Association between autism symptoms and functioning in children with ADHD

Introduction: Autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD) are the two most common neurodevelopmental disorders observed in childhood. The DSM-5 accepts a combined diagnosis of ADHD and ASD, while the DSM-IV did not. The aim of this study was to identify and evaluate the adaptive profile of children and adolescents with a diagnosis of comorbid ADHD and ASD, in comparison with adaptive functioning in subjects with a diagnosis of only ASD or ADHD. Materials and Methods: Ninety-one children (77 boys, 14 girls), aging from 3.1 to 13.4 years (mean age: 8.3 ± 7.2), who met the criteria for a diagnosis of ASD and/or ADHD were enrolled. A neuropsychological evaluation involving cognitive and adaptive assessment was conducted using the Autism Diagnostic Observation Schedule – Second Edition (ADOS-2), the Conners’ Parent Rating Scale – Revised: Long Version (CPRS-R), the Wechsler Intelligence Scale – Fourth Edition or the Griffiths Mental Developmental Scales – Extended Revised, the Vineland Adaptive Behaviour Scale – Second Edition (VABS-II). Conclusion: As to the adaptive skills in the three groups evaluated, a worse general profile was ascertained in the ASD and in ASD plus ADHD groups in comparison with respect to the ADHD-only group. With VABS-II evaluation, we found significant differences among the three groups across all domains and combined scores: Communication (F = 18.960; p < 0.001), Socialization (F = 25.410; p < 0.001), Daily Living Skills (F = 19.760; p < 0.001), Motor (F = 9.615; p < 0.001), and Adaptive behavior composite [ABC] (F = 29.370; p < 0.001). Implications of neurodevelopmental double diagnosis such as ASD plus ADHD are discussed.

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“…Children with ASD+ADHD had a greater treatment need which could imply additional treatments for both school and community services (26, 43, 44).…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Disorders and Adaptive Functions: A Study of Children With Autism Spectrum Disorders (ASD) and/or Attention Deficit and Hyperactivity Disorder (ADHD)

Scandurra

Gialloreti

Barbanera³

et al. 2019

Front. Psychiatry

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“…Our measure of anxiety (CBCL) only provided a broad view of anxiety/internalizing symptoms, and was not indicative of clinically significant anxiety problems. Although prior studies examining sleep in children with comorbid ASD/ADHD have utilized the combination of internalizing and externalizing problems (Thomas, et al, 2015; Green et al, 2016), inclusion of broad externalizing problems was beyond the scope of the current study. Building on this work, continued research is needed to further examine the relative contribution of broad internalizing and externalizing problems within children who meet diagnostic criteria for both ASD and ADHD.…”

Section: Discussionmentioning

confidence: 99%

“…Green and colleagues (2015) also examined parent report of ASD symptoms across children with and without a diagnosis of ADHD. Although higher ASD symptom severity was associated with overall poorer functioning (i.e., internalizing and externalizing problems, more peer problems and poorer quality of life) among children with ADHD, sleep problem severity was similar across both ADHD and non-ADHD groups (Green et al, 2016). Together, findings from preliminary research examining sleep in comorbid ASD/ADHD suggest that sleep problems within this comorbid population do not differ from sleep problems seen among children with ADHD only, however preliminary studies have yet to examine these links among a sample of carefully evaluated children with formally evaluated and diagnosed ASD and ADHD.…”

Section: Sleep In Children With Comorbid Asd and Adhdmentioning

confidence: 98%

“…Recent research examining sleep among children with comorbid ASD/ADHD has noted that sleep problems for children with comorbid ASD/ADHD does not differ from children with ADHD alone (Green, Sciberras, Anderson, Efron, & Rinehart, 2016; Thomas, Monahan, Lukowski, & Cauffman, 2015). Thomas and colleagues (2014) demonstrated that both internalizing and externalizing problems are a risk factor for elevated sleep problems for children with comorbid ASD/ADHD (Thomas et al, 2014), however this association was no longer significant after family SES variables (e.g., parent age, high school education) were taken into account.…”

Section: Sleep In Children With Comorbid Asd and Adhdmentioning

confidence: 99%

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Parent-reported problematic sleep behaviors in children with comorbid autism spectrum disorder and attention-deficit/hyperactivity disorder

Reynolds

Patriquin

Alfano

et al. 2017

Research in Autism Spectrum Disorders

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Background Sleep problems are frequent and well documented in children with Autism Spectrum Disorders (ASD), children with Attention Deficit/Hyperactivity Disorder (ADHD) and children with internalizing problems, however limited work has examined sleep problems in children presenting with comorbid ASD/ADHD. In healthy children, sleep problems negatively impact social, emotional, and academic functioning. The current study sought to examine diagnostic severity as predictors of sleep problems in children with comorbid ASD/ADHD. Additionally, the association between sleep and “real-life” functional domains (i.e., intellectual functioning, academic achievement, and executive functioning) were assessed. Method Sleep, internalizing difficulties, intellectual functioning, academic achievement and executive functioning were assessed in 85 children with who carried the dual diagnoses of ASD and ADHD. Results Internalizing difficulties, rather than ASD or ADHD symptom severity, was the most consistent predictor of problematic sleep behaviors (i.e., nightmares overtiredness, sleeping less than other children, trouble sleeping, and Total Problematic Sleep Behaviors) in this sample. Further, parent report of problematic sleep behaviors was significantly associated with functional domains after controlling for ASD, ADHD, and internalizing symptoms. Conclusions Results suggest that internalizing symptoms are associated with problematic sleep behaviors in children with comorbid ASD/ADHD and may have implications for the “real-life” functioning among children with comorbid ASD/ADHD.

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“…Consequently, our reliance on the mother’s report might have resulted in misclassification, and possible underestimation of the relationship between mother’s pre-pregnancy obesity and her child’s tendency to have ADHD symptoms. The limitations of the CSI-4 are acknowledged [66, 67]. …”

Section: Discussionmentioning

confidence: 99%

Maternal obesity and attention-related symptoms in the preterm offspring

Burg¹,

Jensen

Bor³

et al. 2017

Early Human Development

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Background Maternal pre-pregnancy obesity, in term-born children, is associated with an increased risk of attention problems, however this relationship has not been explored among children born extremely preterm. Aim To estimate the risk of attention problems at age 10 years in children born very preterm to overweight (i.e., body mass index (BMI) 25-29 kg/m2) and obese (i.e., BMI ≥ 30 kg/m2) women relative to the risk among children born to women who were neither overweight nor obese (i.e. BMI < 25 kg/m2). Study design Multi-center prospective cohort study. Methods A total of 764 children born before the 28th week of gestation and whose mother’s pre-pregnancy height and pre-pregnancy weight were obtained at birth had an IQ ≥ 70 at age 10 years when parents and teachers completed Child Symptom Inventory-4 questionnaires that included items about the presence of ADHD. Results Compared to children whose mother’s pre-pregnancy weight was in the normal range (BMI <25 kg/m2), children were at increased risk of parent-identified ADHD behaviors if their mother was overweight (odds ratio (OR) = 1.9; 95% confidence interval (CI): 1.1, 3.3), or obese (OR = 2.3; 95% CI: 1.4, 3.9). They were not at increased risk of teacher-identified ADHD characteristics if their mother was overweight before her pregnancy (OR = 1.0; 95% CI: 0.6, 1.8), or obese (OR = 1.0; 95% CI: 0.6, 1.6). Conclusion Maternal overweight and obesity are associated with increased risk of parent-identified ADHD characteristics at 10 years of age in children born extremely preterm.

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Association between autism symptoms and functioning in children with ADHD

Abstract: ASD symptoms are associated with poorer functioning in children with ADHD. It is important to identify and potentially manage ASD symptoms in children with ADHD given that they exacerbate functional impairments in this already vulnerable group.

Cited by 29 publications

References 36 publications

Neurodevelopmental Disorders and Adaptive Functions: A Study of Children With Autism Spectrum Disorders (ASD) and/or Attention Deficit and Hyperactivity Disorder (ADHD)

Neurodevelopmental Disorders and Adaptive Functions: A Study of Children With Autism Spectrum Disorders (ASD) and/or Attention Deficit and Hyperactivity Disorder (ADHD)

Parent-reported problematic sleep behaviors in children with comorbid autism spectrum disorder and attention-deficit/hyperactivity disorder

Maternal obesity and attention-related symptoms in the preterm offspring

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