Co-Occurring Symptoms in a Mixed Clinical Sample of Children with Autism Spectrum Disorders

Background:  Autism spectrum disorders (ASDs) often co-occur with other psychiatric, neurologic, or medical diagnoses. Sub-syndromal problems are often neglected although these may have almost equally significant impact on the identification, treatment needs, functional status, and prognosis of children with ASD.

Objectives:  This study examined co-occurring problems as rated by parents on the Child Behavior Checklist (CBCL).

Methods:  CBCL data on clinically referred and assessed 6-16-years-old children with ASD (N=110) were compared with equivalent data from age and gender matched typically developed reference children (N=220).

Results:  Mean age of the ASD sample was 11.0 (SD 2.6) and 90 % were males. Mean CBCL total problem score was 61.1 in the ASD sample and 16.8 (SD=14.0) in the reference sample. The most prevalent co-occurring problems, and specific patterns of anxiety, OCD and "thought problems" within the ASD group will be presented and discussed. 

Conclusions:  These data highlight the need for clinicians to keep in mind the high prevalence of co-occurring problems in ASD children. Competitive symptoms or disorders may mask the core symptoms of ASD and lead to false and delayed diagnosis, and may even be the main focus in tailoring the most effective treatment program. CBCL is an excellent screening tool in that aspect, before or as an alternative to more comprehensive assessment of comorbidity.