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Prevalence and Phenomenology of Anxiety in Preschool-Aged Children with Autism Spectrum Disorder

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Abstract

Individuals with autism spectrum disorder (ASD) are at a higher risk for developing co-occurring anxiety symptoms and diagnosable anxiety disorders compared to children with neurotypical development (NTD). The objective of the current study was to characterize the prevalence and phenomenology of anxiety in preschool-aged children with ASD. Our sample consisted of preschoolers (M = 52.8 months, SD = 10.8 months) with ASD (n = 77, 66% with co-occurring intellectual disability, ID) and NTD (n = 55). We employed multi-method (questionnaire and semi-structured diagnostic interview) and multi-informant (parent- and teacher-report) assessments of anxiety. Children with ASD were significantly more likely to meet criteria for an anxiety disorder than children with NTD. Over 70% of our sample with ASD met DSM-5 criteria for an anxiety disorder, with Specific Phobia and Separation Anxiety Disorder being the most prevalent. A range of specific fears was endorsed in the group with ASD, many of which overlapped with ASD symptoms. Parents, but not teachers, also reported greater anxiety symptoms for children with ASD relative to the comparison sample. Prevalence and phenomenology of anxiety in our sample with ASD generally did not differ between those with and without co-occurring ID, with the exception of higher rates of generalized anxiety in those without ID. Results showed poor concordance between parent questionnaires and a semi-structured diagnostic interview in detecting clinically-elevated anxiety in children with ASD. Implications for clinical practice and research are discussed.

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Notes

  1. We use person-first language throughout this manuscript, as this was the language form preferred by our participating families at the time the project was conducted.

  2. Findings did not differ by source of collateral report.

  3. Sensitivity analyses revealed no differences in the pattern or significance of results when these 8 participants were excluded from analyses or when these participants were reclassified as without ID.

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Funding

This work was supported by funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (R15HD091726-01A1; Neece, C. L., & Fenning, R. M.).

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  1. Loma Linda University, Loma Linda, CA, USA

    Neilson Chan & Cameron L. Neece

  2. Claremont McKenna College, Claremont, CA, USA

    Rachel M. Fenning

  3. California State University, Fullerton, Fullerton, CA, USA

    Rachel M. Fenning

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Correspondence to Cameron L. Neece.

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Chan, N., Fenning, R.M. & Neece, C.L. Prevalence and Phenomenology of Anxiety in Preschool-Aged Children with Autism Spectrum Disorder. Res Child Adolesc Psychopathol 51, 33–45 (2023). https://doi.org/10.1007/s10802-022-00964-8

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