Autism, autistic traits and multiple risk behaviours in adolescence: a longitudinal birth cohort study.

This study followed thousands of young people from age 12 to 18 to see how autism and autistic traits relate to risky behaviours like drinking, smoking, and unsafe sex. Young people with social communication difficulties and repetitive behaviours were more likely to engage in risky behaviours at age 12. However, those who were less social actually engaged in fewer risky behaviours as they got older. The patterns were different for boys and girls.

This longitudinal study examined the relationship between autism diagnosis, autistic traits, and multiple risk behaviours (MRBs) in adolescents using data from the Avon Longitudinal Study of Parents and Children. The study tracked up to 4,300 participants from ages 12-18, measuring engagement in 14 risk behaviours including alcohol consumption, smoking, risky sexual behaviours, and physical inactivity. Results showed that social communication difficulties and repetitive behaviours were associated with higher engagement in MRBs at age 12, while reduced sociability was linked to lower rates of risk behaviour engagement over time. Sex-specific patterns emerged, with persistent differences observed in males with social communication difficulties and females with reduced sociability.

Clinicians should assess autistic adolescents for risk behaviour vulnerability, particularly those with social communication difficulties. Different autistic traits may require tailored approaches - some may increase risk while others are protective. Gender-specific interventions may be needed. Early identification and targeted prevention strategies could be beneficial for high-risk autistic youth.

The study does not specify the sample size breakdown by autism diagnosis versus autistic traits. The abstract does not detail how autistic traits were measured or validated. Confounding variables are mentioned but not specified. The relationship between diagnosed autism specifically and risk behaviours is not clearly reported.

Multiple risk behaviours (MRBs), typically beginning in adolescence, are associated with increased risk of adverse health and social outcomes. The association between autism and MRBs is little understood. Data were from the Avon Longitudinal Study of Parents and Children, an UK-based longitudinal, birth cohort study. Exposures were diagnosed autism and four autistic traits: social communication difficulties, pragmatic language, repetitive behaviours and reduced sociability.

Outcomes were participation in up to 14 risk behaviours, including alcohol consumption, smoking, risky sexual behaviours and physical inactivity. Outcome data were collected at ages approximately 12, 14, 16 and 18. Up to 4300 participants were included in latent basis growth curve analyses with adjustment for confounders. Social communication difficulties were associated with an above average level of MRBs engagement at ~12 years (mean difference0.26; 95% CI 0.13-0.40), and above average rate of engagement from ages ~12-18 (0.08; 95% CI 0.02-0.13).

Repetitive behaviours were associated with above average levels of engagement in MRBs at ~12 years (0.24; 95% CI 0.09-0.38). Contrastingly, reduced sociability was associated with a reduced rate of engagement in MRBs from ages ~12-18 (-0.06; 95% CI -0.11 to -0.02). In sex-specific analyses, persisting differences in MRB engagement patterns from ages ~12-18 were observed in males with social communication difficulties and females with reduced sociability temperament. Having elevated levels of some autistic traits appear to have differentiated effects on MRB engagement patterns.

These findings could reflect difficulties fitting in and/or coping mechanisms relating to difficulties with fitting in.