Schwartz C, Barican J, Yung D, Cullen A, Gray-Grant D, & Waddell C. (2023). Addressing mental health needs for children with neurodevelopmental conditions. Vancouver, BC: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

Neurodevelopmental conditions, including autism spectrum disorder (ASD), fetal alcohol spectrum disorder (FASD) and intellectual disabilities, begin very early in a child’s life and are associated with characteristic challenges in daily living. As well as coping with these challenges, many children and their families also face concurrent mental disorders — and mental health care systems that often struggle to meet their needs.

To better address the mental health needs of children with neurodevelopmental conditions, policy-makers need high-quality data — including accurate prevalence estimates to inform service planning and evidence on effective treatments to ensure that these children receive interventions that work. This research report therefore aimed to identify (1) the prevalence of common mental disorders for children with ASD, FASD and intellectual disabilities; and (2) effective psychosocial treatments for common mental health concerns for these children.

The available prevalence data showed that the five most common childhood mental disorders overall — anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant and conduct disorders, and depression — are much more prevalent for children with neurodevelopmental conditions. For example, estimated prevalence for any anxiety disorder was nearly eight times higher for children with ASD, estimated prevalence for ADHD was more than 14 times higher for children with FASD, and estimated prevalence of oppositional defiant and conduct disorders was nearly four times higher for children with intellectual disabilities. These findings suggest that for many children with neurodevelopmental conditions, mental disorders create additional needs — making access to effective treatments imperative.

This review found effective treatments for at least one mental health concern for all three neurodevelopmental conditions. Cognitive-behavioural therapy led to clinically meaningful reductions in anxiety disorder diagnoses and symptoms for children with ASD — across multiple studies. As well, parent training successfully reduced behaviour challenges for children with FASD and intellectual disabilities. We also found emerging evidence that social skills training helps children with FASD. These effective treatments need to be made readily available to all children who need them.

Mental health prevalence and intervention data can inform efforts to support the well-being of children with neurodevelopmental conditions. Next steps include ensuring that all children who have both neurodevelopmental and mental health conditions are identified early and receive timely treatment, and providing these children and their families with mental health resources proportionate to their needs. Services also need to be offered in ways that celebrate children’s strengths and recognize their preferences, thereby meeting society’s collective responsibility to ensure that all children can flourish and meet their potential.

Read the full report here.