MONDAY, Jan. 23 (HealthDay News) -- Many children with autism
also have other developmental or psychiatric conditions, including
learning disabilities, speech delays, attention or seizure
disorders and anxiety.
According to new research, some of those co-occurring conditions
may explain why autism diagnoses often change as children get
older.
In a survey by researchers at Johns Hopkins Bloomberg School of
Public Health in Baltimore, more than one-third of parents with
children between 6 and 17 years old reported that their child's
diagnosis of autism had changed over time.
"We don't know what changed the diagnosis. However, we want to deliver the message that it's important to look at the other coexisting conditions, evaluate them before you make a diagnosis, and also recognize these conditions vary by development age," said study author Li-Ching Lee, an associate scientist in the epidemiology and mental health departments at the School of Public Health.
Autism is a neurodevelopment disorder characterized by problems
with social interaction, communication and restricted interests and
behaviors.
In the study, researchers used 2007-2008 survey data from the
parents of nearly 1,400 children aged 3 to 17 who had received a
diagnosis of an autism spectrum disorder (ASD), including autism,
Asperger disorder -- a mild form of autism, and pervasive
developmental disorder-not otherwise specified.
Parents were asked if their child currently had a diagnosis of
autism or an ASD, or had had one in the past.
Nearly 26 percent of parents of children aged 3 to 5 reported a
change in diagnosis, the researchers said. Nearly 34 percent of
parents of children aged 6 to 11 and 35 percent of the parents of
12- to 17-year-olds reported their child was diagnosed with autism
at some point but no longer was considered to have autism, the
researchers found.
Overall, children with two or more co-occurring developmental or
psychiatric conditions were five times more likely than kids with
fewer coexisting conditions to continue to have an autism
diagnosis, the researchers said.
Kids who had a moderate-to-severe learning disability were 11
times more likely to continue to have an autism diagnosis over
time, while kids with a developmental delay were nine times more
likely to retain an autism diagnosis, the study authors said.
Researchers didn't look at why certain conditions are associated
with a change in autism diagnosis. But some of the symptoms of
various development and psychiatric conditions can overlap, so it's
possible that having certain ones can lead to a misdiagnosis until
the child gets older and their issues become more clear, according
to the study.
For example, kids diagnosed with a hearing problem showed a
tendency to "lose" their autism diagnosis over time. Researchers
speculated that behaviors that initially resembled autism symptoms
-- not responding or not engaging -- were later discovered to stem
from impaired hearing.
The study is published in the February issue of
Pediatrics.
Dr. Joseph Horrigan, assistant vice president and head of
medical research for the advocacy group Autism Speaks, cautioned
not to make too much of the findings. The children weren't actually
followed over time, nor were they actually examined, a methodology
that would be the "gold standard" of research.
Because the results were based on a telephone survey, Horrigan
said, "I'd be a little cautious about over-interpreting whether
this means there's likely to be change in an autism diagnosis or a
loss of an autism diagnosis for a given individual."
Nor did researchers look at kids whose diagnosis went the other
way -- that is, they were initially not diagnosed with autism but
were later diagnosed with it.
However, the findings highlight how often kids with ASD
experience other conditions, some of which may be treatable with
medications or with educational interventions. These include
anxiety, attention-deficit hyperactivity disorder (ADHD),
depression, epilepsy and learning disabilities.
"Up until the recent past, there's been a tendency to spend most of the time and energy on the autism and the autism diagnosis, and thinking about a treatment package that's keyed directly to the autism," Horrigan said. "What's important here is they are highlighting some of the most common co-occurring disorders, a number of which are readily amenable to treatments."
An estimated one in 110 U.S. children -- many more boys than
girls -- has autism, according to the U.S. Centers for Disease
Control and Prevention.
More information
The
U.S. National Institute of Mental Health has more
on autism.