Associated medical disorders and disabilities in children with autistic disorder: a population-based study

Kielinen M, Rantala H, Timonen E, Linna SL, Moilanen I

Autism 2004; 8(1): 39-48

Question: In a Finnish population, what percentage of children with a diagnosis of autistic disorder had other medical conditions?

Background: Children with autistic disorder often have other medical conditions that can complicate their daily living and future functioning. This is a study conducted in Finland that looked at the rates of medical conditions in children and adolescents with a diagnosis of autistic disorder.

Participants: Out of a total population of 152,732 children and adolescents under the age of 16 years (as of Census Day on December 31, 1996), 187 children with a diagnosis of autistic disorder based on DSM-IV criteria were identified and included in the study. Children with Asperger disorder, Rett syndrome, and childhood disintegrative disorder were excluded.

Setting: The University Hospital of Oulu, Finland.

Methods: Records were retrieved from the University Hospital and from the main centres for the intellectually disabled. The data were collected in 1996 to 1997. Diagnosis had to have been made based on DSM-IV criteria. Individual patients had their diagnosis reevaluated at the time of the study. Other medical conditions were noted at the time of the records search.

Main Results: Of the 187 children, 19% had more than one medical condition. The rates at which the medical disorders were found in this population were as follows:

• 12.3% had a condition with known or suspected genetic origin
• 18.2% had a form of seizure disorder
• 13.4% had an impaired ability to walk
• 8.6% had hearing impairment with 1.6% having severe hearing loss
• 7.5% had an associated neurological disorder
• 4.3% had cerebral palsy
• 3.7% were blind
• 3.2% had hydrocephalus, an excessive accumulation of the fluid covering the brain and spinal cord
• 1.1% had fetal alcohol syndrome

Conclusions: This study showed that a significant number of children and adolescents diagnosed with ASD also had other medical conditions, rates that were much higher than would be seen in the general population. The findings are consistent with other studies. The authors caution that their methods likely failed to detect all of the children and adolescents in the study area with autistic disorder and associated medical conditions, so the rates could be higher than what they found.