Autism and Related Conditions
Autism is often accompanied by a range of medical or psychiatric conditions, such as anxiety, ADHD, epilepsy, sleep problems, and gastrointestinal problems. The scientific understanding of this overlap is often elusive.
Addressing co-occurring problems won't eliminate the core features of autism. Yet treating specific symptoms that people are struggling with can tremendously improve daily life for those on the spectrum.
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Autism and ADHD
Studies estimate that 30 to 80 percent of children with autism meet the criteria for ADHD, and 20 to 50 percent of children with ADHD meet the criteria for autism. Clinicians can now provide a dual diagnosis for children with both conditions, per the DSM-5.
Autism and ADHD can look very similar, as both involve struggles with communication, social cues, attention, and impulsivity. Scientists are currently investigating the biological and genetic roots that the conditions may share.
People with both conditions may be more impaired than people with either condition alone. Individuals with autism or parents of children with autism may want to seek a diagnosis if they believe they have ADHD, as that could influence treatment options, such as the decision to prescribe stimulant drugs.
Autism and Anxiety
Nearly 40 percent of children with autism also have an anxiety disorder—which might include social anxiety disorder, obsessive-compulsive disorder, or a specific phobia. The overlap of autism and anxiety may be due to the features of autism, such as sensory overload, communication barriers, social challenges, cognitive rigidity, and task frustration. Distinguishing whether symptoms of autism contribute to anxiety or result from anxiety can be challenging.
Parents of children struggling with anxiety can aim to identify what specifically triggers anxiety in their child, and then plan for or modify those triggers. They may explore treatment options such as medication or cognitive-behavioral therapy.
Autism and Depression
People with autism are four times more likely to suffer from depression than neurotypical individuals. This trend may be due to genetics as well as the loneliness, bullying, or rumination that some with autism face.
Depression is difficult to spot because people with autism can struggle to express their feelings. There are similar barriers to treatment, such as the ability to explore emotions in therapy and tolerate side effects of medications. Still, cognitive-behavioral therapy and antidepressants help some, while social support and employment programs are valuable for all.
Autism and Epilepsy
Just over 1 percent of the general population suffers from seizures, but 20 to 40 percent of people with autism do. Scientists don't fully understand the link between the two, but they may have shared genetic roots and related imbalances in neural communication.
Seizures can lead to severe injury, so parents may want to evaluate their child's risk of seizures with a doctor. If the child is diagnosed with a seizure disorder, they may be prescribed an anticonvulsant. Seizure disorders can develop in adolescence or adulthood, so it's an aspect of autism that should continue to be monitored.
Autism and Sleep Problems
Sleep problems are twice as common for children with autism than for neurotypical children. People with autism can have trouble falling asleep or staying asleep throughout the night. Even worse, a poor night of sleep may exacerbate symptoms of autism, like social impairments and repetitive behaviors.
Sleep problems may be due symptoms of autism such as sensory sensitivity or the conditions that often co-occur with autism, such as ADHD, anxiety, and digestive problems. The genetic underpinnings of autism may also play a role.
Speak with your child’s doctor or your own doctor about whether a sleep evaluation or medication may be merited. Good sleep hygiene, especially keeping a consistent bedtime routine, can help people with autism get a good night’s rest
Autism and Gastrointestinal Problems
Around 70 percent of children with autism have gastrointestinal problems, compared to just 28 percent of neurotypical children, research suggests. These problems include stomach pain, constipation, and diarrhea. Children with autism are also more selective about the foods they eat.
The connection between autism and the gut is still emerging, but one possibility is that the interaction between a child’s genes and certain foods leads to an imbalance of gut bacteria. The risk of autism (and other disorders) is slightly elevated in children delivered by c-section, which suggests another pathway by which gut microbiota is influenced. Additionally, many autistic people suffer from stress and anxiety, which can fuel digestive problems.
Parents or individuals with autism should consult their doctor about which diets or programs they can explore. Anecdotally, some parents have reported that cutting out wheat, gluten or dairy has been helpful.
Autism and Highly Sensitive People
People might confuse autism and high sensitivity because both involve extreme sensitivity to one's environment. A stimulus that seems small to others, such as a shirt's texture or an intrusive noise, can feel overwhelming to people with autism or high sensitivity. They may elicit panic or tantrums if they can't be controlled.
However, the two experiences are very different. Recent research identified three key distinctions. One is that autism is accompanied by social challenges, such as the inability to make eye contact or respond to another's emotion, while highly sensitive people are extremely responsive to those cues. Social interactions are especially meaningful to those with high sensitivity, but they aren't as inherently rewarding to those with autism. Brain areas that involve calmness, sociability, and emotion are less active in people with autism.
Autism and Fragile X syndrome
Fragile X syndrome is a genetic disorder that can lead to developmental delays, intellectual disability, learning disability, and social and communication impairments. The condition is typically caused by a mutation in the gene FMR1, which prevents the production of a protein critical for healthy brain development and communication.
At least one-third of people with Fragile X syndrome also have autism. The substantial overlap between the two underscores the genetic causes of autism. Other genetic disorders linked to autism include Rett syndrome, Down syndrome, and tuberous sclerosis.