خشونت فیزیکی در کودکان و نوجوانان مبتلا به اختلالات طیف اوتیسم

Aggression is a clinically significant problem for many children and adolescents with autism spectrum disorders (ASD). However, there have been few large-scale studies addressing this issue. The current study examined the prevalence and correlates of physical aggression in a sample of 1584 children and adolescents with ASD enrolled in the Autism Treatment Network. The prevalence of aggression was 53%, with highest prevalence among young children. Aggression was significantly associated with a number of clinical features, including self-injury, sleep problems, sensory problems, GI problems, communication and social functioning. In multivariate models, self-injury, sleep problems, and sensory problems were most strongly associated with aggression. The results indicate that aggression is markedly prevalent, and clinical implications and directions for future research are discussed.

There is considerable variability in both core and associated symptom presentation across individuals with autism spectrum disorders (ASD). Although communication problems, social impairment, and restricted and repetitive behaviors are primary features of ASD (American Psychiatric Association, 2000), these symptoms range in type and severity across individuals. There is also variability in co-morbid conditions, ranging from cognitive impairment to medical and psychiatric conditions (Myers and Johnson, 2007 and Simonoff et al., 2008). These co-occurring problems often lead to considerable functional impairment in and of themselves, exacerbating the effects of core symptoms on overall function. Among these associated problems, physical aggression appears to be particularly problematic, and has been associated with serious negative outcomes in the general population (Card and Little, 2006, Coie et al., 1998, Lochman and Wayland, 1994 and Zahn-Waxler et al., 2005), as well as among individuals with autism and other developmental disabilities (Bromley and Blacher, 1991, Lecavalier et al., 2006, McIntyre et al., 2002, Shoham-Vardi et al., 1996 and Tomanik et al., 2004).

Demographic information and aggression prevalence is provided in Table 1 and Table 2. Out of the total sample of 1584 children and adolescents with ASD, 53.7% were reported to be currently demonstrating physical aggression. Given that the sample represented a wide age range (2–17 years), potential age differences between groups were examined (see Table 1). The results indicated that children who were aggressive were significantly younger (M = 5.73 years, SD = 3.30) than those who were not aggressive (M = 6.11 years, SD = 3.60). Fig. 1 illustrates the cross-sectional prevalence of aggression across age groups.