5.1. Explain the following conditions that may co-occur with autism: mental ill-health, learning disability.

There are several conditions that have a higher-than-average likelihood of co-occurring with autistic individuals. This means that individuals with autism are more likely to have another condition.

Two of the most common co-occurring conditions in individuals with autism are mental ill-health and learning disability.

Mental Ill-Health

People with autism are at higher risk of experiencing mental health conditions compared to the general population – this is backed by several studies, including ‘Prevalence of co-occurring mental health diagnoses in the autism population: a systematic review and meta-analysis‘, published in the Lancet. This can be due to the additional stress and challenges they face navigating a world that may not always be accommodating or understanding of their needs. Some of the most common mental health conditions that co-occur with autism include:

• Anxiety Disorders: Many people with autism experience significant anxiety. This can be generalized anxiety about a wide range of things, or more specific anxieties, such as social anxiety or phobias. The rigid thinking and difficulty with change and unpredictability that often accompany autism can contribute to feelings of anxiety.
• Depression: Depression is also common among individuals with autism, particularly adolescents and adults. Feelings of isolation, struggles with social interactions, and experiences of bullying or social rejection can contribute to the development of depression.
• Obsessive-Compulsive Disorder (OCD): Some people with autism may develop OCD, a disorder characterized by repetitive, intrusive thoughts (obsessions) and repetitive behaviors or rituals (compulsions). There’s some overlap between the repetitive behaviors and rituals seen in autism and those seen in OCD, which can make it challenging to diagnose.

Learning Disability

It’s also common for individuals with autism to have co-occurring learning disabilities. A learning disability is a neurological disorder that affects the brain’s ability to receive, process, store, and respond to information. As MENCAP observes “Autism is not a learning disability, but around half of autistic people may also have a learning disability.” Some learning disabilities that may co-occur with autism include:

• Rett’s Syndrome: Around 60% of females with Rett’s Syndrome also have autism
• Cohen’s syndrome: Around 55% of individuals with Cohen’s Syndrome also have autism
• Cornelia de Lange syndrome: Around 40% of individuals with Cornelia de Lange syndrome also have autism
• Fragile X Syndrome: Around 30% of individuals with Fragile X also have autism.
• Down’s Syndrome: Around 15% of individuals with Down’s Syndrome also have autism.

As you can see, the prevalence rates of autism in individuals with these learning disabilities is much higher than the 1% prevalence of autism in the population of the UK as a whole.

Remember, not everyone with autism will have a co-occurring mental health condition or learning disability. However, these conditions are more common among individuals with autism than in the general population. Recognizing and addressing these co-occurring conditions can greatly improve the quality of life for individuals with autism.