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Relation of Autism Spectrum Disorder Severity and Risk for Overweight and Obesity
Kelsey Borner MA1,2, Cathleen Odar Stough MA1,2, Katrina Poppert1,2,
1,3
3,
4,
1,5
Meredith Dreyer Gillette PhD , Cy Nadler, PhD , Rebecca Swinburne Romine PhD Ann Davis, MPH, PhD, ABPP
1 Center
2 University of Kansas, Clinical Child Psychology Program, Lawrence, KS
for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO
3Children’s Mercy-Kansas City , Division of Developmental and Behavioral Sciences, Kansas City. MO
4University of Kansas, The Schiefelbusch Institute for Life Span Studies, Lawrence, KS
5University of Kansas Medical Center, Department of Pediatrics, Kansas City, KS
Background
Results
• Youth with autism spectrum disorder (ASD) are at increased risk for obesity compared
to their typically developing peers (Eaves & Ho, 2008).
Prevalence of Weight Status
• Youth with ASD are also at risk for poor health behaviors, including lower levels of
physical activity (Memari et al., 2013), increased screen time use (Must et al., 2014),
and more sleep problems (Goldman et al., 2012). However, an exploration of how
severity of ASD is related to health risk factors, overweight, and obesity does not yet
exist in a large sample.
• This study examines the relationships between severity of ASD, child weight status,
and health behaviors.
Mild ASD
Moderate-Severe ASD
Obese
23%
Overweight
16%
Methods
Results Continued
Overweight
18%
• Children with moderate to severe ASD also did not differ from children with mild
ASD on likelihood of engaging in vigorous physical activity (VPA) 1-3 days, 4-6
days, or 7 days a week.
• However, children with moderate to severe ASD were more likely to engage in
VPA zero days per week (t (1374) = 2.61, p = .01), in comparison to children with
mild ASD.
Obese
25%
Normal
weight
61%
• There was no difference in rate of overweight (t (916) = .54, p = .59) or obesity (t
(916) = .34, p = .74) based on ASD severity.
Normal
weight
57%
• Children with moderate to severe ASD were more likely to use electronic devices 4
hours or more per day (t (1378) = 2.03, p = .05), and children with mild ASD were
more likely to use electronic devices 1 hour or less per day (t (1378) = -2.58, p =
.01).
• No other differences in television viewing or use of electronic devices were found.
Procedures:
•
•
Participants were drawn from the 2011/2012 National Survey of Children’s Health, a
nationally representative telephone-based survey designed to provide national- and
state-level (50 states, the District of Columbia, and U.S. Virgin Islands) estimates of
child health indicators.
Health Behaviors of Children with ASD by Severity:
Participants are a representative sample of parents of children ages 0-17 selected
using stratified random sampling. Children with a current diagnosis of ASD were
included in the current analyses.
Children with ASD (10 - 17 Years)
Parent reports of child anthropometrics (height/weight), frequency of physical activity,
sleep, and screen time use, and whether or not a doctor had ever told the parent that
the child had an ASD.
0 Days/Week
1-3 Days/Week
4-6 Days/Week
7 Days/Week
Participants:
Adequate Sleep
•
0 Days/Week
1-3 Days/Week
4-6 Days/Week
7 Days/Week
Screen Time
•
•
•
2% (925 / 45,219) reportedly had a current diagnosis of ASD.
• 51.7 % = Mild ASD.
• 47.9 % = Moderate-Severe ASD.
82.0% male.
White: 62.4%; Hispanic: 21.3%; Black:10.2%; Multiracial/Other: 6.1%.
Mean age = 10.31 years (SD =3.95).
Data Analysis
Moderate-Severe ASD
Wald-test; p-value
12.9%
31.8%
35.9%
19.5%
25.0%
28.7%
26.3%
20.0%
F=6.81; p=.01
F=2.28; p>.05
F=2.84; p>.05
F=0.06; p>.05
4.3%
3.8%
28.7%
63.2%
2.6%
16.6%
25.8%
55.0%
F=0.47; p>.05
F=7.50; p<.01
F=0.13; p>.05
F=1.66; p>.05
37.9%
43.2%
18.9%
45.5%
40.6%
13.9%
F=0.43; p>.05
F=2.38; p>.05
F=0.37; p>.05
Non-response and unequal selection probabilities were accounted for by using
sampling weights to help establish population-based estimates.
•
Analyses were conducted using AM Statistical Software (Beta Version 0.06.04. (c)
The American Institutes for Research and Jon Cohen, 2011).
Aside from descriptive analyses, logistic regression was used for all analyses. The
Wald test was used to determine significance.
• ASD severity does not distinguish between overweight/obesity, but does relate to
specific health behaviors.
• Children with moderate to severe ASD were less likely to engage in any VPA on a
weekly basis, and they also used electronic devices more often than children with
mild ASD.
• Although ASD severity does not distinguish between overweight/obesity, the
increased risk for high levels of electronic device use and lower levels of physical
activity may be a significant concern and suggest a need for targeted intervention
for children with more severe ASD.
• The apparent discrepancies in the literature regarding ASD and
obesity/health behavior suggests the need for additional studies with more
direct measurement and/or experimental control.
TV/Video/Video Games:
<1 Hr/Day
1-3 Hrs/Day
≥ 4 Hrs/Day
Never
< 1 Hr/Day
1-3 Hrs/Day
≥ 4 Hrs/Day
9.0%
52.0%
29.5%
9.5%
31.0%
33.2%
21.1%
14.7%
F=3.35; p>.05
F=6.67; p=.01
F=0.08; p>.05
F=4.14; p<.05
58.0%
57.2%
41.9%
42.8%
F=0.13; p>.05
Electronics in Bedroom:
Yes
No
References
Eaves, L. C., & Ho, H. H. (2008). Young adult outcome of autism spectrum disorders. Journal of Autism and
Developmental Disorders, 38(4), 739-747.
Computer/Cell Phone/Electronics:
•
•
Mild ASD
Vigorous Physical Activity
Measures:
•
Conclusions
Memari, A. H., Ghaheri, B., Ziaee, V., Kordi, R., Hafizi, S., & Moshayedi, P. (2013). Physical activity in children and
adolescents with autism assessed by triaxial accelerometry. Pediatric Obesity, 8(2), 150-158.
Must, A., Phillips, S. M., Curtin, C., Anderson, S. E., Maslin, M., Lividini, K., & Bandini, L. G. (2014). Comparison of
sedentary behaviors between children with autism spectrum disorders and typically developing children. Autism, 18,
376-384.
Goldman, S. E., Richdale, A. L., Clemons, T., & Malow, B. A. (2012). Parental sleep concerns in autism spectrum
disorders: Variations from childhood to adolescence. Journal of Autism and Developmental Disorders, 42(4), 531538.
Data used from the 2011/12 National Survey of Children’s Health. Maternal and Child Health Bureau in collaboration with the National Center for Health Statistics.
2011/12 NSCH Indicator Data Set prepared by the Data Resource Center for Child and Adolescent Health, Child and Adolescent Health Measurement Initiative. www.childhealthdata.org