Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population
Objective To determine whether early ear and upper respiratory signs are associated with the development of high levels of autistic traits or diagnosed autism.Design Longitudinal birth cohort: Avon Longitudinal Study of Parents and Children (ALSPAC).Setting Area centred on the city of Bristol in Sou...
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BMJ Publishing Group
2023-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/3/e067682.full |
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| author | Amanda Hall Dheeraj Rai Jean Golding Yasmin Iles-Caven Steven Gregory Richard Maw |
| author_facet | Amanda Hall Dheeraj Rai Jean Golding Yasmin Iles-Caven Steven Gregory Richard Maw |
| author_sort | Amanda Hall |
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| description | Objective To determine whether early ear and upper respiratory signs are associated with the development of high levels of autistic traits or diagnosed autism.Design Longitudinal birth cohort: Avon Longitudinal Study of Parents and Children (ALSPAC).Setting Area centred on the city of Bristol in Southwest England. Eligible pregnant women resident in the area with expected date of delivery between April 1991 and December 1992 inclusive.Participants 10 000+ young children followed throughout their first 4 years. Their mothers completed three questionnaires between 18–42 months recording the frequency of nine different signs and symptoms relating to the upper respiratory system, as well as ear and hearing problems.Outcome measures Primary—high levels of autism traits (social communication, coherent speech, sociability, and repetitive behaviour); secondary—diagnosed autism.Results Early evidence of mouth breathing, snoring, pulling/poking ears, ears going red, hearing worse during a cold, and rarely listening were associated with high scores on each autism trait and with a diagnosis of autism. There was also evidence of associations of pus or sticky mucus discharge from ears, especially with autism and with poor coherent speech. Adjustment for 10 environmental characteristics made little difference to the results, and substantially more adjusted associations were at p<0.001 than expected by chance (41 observed; 0.01 expected). For example, for discharge of pus or sticky mucus from ears the adjusted odds ratio (aOR) for autism at 30 months was 3.29 (95% CI 1.85 to 5.86, p<0.001), and for impaired hearing during a cold the aOR was 2.18 (95% CI 1.43 to 3.31, p<0.001).Conclusions Very young children exhibiting common ear and upper respiratory signs appear to have an increased risk of a subsequent diagnosis of autism or demonstrated high levels of autism traits. Results suggest the need for identification and management of ear, nose and throat conditions in autistic children and may provide possible indicators of causal mechanisms. |
| format | Article |
| id | doaj-art-ce63101c28834defb2f08534a8965280 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-ce63101c28834defb2f08534a89652802025-02-02T04:05:14ZengBMJ Publishing GroupBMJ Open2044-60552023-04-0113310.1136/bmjopen-2022-067682Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood populationAmanda Hall0Dheeraj Rai1Jean Golding2Yasmin Iles-Caven3Steven Gregory4Richard Maw55 Children`s Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK2 Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK3 Bristol Medical School (PHS), University of Bristol, Bristol, UK3 Bristol Medical School (PHS), University of Bristol, Bristol, UK3 Bristol Medical School (PHS), University of Bristol, Bristol, UK2 UBHT, Retired ENT Consultant, Bristol, UKObjective To determine whether early ear and upper respiratory signs are associated with the development of high levels of autistic traits or diagnosed autism.Design Longitudinal birth cohort: Avon Longitudinal Study of Parents and Children (ALSPAC).Setting Area centred on the city of Bristol in Southwest England. Eligible pregnant women resident in the area with expected date of delivery between April 1991 and December 1992 inclusive.Participants 10 000+ young children followed throughout their first 4 years. Their mothers completed three questionnaires between 18–42 months recording the frequency of nine different signs and symptoms relating to the upper respiratory system, as well as ear and hearing problems.Outcome measures Primary—high levels of autism traits (social communication, coherent speech, sociability, and repetitive behaviour); secondary—diagnosed autism.Results Early evidence of mouth breathing, snoring, pulling/poking ears, ears going red, hearing worse during a cold, and rarely listening were associated with high scores on each autism trait and with a diagnosis of autism. There was also evidence of associations of pus or sticky mucus discharge from ears, especially with autism and with poor coherent speech. Adjustment for 10 environmental characteristics made little difference to the results, and substantially more adjusted associations were at p<0.001 than expected by chance (41 observed; 0.01 expected). For example, for discharge of pus or sticky mucus from ears the adjusted odds ratio (aOR) for autism at 30 months was 3.29 (95% CI 1.85 to 5.86, p<0.001), and for impaired hearing during a cold the aOR was 2.18 (95% CI 1.43 to 3.31, p<0.001).Conclusions Very young children exhibiting common ear and upper respiratory signs appear to have an increased risk of a subsequent diagnosis of autism or demonstrated high levels of autism traits. Results suggest the need for identification and management of ear, nose and throat conditions in autistic children and may provide possible indicators of causal mechanisms.https://bmjopen.bmj.com/content/13/3/e067682.full |
| spellingShingle | Amanda Hall Dheeraj Rai Jean Golding Yasmin Iles-Caven Steven Gregory Richard Maw Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population BMJ Open |
| title | Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population |
| title_full | Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population |
| title_fullStr | Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population |
| title_full_unstemmed | Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population |
| title_short | Associations between autistic traits and early ear and upper respiratory signs: a prospective observational study of the Avon Longitudinal Study of Parents and Children (ALSPAC) geographically defined childhood population |
| title_sort | associations between autistic traits and early ear and upper respiratory signs a prospective observational study of the avon longitudinal study of parents and children alspac geographically defined childhood population |
| url | https://bmjopen.bmj.com/content/13/3/e067682.full |
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