S5A-06 SESSION 5A: GENERALITIES IN CRANIOSYNOSTOSIS – PART II EXPLORING CHARACTERISTICS OF AUTISM SPECTRUM DISORDERS AND CRANIOSYNOSTOSIS. DATA FROM THE FOUR UK HIGHLY-SPECIALIST CRANIOFACIAL CENTRES

Abstract

Introduction: Autism spectrum disorders (ASDs) are lifelong neurodevelopmental disabilities affecting a person’s social communication, interests and behaviour. Often research into neurodevelopmental outcomes in craniosynostosis (CS) does not explore ASDs. However there is some evidence of increased prevalence of neurodevelopmental disorders (including ASDs) in CS. The relationship between CS and ASDs is frequently queried by families, thus research into this potential association is timely. Methods: Following previously reported findings presented by the Oxford Craniofacial Unit, data from all four UK highly specialist craniofacial centres were combined. As part of the Craniofacial Collaboration UK (CC-UK) screening protocol, parents of 227 children with radiologically confirmed single suture (71.4%), multisuture (11%) or genetically confirmed syndromic (17.6%) CS completed a 40-item ASD screening tool (Social Communication Questionnaire [SCQ]) when attending routine follow-up at age 5 or 10. Results were compared with published clinical and non-clinical sample data. Results: In the CS cohort, 15.4% of children scored in the clinically elevated SCQ range. This compares with a pooled population prevalence of 3.8% in a combined mainstream school sample. For the CS cohort, greatest difficulty was reported in the Communication (C) domain (M=3.06), then Social Interaction (S) (M=2.14) and Inflexibility (I) (M=1.65) respectively. This pattern differs from the ASD comparator sample, where greatest impairment is in S, followed by I and C respectively. A casenote review of all patients scoring in the elevated range was conducted, to ascertain the role of premature birth, history of raised ICP, suture type, and presence of genetic diagnosis. Full results will be presented. Conclusion: Identifying ASD promptly has important implications for social and education outcomes and creates the opportunity for support resources for families. In this study, the majority (84.6%) of patients with CS scored below threshold for further assessment for ASDs. However results indicate some evidence of elevated risk of scoring above screening threshold for ASDs in both non-syndromic and syndromic CS relative to population data. These scores did not follow the pattern of difficulties in the non-CS ASD cohort. Implications and limitations of the data will be discussed.