Mapping Comorbidities Related to Autism Spectrum Disorder from Infancy to Adolescence: A Scoping Review

Children living with Autism Spectrum Disorder (ASD) often experience not only core ASD symptoms but also a range of comorbid biopsychosocial difficulties, including Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety, epilepsy, sleep problems, and feeding or toileting challenges, each of which may contribute to developmental delays. This review aimed to systematically map and scope existing literature on comorbidities related to ASD from infancy to adolescence, identify the most common comorbidities, and delineate their characteristic symptoms and underlying aetiologies.

The researchers conducted a comprehensive search across academic databases – including MEDLINE, PsycINFO, Academic Search Premier, CINAHL, ScienceDirect, JSTOR Journals, EMBASE, and the Cochrane Library – accessed via platforms, such as EBSCOhost and ProQuest. Data from the 19 studies were analysed using Braun and Clarke’s six-phase framework for thematic analysis. A coding framework was collaboratively developed by the three authors, who independently reviewed and coded the data. Screening and data management were supported by the ASReview tool, and themes were refined through consensus to ensure analytical rigour and reliability.

The review identified a spectrum of common ASD-related comorbidities that vary by developmental stage and context. Of an initial yield of 360 articles, 19 peer-reviewed studies met the inclusion criteria and were thematically analysed. Notably, studies from African settings were sparse, suggesting important regional research gaps.

Cultural, environmental, and health factors influence the identification and prevalence of comorbidities associated with ASD. In clinical practice, our evaluation highlights the need for a comprehensive assessment protocol that takes into account the wide range of potential complications during different stages of development. Clinicians should recognize that symptoms can manifest differently at different ages and adapt their diagnosis and treatment methods accordingly.

Findings highlight the urgent need for culturally contextualised investigations of ASD comorbidities, particularly in underrepresented settings like sub-Saharan Africa. This review underscores the importance of developmental stage–sensitive diagnostic and treatment strategies.