The Spectrum of Co-morbidities in children with ASD (Autism Spectrum Disorder): a retrospective study

Objective: To study the spectrum of co-morbidities in children with ASD Methods: This is a retrospective analysis of ASD (DSM 5 criteria) children (aged 2-18years)between January 2017 to March 2021.Total of 1872 children [1582males (84.5%) and 290 females (15.5%), median age of 5.6 + 3.3yearswith Interquartile range 5.1-8.5years] were enrolled, patients were regularly followed at an interval of 1-3months. Evaluation for symptom severity and behavioural co-morbidities were done by CARS and Autism Behaviour Checklist (ABC). Based on the co-morbidities and severity the standard form of behavioural therapy and medications were prescribed. Results: The proportion of children with co-morbidities was 80% (1499/1872) and 35% had more than one comorbidity. Attention deficit hyperactivity disorder was the most common behavioural comorbidity (57.55%), followed by disruptive behaviour (4.51%) and obsessive-compulsive disorder (1.42%). Amongst 1872 children with ASD, 62% had a psychiatric comorbidity. Amongst systemic abnormalities, neurological comorbidities were common (52.6%) and included global developmental delay/intellectual disability, sleep abnormalities, epilepsy, isolated speech/ language delay and sensory processing disorder. The mean duration of follow-up was 28.9+/-11.46 months. Post-behavioural therapy on follow-up, significant (p<0.0001) improvement in core features was observed as measured by mean CARS score. Significantly high ABC scores were observed in patients with speech/language delay, specific learning disability, sensory processing disorder, wandering and genetic disorder. Conclusion: The presence of comorbidities seen in 80% of the patients did not affect the severity of ASD. Post-therapy, significant improvement in their functional outcome was observed. A holistic scrupulous approach is necessary for best outcome.