Parental Report of Health Conditions and Health Care Use Among Children With and Without Autism: National Survey of Children's Health
Abstract
OBJECTIVE: To compare parent-reported prevalence of health conditions and health care use between children with and without autism. DESIGN: Cross-sectional analysis of the 2003 to 2004 National Survey of Children's Health. SETTING: Population-based sample across the United States. PARTICIPANTS: More than 100 000 parents. The main exposure was "autism" (not further defined), from response to the question: "Has a doctor or health professional ever told you that your child has autism?" MAIN OUTCOME MEASURES: Medical and mental health conditions and measures of health care use. RESULTS: Autism prevalence among children aged 3 to 17 years was 53 per 10 000 (95% confidence interval, 45-61 per 10,000), equating to a national estimate of 324 000 children (95% confidence interval, 274,000-375,000 children). Children with autism had a significantly (P<.001) higher prevalence of depression or anxiety problems (38.9% vs 4.2%) and behavioral or conduct problems (58.9% vs 5.2%) than children without autism. Respiratory, food, and skin allergies were reported by parents more often for children with autism, with food allergies having the strongest relative difference between the groups (odds ratio, 4.5; 95% confidence interval, 3.0-7.0). Children with autism had significantly (P<.001) higher mean physician visits over 12 months for preventive care, nonemergency care, and hospital emergency care, and were far more likely than children without autism to receive physical, occupational, or speech therapy (76.0% vs 6.3%), to need treatment or counseling for an emotional, developmental, or behavioral problem (75.4% vs 7.0%), and, among those taking a prescribed medication, to be using a medication long-term (51.4% vs 14.5%). CONCLUSION: We found markedly higher reports of concurrent conditions and health care use associated with childhood autism in this study.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
High prevalence of atopic disease, including food allergy, is seen in children with ASD.
“High prevalence of atopic disease, including food allergy, is seen in children with ASD [23].”
From Pilot study of probiotic/colostrum supplementation on gut function in children with autism and gastrointestinal symptoms (2019) · cites this paper as [23]
Cites
Lord, C., Rutter, M., & Le Couteur, A. (1994) · Journal of Autism and Developmental Disorders · doi:10.1007/bf02172145 · Cited by 9,065 · see citing works
A Comparison of Alternative Models for the Demand for Medical Care
Duan, N.-H., Manning, W., Morris, C., & Newhouse, J. (1983) · Journal of Business and Economic Statistics · doi:10.1080/07350015.1983.10509330 · Cited by 1,410 · see citing works
Prevalence of Autism in a US Metropolitan Area
Yeargin-Allsopp, M., Rice, C., Karapurkar, T., Doernberg, N., Boyle, C., & Murphy, C. (2003) · JAMA · doi:10.1001/jama.289.1.49 · Cited by 1,248 · see citing works
The epidemiology of autism: a review
FOMBONNE, E. (1999) · Psychological Medicine · doi:10.1017/s0033291799008508 · Cited by 981 · see citing works
Depression in Persons with Autism: Implications for Research and Clinical Care
Ghaziuddin, M., Ghaziuddin, N., & Greden, J. (2002) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1016330802348 · Cited by 579 · see citing works
Autism and Asperger syndrome: coexistence with other clinical disorders
Gillberg, C., & Billstedt, E. (2000) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2000.102005321.x · Cited by 505 · see citing works
Comorbidity of Asperger syndrome: a preliminary report
Ghaziuddin, M., Weidmer‐Mikhail, E., & Ghaziuddin, N. (1998) · Journal of Intellectual Disability Research · doi:10.1111/j.1365-2788.1998.tb01647.x · Cited by 414 · see citing works
Goldstein, S., & Schwebach, A. J. (2004) · Journal of Autism and Developmental Disorders · doi:10.1023/b:jadd.0000029554.46570.68 · Cited by 412 · see citing works
COGNITIVE DEFICITS IN THE PATHOGENESIS OF AUTISM*
Rutter, M. L. (1983) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1983.tb00129.x · Cited by 405 · see citing works
National Autism Prevalence Trends From United States Special Education Data
Newschaffer, C. J., Falb, M. D., & Gurney, J. G. (2005) · PEDIATRICS · doi:10.1542/peds.2004-1958 · Cited by 316 · see citing works
Self-citationDanielsson, S., Gillberg, I. C., Billstedt, E., Gillberg, C., & Olssøn, I. (2005) · Epilepsia · doi:10.1111/j.1528-1167.2005.57504.x · Cited by 296 · see citing works
Sensory-Perceptual Abnormalities in Autism: A Case For More Research?
O'Neill, M., & Jones, R. S. P. (1997) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1025850431170 · Cited by 295 · see citing works
Autism and Known Medical Conditions: Myth and Substance
Rutter, M. L., Bailey, A. J., Bolton, P., & Couteur, A. S. L. (1994) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1994.tb01164.x · Cited by 287 · see citing works
Molloy, C. A., & Manning-Courtney, P. (2003) · Autism · doi:10.1177/1362361303007002004 · Cited by 249 · see citing works
The Pediatrician's Role in the Diagnosis and Management of Autistic Spectrum Disorder in Children
(2001) · PEDIATRICS · doi:10.1542/peds.107.5.1221 · Cited by 243 · see citing works
Black, C., Kaye, J. A., & Jick, H. (2002) · BMJ · doi:10.1136/bmj.325.7361.419 · Cited by 240 · see citing works
AUTISM AND MEDICAL DISORDERS: A REVIEW OF THE LITERATURE
Gillberg, C., & Coleman, M. (1996) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.1996.tb15081.x · Cited by 235 · see citing works
Autistic disorder and gastrointestinal disease
Horvath, K., & Perman, J. A. (2002) · Current Opinion in Pediatrics · doi:10.1097/00008480-200210000-00004 · Cited by 224 · see citing works
AUTISTIC BEHAVIOUR AND ATTENTION DEFICITS IN TUBEROUS SCLEROSIS: A POPULATION‐BASED STUDY
Gillberg, J. C., Gillberg, C., & Ahlsén, G. (1994) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.1994.tb11765.x · Cited by 219 · see citing works
Analysis of Prevalence Trends of Autism Spectrum Disorder in Minnesota
Gurney, J. G., Fritz, M. S., Ness, K. K., Sievers, P., Newschaffer, C. J., & Shapiro, E. (2003) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.157.7.622 · Cited by 205 · see citing works
Self-citationAssociated Medical Disorders and Disabilities in Children with Autistic Disorder
Kielinen, M., Rantala, H., Timonen, E., Linna, S., & Moilanen, I. K. (2004) · Autism · doi:10.1177/1362361304040638 · Cited by 198 · see citing works
Sturm, H., Fernell, E., & Gillberg, C. (2004) · Developmental Medicine & Child Neurology · doi:10.1017/s0012162204000738 · Cited by 184 · see citing works
(2005) · Cited by 151 · see citing works
Epilepsy, Electroencephalographic Abnormalities, and Regression in Children With Autism
Canitano, R., Luchetti, A., & Zappella, M. (2005) · Journal of Child Neurology · doi:10.1177/08830738050200010401 · Cited by 149 · see citing works
Sleep disorders, epilepsy, and autism
Malow, B. A. (2004) · Mental Retardation and Developmental Disabilities Research Reviews · doi:10.1002/mrdd.20023 · Cited by 128 · see citing works
How Commonly Are Known Medical Conditions Associated with Autism?
Barton, M., & Volkmar, F. (1998) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1026052417561 · Cited by 117 · see citing works
Symptoms of ADHD and their correlates in children with intellectual disabilities
Hastings, R. P., Beck, A., Daley, D., & Hill, C. R. (2004) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2004.10.003 · Cited by 115 · see citing works
Autism and Tuberous Sclerosis Complex: Prevalence and Clinical Features
Baker, P., Piven, J., & Satō, Y. (1998) · Journal of Autism and Developmental Disorders · doi:10.1023/a:1026004501631 · Cited by 103 · see citing works
Brief Report: Assessment of Sensory Abnormalities in People with Autistic Spectrum Disorders
Harrison, J., & Hare, D. J. (2004) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-004-5293-z · Cited by 83 · see citing works
How common are gastrointestinal disorders in children with autism?
Kuddo, T., & Nelson, K. B. (2003) · Current Opinion in Pediatrics · doi:10.1097/00008480-200306000-00020 · Cited by 78 · see citing works
Cooley, W. C. (2004) · Current Opinion in Pediatrics · doi:10.1097/01.mop.0000146440.79293.5b · Cited by 77 · see citing works
Autism and ADHD: Common Disorders, Elusive Explanations1
Castillo, M. (2005) · Academic Radiology · doi:10.1016/j.acra.2005.02.012 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Identification, Evaluation, and Management of Children With Autism Spectrum Disorder
Hyman, S. L., Levy, S. E., Myers, S. M., COUNCIL ON CHILDREN WITH DISABILITIES, S. O. D. A. B. P., Kuo, D. Z., Apkon, S., Davidson, L. F., Ellerbeck, K. A., Foster, J. E. A., Noritz, G. H., et al. (2020) · Pediatrics · doi:10.1542/peds.2019-3447 · Cited by 1,548 · see citing works
Patterns of Comorbidity, Functioning, and Service Use for US Children With ADHD, 2007
Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N. (2011) · Pediatrics · doi:10.1542/peds.2010-0165 · Cited by 580 · see citing works
Liptak, G. S., Benzoni, L. B., Mruzek, D. W., Nolan, K. W., Thingvoll, M. A., Wade, C. M., & Fryer, G. E. (2008) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e318165c7a0 · Cited by 504 · see citing works
Levy, S. E., Giarelli, E., Lee, L.-C., Schieve, L. A., Kirby, R. S., Cunniff, C., Nicholas, J., Reaven, J., & Rice, C. E. (2010) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3181d5d03b · Cited by 504 · see citing works
Williams, B. L., Hornig, M., Buie, T., Bauman, M. L., Cho Paik, M., Wick, I., Bennett, A., Jabado, O., Hirschberg, D. L., & Lipkin, W. I. (2011) · PLoS ONE · doi:10.1371/journal.pone.0024585 · Cited by 492 · see citing works
Co-occurring psychiatric conditions in autism spectrum disorder
Rosen, T. E., Mazefsky, C. A., Vasa, R. A., & Lerner, M. D. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1450229 · Cited by 325 · see citing works
Chiri, G., & Warfield, M. E. (2012) · Maternal and Child Health Journal · doi:10.1007/s10995-011-0833-6 · Cited by 283 · see citing works
Schieve, L. A., Gonzalez, V., Boulet, S. L., Visser, S. N., Rice, C. E., Braun, K. V. N., & Boyle, C. A. (2012) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2011.10.008 · Cited by 273 · see citing works
Sanctuary, M. R., Kain, J. N., Chen, S. Y., Kalanetra, K., Lemay, D. G., Rose, D. R., Yang, H. T., Tancredi, D. J., German, J. B., Slupsky, C. M., et al. (2019) · PLOS ONE · doi:10.1371/journal.pone.0210064 · Cited by 255 · see citing works
Zerbo, O., Massolo, M. L., Qian, Y., & Croen, L. A. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2579-2 · Cited by 244 · see citing works
Soke, G. N., Maenner, M. J., Christensen, D., Kurzius-Spencer, M., & Schieve, L. A. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3521-1 · Cited by 194 · see citing works
Tsilioni, I., Taliou, A., Francis, K., & Theoharides, T. C. (2015) · Translational Psychiatry · doi:10.1038/tp.2015.142 · Cited by 199 · see citing works
Characterization of depression in children with autism spectrum disorders
Magnuson, K. M., & Constantino, J. N. (2011) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e318213f56c · Cited by 193 · see citing works
The association between self-injurious behaviors and autism spectrum disorders
Minshawi, N., Hurwitz, S., Fodstad, J., Biebl, S., Morris, D., & McDougle, C. (2014) · Psychology Research and Behavior Management · doi:10.2147/prbm.s44635 · Cited by 188 · see citing works
Tye, C., Runicles, A. K., Whitehouse, A. J. O., & Alvares, G. A. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00751 · Cited by 177 · see citing works
Muskat, B., Burnham Riosa, P., Nicholas, D. B., Roberts, W., Stoddart, K. P., & Zwaigenbaum, L. (2015) · Autism · doi:10.1177/1362361314531341 · Cited by 184 · see citing works
Medical homes for children with autism: a physician survey
Golnik, A., Ireland, M., & Borowsky, I. W. (2009) · Pediatrics · doi:10.1542/peds.2008-1321 · Cited by 176 · see citing works
Association of Food Allergy and Other Allergic Conditions with Autism Spectrum Disorder in Children
Xu, G., Snetselaar, L. G., Jing, J., Liu, B., Strathearn, L., & Bao, W. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.0279 · Cited by 159 · see citing works
Microbiome and nutrition in autism spectrum disorder: Current knowledge and research needs
Berding, K., & Donovan, S. M. (2016) · Nutrition Reviews · doi:10.1093/nutrit/nuw048 · Cited by 146 · see citing works
Sapiets, S. J., Totsika, V., & Hastings, R. P. (2021) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12852 · Cited by 141 · see citing works
Mast cell activation and autism
Theoharides, T. C., Angelidou, A., Alysandratos, K.-D., Zhang, B., Asadi, S., Francis, K., Toniato, E., & Kalogeromitros, D. (2012) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2010.12.017 · Cited by 125 · see citing works
Newcomb, E. T., & Hagopian, L. P. (2018) · International Review of Psychiatry · doi:10.1080/09540261.2018.1435513 · Cited by 119 · see citing works
Walsh, C., Lydon, S., O’Dowd, E., & O’Connor, P. (2020) · Developmental Neurorehabilitation · doi:10.1080/17518423.2020.1716868 · Cited by 107 · see citing works
Increased production of IL-17 in children with autism spectrum disorders and co-morbid asthma
Akintunde, M. E., Rose, M., Krakowiak, P., Heuer, L., Ashwood, P., Hansen, R., Hertz-Picciotto, I., & Van de Water, J. (2015) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2015.07.003 · Cited by 96 · see citing works
Takara, K., & Kondo, T. (2014) · Annals of General Psychiatry · doi:10.1186/s12991-014-0033-z · Cited by 93 · see citing works
Correlates of police involvement among adolescents and adults with autism spectrum disorder
Tint, A., Palucka, A. M., Bradley, E., Weiss, J. A., & Lunsky, Y. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3182-5 · Cited by 87 · see citing works
Neurological disorders in autism: A systematic review and meta-analysis
Pan, P.-Y., Bölte, S., Kaur, P., Jamil, S., & Jonsson, U. (2021) · Autism · doi:10.1177/1362361320951370 · Cited by 83 · see citing works
Priority service needs and receipt across the lifespan for individuals with autism spectrum disorder
Lai, J. K. Y., & Weiss, J. A. (2017) · Autism Research · doi:10.1002/aur.1786 · Cited by 79 · see citing works
Diallo, F. B., Fombonne, É., Kisely, S., Rochette, L., Vasiliadis, H.-M., Vanasse, A., Noiseux, M., Pelletier, É., Renaud, J., St-Laurent, D., et al. (2018) · The Canadian Journal of Psychiatry · doi:10.1177/0706743717737031 · Cited by 72 · see citing works
The Gut-Immune-Brain Axis in Autism Spectrum Disorders; A Focus on Amino Acids
van Sadelhoff, J. H. J., Perez Pardo, P., Wu, J., Garssen, J., van Bergenhenegouwen, J., Hogenkamp, A., Hartog, A., & Kraneveld, A. D. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00247 · Cited by 71 · see citing works
Parent and Provider Perspectives on Procedural Care for Children with Autism Spectrum Disorders
Davignon, M. N., Friedlaender, E., Cronholm, P. F., Paciotti, B., & Levy, S. E. (2014) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000036 · Cited by 66 · see citing works
Health Care Transition Services for Youth With Autism Spectrum Disorders: Perspectives of Caregivers
Kuhlthau, K. A., Delahaye, J., Erickson-Warfield, M., Shui, A., Crossman, M., & van der Weerd, E. (2016) · Pediatrics · doi:10.1542/peds.2015-2851n · Cited by 65 · see citing works
Kuhlthau, K. A., Warfield, M. E., Hurson, J., Delahaye, J., & Crossman, M. K. (2015) · Autism · doi:10.1177/1362361313518125 · Cited by 64 · see citing works
Nosology and epidemiology in autism: classification counts
Fisch, G. S. (2012) · American Journal of Medical Genetics Part C: Seminars in Medical Genetics · doi:10.1002/ajmg.c.31325 · Cited by 51 · see citing works
Schwartzman, J. M., Muscatello, R. A., & Corbett, B. A. (2023) · Autism · doi:10.1177/13623613231162154 · Cited by 50 · see citing works
Gut-to-Brain Axis in Autism Spectrum Disorders
Kraneveld, A. D., Szklany, K., de Theije, C. G. M., & Garssen, J. (2016) · International review of neurobiology · doi:10.1016/bs.irn.2016.09.001 · Cited by 47 · see citing works
Parent perceptions of autism severity: Exploring the social ecological context
Hock, R., & Ahmedani, B. K. (2012) · Disability and Health Journal · doi:10.1016/j.dhjo.2012.06.002 · Cited by 42 · see citing works
Effect of a social script iPad application for children with autism going to imaging
Johnson, N., Bree, O., Lalley, E. E., Rettler, K., Grande, P., Gani, M. O., & Ahamed, S. I. (2014) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2014.04.007 · Cited by 37 · see citing works
Stewart, T. M., Martin, K., Fazi, M., Oldridge, J., Piper, A., & Rhodes, S. M. (2022) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12366 · Cited by 25 · see citing works
Federico, A., Zgodic, A., Flory, K., Hantman, R. M., Eberth, J. M., Mclain, A. C., & Bradshaw, J. (2024) · Disability and Health Journal · doi:10.1016/j.dhjo.2023.101512 · Cited by 18 · see citing works
Murphy, D., Glaser, K., Hayward, H., Eklund, H., Cadman, T., Findon, J., Woodhouse, E., Ashwood, K., Beecham, J., Bolton, P., et al. (2018) · Programme Grants for Applied Research · doi:10.3310/pgfar06020 · Cited by 18 · see citing works
“In the 2003–4 US National Survey of Children’s Health, parents of children with autism reported a significantly higher number of visits to all types of physicians than did parents of children without autism.(182) There is, however, evidence of a fall in the level of support young people with ASD get once they leave sc…”
BackgroundBoada, L., & Parellada, M. (2017) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2016.09.005 · Cited by 15 · see citing works
- Authors
- Gurney, J. G., McPheeters, M. L., & Davis, M. M.
- Affiliations
- University of Michigan (US)
- Venue
- Archives of Pediatrics & Adolescent Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2006-08-01
- Volume
- 160
- Issue
- 8
- Pages
- 825
- ISSN
- 1072-4710 (ISSN-L)
- OpenAlex
- W2122275317
- Cited by
- 411
- References
- 33
- Citations by year
- 2026: 6 · 2025: 21 · 2024: 20 · 2023: 24 · 2022: 24 · 2021: 27 · 2020: 32 · 2019: 20 · 2018: 29 · 2017: 27 · 2016: 29 · 2015: 27 · 2014: 27 · 2013: 16 · 2012: 25
- FWCI
- 4.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Social Sciences › Psychology › Clinical Psychology › Family and Disability Support Research
- Keywords
- autism spectrum disorder, children with autism, health conditions, health care utilization, autism prevalence, anxiety and depression, behavioral problems, food allergy, respiratory allergy, skin allergy, physician visits, speech therapy, occupational therapy, chronic drug administration, National Survey of Children's Health
- MeSH terms
- Adolescent, Autistic Disorder, Child, Child, Preschool, Cross-Sectional Studies, Female, Health Services, Health Status, Health Surveys, Humans, Male, Parents, United States, Comorbidity, Prevalence, Multivariate Analysis, Logistic Models
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
