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Cited by 206Autism Spectrum Disorder ResearchDown syndrome and intellectual disability researchChild Nutrition and Feeding Issues

A systematic review of two outcomes in autism spectrum disorder: epilepsy and mortality.

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WOOLFENDEN, SUE, SARKOZY, VANESSA, RIDLEY, GRETA, COORY, MICHAEL, WILLIAMS, KATRINA·2012·Developmental Medicine & Child Neurology
DOI 10.1111/j.1469-8749.2012.04223.x
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Abstract

Aim It has been reported that rates of epilepsy and mortality are higher among the population with autism spectrum disorder (ASD) than in the general population. The aim of this systematic review is to provide comprehensive evidence for clinicians, carers, and people with ASD regarding these outcomes. Method Studies were eligible for inclusion if the main focus of the study involved observation over a period of 12 months or more of an initially defined population (with appropriate diagnostic label). Studies were also required to have at least 30 participants in order to differentiate case series from cohort studies. The Cochrane Database of Systematic Reviews, the Database of Reviews of Effectiveness, MEDLINE, PsycINFO, EMBASE, and CINAHL were searched. The date of the last search was September 2010. The risk of bias of included studies was assessed and a meta‐analysis was undertaken. Results Twenty‐one studies were identified, 16 measuring the percentage of participants with epilepsy and five measuring mortality using a standardized mortality ratio. The pooled estimate for the percentage of participants with epilepsy was 1.8% (95% CI 0.4–9.4%) in studies in which the majority did not have an intellectual disability and the mean age was <12 years at follow‐up, and 23.7% (95% CI 17.5–30.5%) in studies in which the majority did have an intellectual disability and the mean age at follow‐up was more than 12 years. The pooled estimate for the standardized mortality ratio was 2.8 (95% CI 1.8–4.2). Interpretation The prevalence of epilepsy is higher among the population with ASD than in the general population. People with ASD have a higher risk of mortality than the general population. This has important health promotion implications.

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  • The prevalence of epilepsy in autism spectrum disorder doubles in adolescence (26%) compared to childhood (12%).

    “with the prevalence of epilepsy in ASD doubling in adolescence (26%) compared to childhood (12%) (Hara, 2007; Woolfenden et al., 2012; Sharma et al., 2021).”

    From Tauopathy and Epilepsy Comorbidities and Underlying Mechanisms (2022) · cites this paper as Woolfenden et al., 2012

    The Abstract says epilepsy prevalence in ASD is highest in adolescence and young adulthood. However, the 'Pooled estimate of percentage of participants with epilepsy at follow-up' section reports age-group estimates stratified by intellectual disability—not 12% in childhood and 26% in adolescence—and does not establish a doubling from those figures. No page number was provided for the indexed passages. (LLM, conf=0.88)

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  • A prior systematic review of studies published until 2010 located only 5 studies investigating mortality associations in ASD, so lack of data precluded exploring potential variations in all-cause mortality and quantifying cause-specific mortality risks.

    “A systematic review20 of studies published until 2010 examined ASD and 2 outcomes (epilepsy and mortality). Only 5 studies investigating mortality associations were located,20 so lack of data precluded exploring potential variations in all-cause mortality and quantifying cause-specific mortality risks.”

    From Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis (2022) · cites this paper as [20]

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Research works printed but not linked: 3

  1. Levy SE, Mandell DS, Schultz RT. Autism. Lancet 2009; 374: 1627-38.
  2. Pickett JA, Paculdo DR, Shavelle RM, Strauss DJ. 1998- 2002 update on 'causes of death in autism'. J Autism Dev Disord 2006; 36: 287-8.
  3. Morgan C, Baxter H, Kerr M, MacLean W. Prevalence of epilepsy and associated health service utilization and mortal- ity among patients with intellectual disability. Am J Ment Retard 2003; 108: 293-300.

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Authors
WOOLFENDEN, S., SARKOZY, V., RIDLEY, G., COORY, M., & WILLIAMS, K.
Affiliations
  • UNSW Sydney (AU)
  • Sydney Children's Hospital (AU)
  • The University of Melbourne (AU)
  • Royal Children's Hospital (AU)
ORCID
Venue
Developmental Medicine & Child Neurology
Publisher
Wiley
Published
2012-02-21
Volume
54
Issue
4
Pages
306-312
ISSN
  • 0012-1622 (ISSN-L)
  • 1469-8749
DOI
10.1111/j.1469-8749.2012.04223.x
OpenAlex
W2009058595
Cited by
206
References
42
Citations by year
2026: 7 · 2025: 9 · 2024: 16 · 2023: 20 · 2022: 22 · 2021: 17 · 2020: 20 · 2019: 14 · 2018: 10 · 2017: 17 · 2016: 16 · 2015: 15 · 2014: 11 · 2013: 10 · 2012: 2
FWCI
0.96
Type
journal article
Language
en
Update notices
erratum (2012-06-14)
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Developmental Medicine & Child Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • Griffith Research Online (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords
autism spectrum disorder, epilepsy, mortality, standardized mortality ratio, intellectual disability, comorbidities, health outcomes
MeSH terms
Adolescent, Cause of Death, Child, Child Development Disorders, Pervasive, Child, Preschool, Epilepsy, Humans, Risk Factors, Databases, Bibliographic, Outcome Assessment, Health Care

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