Are autistic kids less healthy?

27 Aug

This is a question that comes up a lot: is the general health of autistic children lower than, say, typically developing children or children with other developmental delays?

Actually, few people make the comparison to other developmental delays, but it is worth doing.

The National Survey of Children’s Health gives us some information to address this question. It is not a perfect set of data to study, but it will give us an idea.

Parents were asked to grade their child’s health with the question “In general, how would you describe [S.C.]’s health? Would you say [his/her] health is excellent, very good, good, fair, or poor?”

The overall population showed the following distribution:

Excellent: 64.9%
very good: 22.9%
good: 9.8%
fair: 2.0%
poor: 0.3%

So, in general, American kids are pretty healthy.

How about autistic kids*? Here’s the distribution:

Excellent: 34.3%
very good: 29.5%
good: 23.0%
fair: 8.8%
poor: 4.3%

That is a big difference from the general population. From 65% “excellent” down to 34% for autistic kids. We don’t know how parents considered “autism” as being in “poor health”, though. In other words, parents could consider their child to not be in “excellent health” just because he/she is autistic. I throw that out for consideration, not as an explanation of these numbers. We just don’t know if this is a factor.

A clearer indication that autistic may have more medical health problems (at least to my eye) is the fact that “poor” is 4.3% for autistic kids, vs. 0.3% for their typical peers. I could be wrong, but I don’t see many parents listing their child’s health as “poor” just because the kids are autistic. I could see parents downgrading from “excellent” to “very good”, for example.

Compare the autistic group to children “who currently have developmental delay problems”. Note that this group includes many of the autistic kids. Here is the distribution for the kids with developmental delays:

Excellent: 30.1%
very good: 29.5%
good: 25.6%
fair: 10.9%
poor: 3.8%

To my eye, autistic kids and developmentally delayed kids are the same in terms of health grades.

In other words: yes, the general health of autistic kids looks like it is worse than the general population. However, the general health of autistic kids looks like it is basically the same as that for all kids with developmental delays.

To answer the obvious complaints:

1) I am not saying that autistic kids do not have health problems. Being autistic does not make one immune to serious health problems. If anything, autistic kids do have lower health grades than typical kids. However, autistic kids do not have lower health grades than developmentally delayed kids.

2) One (probably me) should look at health grades of autistic children who are rated as being more “severe” and see if the general health grades are lower for that subgroup.

3) This is not definitive data, but a response to a survey. However, within the limitations of a survey, I think these data are interesting to consider.

*Autistic kids being children whose parents told the survey team that the child currently has autism or an ASD.

8 Responses to “Are autistic kids less healthy?”

  1. David N. Brown August 27, 2009 at 07:39 #

    I would allow for some “overreporting”: Autistics are likely to attract more attention from adults, which may lead to the recognition of relatively minor health problems that might go unnoticed in “normals”. Also, a fair number of problems are likely to be psychosomatic or psychologically exacerbated by social abuse.

  2. Cindy August 27, 2009 at 10:53 #

    very helpful and resourceful article.. really nice article.. great job..

  3. passionlessDrone August 27, 2009 at 13:27 #

    Hi Sullivan –

    I think we cast our net as wide as possible with a question as open ended as getting parents to describe healthy and consequently get data that is difficult to interpret.

    I believe there have been a couple of review studies that tended to show kids with autism more or less had the same number of hospital visits, with some variations by time (more infections in first 30 days of life), or variations by type of health ‘problem’ (i.e., more of one type of infection compared to normal kids).
    These studies are difficult to assign weight to, IMO, for a variety of reasons, but are still useful.

    I think that if we narrow down from ‘healthy’ to some more precise classifications; i.e., ability to fight pathogens, immunological markers associated with health problems in more well defined situations, ‘co-morbid’ disorders that most parents would classify as ‘unhealthy’, I think we have more evidence that the trend displayed here may be accurate.

    For example,

    Altered gene expression and function of peripheral blood natural killer cells in children with autism

    Where researchers observed increased expression of natural killer cells, but decreased potency of some of the actual chemicals used to destroy pathogens. Similar detection of decreased NK functionality was found in another study, which tried to make a correlation to reduced glutathione levels.

    Macrophage Migration Inhibitory Factor and Autism Spectrum Disorders

    Found increased levels of an immunological marker that has strong evidence towards roles in classically recognized health problems, like arthritis, asthma, and other inflammatory conditions.

    There are many others.

    I’m not sure if this is enough for us to declare children with autism ‘less healthy’ or not, but I do find it interesting to try to look for patterns between clinical observations and other measures.

    The correlation to other developmental disabilities is interesting; I believe there are some findings of compromised immune functioning in some other types of DD’s, but I’m not up to speed enough in that area yet.

    – pD

  4. Stephanie August 28, 2009 at 03:22 #

    One factor might be what it requires from the parents to meet health challenges. Two of my boys with autism are in excellent health, with weight gain and nutrition being our primary concerns. The middle one has health conditions that are complicated by his developmental delays. For example, my stepson had his tonsils out. It was a fairly simple, straightforward procedure. When my middle son had his tonsils out, it was a much bigger deal, requiring overnight hospitalization. He didn’t understand what was going and was out of sorts due to being in a strage place. After his surgery he refused to eat for them. They kept us overnight and were going to keep him longer. I convinced them to let me take him home, where he ate four cheese sticks in a row. I would rate his health as poorer, because we have to go through extra lengths just to get him appropriate care. Even relatively minor ailments can become complicated when the child fights any form of treatment.

    • Sullivan August 28, 2009 at 07:11 #

      Stephanie,

      interesting points. Thanks for sharing that info.

  5. Natasa September 3, 2009 at 08:30 #

    a summary of abnormal health/biomedical findings in autism

    http://www.autismcalciumchannelopathy.com/Abnormal_biomed_findings.html

  6. Hollis February 7, 2014 at 03:11 #

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