Autism in Lebanon: Looking Back to Inform the Future

Background: Autism Spectrum Disorder (ASD) is a group of neurodevelopmental disorders with delays in communication, restricted interests and repetitive behaviors. Although the phenotype of autism is global, risk factors and underlying genetics may be regionally defined. The aim of this study is elucidation of Lebanese ASD patient characteristics and comparison to the same in different populations. Methods: Retrospective chart review of children evaluated at the American University of Beirut Special Kids Clinic (ASKC) from January 2008-March 2022 was undertaken. Patients diagnosed from infancy to 18 years of age were included. Those with known genetic entities were excluded. Sex, age at diagnosis, presence of consanguinity, presence of prenatal/postnatal complications, a family history of autism or other psychiatric/neurological diseases, and birth order details were extracted and analyzed. Results: A total of 1,181 children were included in the analysis with 963 (81.5%) male and 218 (18.5%) female subjects with a male to female ratio of 4.4:1 compared to a ratio of 3.8:1 from the USA. Mean age at diagnosis was 48.0 ±27.4 months. Consanguinity accounted for 159 (16.4%) of parent pairs of affected individuals. Premature birth was present in 123 (12.7%) of cases. Prenatal complications occurred in 112 (11.1%) of subjects. First order birth was documented in 419 (44.8%) of ASD cases. Conclusion: This comprehensive study of ASD patient characteristics in Lebanon demonstrates that the ASD population is comparable with those reported from other countries with few notable exceptions.