Disorders of growth have been reported to be associated with autism, particularly macrocephaly and obesity. The association with tall stature has been less commonly reported.
Objectives:
To evaluate the prevalence of growth disorders amongst Jamaican children with autism and autistic spectrum disorder (ASD).
Methods:
Forty-three children age 2-8 years with autism/ASD were invited to participate. They were matched with their peers for age and gender. Informed consent was obtained. Parents and caregivers were interviewed to obtain information on demographics and socioeconomic status and the medical records were reviewed. The diagnosis of autism/ ASD was established according to DSM IV criteria, the Childhood Autism Rating Scale (CARS) and the Autism Diagnostic Observation Schedule (ADOS). The height, weight and head circumference were measured by one trained research assistant. Student’s T test was used to compare group means, Chi square analysis to evaluate categorical variables and logistic regression analysis to identify associated factors. Ethical approval was obtained.
Results:
There were 73 (84%) males; mean age 5.50 years (S.D. 1.57 years). The two groups of children, those with autism/ASD and those without autism/ASD were similar in socioeconomic status. Nineteen (44.20%) children were diagnosed with mild – moderately severe autism; 16 (37.20%) were severe. Children with autism/ ASD had significantly (P=0.04) greater heights (mean z score 0.77 S.D. 1.11) than children without autism/AS (mean z score 0.27 S.D. 1.00). Children with autism/ ASD also had significantly (P=0.02) greater weights (mean z score 0.62, S.D. 1.02) than children without autism/ASD (mean z score 0.12 S.D. 0.94). Head circumferences were also significantly larger (P=0.04) in children with ASD/ autism (mean 52.12 cm, S.D. 1.78) than children without autism/ASD (mean 51.36 cm, S.D. 1.49). The height/age was significantly lower (P= 0.04) in children with autism ages 4.1-8 years (mean z score 0.59, S.D. 1.14) than in children with autism/ASD ages 2-4 years (mean z score 1.5, S.D. 0.59).
The prevalence of tall stature (height>97th centile) was 21.90% in children with autism/ASD and 7.14% in children without autism/ASD (P=0.05). . The prevalence of overweight/obesity (body mass index >85th centile) was 41.00% in children with autism/ASD and 16.70% in children without autism/ASD (P=0.10). Macrocephaly (head circumference > 97th centile) occurred with a prevalence of 9.52% in children with autism/ASD and 4.7% in children without autism/ASD (P=0.40). There was no significant difference among subcategories of autism/ASD. Logistic regression analysis showed that when socioeconomic status was controlled for, the z score of weight for age was significantly associated with the diagnosis of autism/ASD (P=0.03, C.I. 0.01, 0.246) and the z score of height was significantly associated with age in children with autism/ASD (P=0.05, B coefficient – 1.23, C.I.0.08, 0.98)
Conclusions: Jamaican children with autism/ASD are heavier than their peers. This is similar to other reports and may be due to increased nutritional intake, decreased energy expenditure or may represent an endogenous dysregulation of growth. Height for age is greater in younger Jamaican children with autism/ASD. This may be due to accelerated linear growth in these children at an early age.
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