Neurodevelopmental Outcomes of Preschool-Age Children with Comorbid Sickle Cell Disease and Autism Spectrum Disorder

Abstract

Aim: There are some overlaps in the childhood neurodevelopmental profiles of sickle cell disease and autism spectrum disorder. Nonetheless, there is limited evidence on the neurodevelopmental outcomes of children with comorbid sickle cell disease and autism spectrum disorder. Thus, the aim of this pilot study was to examine preschool-age neurodevelopment including social communication skills of children with a comorbid diagnosis of sickle cell disease and autism spectrum disorder, relative to children with a diagnosis of sickle cell disease only, autism spectrum disorder only, and typically developing children. Methods: Using a cross-sectional research design and convenience sampling, 65 preschool age children were enrolled in this study: 20 participants in each of the three study groups and 5 in the comorbid group. Child outcomes were assessed using standardized parent-rated questionnaires following informed consent. Ages & Stages Questionnaires®, Third Edition (ASQ®-3) was used to screen neurodevelopment across the domains of communication, gross motor, fine motor, problem solving, and personal-social, and the Language Use Inventory screened social communications across the domains of usage of gestures, words, and longer sentences. Regarding data analysis, first, the Chi-squared test of independence was used to compare sample characteristics between groups. Second, one-way ANOVA was used to compare scores on the ASQ®-3 domains and the Language Use Inventory between groups, followed by posthoc tests for significant variables. A p-value of less than 0.05 was considered statistically significant. Results: No significant baseline differences were evident across the four study groups for gender (p=.11), hearing impairments (p=.91), vision impairments (p=.73) as well as maternal sociodemographic characteristics (p>.05). There were no significant differences in the mean scores of any of the ASQ®-3 domains (p>.05) for children with comorbid sickle cell disease and autism compared with autism alone. However, children with comorbid sickle cell disease and autism had significantly lower scores on communication (p.05).