title: Autism traits: The importance of "co-morbid" problems for impairment and contact with services. Data from the Bergen Child Study.
abstract: BACKGROUND
  Co-occurring problems are common in individuals with clinical autism spectrum disorder (ASD) but their relevance for impairment and contact with health services in ASD is largely unexplored.
  
  
  OBJECTIVE
  We investigated the extent of co-occurring problems in children with high ASD traits from a total population sample. We explored the contribution of co-occurring problems to impairment and service contact, and whether there were children without co-occurring problems in this group; as proxy for "ASD only".
  
  
  METHODS
  Children screening positive on the Autism Spectrum Screening Questionnaire (ASSQ) were used as proxy for ASD. Attention Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) were operationalised using symptom counts. A parent or teacher report above the 95th percentile counted as "problem" present for other symptom domains.
  
  
  RESULTS
  92% of ASSQ high-scorers had a minimum of two other problems. Emotional problems, ADHD symptoms and learning problems were the most commonly reported problems, also predicting impairment and contact with services.
  
  
  CONCLUSIONS
  Co-occurring problems were common in ASD screen positive children and contributed strongly to both impairment and to contact with services. Gender differences indicated that female symptoms were perceived as less impairing by parents and teachers.
authors.affiliation: Department of Child and Adolescent Mental Health, Division of Psychiatry, Haukeland University Hospital, Norway. Electronic address: maj-britt.posserud@uni.no.
authors.forename: M
authors.initials: M
authors.lastname: Posserud
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Hysing
authors.affiliation: Section of Research and Innovation Helse Fonna HF, Haugesund, Norway; Department of Speech and Language Disorders, Statped Vest, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway.
authors.forename: W
authors.initials: W
authors.lastname: Helland
authors.affiliation: Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Gillberg
authors.affiliation: Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway.
authors.forename: A J
authors.initials: AJ
authors.lastname: Lundervold
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D000067877:Autism Spectrum Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology*; D008297:Male; D009664:Norway / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012737:Sex Factors
keywords: ASSQ; Autism; Autism spectrum disorders; Comorbidity; Gender differences; Impairment