Autism Spectrum Disorder among Children Attending a Tertiary Care Centre in Tripura, India: A Crosssectional Observational Study
TL;DR
The observed burden of ASD was 0.11% among Paediatric OPD attendees of the Department of Paediatrics, with a clear male predominance, and ADHD was the most frequent comorbidity.
Abstract
Introduction: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by impaired social communication, restricted interests, and repetitive behaviours. Data from low- and middle-income countries, particularly from North East India, remains sparse. Aim: To estimate the burden of ASD and also to describe the sociodemographic and clinical profile of the children with ASD attending a tertiary care hospital in Tripura, India. Materials and Methods: A cross-sectional observational study was conducted in the Outpatient Department (OPD) of Paediatrics at Agartala Government Medical College and GB Panth Hospital, Agartala, Tripura, India, from November 2022 to May 2024. The study included 32 children aged 2-12 years who visited the Paediatrician for social and communication deficits, repetitive behaviours, or developmental delays. Such children were initially screened using the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) and subsequently confirmed with the INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD). Sociodemographic characteristics, perinatal factors, co-morbid conditions, and lifestyle histories were systematically recorded. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 26.0. Results: Out of 28,252 children attending OPD, 32 (0.11%) were diagnosed with ASD. Male-to-female ratio was 4.3:1. The mean age at diagnosis was 3.59±1.38 years. The majority belonged to Hindu Bengali families and the upper-middle socioeconomic class of the modified Kuppuswamy scale. Common presenting complaints were poor social communication, 19 (59.4%), language delay, 6 (18.8%), repetitive behaviours, 4 (12.5%) and hyperactivity, 3 (9.4%). Antenatal risk factors included Pregnancy Induced Hypertension (PIH), 3 (9.4%), hypothyroidism, 3 (9.4%), and gestational diabetes, 2 (6.3%). Co-morbidities included ADHD in 24 (75.0%), intellectual impairment in 20 (62.5%), sleep disorders in 7 (21.9%), and seizures in 6 (18.8%) cases. Conclusion: The observed burden of ASD was 0.11% among Paediatric OPD attendees of the Department of Paediatrics, with a clear male predominance, and ADHD was the most frequent comorbidity. Integration of routine screening during OPD visits may improve early recognition and intervention.