Research Papers

Children With Both Atopic Conditions Such as Eczema and Autism Spectrum Disorder (ASD) Are Likely to Experience More Severe ASD Symptoms


Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by altered social responsiveness and behaviours. The aetiology of ASD is a combination of genetic and environmental factors and is also linked with other common childhood conditions such as atopy (allergies, asthma, eczema and hay fever). In a previous meta-analysis including over one million participants, the researchers found that children with ASD were 1.49 times more likely to also have atopic dermatitis, which raises important questions concerning the skin-brain and gut-brain axis. The aim of this paper was to explore whether atopic conditions were associated with more severe symptoms in a cohort of children with ASD, specifically restricted and repetitive behaviours. The results showed that children with atopy were 2.4 times more likely to experience severe ASD symptoms and 2.7 times more likely to show social difficulties. These findings provide evidence that future investigations into the link between common childhood conditions and ASD symptoms are both warranted and important, in order to assess whether the causation of neurodevelopmental and atopic conditions in children are similar.

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Growing evidence indicates that autism spectrum disorder (ASD) has diverse genetic, neurological, and environmental factors that contribute to its neurodevelopmental course. Interestingly, childhood ASD is often accompanied by skin disorders, such as eczema, and other related atopic manifestations. This link may be due to the shared embryonic origin of epidermal and neural tissue. Accordingly, we consider the potential influence of a skin-brain co-vulnerability and ensuing atopic cascade on ASD symptomatology by investigating whether atopic disorders (asthma, allergies, eczema and hay fever) are associated with increased symptom severity in children with ASD. Overall, 45 atopic and 93 non-atopic children with ASD were assessed using the ADOS-2 on scores of total, social and non-social symptoms. Differences in ASD symptom severity were further evaluated as a function of atopic disease type. Atopic children displayed greater symptom severity overall and in the social domain, relative to non-atopic participants. Atopic children were 2.4 times more likely to experience overall impairments classified within the ADOS-2 highest-level severity bracket and 2.7 times more likely to show social difficulties in this range. Moreover, those reporting comorbid eczema displayed increased symptom severity relative to both their non-atopic peers and those reporting asthma and allergies. Taken together, findings indicate that atopic disorders, and particularly comorbid eczema, are associated with increases in ASD symptom severity. Findings provide grounds for future investigations into this link between childhood skin diseases and ASD symptom severity to advance our understanding of neurodevelopment and to develop targeted assessment and intervention opportunities.

Article Publication Date: 28/09/2022
DOI: 10.1038/s41398-022-02185-5

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