Preschool Ear, Nose, and Throat Problems Linked with Autism

Preschool Ear, Nose, and Throat Problems Linked with Autism

April 26, 2023 — Very young children who have common ear and upper respiratory problems appear to have an increased risk of being diagnosis of autism or showed high levels of autism traits, according to a new study. 

The study’s data comes from the United Kingdom’s Avon Longitudinal Study of Parents and Children (ALSPAC), also known as the “Children of the 90s” study.

ALSPAC has tracked the health of more than 14,000 children whose mothers were resident in the Avon area, northwest of London, and were enrolled when pregnant between 1991 and 1992. The latest study on the cohort drew on data from more than 10,000 young children followed throughout their first 4 years. Their mothers completed three questionnaires between 18-42 months, recording the frequency of nine different signs and symptoms relating to the upper respiratory system, as well as ear and hearing problems.

The researchers connected these with later measures of autistic spectrum disorder.

The analysis, published in the journal BMJ Open, showed that, overall, 177 children (139 boys and 38 girls) had a probable diagnosis of autism, while those with autism traits – including problems with speech coherence, social and communication issues, repetitive and abnormal behaviors, and sociability – represented 10% of the sample with the highest trait scores. 

But other researchers urged caution. Asked to comment, Tim Nicholls, head of influencing and research at the National Autistic Society, said: “These results should be treated with caution. They only indicate a possible association – and we know that correlation is not the same as causation. Therefore, we suggest that firm conclusions should not be drawn from it.

“Medical professionals need to be aware, however, that at least 1% of their patients are autistic. Therefore, in any consultation they should be trained and prepared to support autistic people, whether that is in being referred for a diagnosis, or with a medical issue.”

Mouth Breathing and Ear Symptoms Associated With Autism

Specific symptoms, including mouth breathing (all or much of the time), snoring, pulling/poking ears, ears going red, hearing being worse during a cold, and rarely listening, were significantly tied to high scores on all 15 autistic traits tested and with diagnosed autism. 

There was also evidence of connections between pus or sticky mucus discharge from the ears, especially with diagnosed autism and with poor speech.

The researchers concluded: “Very young children exhibiting common ear and upper respiratory signs appear to have an increased risk of a subsequent diagnosis of autism or demonstrated high levels of autism traits.” 

Early Identification Could Improve Quality of Life

They cautioned, however, that these signs and symptoms are “very common” in childhood, and “most children who experience them do not go on to be diagnosed with autism”. However: “Early identification and treatment of ENT conditions may improve these children’s quality of life and potentially help shed light on some of the origins of autism.”

Amanda Roestorf, PhD, head of research at autism charity Autistica, said, decades of research have shown: that children with autism are likely to have more medical conditions than children without autism. 

“Given the issues raised in previous literature, the study findings provide a basis for considering treatment pathways for ENT problems in autistic children in general practice and secondary care,” Roestorf said. 

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