Health- and oral health-related quality of life among preschool children with autism spectrum disorders
To assess the health-related quality of life (HrQoL) and oral health-related quality of life (OHrQoL) of preschool children with autism spectrum disorders (ASD) and to determine the associated factors.
A case–control study of preschool children with and without ASD was undertaken. H&OHrQoL were assessed employing Pediatric Quality-of-Life Inventory Version 4.0 (PedsQL™ 4.0) and Early Childhood Oral Health Impact Scale (ECOHIS). Differences in PedsQL and ECOHIS scores were determined between groups and correlation between PedsQL and ECOHIS was explored. Regression analyses were conducted to determine key factors associated with H&OHrQoL.
Parents of 510 children (253 cases and 257 controls) completed the H&OHrQoL questionnaire assessments. Significant difference in PedsQL (p < 0.001) and ECOHIS (p < 0.001) scores was apparent between children with and without ASD. There was a positive and weak correlation between PedsQL and ECOHIS scores (r = − 0.45, p < 0.01). In regression analyses, the presence of ASD was associated with an increased likelihood of having lower PedsQL (OR 0.10, 95% CI 0.06–0.15, p < 0.001) and higher ECOHIS scores (OR 2.34, 95% CI 1.60–3.42, p < 0.001).
Differences in H&OHrQoL exist among preschool children with and without ASD. There was a significant but weak correlation between children’s H&OHrQoL. Both H&OHrQoL were associated with autism spectrum disorders.
KeywordsAutism spectrum disorders Health-related quality of life Oral health-related quality of life Preschool children
I would like to express my gratitude to all the parents, children and teachers who participated in this study, as well the assistants and technicians who contributed to the whole project.
This is a Ph.D. study, and no funding was received.
Compliance with ethical standards
Conflict of interest
All the authors declare that there was no conflict of interest.
This study was approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (HKU/HA HKW IRB) [IRB Reference Number: UW 11-184].
Informed consent was obtained from all the individual participants (parents of children with and without ASD) included in the study.
- APA. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington: American Psychiatric Association; 2013.Google Scholar
- Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2016/p0331-children-autism.html. 2016. Accessed Apr 2016.
- Lam PPY, Du RY, Peng S, McGrath CPJ, Yiu CKY. Oral health status of children and adolescents with autism spectrum disorder: a systematic review of case–control studies and meta-analysis. Autism; 2019. (In press).Google Scholar
- Luppanapornlarp S, Leelataweewud P, Putongkam P, Ketanont S. Periodontal status and orthodontic treatment need of autistic children. World J Ortho. 2010;11:256–61.Google Scholar