1. Results Mild ASD Moderate-Severe ASD Relation of Autism Spectrum Disorder Severity and Risk for Overweight and Obesity Kelsey Borner MA 1,2, Cathleen Odar Stough MA 1,2, Katrina Poppert 1,2, Meredith Dreyer Gillette PhD 1,3, Cy Nadler, PhD 3,, Rebecca Swinburne Romine PhD 4, Ann Davis, MPH, PhD, ABPP 1,5 1 Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, MO 2 University of Kansas, Clinical Child Psychology Program, Lawrence, KS 3 Children’s Mercy-Kansas City, Division of Developmental and Behavioral Sciences, Kansas City. MO 4 University of Kansas, The Schiefelbusch Institute for Life Span Studies, Lawrence, KS 5 University of Kansas Medical Center, Department of Pediatrics, Kansas City, KS Background Youth with autism spectrum disorder (ASD) are at increased risk for obesity compared to their typically developing peers (Eaves & Ho, 2008). Youth with ASD are also at risk for poor health behaviors, including lower levels of physical activity (Memari et al., 2013), increased screen time use (Must et al., 2014), and more sleep problems (Goldman et al., 2012). However, an exploration of how severity of ASD is related to health risk factors, overweight, and obesity does not yet exist in a large sample. This study examines the relationships between severity of ASD, child weight status, and health behaviors. Conclusions ASD severity does not distinguish between overweight/obesity, but does relate to specific health behaviors. Children with moderate to severe ASD were less likely to engage in any VPA on a weekly basis, and they also used electronic devices more often than children with mild ASD. Although ASD severity does not distinguish between overweight/obesity, the increased risk for high levels of electronic device use and lower levels of physical activity may be a significant concern and suggest a need for targeted intervention for children with more severe ASD. The apparent discrepancies in the literature regarding ASD and obesity/health behavior suggests the need for additional studies with more direct measurement and/or experimental control. Data used from the 2011/12 National Survey of Children’s Health. Maternal and Child Health Bureau in collaboration with the National Center for Health Statistics. 2011/12 NSCH Indicator Data Set prepared by the Data Resource Center for Child and Adolescent Health, Child and Adolescent Health Measurement Initiative. www.childhealthdata.org Methods Procedures: Participants were drawn from the 2011/2012 National Survey of Children’s Health, a nationally representative telephone-based survey designed to provide national- and state-level (50 states, the District of Columbia, and U.S. Virgin Islands) estimates of child health indicators. Participants are a representative sample of parents of children ages 0-17 selected using stratified random sampling. Children with a current diagnosis of ASD were included in the current analyses. Measures: Parent reports of child anthropometrics (height/weight), frequency of physical activity, sleep, and screen time use, and whether or not a doctor had ever told the parent that the child had an ASD. Participants: 2% (925 / 45,219) reportedly had a current diagnosis of ASD. 51.7 % = Mild ASD. 47.9 % = Moderate-Severe ASD. 82.0% male. White: 62.4%; Hispanic: 21.3%; Black:10.2%; Multiracial/Other: 6.1%. Mean age = 10.31 years (SD =3.95). References Eaves, L. C., & Ho, H. H. (2008). Young adult outcome of autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(4), 739-747. Memari, A. H., Ghaheri, B., Ziaee, V., Kordi, R., Hafizi, S., & Moshayedi, P. (2013). Physical activity in children and adolescents with autism assessed by triaxial accelerometry. Pediatric Obesity, 8(2), 150-158. Must, A., Phillips, S. M., Curtin, C., Anderson, S. E., Maslin, M., Lividini, K., & Bandini, L. G. (2014). Comparison of sedentary behaviors between children with autism spectrum disorders and typically developing children. Autism, 18, 376-384. Goldman, S. E., Richdale, A. L., Clemons, T., & Malow, B. A. (2012). Parental sleep concerns in autism spectrum disorders: Variations from childhood to adolescence. Journal of Autism and Developmental Disorders, 42(4), 531- 538. Data Analysis Non-response and unequal selection probabilities were accounted for by using sampling weights to help establish population-based estimates. Analyses were conducted using AM Statistical Software (Beta Version 0.06.04. (c) The American Institutes for Research and Jon Cohen, 2011). Aside from descriptive analyses, logistic regression was used for all analyses. The Wald test was used to determine significance. Results Continued There was no difference in rate of overweight (t (916) =.54, p =.59) or obesity (t (916) =.34, p =.74) based on ASD severity. Children with moderate to severe ASD also did not differ from children with mild ASD on likelihood of engaging in vigorous physical activity (VPA) 1-3 days, 4-6 days, or 7 days a week. However, children with moderate to severe ASD were more likely to engage in VPA zero days per week (t (1374) = 2.61, p =.01), in comparison to children with mild ASD. Children with moderate to severe ASD were more likely to use electronic devices 4 hours or more per day (t (1378) = 2.03, p =.05), and children with mild ASD were more likely to use electronic devices 1 hour or less per day (t (1378) = -2.58, p =.01). No other differences in television viewing or use of electronic devices were found. Health Behaviors of Children with ASD by Severity: Prevalence of Weight Status Children with ASD (10 - 17 Years) Mild ASDModerate-Severe ASDWald-test; p-value Vigorous Physical Activity 0 Days/Week12.9%25.0%F=6.81; p=.01 1-3 Days/Week31.8%28.7%F=2.28; p>.05 4-6 Days/Week35.9%26.3%F=2.84; p>.05 7 Days/Week19.5%20.0%F=0.06; p>.05 Adequate Sleep 0 Days/Week4.3%2.6%F=0.47; p>.05 1-3 Days/Week3.8%16.6%F=7.50; p<.01 4-6 Days/Week28.7%25.8%F=0.13; p>.05 7 Days/Week63.2%55.0%F=1.66; p>.05 Screen Time TV/Video/Video Games: <1 Hr/Day37.9%45.5%F=0.43; p>.05 1-3 Hrs/Day43.2%40.6%F=2.38; p>.05 ≥ 4 Hrs/Day18.9%13.9%F=0.37; p>.05 Computer/Cell Phone/Electronics: Never9.0%31.0%F=3.35; p>.05 < 1 Hr/Day52.0%33.2%F=6.67; p=.01 1-3 Hrs/Day29.5%21.1%F=0.08; p>.05 ≥ 4 Hrs/Day9.5%14.7%F=4.14; p<.05 Electronics in Bedroom: Yes58.0%41.9% F=0.13; p>.05 No57.2%42.8%