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Autism Spectrum Disorder in Children with an Early History of Paediatric Acquired Brain Injury
Melanie Porter1, Sindella Sugden-Lingard1, Ruth Brunsdon2
1School of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia.
Insights
Early acquired brain injury (ABI) in children may be a risk factor for autism spectrum disorder (ASD). This study found a higher prevalence of ABI in children diagnosed with ASD, suggesting a need for early screening.
Area of Science:
- Neurodevelopmental disorders
- Pediatric neurology
- Brain injury research
Background:
- Autism spectrum disorder (ASD) is a neurodevelopmental condition influenced by genetic and environmental factors.
- Research on acquired brain injury (ABI) as a potential risk factor for ASD is limited.
- Understanding risk factors is crucial for early identification and intervention in ASD.
Purpose of the Study:
- To investigate the potential association between early pediatric acquired brain injury (ABI) and autism spectrum disorder (ASD).
- To determine the prevalence of ABI in children diagnosed with ASD.
- To explore diagnostic delays and comorbidities in children with both ABI and ASD.
Main Methods:
- Retrospective review of hospital records from The Brain Injury Service, Kids Rehab at The Children's Hospital at Westmead (Australia).
- Analysis of approximately 528 cases from January 2000 to January 2020.
- Identification of children with pediatric ABI who subsequently received an ASD diagnosis.
Main Results:
- 14 out of 528 children (2.7%) with pediatric ABI were diagnosed with ASD.
- The mean age at ABI for the ASD sample was 1.55 years, indicating early injury.
- ASD diagnosis was delayed by an average of 5 years compared to the general population; 100% had comorbidities, and 73% had 3+ DSM-5 diagnoses.
Conclusions:
- Early pediatric ABI may be a potential risk factor for ASD.
- Comorbidities associated with ABI may mask ASD symptoms, leading to delayed diagnosis.
- Longitudinal studies are needed to evaluate early ASD screening in children with ABI to optimize intervention.
Abstract:
Autism spectrum disorder (ASD) is a neurodevelopmental condition that arises from a combination of both genetic and environmental risk factors. There is a lack of research investigating whether early acquired brain injury (ABI) may be a risk factor for ASD. The current study comprehensively reviewed all hospital records at The Brain Injury Service, Kids Rehab at the Children's Hospital at Westmead (Australia) from January 2000 to January 2020. Of the approximately 528 cases, 14 children with paediatric ABI were subsequently given an ASD diagnosis (2.7%). For this ASD sample, the mean age at the time of the ABI was 1.55 years, indicating a high prevalence of early ABI in this diagnostic group. The mean age of ASD diagnosis was, on average, 5 years later than the average ASD diagnosis in the general population. Furthermore, 100% of children had at least one medical comorbidity and 73% had three or more co-occurring DSM-5 diagnoses. Although based on a small data set, results highlight early paediatric ABI as a potential risk factor for ASD and the potential for a delayed ASD diagnosis following early ABI, with comorbidities possibly masking symptoms. This study was limited by its exploratory case series design and small sample size. Nonetheless, this study highlights the need for longitudinal investigation into the efficacy of early screening for ASD symptomatology in children who have sustained an early ABI to maximise potential intervention.
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