780 - Longitudinal investigation of child emotional and behavioral problems from early childhood to school age in siblings of children with autism spectrum disorder

Publication Number: 780.5733

Kornkanok Saringkarisate, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Lisa A. Croen, Kaiser Permanente Northern California Division of Research, Pleasanton, CA, United States; Rebecca J. J.. Schmidt, University of California Davis, Davis, CA, United States; Kristen Lyall, Drexel University, Philadelphia, PA, United States; M. Daniele Fallin, Emory University Rollins School of Public Health, Atlanta, GA, United States; Heather Volk, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Ashley Song, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social and communication skills and the presence of restricted or repetitive behaviors. One in 36 children aged 8 years was reported to have ASD in the US. The prevalence is 7 to 14 times higher in siblings of children with ASD.

As ASD occurs within a clinical spectrum, symptoms of ASD can overlap with other neurodevelopmental conditions such as ADHD, anxiety, or intellectual disability. Better delineation of the profile and developmental course of high-risk siblings is lacking in the literature.

Objective: To examine longitudinal changes in emotional and behavioral traits of children from preschool to school age in a high-risk population.

Design/Methods: We leveraged data from the Early Autism Risk Longitudinal Investigation (EARLI), a prospective pregnancy cohort that enrolled women who already had a child with ASD and followed them through a subsequent pregnancy. Parents completed the Child Behavior Checklist (CBCL) when the high-risk siblings reached the preschool and school ages.

T-scores of total problem scores, internalizing and externalizing scores, and DSM-oriented subscale scores (attention-deficit hyperactivity disorder (ADHD) problems and anxiety problems) were analyzed as the primary outcomes. Paired T-tests comparing these outcome scores were performed to evaluate the differences between the preschool and school age data.

Results: Out of 73 participants with CBCL assessment at both preschool and school ages, 20 met criteria for ASD based on the DSM5 at 36 months. Mean ages were 3 and 9 for preschool and school age data. Within the ASD group, only the ADHD (mean difference = 4.55, P=0.002) and anxiety problem scores (mean difference = 6.9, P=0.008) were significantly different. In the non-ASD group, we observed significant differences in all domains except for the externalizing group. For example, the mean difference for total problem scores was 3.96 (P=0.03) and for internalizing group was 8.2 (p < 0.001).

Conclusion(s): Our results show increases in ADHD and anxiety symptoms in children identified with ASD, signifying increased risk for additional comorbidities with age. For those not meeting ASD diagnostic criteria, there was an increase in internalizing, ADHD and anxiety symptoms. These findings suggest that in high-risk siblings with or without ASD, there is an increased risk of developing behavior symptoms with age that warrant ongoing monitoring.

Table 1
Mean difference and p-value