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Aggressive Behavior Problems in Children with Autism Spectrum Disorders: Prevalence and Correlates in a Large
Alison Presmanes Hill1, Katharine E Zuckerman2, Arlene D Hagen3
1Center for Spoken Language Understanding, Department of Pediatrics, Oregon Health & Science University, 840 SW Gaines Street, Portland, OR 97239 ; Institute on Development and Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239.
Insights
Aggressive behavior problems (ABP) affect one in four children with Autism Spectrum Disorders (ASD). Comorbid sleep, internalizing, and attention issues are strongly linked to ABP, suggesting potential treatment targets.
Area of Science:
- Neurodevelopmental Disorders
- Child Psychiatry
- Behavioral Science
Background:
- Aggressive behavior problems (ABP) are common in children with Autism Spectrum Disorders (ASD) but poorly understood.
- ABP in ASD often co-occurs with other significant problems, influencing medical interventions and functioning.
Purpose of the Study:
- To determine the prevalence and correlates of ABP in a clinical sample of children with ASD.
- To investigate associations between ABP and medical interventions, behavioral functioning, and comorbid conditions in ASD.
Main Methods:
- Examined a clinical sample of 400 children with ASD aged 2-16.9 years.
- Assessed ABP using Child Behavior Checklist (CBCL) Aggressive Behavior scale scores (T-scores ≥ 70).
- Analyzed sociodemographic factors, medical interventions, cognitive functioning, ASD severity, and comorbid problems.
Main Results:
- One in four children with ASD exhibited clinically significant ABP.
- ABP was not associated with sociodemographic factors.
- ABP correlated with increased psychotropic drug and melatonin use, lower cognitive function, lower ASD severity, and higher rates of sleep, internalizing, and attention problems.
Conclusions:
- Sleep, internalizing, and attention problems are significantly associated with ABP in children with ASD.
- These comorbid conditions may serve as therapeutic targets for reducing aggressive behavior.
- Identifying high-risk profiles can aid in the proactive prevention of ABP in ASD.
Abstract:
Aggressive behavior problems (ABP) are frequent yet poorly understood in children with Autism Spectrum Disorders (ASD) and are likely to co-vary significantly with comorbid problems. We examined the prevalence and sociodemographic correlates of ABP in a clinical sample of children with ASD (N = 400; 2-16.9 years). We also investigated whether children with ABP experience more intensive medical interventions, greater impairments in behavioral functioning, and more severe comorbid problems than children with ASD who do not have ABP. One in four children with ASD had Child Behavior Checklist scores on the Aggressive Behavior scale in the clinical range (T-scores ≥ 70). Sociodemographic factors (age, gender, parent education, race, ethnicity) were unrelated to ABP status. The presence of ABP was significantly associated with increased use of psychotropic drugs and melatonin, lower cognitive functioning, lower ASD severity, and greater comorbid sleep, internalizing, and attention problems. In multivariate models, sleep, internalizing, and attention problems were most strongly associated with ABP. These comorbid problems may hold promise as targets for treatment to decrease aggressive behavior and proactively identify high-risk profiles for prevention.
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