Nearly 78 per cent of children with autism have at least one mental health condition and nearly half have two mental health conditions or more, according to a new U.S. study from UBC's department of psychology and the AJ Drexel Autism Institute at Drexel University (Pennsylvania).
The study also found mental health conditions present in 44.8 per cent of pre-school age children with autism. The scope of the issue among that age group had not previously been established using a large, population-based sample.
By contrast, the study found that only 14.1 per cent of youth without autism (ages 3-17) had mental health conditions.
It is the first research since 2008 to examine the prevalence of mental health conditions among children with autism at a population level, and signals a need for healthcare systems to adapt to account for the overlap.
"For a long time, mental health in kids with autism was neglected because the focus was on autism. There's much greater awareness now, but we don't have enough people trained to provide mental health treatments to kids on the autism spectrum," said Dr. Connor Kerns, an assistant professor in UBC's psychology department and lead author of the study. "We need to bridge these two systems and the different sets of providers that tend to treat these children."
Autism, or autism spectrum disorder (ASD), is a complex brain development disorder that impacts approximately 2.6 per cent of the U.S. population. People with autism can have difficulty communicating and interacting socially. They often demonstrate restricted, repetitive behaviour patterns. The term "spectrum" reflects the fact that symptoms can vary widely from one person to the next.
First look at pre-school age group reveals nearly 45% prevalence
The researchers analyzed data from the 2016 National Survey of Children's Health, a survey of more than 42,000 caregivers with a total of 1,131 ASD-diagnosed children in their care.
These children were considered to also have a mental health condition if the parent/caregiver had reported a healthcare provider diagnosing the child with any of the following:
- anxiety (39.5%)
- depression (15.7%)
- behavior/conduct problem (60.8%)
- Tourette syndrome (1.8%)
- ADHD (48.4%)
Mental health conditions became more prevalent as children with autism grew older:
| Age | 3-5 years | 6-11 years | 12-17 years |
| 1 or more mental health conditions | 44.8% | 81.4% | 85.9% |
| 2 or more mental health conditions | 12.6% | 49.7% | 61.7% |
Still, the 44.8-per-cent prevalence among pre-school children is significant because early intervention is known to increase the effectiveness of mental health treatment.
'Something specific about autism'
The study compared the prevalence of mental health conditions in children with ASD, children with intellectual disabilities, and children with other ongoing, chronic conditions that require attention from the healthcare system. Mental health conditions were significantly more prevalent among children with autism than among the other groups.
For example, anxiety was 6.3 times more prevalent among children with autism than among children with intellectual disabilities, and three times more prevalent than it was among children with other special healthcare needs.
"There's something specific about autism that is increasing this mental health burden, and it's true not only for anxiety, but also for depression, behaviour problems and attention problems. This is a special population that requires special attention," said Dr. Kerns.
The researchers hope these eye-opening new numbers will prompt changes to public policy that make it easier for mental health treatments to be approved and funded for children with autism.
"If we think about ways to screen and intervene against these mental health conditions before these children even get to school, then we might be way ahead of the game," said Dr. Kerns. "The longer mental health conditions are allowed to exist and worsen, the harder they are going to be to treat. It's much better to catch them early. Right now, we don't have a great system for doing that."
The study was published Dec. 22 in The Journal of Clinical Psychiatry.
