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

Amanda J Hall, Richard Maw, Yasmin L Iles-Caven , Steve Gregory, Dheeraj Rai, Jean Golding*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

4 Citations (Scopus)

Abstract

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 ten environmental characteristics made little difference to the results, and substantially more adjusted associations were at P
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 ENT conditions in autistic children and may provide possible indicators of causal mechanisms.
Original languageEnglish
Article numbere067682
Number of pages9
JournalBMJ Open
Volume13
Issue number3
DOIs
Publication statusPublished - 24 Apr 2023

Bibliographical note

Funding Information:
This publication was made possible through the support of grants from the Medical Research Council (G0400085) and the John Templeton Foundation (ref no. 61917). The UK Medical Research Council and Wellcome Trust (Grant ref: 217065/Z/19/Z) and the University of Bristol (grant ref: N/A) currently provide core support for ALSPAC. This publication is the work of the authors who will serve as guarantors for the contents of this paper. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). The opinions expressed in this publication are those of the author(s) and do not necessarily reflect the views of the John Templeton Foundation.

Funding Information:
JG and RM are retired; YIC and SG are funded by the John Templeton Foundation (61917). The authors declare no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work.

Publisher Copyright:
© 2023 BMJ Publishing Group. All rights reserved.

Research Groups and Themes

  • ALSPAC
  • autism
  • hearing
  • early childhood
  • upper respiratory symptoms
  • snoring

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