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Autism and Associated Medical and Familial Factors: A Case Control Study

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Abstract

To systematically review medical and familial conditions in autistic subjects (AU) as compared to other developmentally disabled controls (DD). Data was gathered prospectively for 102 AUs and 106 DDs who were comparable for age, sex, and nonverbal intelligence. Chi-square and t test analyses were used to evaluate the data collected for AUs and DDs. Demographic data for AUs and DDs was similar for age, sex, and nonverbal IQ scores. The only statistically significant demographic differences were higher educational levels in mothers of AUs and increased number of firstborn AUs. Family history data revealed a greater number of reported maternal learning disabilities for DDs and increased paternal mental retardation for AUs but no differences in familial medical or psychiatric disorders. No prenatal or perinatal risk factors were identified in the AU group although increased alcohol use during pregnancy and decreased gestational age was found in the DD group. Review of developmental and behavioral issues revealed delayed toileting, tantrums, strong food preferences, and preoccupations to be significantly increased in AUs as compared to DDs. No significant differences were noted between the two groups in health problems or doctor visits. However, AUs had significantly larger mean head size than DDs. This study confirmed several previously established findings in autism including 4 to 1 male prevalence, increased head size, strong food preferences, and lack of prenatal/perinatal findings specifically associated with autism. However, the data suggested no increased prevalence of health problems among AUs or their family members compared to DDs. Several biologic interventions and etiologic theories of autism have been based on the assumption of medical differences in this population, an assumption called into question by current data.

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References

  • Bailey, A., LeCouteur, A., Gottesman, I., Bolton, P., Simonoff, E., Yuzda, E., and Rutter, M. (1995). Autism as a strongly genetic disorder: Evidence from a British twin study. Psychol. Med. 25: 63-77.

    Google Scholar 

  • Bailey, A., Phillips, W., and Rutter, M. (1996). Autism: Towards an integration of clinical, genetic, neuropsychological perspectives. J. Child. Psychol. Psychiatry 37: 89-126.

    Google Scholar 

  • Barak, Y., Ring, A., Sulkes, J., Cabbaj, V., and Elizur, A. (1995). Season of birth and autistic disorders in Israel. Am. J. Psychiatry 152: 798-802.

    Google Scholar 

  • Bartlik, B. D. (1981). Monthly variations in births of autistic children in North Carolina. J. Am. Med. Womens. Assoc. 36: 363-368.

    Google Scholar 

  • Barton, M., and Volkmar, F. R. (1998). How commonly are known medical conditions associated with autism? J. Autism. Dev. Disord. 28(4): 273-278.

    Google Scholar 

  • Bolton, P. J., Murphy, M., MacDonald, H., Whitlock, B., Pickles, A., and Rutter, M. (1997). Obstetric complications in autism: Consequences or causes of the condition? J. Am. Acad. Child. Adolesc. Psychiatry 36: 272-281.

    Google Scholar 

  • Bolton, P. E., Pickles, A., Murphy, M., and Rutter, M. (1998). Autism, affective and other psychiatric disorders: Patterns of familial aggregation. Psychol. Med. 28: 385-395.

    Google Scholar 

  • Comi, A. M., Zimmerman, A. W., Frye, V. H., Law, P. A., and Peeden, J. N. (1999). Familial clustering of autoimmune disorders and evaluation of medical risk factors in autism. J. Child. Neurol. 14: 388-394.

    Google Scholar 

  • Dalrymple, N. J., and Ruble, L. A. (1992). Toilet training and behaviors of people with autism: Parent views. J. Autism Dev. Disord. 22: 265-275.

    Google Scholar 

  • Davidovitch, M., Patterson, B., and Gartside, P. (1996). Head circumference measurements in children with autism. J. Child. Neurol. 11: 389-393.

    Google Scholar 

  • Delong, G. R., and Dwyer, J. T. (1988). Correlation of family history with specific autistic subgroups: Asperger's syndrome and bipolar affective disorders. J. Autism Dev. Disord. 18: 593-600.

    Google Scholar 

  • Fombonne, E., Bolton, P., Prior, J., Jordan, H., and Rutter, M. (1997). A family study of autism: Cognitive patterns and levels in parents and siblings. J. Child. Psychol. Psychiatry 38: 667-683.

    Google Scholar 

  • Gillberg, C., Gillberg, I. C., and Steffenberg, S. (1992). Siblings and parents of children with autism: A controlled population-based study. Dev. Med. Child. Neurol. 34: 389-398.

    Google Scholar 

  • Hering, E., Epstein, R., Elroy, S., Ianev, D. R., and Zelnik, N. (1999). Sleep patterns in autistic children. J. Autism Dev. Disord. 29: 143-147.

    Google Scholar 

  • Horvath, K., Stefanatos, G., Sokolski, K. N., Wachtel, R., Nabor, L., and Tildon, J. (1998). Improved social and language skills after secretin administration in patients with autistic spectrum disorders. J. Assoc. Acad. Minor Phys. 9: 9-15.

    Google Scholar 

  • Jones, M. B., and Szatmari, P. (1988). Stoppage rules and genetic studies of autism. J. Autism Dev. Disord. 18: 31-40.

    Google Scholar 

  • Konstantareas, M., Hauser, P., Lerox, C., and Homatidis, S. (1986). Season of birth in infantile autism. Child. Psychiatry Hum. Dev. 17: 53-65.

    Google Scholar 

  • Konstantareas, M., and Homatidis, S. (1987). Brief report: Ear infections in autistic and normal children. J. Autism Dev. Disord. 17: 585-593.

    Google Scholar 

  • Landa, R., Piven, J., Wzorek, M. M., Gayli, J., Chase, G. A., and Folstein, S. E. (1992). Social language in parents of autistic individuals. J. Speech. Hear. Res. 34: 1339-1345.

    Google Scholar 

  • Landau, E. C., Cicchetti, D. V., Klin, A., and Volmar, F. R. (1999). Season of birth in autism: A fiction revisited. J. Autism Dev. Disord. 29: 385-393.

    Google Scholar 

  • Leboyer, M., Plumet, M. H., Goldblum, M., Perez-Dias, F., & Marchaland, C. (1995). Verbal versus visuospatial abilities in relatives of autistic females. Dev. Neuropsychol. 11: 139-155.

    Google Scholar 

  • LeCouteur, A., Bailey, A., Goode, S., Pickles, A., Robertson, S., Gottesman, I., and Rutter, M. (1996). A broader phenotype of autism: The clinical spectrum in twins. J. Child. Psychol. Psychiatry 37: 785-801.

    Google Scholar 

  • Minton, J., Cambell, M., Green, W. H., Jennings, S., and Samit, C. (1982). Cognitive assessment of siblings of autistic children. J. Am. Acad. Child Adolesc. Psychiatry 21: 256-261.

    Google Scholar 

  • Mouridsen, S. E., Nielsen, S., Rich, B., and Isager, T. (1994). Season of birth in infantile autism and other types of childhood psychoses. Child Psychiatry Hum. Dev. 25: 31-43.

    Google Scholar 

  • Nelson, K. B. (1991). Prenatal and perinatal factors in the etiology of autism. Pediatrics 87(Suppl): 761-766.

    Google Scholar 

  • Patterson, B., Ekvall, S., and Mayes, S. D. (1993). Autism. In Ekvalls, S. (ed.), Pediatric Nutrition in Chronic Diseases and Developmental Disorders—Prevention, Assessment and Treatment, New York: Oxford University Press; pp. 131-136.

    Google Scholar 

  • Piven, J., Arndt, S., and Bailey, J. (1996). Regional brain enlargement in autism: A magnetic resonance imaging study. J. Am. Acad. Child Adolesc. Psychiatry 35: 530-536.

    Google Scholar 

  • Piven, J., Chase, G. A., Landa, R., Wzorek, M., Gayle, J., and Cloud, D. (1991a). Psychiatric disorders in the parents of autistic individuals. J. Am. Acad. Child Adolesc. Psychiatry 29: 177-183.

    Google Scholar 

  • Piven, J., Chase, G. A., and Nelson, K. B. (1991b). Prenatal and perinatal factors in the etiology of autism. Pediatrics 87(Suppl.): 761-766.

    Google Scholar 

  • Piven, J., and Palmer, P. (1997). Cognitive deficits in parents from multiple incidence autism families. J. Child Psychol. Psychiatry 38: 1011-1022.

    Google Scholar 

  • Piven, J., Palmer, P., Jacobi, D., Childress, D., and Arndt, S. (1997a). Broader autism phenotype: Evidence from a family history study of multiple incidence autism families. Am. J. Psychiatry 154: 185-190.

    Google Scholar 

  • Piven, J., Wzorek, M., Landa, R., Lainhart, J., Bolton, P., Chase, G. A., and Folstein, S. (1994). Personality characteristics of the parents of autistic individuals. Psychol. Med. 24: 783-795.

    Google Scholar 

  • Piven, J., Palmer, P., Landa, R., Santangelo, S., Jacobi, D., and Childress, D. (1997b). Personality and language characteristics in parents from multiple-incidence autistic families. Am. J. Med. Genet. 74: 398-411.

    Google Scholar 

  • Rapin, I. (1997). Autism. N. Engl. J. Med. 337(2): 97-103.

    Google Scholar 

  • Richdale, A. L. (1999). Sleep problems in autism: Prevalence, cause and intervention. Dev. Med. Child Neurol. 41: 60-66.

    Google Scholar 

  • Ritvo, E. R., Freeman, B. J., Pingree, C., Mason-Brothers, A., Jorde, L., Jenson, W. R., and McMahon, W. M. (1989). The UCLA-University of Utah epidemiologic study of autism: Prevalence. Am. J. Psychiatry 146: 194-199.

    Google Scholar 

  • Ritvo, E. R., Spence, M. A., Freeman, B. J., Brothers, A., Mo, A., and Marazita, M. L. (1985). Evidence for autosomal recessive inheritance in 46 families with multiple incidence autism. Am. J. Psychiatry 142: 187-192.

    Google Scholar 

  • Rosenthal, V., Nordin, V., Sandstrom, M., Ahlsen, G., and Gillberg, C. (1999). Autism and hearing loss. J. Autism Dev. Disord. 29: 349-357.

    Google Scholar 

  • Shearer, T. R., Larson, K., Neuschwander, J., and Gedney, B. (1982). Minerals in the hair and nutrient intake of autistic children. J. Autism Dev. Disord. 72: 25.

    Google Scholar 

  • Smalley, S. L., Asarnow, R. F., and Spence, A. M. (1988). Autism and genetics. Arch. Gen. Psychiatry 45: 953-961.

    Google Scholar 

  • Smalley, S. L., McCracken, K., and Tanguay, P. (1995). Autism, affective disorders and social phobia. Am. J. Med. Genet. 60: 19-26.

    Google Scholar 

  • Szatmari, P., Jones, M. B., Fisman, S., Tuff, L., Bartolucci, G., Mahoney, W. J., and Bryson, S. E. (1995). Parents and collateral relatives of children with pervasive developmental disorders: A family history study. Am. J. Med. Genet. 60: 282-289.

    Google Scholar 

  • Tsai, L. Y., and Stewart, M. A. (1983). Etiologic implications of maternal age and birth order in infantile autism. J. Autism Dev. Disord. 13: 57-65.

    Google Scholar 

  • Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, P. M., Malik, M., Berelowitz, M., Dhillon, A. P., Thomson, M. A., Harvey, P., Valentine, A., Davies, S. E., and Walker-Smith, J. A. (1998). Ileal-lymphoid-nodular hyperplasia, nonspecific colitis, and pervasive developmental disorder in children. Lancet. 351: 637-641.

    Google Scholar 

  • Williams, P. G., and Bloom, A. S. (1999). Case reports in autism: Issues in diagnosis and treatment. J. Ky. Med. Assoc. 97: 56-60.

    Google Scholar 

  • Williams, P. G., Dalrymple, N. J., and Neal, J. (2000). Eating habits of children with autism. Pediatr. Nurs. 26: 259-264.

    Google Scholar 

  • Woodhouse, W., Bailey, A., Rutter, M., Bolton, P., Baird, G., and LeCouteur, A. (1996). Head circumference in autism and other pervasive developmental disorders. J. Child. Psychol. Psychiatry 37: 665-671.

    Google Scholar 

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Williams, G., Oliver, J.M., Allard, A. et al. Autism and Associated Medical and Familial Factors: A Case Control Study. Journal of Developmental and Physical Disabilities 15, 335–349 (2003). https://doi.org/10.1023/A:1026310216069

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