Health Condition Co-Morbidities in Children with Autism and Their Association with Challenging Behavior

Objectives: In this cohort study, we assessed the occurrence of health conditions in children with autism, assessed whether clusters of health conditions were present, and whether somatic conditions were associated with challenging behaviors. Method: Medical histories and adaptive/maladaptive behavior reports of 246 children with autism were extracted from an electronic database and subjected to cluster analyses. Two-thirds of the participants had one or more serious health conditions and one-third had two or more health co-morbidities. Results: Analyses revealed three significant clusters of health conditions: (a) allergies/sinus infections and respiratory illness/not asthma; (b) gastroesophageal reflux disease (GERD), constipation, and epilepsy/seizures; and (c) headache/migraine and sleep dysregulation. Group comparisons and effect sizes of individual health conditions showed associations among (i) GERD and aggression and self-injury and (ii) sleep dysregulation and aggression and self-injury. Conclusions: Our findings suggest that children with autism may have higher rates of common health conditions than found in the general pediatric population, that health conditions may cluster among individuals, and that some health conditions (GERD and disordered sleep) were associated with increased levels of self-injury and aggression. These data call for more attention to the mechanisms contributing to health conditions, and their cooccurrence with challenging behaviors, in children with autism.