Autism and intellectual disability comorbidity

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Target exams

Red flags

• Behaviour change attributed only to autism or ID without medical pain screen, epilepsy review, or communication assessment — diagnostic overshadowing
• New staring spells, nocturnal events, developmental regression, or post-ictal behavioural change — evaluate for epilepsy; do not assume stereotypy
• Severe self-injury or aggression with injury risk — safety plan, functional analysis, medical exclusion first; do not start antipsychotics without formulation
• Suspected catatonia (mutism, posturing, refusal to eat or drink) in dual diagnosis — medical-psychiatric emergency pathway
• Acute behavioural crisis after antiepileptic drug change — consider peri-ictal change, forced normalisation patterns, or AED psychiatric adverse effects
• Withholding AAC while waiting for speech to appear — communication access is urgent treatment