Childhood autistic traits are associated with psychotic experiences in adolescence


Forty years ago, autism was regularly referred to as childhood schizophrenia and the links between the two conditions have continued to this day. Recent studies have shown that the features of autism spectrum disorders sometimes precede the onset of childhood-onset schizophrenia.

This cohort study published by researchers from Cardiff University looks at the relationship between early autistic traits that occur in young children and psychotic experiences that occur later in adolescents. It shows that speech problems, odd rituals or unusual habits in young children are associated with an increased risk of psychosis in adolescence.

The study involved 6,439 children from the South West of England who were all part of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. The mothers of all these children answered questions about their kids’ behaviour before the age of 3 and later when they were aged 7-8. The questions covered:

  • Speech development
  • Social interaction
  • Odd rituals or unusual habits that were hard to interrupt
  • Whether or not these traits had cleared up completely by the age of 7 or 8

At the age of 12, the children were interviewed by psychologists (who were blind to their childhood autistic traits) and assessed for psychosis-like symptoms such as hallucinations, delusions and thought interference. Experiences that may have been caused by sleep, substance use or fever were excluded. Known confounders were also excluded.

Here’s what they found:

  • Over 11% of the children in the study (744) reported suspected or definite psychotic experiences
  • Children whose mothers had concerns about their speech at age 3 were more likely to have suspected or definite psychotic experiences at age 12 (OR 1.58, 95% CI 1.19 to 2.10)
  • Children whose mothers reported continued concerns over speech development at age 7–8 were more likely to have suspected or definite psychotic experiences at age 12 (OR 2.11, 95% CI 1.35 to 3.30)
  • There was no significant association between maternal concern about unusual rituals at age 3 and psychotic experiences at age 12 (OR 1.74, 95% CI 0.94 to 3.23)
  • But there was a significant association between maternal concern over unusual rituals at age 7–8 and psychotic experiences at age 12 (OR 3.05, 95% CI 1.49 to 6.22)
  • Maternal concerns about early or persistent social interaction problems were not associated with psychotic experiences at age 12 (problems by age 3: OR 1.11, 95% CI 0.76 to 1.63; problems persisting at age 7 to 8: OR 1.41, 95% CI 0.82 to 2.45)

The researchers concluded:

Childhood autistic traits, and particularly speech problems and odd rituals or unusual habits, are associated with psychotic experiences in adolescence. This may be a result of a shared aetiology or because autistic traits may also be an early precursor of psychotic experiences.

This study tells us that clinicians who work with young people with autism should consider the possibility of psychosis.


Bevan Jones R, Thapar A, Lewis G, Zammit S. The association between early autistic traits and psychotic experiences in adolescence. Schizophr Res. 2012 Mar;135(1-3):164-9. Epub 2012 Jan 13. [PubMed abstract]

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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