Behavioral and environmental contributory factors for obesity in children with autism: A secondary data analysis from the National Survey of Children's Health 2007

Background: Though childhood obesity and autism spectrum disorders (ASD) have been well researched in isolation, the existing literature has yet to thoroughly examine the co-occurrence of the two conditions. It is not presently understood how likely the two conditions are to co-occur. lt is also unclear how environmental and behavioral risk factors for childhood obesity may contribute more significantly to likelihood for obesity in children with ASD compared to youth without autism. Additionally, the role of functional limitations and diagnostic severity in likelihood for obesity within children with ASD has not been examined.;Objectives: First, this study aimed to identify whether children with ASD are more likely to be obese compared to youth without ASD. Second, the present study examined whether any identified discrepancy in likelihood for obesity between the two groups remained after controlling for sociodemographic factors. Third, the present study examined whether physical activity and screen-based behavior, individual health behaviors associated with childhood obesity and also particularly relevant to ASD, account for any identified discrepancy in likelihood for obesity between the two groups. Finally, this study examined the contribution of functional limitations and diagnostic severity to the likelihood for obesity in youth with ASD.;Methods: A nationally representative sample from the National Survey of Children's Health (NSCH) 2007 was used. Children age 10-17 (n = 41,902) were grouped based on presence of current ASD diagnosis (ASD n = 464; non-ASD n = 41 ,438). Chi-square analyses were used to examine prevalence for obesity between children with ASD and children without ASD. Binary logistic regression models were created to identify whether environmental and for behavioral factors account for significant discrepancy in likelihood for obesity between children with obesity and those not so diagnosed, and to address whether functional limitations or diagnostic severity account for differences in likelihood for obesity in children with ASD.;Results: The prevalence of obesity among those with ASD (n = 464) is 25.40%, compared to 13.50% in the non-ASD group (n = 41,438, p < .000). Children with ASD are more than twice as likely to be obese than children without ASD (Unadjusted OR = 2.19; 95% CI= 1.78, 2.71 ). Among youth with ASD, children with a mode rate (OR = 1.26, 95% CI= 0.77, 2.05) or severe ASD diagnosis (OR= 2.37, 95% CI= 1.19, 4.71) were more likely to be obese compared to those with a mild diagnostic severity.;Conclusions: Present findings indicate that children in the United States with ASD are twice as likely to be obese, compared to non-ASD peers. Furthermore, among youth with ASD, increased severity of diagnosis and functional limitations are significantly associated with increased likelihood for obesity. The present findings suggest that heightened efforts at early identification and intervention may be warranted to prevent and treat obesity in ASD.