As a clinician who specializes in the assessment and treatment of mental health disorders in children, the most complex clinical presentations have involved a combination of mood, behavioral, and neurodevelopmental symptoms in addition to autism. Autism spectrum disorder (ASD) is described as a complex developmental disorder characterized by difficulty in social interaction and communication along with restricted or repetitive patterns of thought and behaviors.

Diagnoses of autism and Asperger’s syndrome are now classified under autism spectrum disorder. Since autism falls on a “spectrum”, how these symptoms present can look very different to each person. While some children may be identified and diagnosed early, other children tend to “fall through the cracks” as symptoms such as social awkwardness, difficultly with social cues and nuances, hyper-focus, and difficulties with sensory integration and transition may be overlooked. These children may receive a diagnosis later in life such as middle school or even into adulthood.

In Minnesota, 1 in every 42 children have autism versus 1 in every 59 children with autism when comparing data from national averages. cdc.gov/ncbddd/autism
Boys were 3.9X’s more likely to be diagnosed than girls. By 56 months, half of children were diagnosed with autism. Early signs and symptoms may be first noticed by someone such as a concerned parent or guardian, pediatrician, or early childhood teacher.

Children on the autism spectrum can present with behavioral challenges that parents, educators, and mental health workers may feel not fully equipped to address. Behaviors are often impacted by co-morbidity of other mental health and medical-related issues. According to a new study in an article released by sciencedaily nearly 78% of children have at least one mental health condition and nearly half have two or more conditions.

Attention-deficit hyperactivity disorder and anxiety are two of the most common diagnoses, estimated at nearly 50% and 40% respectively. Some estimates for anxiety have ranges in the 70-80% range as this is very common. Other commonly co-occurring diagnoses that therapists see include obsessive-compulsive disorder (OCD), oppositional defiant disorder (ODD), and depression.

For professionals who work with children on the autism spectrum, co-occurring medical conditions such as epilepsy, seizures, or gastrointestinal issues may be present and are also quite common (estimate approximately one-third). Difficulties with sleep and feeding are common. Children may struggle with developmental coordination and sensory integration. While some children demonstrate impairment in their language or intellectual abilities, other children demonstrate giftedness or scattered development. Understanding co-morbidity and the complexities in how they present with children with autism is so important. As helping professionals, let us work together to screen, intervene early, educate ourselves, and provide high-quality services that are tailored to a child’s individual needs.

Written By: Charlotte Johnson, MA, LPCC