Describing Multidomain Health Outcomes in Autistic Children in the ECHO Program

Objective: The goal of this study is to characterize health outcomes across 3 domains—overall well-being, behavioral health, and physical health—in a large sample of autistic and non-autistic children and adolescents in the Environmental influences on Child Health Outcomes (ECHO) program. Method: First, we examined differences in health outcomes between autistic (N = 286) and non-autistic (N = 4,225) children and adolescents in the ECHO Program. Using a subsample of 1,809 participants (116 autistic participants) with complete outcome data, we conducted latent profile analyses (LPAs) to define profiles of health outcomes for autistic children and adolescents and for the combined sample of autistic and non-autistic participants. Finally, we examined demographic factors in relation to the health outcome profiles. Results: Autistic participants demonstrated poorer health outcomes than non-autistic participants for most outcome measures across the domains of overall well-being, behavioral health, and physical health. In the combined sample LPA, 3 profiles, representing more positive health (n = 566, 31.3%), poorer health (n = 462, 25.5%), and mixed health (n = 781, 43.2%), were identified. The profile with the poorer health outcomes had the highest proportion of autistic participants (n = 64, 13.9%). However, within the autistic group, LPA revealed 2 profiles of autistic participants, with 1 profile (n = 70, 60.3%) having more positive health outcomes across all domains. Conclusion: Although autistic participants demonstrated poorer health outcomes than non-autistic participants on most measures, examining latent profiles within the group of autistic participants highlighted variability in the health outcomes among autistic youth. Results emphasize the importance of examining variability within autistic samples to better understand multidimensional health influences and outcomes of individuals on the autism spectrum. Plain language summary: This study compared health outcomes in a large sample of autistic and non-autistic children and adolescents within the Environmental influences on Child Health Outcomes (ECHO) program. While autistic participants demonstrated poorer health outcomes than non-autistic participants on most measures, examining profiles within the group of autistic participants highlighted variability in the health outcomes among autistic youth. Results emphasize the importance of examining variability within autistic samples to better understand multidimensional health influences and outcomes of individuals with autism spectrum disorder. Diversity & Inclusion Statement: One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science.