 (Charman and Baird 2002). The average age of ASD diagnosis is >3 years in the general population and even older in minority populations, suggesting that many children are not diagnosed as quickly as possible (Mandell et al 2005). Earlier diagnosis of ASD is critical because earlier treatment can reduce the degree of impairment and improve function (Lord et al 2005). A possible first step toward earlier ASD diagnosis is risk stratification of children into groups who have lower and higher risks of ASD so that higher risk children can be monitored more closely. Clinical factors that precede an ASD diagnosis and are strongly associated with risk of ASD could be immensely useful for risk stratification

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Conclusion