Abstract
Adolescence is a time of exceptional physical health juxtaposed against significant psychosocial and weight-related problems. The study included 241, 10-to-13-year-old youth with autism spectrum disorder (ASD, N = 138) or typical development (TD, N = 103). Standardized exams measured pubertal development, height (HT), weight (WT), heart rate (HR), blood pressure (BP) and Body Mass Index (BMI). Analysis of Variance showed no significant between-group differences for HT, WT, HR, or BP (all p > 0.05). There was a significant difference in BMI-percentile between the groups (F(1,234) = 6.05, p = 0.01). Using hierarchical linear regression, significant predictors of BMI-percentile included diagnosis, pubertal stage and socioeconomic status. Pre-to-early pubescent children with ASD evidence higher BMI percentiles compared to youth with TD suggesting they may be at heightened risk for weight-related health concerns.
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Anderson, S. E., & Whitaker, R. C. (2009). Prevalence of obesity among US preschool children in different racial and ethnic groups. Archives of Pediatrics and Adolescent Medicine, 163(4), 344–348. https://doi.org/10.1001/archpediatrics.2009.18.
APA. (2013). Diagnostic and statistical manual of mental disorders, Fifth Edition (DSM-5). Washinton, D.C.: American Psychiatric Association.
Bal, E., Harden, E., Lamb, D., Van Hecke, A. V., Denver, J. W., & Porges, S. W. (2010). Emotion recognition in children with autism spectrum disorders: Relations to eye gaze and autonomic state. Journal of Autism and Developmental Disorders, 40(3), 358–370. https://doi.org/10.1007/s10803-009-0884-3.
Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., et al. (2010). Food selectivity in children with autism spectrum disorders and typically developing children. Journal of Pediatrics, 157(2), 259–264. https://doi.org/10.1016/j.jpeds.2010.02.013.
Benevides, T. W., & Lane, S. J. (2013). A review of cardiac autonomic measures: Considerations for examination of physiological response in children with autism spectrum disorder. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-013-1971-z.
Biddle, S. J. H., Pearson, N., Ross, G. M., & Braithwaite, R. (2010). Tracking of sedentary behaviours of young people: A systematic review. Preventive Medicine, 51(5), 345–351. https://doi.org/10.1016/j.ypmed.2010.07.018.
Bricout, V. A., Pace, M., Dumortier, L., Favre-Juvin, A., & Guinot, M. (2018). Autonomic responses to head-up tilt test in children with autism spectrum disorders. Journal of Abnormal Child Psychology, 46(5), 1121–1128. https://doi.org/10.1007/s10802-017-0339-9.
Broder-Fingert, S., Brazauskas, K., Lindgren, K., Iannuzzi, D., & Van Cleave, J. (2014). Prevalence of overweight and obesity in a large clinical sample of children with autism. Academic Pediatric, 14(4), 408–414. https://doi.org/10.1016/j.acap.2014.04.004.
Buchan, D. S., Bobby, L. M., Grace, F. M., Brown, E., Sculthorpe, N., Cuttingham, C., et al. (2017). Utility of three anthropometric indices in assessing the cardiometabolic risk profile in children. American Journal of Human Biology, 29(3), e22934.
CDC. (2010). Youth risk behavior surveillance—United States 2009. Morbidity and Mortality Weekly Report, 59(SS-5), 1–142.
Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246. https://doi.org/10.1016/j.jada.2009.10.032.
Chaidez, V., Hansen, R. L., & Hertz-Picciotto, I. (2014). Gastrointestinal problems in children with autism, developmental delays or typical development. Journal of Autism and Developmental Disorders, 44(5), 1117–1127. https://doi.org/10.1007/s10803-013-1973-x.
Chrousos, G. P., Torpy, D. J., & Gold, P. W. (1998). Interactions between the hypothalamic-pituitary-adrenal axis and the female reproductive system: Clinical implications. Annals of Internal Medicine, 129(3), 229–240.
Corbett, B. A. (2017). Examining stress and arousal across pubertal development in ASD. National Institute of Mental Health, R01 MH111599.
Corbett, B. A., Muscatello, R. A., Tanguturi, Y., McGinn, E., & Ioannou, S. (2019). Pubertal development measurement in children with and without autism spectrum disorder: A comparison between physical exam, parent- and self-report. Journal of Autism and Developmental Disorders, 49(12), 4807–4819. https://doi.org/10.1007/s10803-019-04192-w.
Corbett, B. A., Vandekar, S., Muscatello, R. A., & Tanguturi, Y. (in press). Pubertal timing during early adolescence: Advanced pubertal onset in females with autism spectrum disorder. Autism Research.
Criado, K. K., Sharp, W. G., McCracken, C. E., De Vinck-Baroody, O., Dong, L., Aman, M. G., et al. (2018). Overweight and obese status in children with autism spectrum disorder and disruptive behavior. Autism, 22(4), 450–459. https://doi.org/10.1177/1362361316683888.
Croen, L. A., Zerbo, O., Qian, Y., Massolo, M. L., Rich, S., Sidney, S., et al. (2015). The health status of adults on the autism spectrum. Autism, 19(7), 814–823. https://doi.org/10.1177/1362361315577517.
Curtin, C., Anderson, S. E., Must, A., & Bandini, L. (2010). The prevalence of obesity in children with autism: A secondary data analysis using nationally representative data from the National Survey of Children’s Health. BMC Pediatrics, 10, 11. https://doi.org/10.1186/1471-2431-10-11.
Curtin, C., Jojic, M., & Bandini, L. G. (2014). Obesity in children with autism spectrum disorder. Harvard Review of Psychiatry, 22(2), 93–103. https://doi.org/10.1097/HRP.0000000000000031.
Dahl, R. E. (2004). Adolescent brain development: A period of vulnerabilities and opportunities. Keynote address. Annals of the New York Academy of Sciences, 1021, 1–22. https://doi.org/10.1196/annals.1308.001.
Eagle, T. F., Sheetz, A., Gurm, R., Woodward, A. C., Kline-Rogers, E., Leibowitz, R., et al. (2012). Understanding childhood obesity in America: Linkages between household income, community resources, and children’s behaviors. American Heart Journal, 163(5), 836–843. https://doi.org/10.1016/j.ahj.2012.02.025.
Edmiston, E. K., Blain, S. D., & Corbett, B. A. (2017). Salivary cortisol and behavioral response to social evaluative threat in adolescents with autism spectrum disorder. Autism Research, 10(2), 346–358. https://doi.org/10.1002/aur.1660.
Evans, E. W., Must, A., Anderson, S. E., Curtin, C., Scampini, R., Maslin, M., et al. (2012). Dietary patterns and body mass index in children with autism and typically developing children. Research in Autism Spectrum Disorders, 6(1), 399–405. https://doi.org/10.1016/j.rasd.2011.06.014.
Forbes, E. E., & Dahl, R. E. (2010). Pubertal development and behavior: Hormonal activation of social and motivational tendencies. Brain Cognition, 71(1), 66–72.
Graber, J. A., Lewinsohn, P. M., Seeley, J. R., & Brooks-Gunn, J. (1997). Is psychopathology associated with the timing of pubertal development? Journal of the American Academy of Child and Adolescent Psychiatry, 36(12), 1768–1776. https://doi.org/10.1097/00004583-199712000-00026.
Granger, D. A., Hibel, L. C., Fortunato, C. K., & Kapelewski, C. H. (2009). Medication effects on salivary cortisol: Tactics and strategy to minimize impact in behavioral and developmental science. Psychoneuroendocrinology, 34(10), 1437–1448. https://doi.org/10.1016/j.psyneuen.2009.06.017.
Granich, J., Lin, A., Hunt, A., Wray, J., Dass, A., & Whitehouse, A. J. (2016). Obesity and associated factors in youth with an autism spectrum disorder. Autism, 20(8), 916–926. https://doi.org/10.1177/1362361315616345.
Hales, C. M., Carroll, M. D., Fryar, C. D., & Ogden, C. L. (2018). Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief, 288. Hyattsville, MD: National Center for Health Statistics.
Healy, S., Aigner, C. J., & Haegele, J. A. (2019). Prevalence of overweight and obesity among US youth with autism spectrum disorder. Autism, 23(4), 1046–1050. https://doi.org/10.1177/1362361318791817.
Heffernan, K. S., Columna, L., Russo, N., Myers, B. A., Ashby, C. E., Norris, M. L., et al. (2018). Brief report: Physical activity, body mass index and arterial stiffness in children with autism spectrum disorder: Preliminary findings. Journal of Autism and Developmental Disorders, 48(2), 625–631. https://doi.org/10.1007/s10803-017-3358-z.
Hill, A. P., Zuckerman, K. E., & Fombonne, E. (2015). Obesity and autism. Pediatrics, 136(6), 1051–1061. https://doi.org/10.1542/peds.2015-1437.
Hollocks, M. J., Howlin, P., Papadopoulos, A. S., Khondoker, M., & Simonoff, E. (2014). Differences in HPA-axis and heart rate responsiveness to psychosocial stress in children with autism spectrum disorders with and without co-morbid anxiety. Psychoneuroendocrinology, 46, 32–45. https://doi.org/10.1016/j.psyneuen.2014.04.004.
Iannotti, R. J., & Wang, J. (2013). Trends in physical activity, sedentary behavior, diet, and BMI among US adolescents, 2001–2009. Pediatrics, 132(4), 606–614. https://doi.org/10.1542/peds.2013-1488.
Jansen, L. M., Gispen-de Wied, C. C., van der Gaag, R. J., & van Engeland, H. (2003). Differentiation between autism and multiple complex developmental disorder in response to psychosocial stress. Neuropsychopharmacology, 28(3), 582–590.
Jones, R. A., Downing, K., Rinehart, N. J., Barnett, L. M., May, T., McGillivray, J. A., et al. (2017). Physical activity, sedentary behavior and their correlates in children with autism spectrum disorder: A systematic review. PLoS One, 12(2), e0172482. https://doi.org/10.1371/journal.pone.0172482.
Kahathuduwa, C. N., West, B. D., Blume, J., Dharavath, N., Moustaid-Moussa, N., & Mastergeorge, A. (2019). The risk of overweight and obesity in children with autism spectrum disorders: A systematic review and meta-analysis. Obesity Reviews, 20(12), 1667–1679. https://doi.org/10.1111/obr.12933.
Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., et al. (2002). 2000 CDC Growth Charts for the United States: Methods and development. Vital and Health Statistics, 11(246), 1–190.
Kumar, S., & Kelly, A. S. (2017). Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clinic Proceedings, 92(2), 251–265. https://doi.org/10.1016/j.mayocp.2016.09.017.
Kushki, A., Brian, J., Dupuis, A., & Anagnostou, E. (2014). Functional autonomic nervous system profile in children with autism spectrum disorder. Molecular Autism, 5, 39. https://doi.org/10.1186/2040-2392-5-39.
Lainhart, J. E., Bigler, E. D., Bocian, M., Coon, H., Dinh, E., Dawson, G., et al. (2006). Head circumference and height in autism: A study by the Collaborative Program of Excellence in Autism. American Journal of Medical Genetics Part A, 140(21), 2257–2274. https://doi.org/10.1002/ajmg.a.31465.
Levy, S. E., Pinto-Martin, J. A., Bradley, C. B., Chittams, J., Johnson, S. L., Pandey, J., et al. (2019). Relationship of weight outcomes, co-occurring conditions, and severity of autism spectrum disorder in the study to explore early development. Journal of Pediatrics, 205, 202–209. https://doi.org/10.1016/j.jpeds.2018.09.003.
Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012). Autism Diagnostic Observation Schedule (ADOS-2) (2nd ed.). Torrance, CA: Western Psychological Services.
Marshal, W. A., & Tanner, J. M. (1970). Variations in the pattern of pubertal changes in boys. Archives of Disease in Childhood, 45(239), 13–23.
Marshall, W. A., & Tanner, J. M. (1969). Variations in pattern of pubertal development in girls. Archives of Disease in Childhood, 44(235), 291–303.
Matheson, B. E., & Douglas, J. M. (2017). Overweight and obesity in children with autism spectrum disorder (ASD): A critical review investigating the etiology, development, and maintenance of this relationship. Review Journal of Autism and Developmental Disorders, 4(2), 142–156. https://doi.org/10.1007/s40489-017-0103-7.
Mazurek, M. O., Shattuck, P. T., Wagner, M., & Cooper, B. P. (2012). Prevalence and correlates of screen-based media use among youths with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(8), 1757–1767. https://doi.org/10.1007/s10803-011-1413-8.
McCoy, S. M., Jakicic, J. M., & Gibbs, B. B. (2016). Comparison of obesity, physical activity, and sedentary behaviors between adolescents with autism spectrum disorders and without. Journal of Autism and Developmental Disorders, 46(7), 2317–2326. https://doi.org/10.1007/s10803-016-2762-0.
McCoy, S. M., & Morgan, K. (2020). Obesity, physical activity, and sedentary behaviors in adolescents with autism spectrum disorder compared with typically developing peers. Autism, 24(2), 387–399. https://doi.org/10.1177/1362361319861579.
Mitchell, J. A., Rodriguez, D., Schmitz, K. H., & Audrain-McGovern, J. (2013). Greater screen time is associated with adolescent obesity: A longitudinal study of the BMI distribution from ages 14 to 18. Obesity, 21(3), 572–575. https://doi.org/10.1002/oby.20157.
Must, A., Phillips, S., Curtin, C., & Bandini, L. G. (2015). Barriers to physical activity in children with autism spectrum disorders: Relationship to physical activity and screen time. Journal of Physical Activity and Health, 12(4), 529–534. https://doi.org/10.1123/jpah.2013-0271.
Must, A., Eliasziw, M., Phillips, S. M., Curtin, C., Kral, T. V., Segal, M., et al. (2017). The effect of age on the prevalence of obesity among US youth with autism spectrum disorder. Childhood Obesity, 13(1), 25–35. https://doi.org/10.1089/chi.2016.0079.
Nelson, M. C., Neumark-Sztainer, D., Hannan, P. J., Sirard, J. R., & Story, M. (2006). Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics, 118(6), E1627–E1634. https://doi.org/10.1542/peds.2006-0926.
Pace, M., & Bricout, V. A. (2015). Low heart rate response of children with autism spectrum disorders in comparison to controls during physical exercise. Physiology & Behavior, 141, 63–68. https://doi.org/10.1016/j.physbeh.2015.01.011.
Phillips, K. L., Schieve, L. A., Visser, S., Boulet, S., Sharma, A. J., Kogan, M. D., et al. (2014). Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities. Maternal and Child Health Journal, 18(8), 1964–1975. https://doi.org/10.1007/s10995-014-1442-y.
Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. https://doi.org/10.1016/j.biopsycho.2006.06.009.
Porges, S. W., Heilman, K. J., Bazhenova, O. V., Bal, E., Doussard-Roosevelt, J. A., & Koledin, M. (2007). Does motor activity during psyhophysiological paradigms confound the quantification and interpretation of heart rate and heart rate variability measures in young children? Developmental Psychobiology, 49, 485–494.
Reynolds, A. M., & Malow, B. A. (2011). Sleep and autism spectrum disorders. Pediatric Clinics of North America, 58(3), 685–698. https://doi.org/10.1016/j.pcl.2011.03.009.
Rutter, M., Bailey, A., & Lord, C. (2003). The Social Communication Questionnaire. Los Angeles: Western Psychological Services.
Sawyer, M. G., Harchak, T., Wake, M., & Lynch, J. (2011). Four-year prospective study of BMI and mental health problems in young children. Pediatrics, 128(4), 677–684. https://doi.org/10.1542/peds.2010-3132.
Shedlock, K., Susi, A., Gorman, G. H., Hisle-Gorman, E., Erdie-Lalena, C. R., & Nylund, C. M. (2016). Autism spectrum disorders and metabolic complications of obesity. Journal of Pediatrics, 178(183–187), e181. https://doi.org/10.1016/j.jpeds.2016.07.055.
Siegel, M., & Beaulieu, A. A. (2012). Psychotropic medications in children with autism spectrum disorders: A systematic review and synthesis for evidence-based practice. Journal of Autism and Developmental Disorders, 42(8), 1592–1605. https://doi.org/10.1007/s10803-011-1399-2.
Spear, L. P. (2000). The adolescent brain and age-related behavioral manifestations. Neuroscience and Biobehavioral Reviews, 24(4), 417–463. https://doi.org/10.1016/S0149-7634(00)00014-2.
Steinberg, L. (2005). Cognitive and affective development in adolescence. Trends in Cognitive Sciences, 9(2), 69–74. https://doi.org/10.1016/j.tics.2004.12.005.
Strauss, R. S. (2000). Childhood obesity and self-esteem. Pediatrics, 105(1), e15. https://doi.org/10.1542/peds.105.1.e15.
Thomas, S., Hinkley, T., Barnett, L. M., May, T., & Rinehart, N. (2019). Young children with ASD participate in the same level of physical activity as children without ASD: Implications for early intervention to maintain good health. Journal of Autism and Developmental Disorders, 49(8), 3278–3289. https://doi.org/10.1007/s10803-019-04026-9.
Toscano, C. V. A., Ferreira, J. P., Gaspar, J. M., & Carvalho, H. M. (2018). Growth and weight status of Brazilian children with autism spectrum disorders: A mixed longitudinal study. Jornal de Pediatria, 95(6), 705–712.
Tyler, C. V., Schramm, S. C., Karafa, M., Tang, A. S., & Jain, A. K. (2011). Chronic disease risks in young adults with autism spectrum disorder: Forewarned is forearmed. American Journal on Intellectual and Developmental Disabilities, 116(5), 371–380. https://doi.org/10.1352/1944-7558-116.5.371.
Waylen, A., & Wolke, D. (2004). Sex ‘n’ drugs ‘n’ rock ‘n’ roll: The meaning and social consequences of pubertal timing. European Journal of Endocrinology, 151(Suppl 3), U151–U159.
Wechsler, D. (2011). Wechsler Abbreviated Scale of Intelligence II (2nd ed.). San Antonio, TX: PsychCorp.
Whiteley, P., Dodou, K., Todd, L., & Shattock, P. (2004). Body mass index of children from the United Kingdom diagnosed with pervasive developmental disorders. Pediatrics International, 46(5), 531–533. https://doi.org/10.1111/j.1442-200x.2004.01946.x.
Zuckerman, K. E., Hill, A. P., Guion, K., Voltolina, L., & Fombonne, E. (2014). Overweight and obesity: Prevalence and correlates in a large clinical sample of children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(7), 1708–1719. https://doi.org/10.1007/s10803-014-2050-9.
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This study was funded by the National Institute of Mental Health (MH111599 PI: Corbett) with core support from the National Center for Advancing Translational Sciences (CTSA UL1 TR000445). None of the funding sources were involved in the study design, collection, analysis and interpretation of the data, writing of the report, or the decision to submit the article for publication.
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This study was funded by the National Institute of Mental Health (MH111599 PI: Corbett) with core support from the National Center for Advancing Translational Sciences (CTSA UL1 TR000445).
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BAC conceived of the study, supervised the implementation of study protocols and data collection, contributed to diagnostic assessments, analyzed and interpreted statistical analyses, and drafted and finalized the manuscript. RAM contributed to neuropsychological assessments and data collection, contributed to statistical analysis and interpretation of findings, and assisted with preparation of the drafted and finalized manuscript. BKH contributed to interpretation of the findings, drafting of the original manuscript, and review and editing of the final manuscript. MEK assisted with data collection and data management and contributed to reviewing and editing of drafts and the final manuscript. YT performed the majority of the physical examinations for the study and contributed to the final manuscript.
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Corbett, B.A., Muscatello, R.A., Horrocks, B.K. et al. Differences in Body Mass Index (BMI) in Early Adolescents with Autism Spectrum Disorder Compared to Youth with Typical Development. J Autism Dev Disord 51, 2790–2799 (2021). https://doi.org/10.1007/s10803-020-04749-0
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DOI: https://doi.org/10.1007/s10803-020-04749-0