Quality of life among preschool children with Autism Spectrum disorders

Abstract

OBJECTIVES: To assess the health- and oral health-related quality of life of preschool children with autism spectrum disorders (ASDs) and to determine factors associated with their quality of life. METHODS: A community based case-control epidemiological study of preschool children with and without ASDs was undertaken. Health-related Quality of Life was assessed employing the Pediatric Quality of Life Inventory Version 4.0 (PedsQL™ 4.0) and Oral Health-related Quality of Life was assessed employing the Early Childhood Oral Health Impact Scale (ECOHIS). Differences in PedsQL™ 4.0 and ECOHIS scores were determined between the groups, and correlation between PedsQL and ECOHIS were explored. Following on regression analyses were conducted to determine key factors associated with health-related quality of life. RESULTS: Clinical oral examinations were conducted among 514 children (257 cases and 257 controls) and among them complete HQoL and OHQoL assessments were available for 483 children (244 cases and 239 controls). Significant differences in PedsQL™ 4.0 scores were apparent between children with and without ASDs (P<0.001). In addition, significant differences in ECOHIS scores between children with and without ASDs existed (P<0.001). Children with ASDs fared worse than the age-gender matched control group. There was a positive and strong correlation between PedsQL™ 4.0 and ECOHIS scores(r 0.47, P < 0.001). In regression analyses, presence of ASDs was associated with an increased likelihood of having a high PedsQL™ 4.0 score (OR, 7.66, 95%CI 4.85-12.12, p<0.001); and ECOHIS scores was associated with a high PedsQL™ 4.0 score (OR, 1.14, 95%CI 1.09-1.19, p<0.001) controlling for socio-demographic factors (child’s age and gender, parental education and family income level) and parental global-ratings of oral health. CONCLUSIONS: Differences in health- and oral health-related quality of life exist among preschool children with ASDs. There was a significant and moderate correlation between children’s health-related quality of life and oral health-related quality of life. Health-related quality of life was associated having an autism spectrum disorder and with oral health-related quality of life impact.