History of Maltreatment is not Associated with Symptom Profiles of Children with Autism

Some authors hypothesize that autism in children from orphanages results from neglect, which has been referred to as “quasi-autistic pattern” and “post-institutional autistic syndrome.” However, studies of children who have been neglected show even higher rates of ADHD, oppositional defiant and conduct disorders, anxiety, and depression than rates of autism. Our study determined if autism symptoms differed between children with autism who were and were not maltreated and if duration of and number of years since removal from neglect were related to symptoms in 789 children with autism, 2–17 years of age. Mean scores on a 30-item autism diagnostic symptom checklist (Checklist for Autism Spectrum Disorder, CASD) did not differ between the 700 children with autism who were not maltreated (21.6), the 80 children with autism who were neglected (21.5) and the 89 with autism who experienced neglect and/or physical or sexual abuse (21.1). These scores were similar to the mean of 21.7 for the 1052 children in the CASD autism normative sample. Correlations between CASD scores and duration of neglect and number of years since removal from neglect were close to zero. Findings suggest that symptoms of autism are likely independent of maltreatment. This has important implications for treatment. Autism in maltreated children should not be considered as “quasi-autism” or possibly temporary because these children may then be denied evidence-based intervention that can improve outcomes in children with autism.