Assessing and managing attention-deficit hyperactivity disorder in people with intellectual disability

Abstract

SUMMARY Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a higher prevalence rate in people with intellectual disability compared with their peers without such disability. The classic presentation is that of inattention and/or hyperactivity and impulsivity, but these symptoms can manifest differently in people with intellectual disability. Despite a higher prevalence, the rate of diagnosis and treatment of ADHD in intellectual disability remains low. This article discusses the clinical presentation of ADHD in people with intellectual disability and the relationship between ADHD and other comorbid conditions, such as autism and bipolar disorder. Pharmacological and non-pharmacological interventions are discussed from a practical and a clinical point of view.

Stopping inappropriate medication of children with intellectual disability, autism or both: the STOMP–STAMP initiative

“…This is avoidable. A recent article in this journal gave a helpful overview of diagnosing and managing ADHD (mainly in adults) with intellectual disability (Perera 2022) which is recommended reading for child psychiatrists who treat young adults.…”

“…Diagnostic overshadowing can also be problematic when the diagnosis of intellectual disability prevents further thinking about whether criteria would be met for a diagnosis of an autism spectrum disorder. Reilly et al (2015) described how professionals may lack expertise in the recognition of autism and ADHD in children with intellectual disability that is due to a neurogenetic syndrome.…”

Neurodevelopmental disorders including intellectual disability: a clinical tool kit for mental health professionals

“…Hassiotis & Rudra (2022) describe a stepped-care model for behaviours that challenge in adults with intellectual disability, within the context of the relative lack of single interventions showing clinical and cost-effectiveness. Perera and colleagues (2022) describe the presentation of ADHD symptoms and functional impairments in people with intellectual disabilities, to promote accurate diagnosis by clinicians; they also explore the relationship between autism and bipolar disorder.…”

Video-Based Behaviorally Coded Movement Assessment for Adolescents with Intellectual Disabilities: Application in Leg Dribbling Performance

“…Adolescents with intellectual disabilities (ID) exhibit relatively unstable and variable movement characteristics. Their motor impairments include deficiencies in the aspects of motor control, such as coordination, reaction time, agility, balance control, muscle strength, and endurance, and they may exhibit comorbidities such as attention deficit hyperactivity disorders or developmental coordination disorders [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Consequently, they are less fit than the typically developing (TD) peers and often have difficulties engaging in movements such as walking and running [ 1 , 2 , 11 , 12 ].…”