The Prevalence of High-Risk Children in the Community for Autism Spectrum Disorder and Their Associated Psychiatric Comorbidities

Background: This study aimed to estimate the prevalence and associated demographic factors of autism spectrum disorder (ASD) in children aged 3 to 6 years in Bahrain, as well as to identify co-occurring developmental disorders. Methodology: The study sample comprised 500 children who attended eight health centers across four governorates (Group A) in Bahrain. A second group (Group B) consisted of all children who completed their diagnosis at the Child and Adolescent Psychiatric Unit for ASD from June 2023 to May 2024 to identify associated developmental disorders (n = 232). Group A mothers were interviewed using the M-CHAT-R. For Group B, we used children’s files, the General Intelligence Scale (Stanford-Binet), the M-CHAT-R, the CARS, Conners’ Form, and the Zarit Burden Interview to assess family burden. Additionally, a file review was conducted to determine the presence of intellectual disability (ID) in Group B cases. The Conner-3 Short Forms Test was administered to all cases aged 6 years or older (n = 64), and family burden was assessed using the Zarit Burden Interview Scale for reachable cases (n = 176). Results: Group A findings indicated an overall screen-based/at risk prevalence of ASD of 2.6%, with a higher prevalence in males (1.6%) compared to females (1%). In Group B, there was a78% prevalence of ID and a 17.2% prevalence of attention-deficit/hyperactivity disorder (ADHD). The study also found that the impact of having a child with ASD on the family varied based on the nature and severity of the disorder or disability, with moderate to severe burden reported at approximately 38%. Conclusions: The prevalence of ASD among young children was notably high, particularly among males. The most common comorbidities were ID followed by ADHD. The family burden associated with ASD was significant, with more than one third reporting moderate to severe burden. These data are essential for informing health education and social service planning.