Autism Linked to Common Ear, Nose, and Throat Issues in Early Childhood: Study

An undated image of a child playing with magnetic letters in a pre-school nursery in the United Kingdom. PA

A new study involving more than 10,000 young children has found a connection between ear, nose, and throat (ENT) issues in early childhood and autism in later life.

While the causes of autism are likely a combination of genetic and environmental factors, early identification and treatment of ENT conditions could have long-term benefits on children’s quality of life and potentially provide more insight into the origin of autism, the scientists said.

For their study, scientists at the University of Bristol and Aston University in the United Kingdom analyzed data from more than 10,000 children enrolled in a multi-generational medical research project, where the participants were closely monitored throughout the first four years of their life.

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The children’s mothers completed three questionnaires when their children became 18, 30, and 42 months old, which were designed to record the frequency of signs and symptoms related to ENT or any hearing problems. When their children reached ages 3, 6, and 9, the mothers completed another three questionnaires designed to detect behavioral traits characteristic of autism.

Overall, scientists identified 177 children with a probable diagnosis of autism, including 139 boys and 38 girls.

They also found that certain ENT symptoms—notably breathing through the mouth, snoring, ear pulling or poking, ears going red, deterioration of hearing during a cold, ear discharge, and rarely listening—were more commonly associated with high levels of autistic traits in aspects like speech coherence, social and communication issues, repetitive and abnormal behaviors, and sociability.

The results also showed that children with pus or sticky discharge from their ears were more than three times as likely to have traits associated with autism, specifically poor speech coherence. Those with deteriorated hearing during a cold were more than twice as likely to do so.

However, the scientists noted that these ENT symptoms are common in childhood, and only a small portion of children who had them were eventually diagnosed with autism.

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“These ENT signs and symptoms are very common in childhood, and most children who experience them do not go on to be diagnosed with autism,” the study’s authors said in a press release. “For example, of the group of around 1,700 children who snored at age 30 months, most (1,660) weren’t diagnosed with autism later on.”

With that said, they concluded that the associations they found “may be important because (1) these ear and respiratory signs may be early markers of increased risk of autism, (2) they may inform the origins of autism, or (3) they may highlight co-occurring conditions that if treated may lead to a better quality of life for children with autism.”

“It is not possible to determine whether these ENT conditions have a causal role in the development of autistic traits or are related to an unmeasured factor,” they added. “One possibility, for example, could be the consequence of the increased prevalence of minor physical anomalies in individuals with autism, including anatomical differences in the structure and/or positioning of the ear, with such differences in ear morphology increasing the risk of ENT conditions.”

The study was published on April 24 online in the open-access journal BMJ Open.