Autism and Epilepsy: What Ontario Families Need to Know

A 2008 meta-analysis by Amiet et al. reported a pooled epilepsy prevalence of 21.4% in autistic individuals. Risk factors for epilepsy in autism include co-occurring intellectual disability (odds ratio 3.7), female sex, and regression in early development. The risk persists across the lifespan, with seizure onset occurring at any age.

Common seizure types in autistic individuals include focal seizures (which may be subtle and mistaken for stimming or inattention), absence seizures (brief staring episodes), and generalized tonic-clonic seizures. Subclinical epileptiform activity detected on EEG is also common in autistic individuals without clinical seizures, though the clinical significance of this finding remains debated.

Parents should watch for regression in skills, new onset of staring spells, unexplained falls, nighttime convulsive movements, or sudden behavioural deterioration — all potential indicators of seizure activity.

Anti-seizure medication decisions should be made with the treating neurologist. Ask about seizure type, side effects, cognition, behaviour, and how the medication may affect school or therapy.

Ontario epilepsy resources include: the Epilepsy Program at SickKids (Toronto), the Epilepsy Monitoring Unit at McMaster Children's Hospital (Hamilton), London Health Sciences Centre's Epilepsy Program, and CHEO's Neurology Division (Ottawa). Epilepsy Ontario provides education, support groups, and navigation assistance across the province.

When epilepsy co-occurs with autism, intervention planning should account for seizure medication effects on attention and behaviour, seizure safety during therapy sessions, and the potential impact of uncontrolled seizures on developmental progress. Communicate seizure action plans to all therapists and educators involved in the child's care.