Age-Based Patterns of Parent-Reported Medical and Behavioral Problems in Children and Adolescents with ASD

Thursday, May 11, 2017: 5:30 PM-7:00 PM
Golden Gate Ballroom (Marriott Marquis Hotel)
A. R. Marvin1, J. K. Law2, A. R. Marvin2 and P. H. Lipkin2,3, (1)Painter Bldg 1st Fl, Kennedy Krieger Institute, Baltimore, MD, (2)Medical Informatics, Kennedy Krieger Institute, Baltimore, MD, (3)Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD

Medical and behavioral problems are common in autism spectrum disorder (ASD); however, prevalence may vary by child’s age and cognitive and verbal functioning.


To compare select medical and behavioral problems recently experienced by young children and adolescents with ASD, as reported by their parents


Parent participants in the Interactive Autism Network (IAN)— a large, validated and verified, internet-mediated parent-report research registry—completed the Birth and Diagnosis Questionnaire (BDQ) on their child(ren) with ASD. The BDQ collects baseline data relating to each child’s birth, ASD diagnosis, and development. In addition, the BDQ asks about the degree (“None”, “Mild”, “Moderate”, or “Severe”) to which the child has experienced 15 common medical/behavioral conditions associated with ASD during the past 30 days. See Table 1 for list of conditions. Parents were also asked to characterize their child’s current level of functioning, including cognitive and verbal ability. A rating of “significantly below age level” on the cognitive functioning question was used as a proxy for intellectual disability (ID). A rating of “meaningful, fluent speech” was used to determine whether the child had normal verbal ability. Respondents were grouped into young children (6 to 10) and adolescents (ages 13 to 17). Children all had a professional diagnosis of ASD and a confirmatory score on the Social Communication Questionnaire >=12. Ordered Logistic Regression was performed on responses to the 15 condition questions by age group and degree of condition severity (“None”, “Mild”, “Moderate”, or “Severe”). Control predictor variables included in the models were: Intellectual Disability; Normal Verbal Ability; Gender; Race; and Ethnicity.


Young Children (6-10 years): n=680; 80.4% male; 83.1% white; 10.3% Hispanic; mean (SD) age 8.6 (1.45) years; Adolescents (13-17 years): n=641; 81.6% male; 85.3% white; 11.2% Hispanic; mean (SD) age 15.1 (1.38) years. There was no statistical significant different in gender, race, or ethnicity.

See Table 1 for responses for each condition and the results of the Ordered Logistic Regression.

The areas of difficulty with the highest prevalence for both age-groups were: difficulty controlling emotions; irritability/aggression; hyperactively and impulsivity; anxiety; sensitivity to sounds; and sensitivity to textures/touch.

Young children experience more difficulties in: irritability/aggression; difficulty controlling emotions; self-injurious behavior; hyperactivity and impulsivity; movement/coordination; feeding; bowel movements; placing self in danger; placing others in danger; and elopement. Adolescents experienced a higher rate of depression. There was no age-related difference for: anxiety; sleep problems; sensitivity to sounds; and sensitivity to touch.

Intellectual Disability and/or abnormal verbal development were associated with 13 of the 15 factors. Gender in combination with cognitive and verbal functioning was associated with the following: depression (female + normal verbal development), anxiety (female + ID); and hyperactively and impulsivity (male + ID).


Parents of young children report more challenges for their children than reported for adolescents in behavior, coordination, GI concerns, and safety, while adolescents had greater problems with depression. Professionals should provide age-based anticipatory guidance and health and behavior surveillance for early identification and treatment of these conditions.