Clinical profile of children with autism spectrum disorder (ASD) in a tertiary care center: a descriptive study

Abstract

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition and the data from Nepal remain scarce. This study aimed to describe the clinical profile of children with ASD presenting to a tertiary care center in Nepal.

Method: This prospective observational study at Patan Hospital included 30 children with ASD. Childhood Autism Rating Scale, Child Behavior Checklist, and GMDS were used for assessment. Thyroid function, vitamin D, ferritin, vitamin B12, and brainstem evoked response audiometry were evaluated.

Result: Among 30 children males counted 18(60%). Severe ASD was seen in 16 (53%) with a mean CARS score of 35.35 ± 3.94. All had poor response to name, poor eye contact and speech delay. Hand-leading behavior, parallel play, and hyperactivity was seen in 29 (97%) each. Tantrums 28(93%), delayed toilet 26(87%), sensory issues 20(67%), picky eating 13(43%), sleep disturbances 6(20%), and repetitive motor behaviors 6(20%) were common presentations. Withdrawal symptoms 15 (50%), attention problem 12 (40%), sleep problems in 10 (33%) were noted. All had age-appropriate gross motor skills and deficits in personal-social domains. Significant language delay, deficit in hand eye co-ordination and cognitive impairment was seen 93%, 50% and 40% respectively. Vitamin D, serum ferritin and vitamin B12 waslow in 25(83%), 11(37%) and 4(13%) respectively.

Conclusion: Speech delay, poor response to name, reduced eye contact, hyperactivity, parallel play, and sensory processing difficulties were the most common clinical presentations among children with ASD. Withdrawal symptoms, sleep disturbances, and inattention were frequent behavioral problems and majority have low vitamin D and iron.