‘Medical Comorbidities in Autistic Spectrum Disorders’ a review prepared by British charities Treating Autism and Autism Treatment Trust, and officially launched on Autism Awareness Day, has been welcomed by medical and research professionals in UK, EU and USA. It details current research into health problems commonly experienced by people with autism, which are, however, routinely overlooked by the medical profession. It has far-reaching implications for the treatment of medical conditions existing simultaneously with autism (comorbidities).
In summary, the review shows that:
Recent large-scale studies confirm that certain medical conditions are significantly more prevalent in people with autism compared to typical populations. A detailed assessment conducted by the CDC shows that children with autism had much higher than expected rates of all of the medical conditions studied, including: eczema, allergies, asthma, ear and respiratory infections, gastrointestinal problems, severe headaches, migraines, and seizures.
Mortality is significantly increased in autism, with death rates far higher than the norm; most deaths resulting from epilepsy, gastrointestinal conditions and respiratory disorders. Deaths from gastrointestinal and respiratory disorders have been shown to be approximately 40 and 25 times higher, respectively, in moderately to severely affected patients versus typical peers.
The failure to identify and treat comorbidities is due in part to communication impairments, but widespread underdiagnosis is also the result of assumptions that aberrant behaviours and symptoms are ‘just a part of autism’. There is no evidence supporting the attribution of behaviours such as head banging, night waking, aggression and posturing to the pathophysiology of autism. Behaviours in the ASD population are often physical in origin, identifiable through investigation, and treatable or manageable through appropriate medical care.
Abnormalities found to date in ASD include, but are not confined to, neuroinflammation and immune dysregulation, abnormal gut flora, autonomic dysfunction, oxidative stress and mitochondrial dysfunction.
Accumulating scientific evidence challenges the previously held belief that autism is an in-born and unchangeable condition: numerous studies confirm that a significant percentage of previously typically-developing children regress into autism, and so far no genetic model has been proposed to account for the loss of pre-existing social skills and new emergence of health impediments. Furthermore, some children present with decreasing symptoms, or even complete recovery from autism.
Specific medical problems are associated with the severity of ASD. The severity of the medical problems experienced relates to the severity of the ASD behavioural symptoms. Successfully addressing comorbidities often leads to significant improvement in overall functioning.
Children and adults with autism have a greater need for paediatric and/or specialist services than the general population, both for their core functional deficits and concurrent medical conditions. Appropriate and individualised medical assessment must be carried out in all cases, including a documented clinical examination.
Appropriate treatment is a human right currently denied to many people with ASD in the UK. Correctly identifying and addressing medical comorbidities in autism will help reduce the immense emotional, physical and financial burden on families and carers, and is fiscally responsible to the wider society.
Dr Lorene Amet, from the Autism Treatment Trust, commented: “We have received numerous reports from parents of children with autism stating that chronic medical problems are widely overlooked by health professionals. According to these reports, symptoms are rarely investigated, but are instead often ascribed to the umbrella diagnosis of ‘autism behaviours’. In a survey carried out by our charity, more than 80% of parents felt that their concerns for their child’s health had not been thoroughly investigated.
“It is extremely worrying that the medical needs of such a vulnerable group of people are being routinely neglected. In the wake of recent health care scandals, such as the abuse at Winterbourne View, we cannot afford to be complacent about the treatment of people with learning disabilities.”
In order to raise awareness of the needless suffering caused by the neglect of treatable medical issues, the charities are making this document freely available to all medical and health care professionals involved in the care of people with autism, as well as to many policy makers and politicians.
About Treating Autism
Treating Autism is a UK charity representing nearly 1000 families affected by autism. It is run entirely by volunteer parents of children with autism.
About Autism Treatment Trust
Autism Treatment Trust is a charity which assists individuals with autism and their families to access diagnosis services and medical and educational interventions. ATT is also conducting some research in the environmental causes of autism.