Over the years, the number of children diagnosed with autism has increased dramatically. According to a research and advocacy group, Autism Speaks, the prevalence of autism has increased 20 times since 1980. This is mainly because a whole spectrum of traits are now considered to be autistic behavior, unlike in the past when social isolation and repetitive behavior alone were the main symptoms. Therefore, more children were identified with the disorder with improved criteria for diagnosis.
The term autism spectrum disorder (ASD) was coined in 2013 to denote a wide range of problems such as social challenges, problems making friends, lack of eye contact, and selective interests by the American Psychiatric Association (APA). Previously, Asperger’s Syndrome was diagnosed in people with poor communication skills. It was then summarized, along with ASD and other common developmental disorders, in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a classification of various disorders for the guidance of psychiatrists.
Due to the expansion of the spectrum to include additional symptoms, one in 54 8-year-olds was diagnosed with CDC ASD in 2016 according to the MMWR surveillance summary (Morbidity and Mortality Weekly Report). In early 2014, one in 59 8-year-olds had this neurological disorder, which affects four times more boys than girls.
Diagnosing early can help them function better later by giving them opportunities to learn socially adaptive skills. For this reason, the American Academy of Pediatrics recommends screening children as early as 18 to 24 months of age. It could be more, however, just testing how children react to objects, how they behave sensory, how they communicate non-verbally, and how they can adapt to the disorder during a screening process.
A new study finds another early warning sign of ASD and attention deficit hyperactivity disorder (ADHD) at one year of age: These children tend to need more hospital care than other children of the same age. ADHD and ASD were analyzed together because ADHD symptoms affect many children with ASD and vice versa. They have many overlapping traits in common, including the fact that they don’t deal with other people’s feelings. According to research, “one in eight children currently diagnosed with ADHD have also been diagnosed with ASD.”
What the study said
Duke University researchers have accessed health records from inpatient and outpatient visits to the Duke University Health System (DUHS). Over a 10-year period, approximately 200,400 infants born between 2006 and 2016 at the Durham, North Carolina center were screened for the number of outpatient visits with or without ASD and ADHD or both.
They identified 29,931 children who visited the medical center more than twice. Among them, children with ASD in particular showed twice the rate of hospitalizations and outpatient visits than other average children. In addition, children with ASD had a higher rate of ventilator and physical therapy treatment. They also visited the eye clinics more often than normal infants.
In the study, 29% of the patients with ASD had ADHD and 10.6% of the patients with ADHD had ASD. “Children with ADHD visit the emergency room (ED) roughly twice as often as children without ADHD. Even higher rates have been reported in patients with comorbid psychiatric illnesses,” the article recently published in the Scientific Reports Journal said.
For those who had ADHD, they had “increased chances of getting blood transfusions”. “These factors are exacerbated in children with coexisting ASD and ADHD, who have higher health costs than children with both disorders alone,” the paper added.
The take away
Once pediatricians are informed about these indications, it can lead to a faster diagnosis so that these children can lead full lives for years to come, the researchers stressed.
“We know that children with these diagnoses have more interactions with the health system after diagnosis. However, this shows that certain usage patterns begin early in these children’s lives. This could provide an opportunity to take action earlier, “senior writer Matthew Engelhard, MD, PhD and senior researcher in Duke’s Department of Psychiatry and Behavioral Sciences said in the press release.
Seema Prasad is a freelance health reporter based in Bengaluru, India. She tweeted @SeemaPrasad_me