The Association of Paternal IQ With Autism Spectrum Disorders and Its Comorbidities: A Population-Based Cohort Study

Objective: Original case descriptions of autism noted that parents of the affected children tended to be highly educated and intelligent, a characterization that has endured publicly. Recent genetic studies indicate that risk for autism spectrum disorders (ASD) is associated with high intelligence. We examined the association between paternal intelligence and ASD, considering co-occurring intellectual disability (ID) and attention-deficit/ hyperactivity disorder (ADHD). Method: We used a register-based cohort study design including 360,151 individuals with fathers conscripted to the Swedish military, resident in Stockholm, Sweden, born from 1984 to 2008, and followed until December 31, 2011, for diagnosis of ASD, ADHD, and/or ID. Risk of neurodevelopmental disorders relative to paternal IQ (rated on a 9-point scale) was assessed using a score of 5 (average intelligence) as the referent in models accounting for potentially nonlinear relationships and clustering of siblings. Results: We observed an association between high paternal IQ and offspring risk of ASD without ID/ADHD in models adjusted for individual and family characteristics (ORIQ = 9 1.32, 95% CI 1.15-1.52), an association that appeared to be driven largely by the fathers' score on the technical comprehension portion of the test (ORTechnical (IQ = 9) 1.53, 95% CI 1.31-1.78). Conversely, low paternal IQ was associated with ASD+ID (ORIQ = (1)1.78, 95% CI 1.27-2.49) and ASD+ADHD (OR(IQ = 1)1.40, 95% CI 1.16-1.70); low paternal IQ was strongly associated with ID (ORIQ = 1 4.46, 95% CI 3.62-5.49) and present also for ADHD (OR(IQ = 1)1.56, 95% CI 1.42-1.72)] without co-occurring ASD or ID. Conclusion: The relationship between paternal IQ and offspring risk of ASD was nonmonotonic and varied by the presence of co-occurring disorders, probably reflecting phenotypic diversity among affected individuals.