Medical conditions associated with autism
A range of physical and mental-health conditions frequently accompany autism. They include, but are not limited to, the following:
- Gastrointestinal (GI) problems
- Feeding issues
- Disrupted sleep
- Attention-deficit/hyperactivity disorder (ADHD)
- Obsessive compulsive disorder (OCD)
- Bipolar Disorder
- Down syndrome (DS)
GI disorders are nearly eight times more common among children with autism than other children.
GI disorders commonly include:
- Chronic constipation
- Abdominal pain
- Gastroesophageal reflux
- Bowel inflammation
The Autism Speaks Autism Care Network (ACNet) has developed medical guidelines to help doctors recognize and manage these issues.
Epilepsy (seizure disorder) affects up to a third of people with autism. By contrast, it affects only 1 to 2 percent of the general population.
Red flags of epilepsy include:
- Unexplained staring spells
- Involuntary movements
- Unexplained confusion
- Severe headaches
Less-specific signs can include:
- Disrupted sleep
- Unexplained changes in abilities or emotions
Treatment of epilepsy is crucial to prevent brain damage. If you suspect that you or your child may have epilepsy, seek evaluation from a neurologist. Evaluation typically involves an electroencephalogram (EEG) to check for seizure-related brain activity.
- Having an Electroencephalogram (EEG): A Guide for Parents
- Having an Electroencephalogram (EEG): A Guide for Providers (caring for people with autism)
Explaining Seizures to Children with Epilepsy and Their Peers
Sometimes it can be difficult for children to understand what is happening when they are having a seizure. In addition, it can be very scary for their peers or friends who witness them. Autism Speaks has put together Visual Stories to explain to children how people with epilepsy are just like everyone else!
If a family member suffers from seizures, you may want to consider a medical alert bracelet that can inform first responders of the seizure disorder and any medications that the individual may take. There are a variety of options available on the internet.
Feeding and eating problems affect around 7 out of 10 children with autism.
These issues can include extremely restricted food habits and aversions to certain tastes and textures. Many adults with autism likewise describe food aversions and restricted eating patterns.
These challenges often stem from autism-related hypersensitivities and/or a strong need for sameness.
Chronic overeating leading to obesity is another challenge. It can stem from an inability to sense when “full” and/or eating as a soothing sensory behavior.
The eating of non-food items – is a particularly dangerous tendency often associated with autism. It appears to be most common among those severely affected by autism. See ATN/AIR-P’s Pica: A Guide for Parents.
Many autism clinics – such as those in the Autism Speaks ACNet – have specialized feeding programs staffed by behavioral therapists and nutritionists. Outside such programs, some speech, behavioral and occupational therapists can help.
Over half of children with autism – and possibly as many as four in five – have one or more chronic sleep problems.
Many adults on the spectrum likewise have difficulty falling asleep and staying asleep through the night. These sleep issues tend to worsen behavioral challenges, interfere with learning and decrease overall quality of life.
Researchers with the Autism Treatment Network have developed and tested autism-specific strategies for improving sleep:
- Strategies to Improve Sleep in Children with Autism Spectrum Disorder
- Sleep Strategies for Teens with Autism
- Melatonin and Sleep Problems in ASD: An ATN/AIR-P Guide for Parents
ADHD affects an estimated 30 to 60 percent of people with autism, versus 6 to 7 percent of the general population.
ADHD involves a persistent pattern of inattention, difficulty remembering things, trouble with managing time, organizational tasks, hyperactivity and/or impulsivity that interferes with learn and daily life.
Symptoms of ADHD can overlap with those of autism. As a result, ADHD can be difficult to distinguish in someone on the spectrum.
If you suspect that you or your child has autism and ADHD, we recommend evaluation by a specialist familiar with both conditions. If the evaluation confirms ADHD, ask your healthcare provider to help you tailor a treatment plan appropriate to you or your child’s needs.
Treatment may include behavioral strategies and in some cases medication for ADHD.
Anxiety disorders affect up to 42 percent of people with autism. By contrast, they affect an estimated 3 percent of children and 15 percent of adults in the general population.
Because people with autism may have trouble assessing and expressing how they feel, behavior often provides the best clues in those experiencing anxiety. Anxiety can trigger racing heart, muscle tightness and stomach aches, some people may event feel frozen in place.
Social anxiety – or extreme fear of new people, crowds and social situations – is especially common among people with autism. In addition, many people with autism have difficulty controlling anxiety once something triggers it.
Anxiety can be triggered at different points in time and by different activities – including some that were previously enjoyable.
Anxiety can be diagnosed by a medical professional.
Treatments include behavioral interventions including cognitive behavioral therapy programs adapted for people with autism. In some cases anti-anxiety medication may also be helpful.
- Managing anxiety in children with autism
- Easing anxiety in children with autism and limited verbal skills
Depression affects an estimated 7 percent of children and 26 percent of adults with autism. By contrast, it affects around 2 percent of children and 7 percent of adults in the general population.
Depression rates for people with autism rise with age and intellectual ability. Autism-related communication challenges can mask depression. Telltale signs can include loss of interest in once-favorite activities, a noticeable worsening in hygiene, chronic feelings of sadness, hopelessness, worthlessness and irritability. At its most serious, depression can include frequent thoughts about death and/or suicide.
If you suspect that you or your child with autism is depressed, we urge you to seek evaluation and treatment.
Treatments may include cognitive behavioral therapy and in some cases antidepressant medications.
Research suggests that OCD is more common among teens and adults with autism than it is in the general population.
However, it can be difficult to distinguish OCD symptoms from the repetitive behaviors and restricted interests that are a hallmark of autism.
If you suspect that you or your child has developed OCD in addition to autism, we encourage you to seek evaluation by a mental health provider who has experience with both conditions.
Autism and schizophrenia both involve challenges with processing language and understanding other people’s thoughts and feelings. Clear differences include schizophrenia’s psychosis which often involves hallucinations. In addition, autism’s core symptoms typically emerge between ages 1 -3 years; schizophrenia emerges in early adulthood.
Treatments: Anti-psychotic medications
People with bipolar disorder tend to alternate between a frenzied state known as mania and episodes of depression.
It is important to understand the symptoms of true bipolar disorder from those of autism by looking at when the symptoms appeared and how long they lasted. For example, a child with autism may be consistently high-energy and socially intrusive through childhood. As such, her tendency to talk to strangers and make inappropriate comments are likely part of her autism, and not a symptom of a manic mood swing.
Treatments: Some of the medications used to treat bipolar disorder can be problematic for some with autism who has difficulty recognizing and expressing feelings. A psychiatrist can provide additional medications that may be safer.
Some of these conditions are described more extensively in Autism and Health: A special report by Autism Speaks.
Research shows that about 16-18 percent of people with Down syndrome also have autism spectrum disorder (Richards et al., 2015).
When autism occurs in someone with Down syndrome, the characteristics of autism (social and behavioral challenges, communication difficulties and restricted interests) may be observed in addition to the symptoms of Down syndrome (intellectual disability, speech and language delays).
Click here to learn more about the DS-ASD diagnosis.