Comorbidity in Autism Spectrum Disorder, Prevalence and its Implication: What Speech Therapists Need to Know

  • Judy Muthoni
  • George Mathenge Wairungu
Keywords: Autism Spectrum Disorder, Comorbidity, Speech therapy, ADHD, Multidisciplinary team, Symptomatology


Alarmingly, multiple researches indicate that individuals with Autism Spectrum Disorder have a short lifespan. They die earlier than typical population not because of ASD symptoms but due to untreated or undiagnosed physical and mental health comorbidities. Comorbidity refers to secondary conditions that coexist with the more dominant primary condition. In this case, Autism Spectrum Disorder. Research indicates that 74% of individuals with Autism Spectrum Disorder exhibit at least one comorbidity. Comorbidities in ASD are common but difficult to diagnose because majority of individuals with ASD have challenges recognizing and communicating the symptoms. This is further complicated by commonly overlapping phenotypic symptomatology between ASD and some comorbidities. The etiology of ASD is not clear and neither is that of its comorbidities. The aim of this study is to qualitatively analyze literature on ASD comorbidities currently published in renowned peer reviewed journals. This is a qualitative desktop research assuming a descriptive research design. It is anchored in Lev Vygotsky’s Social Constructivism theory of 1968. Comorbidities generally affect personalities, behavior and quality of life of individuals with ASD. One of the hall mark features of ASD is poor social communication skills. It requires a speech therapy intervention. It is important that speech therapists understand nature of comorbidities so that they can effectively manage them during therapy sessions. Further, speech therapy intervention is more effectively done through a multidisciplinary team approach. Speech therapists should be able to determine appropriately which professionals and support staff to collaborate with. Generally, attention, behavior problems, psychiatric and neurological disorders are the most common comorbidities in individuals with ASD.


Adams, H. L., Matson, J. L., Cervantes, P. E., & Goldin, R. L. (2014). The relationship between autism symptom severity and sleep problems: should bidirectionality be considered? Research in Autism Spectrum Disorders, 8(3), 193–199.
Al-Beltagi M. (2021). Autism medical comorbidities. World journal of clinical pediatrics, 10(3), 15–28.
An, J., Na, Y., & Zhang, P. (2019). How do parents of children with ASD use information grounds to seek for ASD‐related information?. Proceedings of the Association for Information Science and Technology, 56(1), 10-20.
Bennett, H. J., Jones, T., Valenzuela, K. A., & Haegele, J. A. (2022). Coordination variability during running in adolescents with autism spectrum disorder. Autism: the international journal of research and practice, 26(5), 1201–1215.
Besag F. M. (2017). Epilepsy in patients with autism: links, risks and treatment challenges. Neuropsychiatric disease and treatment, 14, 1–10.
Brondino, N., Fusar-Poli, L., Miceli, E., Di Stefano, M., Damiani, S., Rocchetti, M., & Politi, P. (2019). Prevalence of medical comorbidities in adults with autism spectrum disorder. Journal of general internal medicine, 34, 1992-1994.
Brookman-Frazee, L., Stadnick, N., Chlebowski, C., Baker-Ericzén, M., & Ganger, W. (2018). Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services. Autism, 22(8), 938-952.
Burns, J., Phung, R., McNeill, S., Hanlon-Dearman, A., & Ricci, M. F. (2023). Comorbidities affecting children with autism spectrum disorder: A retrospective chart review. Children, 10(8), 1414.
Campisi, L., Imran, N., Nazeer, A., Skokauskas, N., & Azeem, M. W. (2018). Autism spectrum disorder. British Medical Bulletin, 127(1), 91-100.
Chandrasekhar, T., & Sikich, L. (2022). Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan. Dialogues in clinical neuroscience, 17(2), 219-227.
Chen, W. J., Zhang, Z., Wang, H., Tseng, T. S., Ma, P., & Chen, L. S. (2021). Perceptions of Autism Spectrum Disorder (ASD) Etiology among Parents of Children with ASD. International journal of environmental research and public health, 18(13), 6774.
Crane-Godreau & Payne, P. (2019). Addressing anxiety a comorbid of Autism Spectrum Disorder of Autism Spectrum Disorder: A case report using Qigong sensory training Methods. Autism Open Access, 9(3).
Dizitzer, Y., Meiri, G., Flusser, H., Michaelovski, A., Dinstein, I., & Menashe, I. (2020). Comorbidity and health services' usage in children with autism spectrum disorder: A nested case–control study. Epidemiology and psychiatric sciences, 29, e95.
Doshi-Velez, F., Ge, Y., & Kohane, I. (2014). Comorbidity clusters in autism spectrum disorders: an electronic health record time-series analysis. Pediatrics, 133(1), e54-e63.
Fodstad, J. C., Elias, R., & Sarawgi, S. (2020). Intellectual Disability in Autism Spectrum Disorder. In S. W. White, B. B. Maddox, & C. A. Mazefsky (Eds.), The Oxford Handbook of Autism and Co-Occurring Psychiatric Conditions. Oxford Library of Psychology.
Frye, R. E., & Rossignol, D. A. (2016). Identification and treatment of pathophysiological comorbidities of autism spectrum disorder to achieve optimal outcomes. Clinical Medicine Insights: Pediatrics, 10, CMPed-S38337.
Fulceri, F., Morelli, M., Santocchi, E., Cena, H., Del Bianco, T., Narzisi, A., ... & Muratori, F. (2016). Gastrointestinal symptoms and behavioral problems in preschoolers with Autism Spectrum Disorder. Digestive and Liver disease, 48(3), 248-254.
Grzadzinski, R., Huerta, M., & Lord, C. (2013). DSM-5 and autism spectrum disorders (ASDs): an opportunity for identifying ASD subtypes. Molecular autism, 4(1), 1-6.
Hodges, H., Fealko, C., & Soares, N. (2020). Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation. Transl Pediatr., 9(Suppl 1), S55-S65.
Hoffman, J. & Hudak, R. (2022). Conceptualizing and Treating ObsessiveCompulsive Disorder in Adults with Autism Spectrum Disorder. Journal of therapeutic schools and programs, 14, 2689-2847.
Hossain, M. M., Khan, N., Sultana, A., Ma, P., McKyer, E. L. J., Ahmed, H. U., & Purohit, N. (2020). Prevalence of comorbid psychiatric disorders among people with autism spectrum disorder: An umbrella review of systematic reviews and meta-analyses. Psychiatry research, 287, 112922.
Houghton, R. (2021). Utilisation and outcomes of treatment in Autism Spectrum Disorder. [Doctoral Thesis, Maastricht University]. Gildeprint Drukkerijen.
Hours, C., Recasens, C., & Baleyte, J. M. (2022). ASD and ADHD Comorbidity: What Are We Talking About? Frontiers in psychiatry, 13, 837424.
Khachadourian, V., Ameis, S. H., Desarkar, P., Drmic, I. E., Lai, M. C., Lerch, J. P., & Anagnostou, E. (2023). Examining and comparing social perception abilities across childhood-onset neurodevelopmental disorders. Journal of the American Academy of Child & Adolescent Psychiatry.
Khachadourian, V., Mahjani, B., Sandin, S., Kolevzon, A., Buxbaum, J. D., Reichenberg, A., & Janecka, M. (2023). Comorbidities in autism spectrum disorder and their etiologies. Translational Psychiatry, 13(1), 71.
Koo, H. W., Ismail, J., Yang, W. W., & Syed Zakaria, S. Z. (2021). Sleep Disturbances in Children With Autism Spectrum Disorder at a Malaysian Tertiary Hospital. Frontiers in pediatrics, 8, 608242.
Kreiser, N. L., & White, S. W. (2014). ASD in females: are we overstating the gender difference in diagnosis?. Clinical child and family psychology review, 17, 67-84.
Madra, M., Ringel, R., & Margolis, K. G. (2020). Gastrointestinal Issues and Autism Spectrum Disorder. Child and adolescent psychiatric clinics of North America, 29(3), 501–513.
Magnuson, K. M., & Constantino, J. N. (2011). Characterization of depression in children with autism spectrum disorders. Journal of developmental and behavioral pediatrics: JDBP, 32(4), 332–340.
Mang’ombe, A.S. & Wairungu G.M. (2021). Autism Spectrum Disorder: A review of contemporary literature on common communication difficulties and recommended research based intervention strategies. International Journal of Research and Scientific Innovation, VII(IV).
Mannix, M. (2016). Medical comorbidities in autism spectrum disorder. The Brown University Child and Adolescent Behavior Letter, 32(2), 1-7.
Matson, J. L., & Cervantes, P. E. (2013). Comorbidity among persons with intellectual disabilities. Research in Autism Spectrum Disorders, 7(11), 1318-1322.
McPartland, J. C., Lerner, M. D., Bhat, A., Clarkson, T., Jack, A., Koohsari, S., ... & Trevisan, D. A. (2021). Looking back at the next 40 years of ASD neuroscience research. Journal of Autism and Developmental Disorders, 51(12), 4333-4353.
Miot, S., Akbaraly, T., Michelon, C., Couderc, S., Crepiat, S., Loubersac, J., Picot, M. C., Pernon, É., Gonnier, V., Jeandel, C., Blain, H., & Baghdadli, A. (2019). Comorbidity Burden in Adults with Autism Spectrum Disorders and Intellectual Disabilities-A Report from the EFAAR (Frailty Assessment in Ageing Adults with Autism Spectrum and Intellectual Disabilities) Study. Frontiers in psychiatry, 10, 617.
Mpaka, D. M., Okitundu, D. L. E. A., Ndjukendi, A. O., N’situ, A. M., Kinsala, S. Y., Mukau, J. E., ... & Steyaert, J. (2016). Prevalence and comorbidities of autism among children referred to the outpatient clinics for neurodevelopmental disorders. The Pan African Medical Journal, 25.
Ndiema, D.C & Wairungu G.M. (2021). Learners with Autism Spectrum Disorder: What socio-communication difficulties entail and the recommended research based intervention strategies. International Journal of Research and Innovation in Social Science (IJRISS), 5(12), 413-419.
Nimmo-Smith, V., Heuvelman, H., Dalman, C., Lundberg, M., Idring, S., Carpenter, P., Magnusson, C., & Rai, D. (2020). Anxiety Disorders in Adults with Autism Spectrum Disorder: A Population-Based Study. Journal of autism and developmental disorders, 50(1), 308–318.
Nyakundi J.C & Wairungu G.M. (2021). Applied behaviour Analyses as an intervention strategy in learners with Autism Spectrum Disorder. International Journal of Research and Innovation in Social Science (IJRISS), 5(7), 200-507.
Pazuniak, M., & Pekrul, S. R. (2020). Obsessive-Compulsive Disorder in Autism Spectrum Disorder Across the Lifespan. Child and adolescent psychiatric clinics of North America, 29(2), 419–432.
Rao, P. S. (2020). Pediatric Cardiology: How It Has Evolved over the Last 50 Years. Cambridge Scholars Publishing.
Romero, M., Aguilar, J. M., Del-Rey-Mejías, Á., Mayoral, F., Rapado, M., Peciña, M., Barbancho, M. Á., Ruiz-Veguilla, M., & Lara, J. P. (2016). Psychiatric comorbidities in autism spectrum disorder: A comparative study between DSM-IV-TR and DSM-5 diagnosis. International journal of clinical and health psychology: IJCHP, 16(3), 266–275.
Sala, R., Amet, L., Blagojevic-Stokic, N., Shattock, P., & Whiteley, P. (2020). Bridging the gap between physical health and autism spectrum disorder. Neuropsychiatric Disease and Treatment, 16, 1605-1618.
Sauer, A. K., Stanton, J., Hans, S., & Grabrucker, A. (2021). Autism spectrum disorders: etiology and pathology. Exon Publications, 1-15.
Segers, M., & Rawana, J. (2014). What do we know about suicidality in autism spectrum disorders? A systematic review. Autism Research, 7(4), 507-521.
Singer, E. V., Niarchou, M., Maxwell-Horn, A., Hucks, D., Johnston, R., Sutcliffe, J. S., ... & Malow, B. A. (2022). Characterizing sleep disorders in an autism-specific collection of electronic health records. Sleep Medicine, 92, 88-95.
Siriwat, R., Xu, Y., Hossain, M. M., & Simakajornboon, N. (2018). 0839 Sleep disorders in children with Autism Spectrum Disorder. Sleep, 41, A311.
Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of business research, 104, 333-339.
Srivastava, A. K., & Schwartz, C. E. (2014). Intellectual disability and autism spectrum disorders: causal genes and molecular mechanisms. Neuroscience and biobehavioral reviews, 46(Pt 2), 161–174.
Torres-Carrión, P. V., González-González, C. S., Aciar, S., & Rodríguez-Morales, G. (2018, April). Methodology for systematic literature review applied to engineering and education. In 2018 IEEE Global engineering education conference (EDUCON) (pp. 1364-1373). IEEE.
van Steensel, F. J., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis. Clinical child and family psychology review, 14(3), 302–317.
Wairungu, G.M. (2020). Sensory processing disorder in individuals with Autism Spectrum Disorder. International Journal of Research and Scientific Innovation (IJRSI), 5(6).
Wang, K., Wang, C., Guo, D., van Wijngaarden, M., & Begeer, S. (2018). Children with autism spectrum disorder from China and the Netherlands: Age of diagnosis, gender and comorbidities. Research in autism spectrum disorders, 54, 76-82.
Yu, J. X., Chang, L., & Qin, L. (2022). Keyword search in databases. Springer Nature.
Zaboski, B. A., & Storch, E. A. (2018). Comorbid autism spectrum disorder and anxiety disorders: a brief review. Future neurology, 13(1), 31–37.
Zachor, D., Yang, J. W., Itzchak, E. B., Furniss, F., Pegg, E., Matson, J. L., ... & Jung, W. (2011). Cross-cultural differences in comorbid symptoms of children with autism spectrum disorders: an international examination between Israel, South Korea, the United Kingdom and the United States of America. Developmental Neurorehabilitation, 14(4), 215-220.
Zhang, A., Li, J., Zhang, Y., Jin, X., & Ma, J. (2019). Epilepsy and Autism Spectrum Disorder: An Epidemiological Study in Shanghai, China. Frontiers in psychiatry, 10, 658.
How to Cite
Muthoni, J., & Wairungu, G. M. (2023). Comorbidity in Autism Spectrum Disorder, Prevalence and its Implication: What Speech Therapists Need to Know. European Journal of Science, Innovation and Technology, 3(6), 147-157. Retrieved from