Ziske Maritska* -  Universitas Sriwijaya, Indonesia
Rahmi Isman -  Universitas Sriwijaya, Indonesia
Bintang Arroyantri Prananjaya -  Universitas Sriwijaya, Indonesia
Nita Parisa -  Universitas Sriwijaya, Indonesia

DOI : 10.24269/ijhs.v6i2.4615

Autism Spectrum Disorders (ASD) is a neurodevelopmental disorder characterized by two core symptoms; impairments in social communication and restricted or repetitive behavior. ASD is a broad group of conditions where patients have a variety of abilities and needs. Their ASD related-physical and psychological comorbidities also affect their mortality risk. This study wished to investigate physical comorbidities associated with ASD in the national reference hospital in Indonesia. This is a descriptive study with a cross-sectional approach on children with ASD who visited RSUP Dr. Mohammad Hoesin, Palembang, during 2014-2018. Data were obtained from the medical records and telephone interviews with the parents. Of all the 60 participants included in the study, most are male (n=52;86,7%). The most prevalent ASD-related physical comorbidities were gastrointestinal disorders (n=27;45%), followed by nervous system disorders (n=35;58,3%), and immune system disorders (n=11;18,3%). Despite the small sample size, the prevalence of ASD-related physical comorbidities in children with ASD is profoundly high, implying the need to do early detection from both parents and health professionals to prevent morbidity and complications that may occur. Children with autism can benefit from various therapies start in early childhood and continue throughout their lives to improve their development, and quality of life.

Autism spectrum disorder, ASD, physical comorbidities
  1. Eissa N, Al-Houqani M, Sadeq A, Ojha SK, Sasse A, Sadek B. Current enlightenment about etiology and pharmacological treatment of autism spectrum disorder. Front Neurosci. 2018;12(MAY).
  2. Buie T, Campbell DB, Fuchs GJ, Furuta GT, Levy J, Van De Water J, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: A consensus report. Pediatrics. 2010;125(SUPPL. 1).
  3. Jolanta Wasilewska J, Klukowski M. Gastrointestinal symptoms and autism spectrum disorder: links and risks – a possible new overlap syndrome. Pediatr Heal Med Ther. 2015;153.
  4. Tye C, Runicles AK, Whitehouse AJO, Alvares GA. Characterizing the interplay between autism spectrum disorder and comorbid medical conditions: An integrative review. Front Psychiatry. 2018;9(January):1–21.
  5. Lyall K, Van de Water J, Ashwood P, Hertz-Picciotto I. Asthma and allergies in children with autism spectrum disorders: Results from the CHARGE study. Autism Res. 2015;8(5):567–74.
  6. Sanctuary MR, Kain JN, Angkustsiri K, German JB. Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis. Front Nutr. 2018;5(May):1–20.
  7. McElhanon BO, McCracken C, Karpen S, Sharp WG. Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-analysis. Pediatrics. 2014;133(5):872–83.
  8. Strati F, Cavalieri D, Albanese D, De Felice C, Donati C, Hayek J, et al. New evidences on the altered gut microbiota in autism spectrum disorders. Microbiome. 2017;5(1):1–11.
  9. Autism Treatment Trust. Medical Comorbidities in Autism Spectrum Disorders. Treat Autism Publ [Internet]. 2014;(March):19. Available from: file:///C:/Users/shoeppner/Desktop/Medical-Comorbidities-in-Autism-Spectrum-Disorders-2013.pdf
  10. Samsam M, Ahangari R, Naser SA. Pathophysiology of autism spectrum disorders: Revisiting gastrointestinal involvement and immune imbalance. World J Gastroenterol. 2014;20(29):9942–51.
  11. Akintunde ME, Rose M, Krakowiak P, Heuer L, Ashwood P, Hansen R, et al. Increased production of IL-17 in children with autism spectrum disorders and co-morbid asthma. J Neuroimmunol [Internet]. 2015;286:33–41. Available from:
  12. Zerbo O, Leong A, Barcellos L, Bernal P, Fireman B, Croen LA. Immune mediated conditions in autism spectrum disorders. Brain Behav Immun [Internet]. 2015;46:232–6. Available from:
  13. Billeci L, Tonacci A, Tartarisco G, Ruta L, Pioggia G, Gangemi S. Association Between Atopic Dermatitis and Autism Spectrum Disorders: A Systematic Review. Am J Clin Dermatol. 2015;16(5):371–88.
  14. Mrozek-Budyn D, Majewska R, Kletyka A, Augustyniak M. The Frequency And Risk Factors Of Allergy And Asthma In Children With Autism - Case-Control Study Chair of Epidemiology and Preventive Medicine Jagiellonian University Medical College Regional Sanitary-Epidemiological Station in Myslenice. Przegl Epidemiol. 2013;67(3):675–9.
  15. Kliegman RM, Stanton BF, St Geme III J, Schor NF. Nelson Textbook of Pediatrics. 20th ed. Behrman RE, editor. Philadelphia: Elsevier; 2016. 5315 p.
  16. Doshi-Velez F, Ge Y, Kohane I. Comorbidity Clusters in Autism Spectrum Disorders: An Electronic Health Record Time-Series Analysis. Pediatrics. 2014;133(1):e54–63.
  17. McCleery JP, Elliott NA, Sampanis DS, Stefanidou CA. Motor development and motor resonance difficulties in autism: relevance to early intervention for language and communication skills. Front Integr Neurosci. 2013;7(April):1–20.
  18. Mosconi MW, Sweeney JA. Sensorimotor dysfunctions as primary features of autism spectrum disorders. Sci China Life Sci. 2015;58(10):1016–23.
  19. Moraes ÍAP de, Massetti T, Crocetta TB, Silva TD da, Menezes LDC de, Monteiro CB de M, et al. Motor learning characterization in people with autism spectrum disorder: A systematic review. Dement Neuropsychol [Internet]. 2017;11(3):276–86. Available from:
  20. Aldinger KA, Lane CJ, Veenstra-VanderWeele J, Levitt P. Patterns of Risk for Multiple Co-Occurring Medical Conditions Replicate Across Distinct Cohorts of Children with Autism Spectrum Disorder. Autism Res. 2015;8(6):771–81.
  21. Charman T, Findon JL, Howes OD, King BH, Loth E, Mcalonan GM, et al. Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology. J Psychopharmacol [Internet]. 2018;32(1):3–29. Available from:
  22. Ferri SL, Abel T, Brodkin ES. Sex Differences in Autism Spectrum Disorder: a Review. Curr Psychiatry Rep [Internet]. 2018;20. Available from: ttps://
  23. Goin-Kochel RP, Mire SS, Dempsey AG, Fein RH, Guffey D, Minard CG, et al. Parental report of vaccine receipt in children with autism spectrum disorder: Do rates differ by pattern of ASD onset? Vaccine [Internet]. 2016;34(11):1335–42. Available from:
  24. Sharp WG, Postorino V, McCracken CE, Berry RC, Criado KK, Burrell TL, et al. Dietary Intake, Nutrient Status, and Growth Parameters in Children with Autism Spectrum Disorder and Severe Food Selectivity: An Electronic Medical Record Review. J Acad Nutr Diet [Internet]. 2018;118(10):1943–50. Available from:
  25. Muskens JB, Velders FP, Staal WG. Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review. Eur Child Adolesc Psychiatry. 2017;26(9):1093–103.
  26. Ferguson BJ, Marler S, Altstein LL, Lee EB, Akers J, Sohl K, et al. Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder. Autism Res. 2017;10(2):276–88.
  27. Holingue C, Newill C, Lee LC, Pasricha PJ, Daniele Fallin M. Gastrointestinal symptoms in autism spectrum disorder: A review of the literature on ascertainment and prevalence. Autism Res. 2018;11(1):24–36.
  28. Pacheva I, Ivanov I, Yordanova R, Gaberova K, Galabova F, Panova M, et al. Epilepsy in children with autistic spectrum disorder. J Child Neurol. 2019;6(2):316–22.
  29. Tuchman R, Cuccaro M. Epilepsy and autism: Neurodevelopmental perspective. Curr Neurol Neurosci Rep. 2011;11(4):428–34.
  30. Mostafa GA, Hamza RT, El-Shahawi HH. Allergic manifestations in autistic children: Relation to disease severity. J Pediatr Neurol. 2008;6(2):115–23.
  31. Zheng Z, Zhang L, Zhu T, Huang J, Qu Y, Mu D. Association between asthma and autism spectrum disorder: A meta-analysis. PLoS One [Internet]. 2016;11(6):1–11. Available from:
  32. Kotey S, Ertel K, Whitcomb B. Co-occurrence of Autism and Asthma in a Nationally-Representative Sample of Children in the United States. J Autism Dev Disord. 2014;44(12):3083–8.
  33. Gurney JG, McPheeters ML, Davis MM. Parental report of health conditions and health care use among children with and without autism: National survey of children’s health. Arch Pediatr Adolesc Med. 2006;160(8):825–30.
  34. Akpınar F, Kutluk G, Özomay G, YORBİK Ö, Çetinkaya F. Frequencies of Allergic Diseases Among Children with Autism Spectrum Disorders. Asthma Allergy Immunol. 2019;(6):25–7.
  35. Magalhães ES, Pinto-Mariz F, Bastos-Pinto S, Pontes AT, Prado EA, deAzevedo LC. Immune allergic response in Asperger syndrome. J Neuroimmunol [Internet]. 2009;216(1–2):108–12. Available from:
  36. Xu G, Snetselaar LG, Jing J, Liu B, Strathearn L, Bao W. Association of Food Allergy and Other Allergic Conditions With Autism Spectrum Disorder in Children. JAMA Netw Open. 2018;1(2):e180279.

Full Text:
Article Info
Submitted: 2021-12-25
Published: 2022-09-16
Section: Artikel
Article Statistics: