The role of intellectual disability with autism spectrum disorder and the documented cooccurring conditions: A population-based study
Corresponding Author
Semra Etyemez
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Correspondence
Semra Etyemez, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Email: [email protected]
Amy Esler, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Amy Esler
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
Correspondence
Semra Etyemez, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Email: [email protected]
Amy Esler, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Email: [email protected]
Search for more papers by this authorAniket Kini
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Search for more papers by this authorPeng-Chou Tsai
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Search for more papers by this authorMonica DiRienzo
National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
Search for more papers by this authorMatthew Maenner
National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
Search for more papers by this authorLi-Ching Lee
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
This article is dedicated to the memory of our dear colleague Li-Ching Lee who passed away on May 20, 2021.
Search for more papers by this authorCorresponding Author
Semra Etyemez
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Correspondence
Semra Etyemez, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Email: [email protected]
Amy Esler, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Email: [email protected]
Search for more papers by this authorCorresponding Author
Amy Esler
Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
Correspondence
Semra Etyemez, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Email: [email protected]
Amy Esler, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Email: [email protected]
Search for more papers by this authorAniket Kini
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Search for more papers by this authorPeng-Chou Tsai
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Search for more papers by this authorMonica DiRienzo
National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
Search for more papers by this authorMatthew Maenner
National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia, USA
Search for more papers by this authorLi-Ching Lee
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
This article is dedicated to the memory of our dear colleague Li-Ching Lee who passed away on May 20, 2021.
Search for more papers by this authorAbstract
Previous research has identified that patterns of cooccurring conditions (CoCs) associated with autism spectrum disorder (ASD) differ based on the presence of intellectual disability (ID). This study explored the association of documented CoCs among 8-year-old children with ASD and ID (ASD+ID, n = 2416) and ASD without ID (ASD-ID, n = 5372) identified by the Autism and Developmental Disabilities Monitoring Network, surveillance years (SYs) 2012 and 2014. After adjusting for demographic variables, record source, surveillance site, and SY, children with ASD+ID, as compared with children with ASD-ID, were more likely to have histories of nonspecific developmental delays and neurological disorders documented in their records but were less likely to have behavioral and psychiatric disorders. ID plays a key role on how children with ASD would experience other CoCs. Our results emphasize how understanding the pattern of CoCs in ASD+ID and ASD-ID can inform comprehensive and multidisciplinary approaches in assessment and management of children in order to develop targeted interventions to reduce possible CoCs or CoCs-related impairments.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from CDC. Restrictions apply to the availability of these data, which were used under license for this study. Data are available from the author(s) with the permission of CDC.
Supporting Information
| Filename | Description |
|---|---|
| aur2831-sup-0001-TableS1.docxWord 2007 document , 28.3 KB | TABLE S1: Associations between cooccurring conditions and intellectual disability status among children with autism spectrum disorder stratified by site |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- APA. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR ( 4th ed., text rev. ed.). American Psychiatric Association.
- APA. (2013). Diagnostic and statistical manual of mental disorders ( 5th ed.). American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596
- Autism and Developmental Disabilities Monitoring Network Surveillance Year 2002 Principal Investigators & Centers for Disease Control and Prevention. (2007). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2002. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, DC: 2002), 56(1), 12–28.
- Boyd, B. A., Baranek, G. T., Sideris, J., Poe, M. D., Watson, L. R., Patten, E., & Miller, H. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research, 3(2), 78–87. https://doi.org/10.1002/aur.124
- Cervantes, P. E., Matson, J. L., Adams, H. L., & Konst, M. J. (2014). The relationship between cognitive development and conduct problems in young children with autism spectrum disorder. Research in Autism Spectrum Disorders, 8(10), 1287–1294. https://doi.org/10.1016/j.rasd.2014.06.015
- Christensen, D. L., Braun, K. V. N., Baio, J., Bilder, D., Charles, J., Constantino, J. N., Daniels, J., Durkin, M. S., Fitzgerald, R. T., Kurzius-Spencer, M., Lee, L.-C., Pettygrove, S., Robinson, C., Schulz, E., Wells, C., Wingate, M. S., Zahorodny, W., & Yeargin-Allsopp, M. (2018). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2012. MMWR Surveillance Summaries, 65(13), 1–23. https://doi.org/10.15585/mmwr.ss6513a1
10.15585/mmwr.ss6513a1 Google Scholar
- Close, H. A., Lee, L.-C., Kaufmann, C. N., & Zimmerman, A. W. (2012). Co-occurring conditions and change in diagnosis in autism spectrum disorders. Pediatrics, 129(2), e305–e316. https://doi.org/10.1542/peds.2011-1717
- Craig, F., Lamanna, A. L., Margari, F., Matera, E., Simone, M., & Margari, L. (2015). Overlap between autism spectrum disorders and attention deficit hyperactivity disorder: Searching for distinctive/common clinical features. Autism Research, 8(3), 328–337. https://doi.org/10.1002/aur.1449
- Doshi-Velez, F., Ge, Y., & Kohane, I. (2014). Comorbidity clusters in autism spectrum disorders: An electronic health record time-series analysis. Pediatrics, 133(1), e54–e63. https://doi.org/10.1542/peds.2013-0819
- Engel-Yeger, B., Hardal-Nasser, R., & Gal, E. (2016). The relationship between sensory processing disorders and eating problems among children with intellectual developmental deficits. British Journal of Occupational Therapy, 79(1), 17–25. https://doi.org/10.1177/0308022615586418
- Esler, A. N., Sample, J., Hall-Lande, J., Harris, B., Rice, C., Poynter, J., Kirby, R. S., & Wiggins, L. (2022). Patterns of Special Education Eligibility and Age of First Autism Spectrum Disorder (ASD) Identification Among US Children with ASD. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-022-05475-5
- Estes, A. M., Dawson, G., Sterling, L., & Munson, J. (2007). Level of intellectual functioning predicts patterns of associated symptoms in school-age children with autism spectrum disorder. American Journal of Mental Retardation: AJMR, 112(6), 439–449. https://doi.org/10.1352/0895-8017(2007)112[439:loifpp]2.0.co;2
- Feliciano, P., Zhou, X., Astrovskaya, I., Turner, T. N., Wang, T., Brueggeman, L., Barnard, R., Hsieh, A., Snyder, L. G., Muzny, D. M., Sabo, A., Consortium, S. P. A. R. K., Gibbs, R. A., Eichler, E. E., O'Roak, B. J., Michaelson, J. J., Volfovsky, N., Shen, Y., & Chung, W. K. (2019). Exome sequencing of 457 autism families recruited online provides evidence for autism risk genes. NPJ Genomic Medicine, 4, 19. https://doi.org/10.1038/s41525-019-0093-8
- Flor, J., Bellando, J., Lopez, M., & Shui, A. (2017). Developmental functioning and medical co-morbidity profile of children with complex and essential autism. Autism Research, 10(8), 1344–1352. https://doi.org/10.1002/aur.1779
- Fulceri, F., Morelli, M., Santocchi, E., Cena, H., Del Bianco, T., Narzisi, A., Calderoni, S., & Muratori, F. (2016). Gastrointestinal symptoms and behavioral problems in preschoolers with autism spectrum disorder. Digestive and Liver Disease, 48(3), 248–254. https://doi.org/10.1016/j.dld.2015.11.026
- Goldin, R. L., Matson, J. L., & Cervantes, P. E. (2014). The effect of intellectual disability on the presence of comorbid symptoms in children and adolescents with autism spectrum disorder. Research in Autism Spectrum Disorders, 8(11), 1552–1556. https://doi.org/10.1016/j.rasd.2014.08.006
- Green, D., Chandler, S., Charman, T., Simonoff, E., & Baird, G. (2016). Brief report: DSM-5 sensory behaviours in children with and without an autism spectrum disorder. Journal of Autism and Developmental Disorders, 46(11), 3597–3606. https://doi.org/10.1007/s10803-016-2881-7
- Grzadzinski, R., Huerta, M., & Lord, C. (2013). DSM-5 and autism spectrum disorders (ASDs): An opportunity for identifying ASD subtypes. Molecular Autism, 4(1), 12. https://doi.org/10.1186/2040-2392-4-12
- Hill, A. P., Zuckerman, K. E., Hagen, A. D., Kriz, D. J., Duvall, S. W., van Santen, J., Nigg, J., Fair, D., & Fombonne, E. (2014). Aggressive behavior problems in children with autism spectrum disorders: Prevalence and correlates in a large clinical sample. Research in Autism Spectrum Disorders, 8(9), 1121–1133. https://doi.org/10.1016/j.rasd.2014.05.006
- Kiani, R., & Miller, H. (2010). Sensory impairment and intellectual disability. Advances in Psychiatric Treatment, 16(3), 228–235. https://doi.org/10.1192/apt.bp.108.005736
10.1192/apt.bp.108.005736 Google Scholar
- Kohane, I. S., McMurry, A., Weber, G., MacFadden, D., Rappaport, L., Kunkel, L., Bickel, J., Wattanasin, N., Spence, S., Murphy, S., & Churchill, S. (2012). The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS One, 7(4), e33224. https://doi.org/10.1371/journal.pone.0033224
- Kurzius-Spencer, M., Pettygrove, S., Christensen, D., Pedersen, A. L., Cunniff, C., Meaney, F. J., Soke, G. N., Harrington, R. A., Durkin, M., & Rice, S. (2018). Behavioral problems in children with autism spectrum disorder with and without co-occurring intellectual disability. Research in Autism Spectrum Disorders, 56, 61–71. https://doi.org/10.1016/j.rasd.2018.09.002
- Lamanna, A. L., Craig, F., Matera, E., Simone, M., Buttiglione, M., & Margari, L. (2017). Risk factors for the existence of attention deficit hyperactivity disorder symptoms in children with autism spectrum disorders. Neuropsychiatric Disease and Treatment, 13, 1559–1567. https://doi.org/10.2147/NDT.S132214
- Levy, S. E., Giarelli, E., Lee, L.-C., Schieve, L. A., Kirby, R. S., Cunniff, C., Nicholas, J., Reaven, J., & Rice, C. E. (2010). Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United States. Journal of Developmental & Behavioral Pediatrics, 31(4), 267–275. https://doi.org/10.1097/DBP.0b013e3181d5d03b
- Lundström, S., Reichenberg, A., Melke, J., Råstam, M., Kerekes, N., Lichtenstein, P., Gillberg, C., & Anckarsäter, H. (2015). Autism spectrum disorders and coexisting disorders in a nationwide Swedish twin study. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 56(6), 702–710. https://doi.org/10.1111/jcpp.12329
- Maenner, M. J., Shaw, K. A., Baio, J., Washington, A., Patrick, M., & DiRienzo, M. (2020). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2016. MMWR Surveillance Summaries, 69, 69–12. https://doi.org/10.15585/mmwr.ss6904a1
- Maenner, M. J., Shaw, K. A., Bakian, A. V., Bilder, D. A., Durkin, M. S., Esler, A., Furnier, S. M., Hallas, L., Hall-Lande, J., Hudson, A., Hughes, M. M., Patrick, M., Pierce, K., Poynter, J. N., Salinas, A., Shenouda, J., Vehorn, A., Warren, Z., Constantino, J. N., … Cogswell, M. E. (2021). Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR. Surveillance Summaries, 70(11), 1–16. https://doi.org/10.15585/mmwr.ss7011a1
- Mannion, A., & Leader, G. (2013). Comorbidity in autism spectrum disorder: A literature review. Research in Autism Spectrum Disorders, 7(12), 1595–1616. https://doi.org/10.1016/j.rasd.2013.09.006
- Matson, J. L., Rivet, T. T., Fodstad, J. C., Dempsey, T., & Boisjoli, J. A. (2009). Examination of adaptive behavior differences in adults with autism spectrum disorders and intellectual disability. Research in Developmental Disabilities, 30(6), 1317–1325. https://doi.org/10.1016/j.ridd.2009.05.008
- Mattila, M.-L., Hurtig, T., Haapsamo, H., Jussila, K., Kuusikko-Gauffin, S., Kielinen, M., Linna, S.-L., Ebeling, H., Bloigu, R., Joskitt, L., Pauls, D. L., & Moilanen, I. (2010). Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: A community- and clinic-based study. Journal of Autism and Developmental Disorders, 40(9), 1080–1093. https://doi.org/10.1007/s10803-010-0958-2
- Mayes, S. D., Calhoun, S. L., Mayes, R. D., & Molitoris, S. (2012). Autism and ADHD: Overlapping and discriminating symptoms. Research in Autism Spectrum Disorders, 6(1), 277–285. https://doi.org/10.1016/j.rasd.2011.05.009
- Mayes, S. D., Calhoun, S. L., Murray, M. J., & Zahid, J. (2011). Variables associated with anxiety and depression in children with autism. Journal of Developmental and Physical Disabilities, 23(4), 325–337. https://doi.org/10.1007/s10882-011-9231-7
- Miles, J. H., Takahashi, T. N., Hong, J., Munden, N., Flournoy, N., Braddock, S. R., Martin, R. A., Spence, M. A., Hillman, R. E., & Farmer, J. E. (2008). Development and validation of a measure of dysmorphology: Useful for autism subgroup classification. American Journal of Medical Genetics Part A, 146A(9), 1101–1116. https://doi.org/10.1002/ajmg.a.32244
- Miles, J. H., Takahashi, T. N., Bagby, S., Sahota, P. K., Vaslow, D. F., Wang, C. H., Hillman, R. E., & Farmer, J. E. (2005). Essential versus complex autism: Definition of fundamental prognostic subtypes. American Journal of Medical Genetics Part A, 135A(2), 171–180. https://doi.org/10.1002/ajmg.a.30590
- Muratori, F., Turi, M., Prosperi, M., Narzisi, A., Valeri, G., Guerrera, S., Santocchi, E., Apicella, F., Lattarulo, C., Calderoni, S., & Vicari, S. (2019). Parental perspectives on psychiatric comorbidity in preschoolers with autism Spectrum disorders receiving publicly funded mental health services. Frontiers in Psychiatry, 10, 107. https://doi.org/10.3389/fpsyt.2019.00107
- R: The R Project for Statistical Computing. (2020). https://www.r-project.org/
- Rai, D., Heuvelman, H., Dalman, C., Culpin, I., Lundberg, M., Carpenter, P., & Magnusson, C. (2018). Association between autism Spectrum disorders with or without intellectual disability and depression in young adulthood. JAMA Network Open, 1(4), e181465. https://doi.org/10.1001/jamanetworkopen.2018.1465
- Rieske, R. D., Matson, J. L., Beighley, J. S., Cervantes, P. E., Goldin, R. L., & Jang, J. (2015). Comorbid psychopathology rates in children diagnosed with autism spectrum disorders according to the DSM-IV-TR and the proposed DSM-5. Developmental Neurorehabilitation, 18(4), 218–223. https://doi.org/10.3109/17518423.2013.790519
- Salazar, F., Baird, G., Chandler, S., Tseng, E., O'sullivan, T., Howlin, P., Pickles, A., & Simonoff, E. (2015). Co-occurring psychiatric disorders in preschool and elementary school-aged children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2283–2294. https://doi.org/10.1007/s10803-015-2361-5
- Shapira, S. K., Tian, L. H., Aylsworth, A. S., Elias, E. R., Hoover-Fong, J. E., Meeks, N. J. L., Souders, M. C., Tsai, A. C.-H., Zackai, E. H., Alexander, A. A., Yeargin-Allsopp, M., & Schieve, L. A. (2019). A novel approach to dysmorphology to enhance the phenotypic classification of autism spectrum disorder in the study to explore early development. Journal of Autism and Developmental Disorders, 49(5), 2184–2202. https://doi.org/10.1007/s10803-019-03899-0
- Siegel, M. (2018). The severe end of the spectrum: Insights and opportunities from the autism inpatient collection (AIC). Journal of Autism and Developmental Disorders, 48(11), 3641–3646. https://doi.org/10.1007/s10803-018-3731-6
- Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), 921–929. https://doi.org/10.1097/CHI.0b013e318179964f
- Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. A. (2017). Brief report: Estimated prevalence of a community diagnosis of autism spectrum disorder by age 4 years in children from selected areas in the United States in 2010: Evaluation of birth cohort effects. Journal of Autism and Developmental Disorders, 47(6), 1917–1922. https://doi.org/10.1007/s10803-017-3094-4
- Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. A. (2018). Prevalence of co-occurring medical and behavioral conditions/symptoms among 4- and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. Journal of Autism and Developmental Disorders, 48(8), 2663–2676. https://doi.org/10.1007/s10803-018-3521-1
- StataCorp. (2017). Stata statistical software: Release 15. StataCorp LLC.
- Tureck, K., Matson, J. L., Cervantes, P., & Konst, M. J. (2014). An examination of the relationship between autism spectrum disorder, intellectual functioning, and comorbid symptoms in children. Research in Developmental Disabilities, 35(7), 1766–1772. https://doi.org/10.1016/j.ridd.2014.02.013
- Van Naarden Braun, K., Pettygrove, S., Daniels, J., Miller, L., Nicholas, J., Baio, J., Schieve, L., Kirby, R. S., Washington, A., Brocksen, S., Rahbar, H., Rice, C., & Centers for Disease Control and Prevention. (2007). Evaluation of a methodology for a collaborative multiple source surveillance network for autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2002. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, DC: 2002), 56(1), 29–40.
- Wu, Y.-T., Maenner, M. J., Wiggins, L. D., Rice, C. E., Bradley, C. C., Lopez, M. L., Kirby, R. S., & Lee, L.-C. (2016). Retention of autism spectrum disorder diagnosis: The role of co-occurring conditions in males and females. Research in Autism Spectrum Disorders, 25, 76–86. https://doi.org/10.1016/j.rasd.2016.02.001
Citing Literature
