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Journal of Autism and Developmental Disorders

06-01-2025 | Original Article

Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts

Auteurs: Heather E. Volk, Diogo Fortes, Rashelle Musci, Amanda Kim, Theresa M. Bastain, Carlos A. Camargo Jr, Lisa A. Croen, Dana Dabelea, Cristiane S. Duarte, Anne L. Dunlop, Kennedy Gachigi, Akhgar Ghassabian, Irva Hertz-Picciotto, Kathi C. Huddleston, Robert M. Joseph, Daniel Keating, Rachel S. Kelly, Young Shin Kim, Rebecca J. Landa, Leslie D. Leve, Kristen Lyall, Jessie B. Northrup, Thomas O’Connor, Sally Ozonoff, Anna Ross, Rebecca J. Schmidt, Julie B. Schweitzer, Lauren C. Shuffrey, Coral Shuster, Emily Vance, Scott T. Weiss, Greta Wilkening, Robert O. Wright

Gepubliceerd in: Journal of Autism and Developmental Disorders

Abstract

Purpose

Our goals were to: 1) examine the occurrence of behavioral and emotional symptoms in children on the autism spectrum in a large national sample, stratifying by sex, and 2) evaluate whether children with increased autism-related social communication deficits also experience more behavioral and emotional problems.

Methods

Participants (n = 7,998) were from 37 cohorts from the Environmental influences on Child Health Outcomes (ECHO) Program. Cross-sectional information on demographic factors, parent-report of an ASD diagnosis by clinician, Social Responsiveness Scale (SRS) scores, and Child Behavior Checklist (CBCL) scores were obtained for children aged 2.5–18 years by surveys. We examined mean differences in CBCL Total Problems and DSM-oriented subscale scores by autism diagnosis and by child sex. Analyses using logistic regression were conducted to examine whether autism was associated with higher CBCL scores. We further examined if these relationships differed by child age category (< 6 years, 6–11 years, 12 + years). The relationships between SRS score and CBCL total and subscale scores were examined using quantile regression models, with analyses adjusted for child sex and age.

Results

In ECHO, 553 youth were reported by a parent to have a clinician diagnosis of autism spectrum disorder (ASD) (432 [78%] boys and 121 [22%] girls). Youth on the spectrum had higher mean CBCL raw scores on Total Problems and all DSM-oriented subscales compared to those not on the spectrum (all p < 0.0001). Analyses adjusted for sex and stratified by age group indicated that higher odds of autism diagnosis were associated with total, depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) scales in the top 30% of the CBCL score distribution. Autistic girls were more likely to have parent-reported depression and anxiety compared to autistic boys. In quantile regression analyses, we observed evidence of stronger associations between SRS and CBCL for those in higher quantiles of CBCL total problems scale score (beta representing 1-unit change in SRS associated with 1-unit increase in CBCL total problems scale score), among children in the 70-90th percentile (β = 1.60, p < 0.01), or top 10th percentile (β = 2.43, p < 0.01) of the CBCL total problems scale score distribution. Similar findings were seen for the DSM-oriented depression, anxiety, and ADHD subscales.

Conclusion

Results from this large national sample suggest increased behavioral and emotional problems among autistic children compared to non-autistic children throughout early life. Among children on the spectrum this may warrant increased monitoring for co-occurring behavioral and emotional problems.

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Titel: Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts
Auteurs: Heather E. Volk
Diogo Fortes
Rashelle Musci
Amanda Kim
Theresa M. Bastain
Carlos A. Camargo Jr
Lisa A. Croen
Dana Dabelea
Cristiane S. Duarte
Anne L. Dunlop
Kennedy Gachigi
Akhgar Ghassabian
Irva Hertz-Picciotto
Kathi C. Huddleston
Robert M. Joseph
Daniel Keating
Rachel S. Kelly
Young Shin Kim
Rebecca J. Landa
Leslie D. Leve
Kristen Lyall
Jessie B. Northrup
Thomas O’Connor
Sally Ozonoff
Anna Ross
Rebecca J. Schmidt
Julie B. Schweitzer
Lauren C. Shuffrey
Coral Shuster
Emily Vance
Scott T. Weiss
Greta Wilkening
Robert O. Wright
Publicatiedatum: 06-01-2025
Uitgeverij: Springer US
Gepubliceerd in: Journal of Autism and Developmental Disorders
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI: https://doi.org/10.1007/s10803-024-06670-2

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Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts

Abstract

Purpose

Methods

Results

Conclusion

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