Journal article
Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts
Journal of autism and developmental disorders, 101613
06 Jan 2025
PMID: 39762643
Featured in Collection : UN Sustainable Development Goals @ Drexel
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 (beta = 1.60, p < 0.01), or top 10th percentile (beta = 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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Details
- Title
- Co-occurring Psychopathology in Children With and Without Autism Spectrum Disorder (ASD): Differences by Sex in the ECHO Cohorts
- Creators
- Heather E. Volk - Johns Hopkins UniversityDiogo Fortes - Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, 624 N Broadway,HH811, Baltimore, MD 20215 USARashelle Musci - Johns Hopkins UniversityAmanda Kim - Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, 624 N Broadway,HH811, Baltimore, MD 20215 USATheresa M. Bastain - University of North Carolina at Chapel HillCarlos A. Camargo - Massachusetts General HospitalLisa A. Croen - Kaiser PermanenteDana Dabelea - Colorado School of Public HealthCristiane S. Duarte - Columbia UniversityAnne L. Dunlop - Emory UniversityKennedy Gachigi - Johns Hopkins UniversityAkhgar Ghassabian - New York UniversityIrva Hertz-Picciotto - University of California, DavisKathi C. Huddleston - University of South DakotaRobert M. Joseph - Boston UniversityDaniel Keating - Univ Michigan, Inst Social Res, Dept Psychol, Ann Arbor, MI USARachel S. Kelly - Brigham and Women's HospitalYoung Shin Kim - UCSF, Dept Psychiat & Behav Sci, San Francisco, CA USARebecca J. Landa - Johns Hopkins UniversityLeslie D. Leve - University of OregonKristen Lyall - Drexel University, Epidemiology and BiostatisticsJessie B. Northrup - University of PittsburghThomas O'Connor - University of Rochester Medical CenterSally Ozonoff - University of California, DavisAnna Ross - Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, 624 N Broadway,HH811, Baltimore, MD 20215 USARebecca J. Schmidt - University of California, DavisJulie B. Schweitzer - Univ Calif Davis, MIND Inst, Davis, CA USALauren C. Shuffrey - Hassenfeld Childrens Hosp NYU Langone, Child Study Ctr, Dept Child & Adolescent Psychiat, New York, NY USACoral Shuster - Women & Infants Hospital of Rhode IslandEmily Vance - Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, 624 N Broadway,HH811, Baltimore, MD 20215 USAScott T. Weiss - Harvard Med Sch, Boston, MA USAGreta Wilkening - University of Colorado Anschutz Medical CampusRobert O. Wright - Ichan Sch Med Mt Sinai, New York, NY USA
- Publication Details
- Journal of autism and developmental disorders, 101613
- Publisher
- Springer Nature
- Number of pages
- 12
- Grant note
- NIH Office of the Director; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:001390980400001
- Scopus ID
- 2-s2.0-85214282978
- Other Identifier
- 991022018093604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychology, Developmental