The majority of children with autism spectrum disorders (ASD) have at least one mental health condition, according to a new study by U.S. and Canadian researchers.

Connor Kerns and colleagues analyzed survey data collected from more than 42,000 caregivers of children, calculating the prevalence of mental conditions in four different groups: children with ASD, children with intellectual disability, children with special health care needs, and children with none of these issues.

The researchers found that nearly 78% of children with ASD had at least one mental health condition, and nearly half had two or more. In contrast, only 14.1% of children without ASD had mental health conditions. Children with ASD also had a higher prevalence of mental conditions than children with intellectual disability or special health care needs.

The most common mental health conditions seen in children with ASD were behavior/conduct problems (60.8%), anxiety (39.5%), attention deficit disorder or attention-deficit hyperactivity disorder (48.4%), and depression (15.7%). While mental health conditions became more prevalent as children with ASD aged, the researchers found that they were already present in nearly 45% of preschool children with ASD.

Kerns says, “There’s something specific about autism that is increasing this mental health burden, and it’s true not only for anxiety, but also for depression, behavior problems, and attention problems. This is a special population that requires special attention.”

She adds, “For a long time, mental health in kids with autism was neglected because the focus was on autism. There’s much greater awareness now, but we don’t have enough people trained to provide mental health treatments to kids on the autism spectrum. We need to bridge these two systems and the different sets of providers that tend to treat these children.”

It is crucial to detect mental conditions in children with ASD early on, Kerns says, because the longer these problems go untreated, the harder they are to treat. “Right now,” she says, “we don’t have a great system for that.”

“Prevalence and correlates of caregiver reported mental health conditions in youth with autism spectrum disorder in the United States,” Connor M. Kerns, Jessica E. Rast, and Paul T. Shattuck, Journal of Clinical Psychiatry, January 2021 (online). Address: Connor Kerns, [email protected] psych.ubc.ca.

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“Mental health conditions alarmingly high among children with autism, study finds,” news release, University of British Columbia, January 19, 2021

This article originally appeared in Autism Research Review International, Vol. 35, No. 1, 2021