Examining the Overlap Between ADHD and Autism Spectrum Disorder (ASD) Using Candidate Endophenotypes of ADHD

Salunkhe, Gayatri; Weissbrodt, K.; Feige, Bernd; Saville, Christopher W. N.; Berger, Andrea; Dundon, Neil M.; Bender, Stephan; Smyrnis, Nikolaos; Beauducel, André; Biscaldi, Monica; Klein, Christoph

doi:10.1177/1087054718778114

Cited by 23 publications

(33 citation statements)

References 84 publications

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“…Increased reaction-time variability is one of the most replicable findings in the ADHD literature [28,[33][34][35]48]. This within-subject moment-to-moment fluctuation of task performance is known as Intra-Subject Variability (ISV).…”

Section: Intra-subject Variabilitymentioning

confidence: 95%

“…The few studies that measured ISV in an ASD group compared to an ADHD group have yielded mixed results [19,55]. However, studies that directly compared ASD− (no comorbid ADHD) and ASD+ (ASD with comorbid ADHD) groups with an ADHD group have found evidence of increased ISV in ASD only in the presence of comorbid ADHD [48,52,53].…”

Section: Intra-subject Variabilitymentioning

confidence: 99%

“…Some research groups have tried deciphering the shared and common etiological factors of ADHD and ASD by studying the two disorders in tandem, with or without a co-morbid group. These studies have measured a variety of constructs and functions, for instance, face recognition, face and gaze direction, imitation, motor function, working memory, attention, inhibition, executive function and intrasubject variability [7,48,50,52,53]. While atypical performance on some of these constructs has been common to both disorders, most others show clear dissociation; with the ASD + ADHD group occasionally showing additive effects of both disorders.…”

Section: Introductionmentioning

confidence: 99%

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Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders?

Seernani

Damania

Ioannou

et al. 2020

Eur Child Adolesc Psychiatry

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Recent debates in the literature discuss commonalities between Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) at multiple levels of putative causal networks. This debate requires systematic comparisons between these disorders that have been studied in isolation in the past, employing potential markers of each disorder to be investigated in tandem. The present study, choose superior local processing, typical to ASD, and increased Intra-Subject Variability (ISV), typical to ADHD, for a head-to-head comparison of the two disorders, while also considering the comorbid cases. It directly examined groups of participants aged 10-13 years with ADHD, ASD with (ASD+) or without (ASD−) comorbid ADHD and a typically developing (TD) group (total N = 85). A visual search task consisting of an array of paired words was designed. The participants needed to find the specific pair of words, where the first word in the pair was the cue word. This visual search task was selected to compare these groups on overall search performance and trial-to-trial variability of search performance (i.e., ISV). Additionally, scanpath analysis was also carried out using Recurrence Quantification Analysis (RQA) and the Multi-Match Model. Results show that only the ASD− group exhibited superior search performance; whereas, only the groups with ADHD symptoms showed increased ISV. These findings point towards a double dissociation between ASD and ADHD, and argue against an overlap between ASD and ADHD.

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Section: Intra-subject Variabilitymentioning

confidence: 95%

Section: Intra-subject Variabilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders?

Seernani

Damania

Ioannou

et al. 2020

Eur Child Adolesc Psychiatry

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“…Studies examining ISV in ASD compared to ADHD have produced contradictory findings [50,14]. However, studies differentiating the ASD group based on comorbid ADHD, and thus measuring ADHD in comparison to ASD-(no comorbid ADHD) and ASD+ (ASD with comorbid ADHD) groups have only reported increased ISV when ADHD symptoms are present in the ASD group [3,37,46].…”

Section: Autism Spectrum Disorder and Intra-subject Variabilitymentioning

confidence: 99%

“…A vast number of studies trying to decipher the ASD+ADHD interaction have focused mainly on additive or interactive models of deficits in each disorder [37,[45][46][47][48]. To understand if and how ASD and ADHD interact with each other, superior performance needs to be given just as much importance as deficit-based models.…”

Section: Asd Versus Adhdmentioning

confidence: 99%

Studying global processing in autism and attention-deficit/hyperactivity disorder with gaze movements: The example of a copying task

Seernani

Ioannou

Damania

et al. 2019

Preprint

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Recent discussions in the literature, along with the revision of the Diagnostic and StatisticalManual (DSM) [2], suggest aetiological commonalities between the highly comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).Addressing this discussion requires studying these disorders together by comparing constructs typical to each of them. In the present study, we investigate global processing, known to be difficult for participants with ASD, and Intra-Subject Variability (ISV), known to be consistently increased in participants with ADHD, in groups, aged 10-13 years, with ADHD (n=25), ASD without comorbid ADHD (ASD-) (n=13) and ASD with ADHD (ASD+) (n=18) in comparison with a typically developing group (n=22). A Copying task, typically requiring global processing and in this case particularly designed using equally complex stimuli to also measure ISV across trials, was selected. Oculomotor measures in this task proved to be particularly sensitive to group differences. While increased ISV was not observed in the present task in participants with ADHD, both ASD groups needed to look longer on the figure to be drawn, indicating that global processing takes longer in ASD. However, the ASD+ group needed to fixate on the figure only between drawing movements, whereas the ASDgroup needed to do this throughout the drawing process. The present study provides evidence towards ASD and ADHD being separate, not-overlapping, disorders. Since the pure ASDgroup was affected more by central coherence problems than the ASD+ group, it may suggest that neuropsychological constructs interact differently in different clinical groups and subgroups.

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Exploring telediagnostic procedures in child neuropsychiatry: addressing ADHD diagnosis and autism symptoms through supervised machine learning

Grazioli

Crippa

Rosi

et al. 2023

Eur Child Adolesc Psychiatry

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Recently, there has been an increase in telemedicine applied to child neuropsychiatry, such as the use of online platforms to collect remotely case histories and demographic and behavioral information. In the present proof-of-concept study, we aimed to understand to what extent information parents and teachers provide through online questionnaires overlaps with clinicians’ diagnostic conclusions on attention-deficit/hyperactivity disorder (ADHD). Moreover, we intended to explore a possible role that autism spectrum disorders (ASD) symptoms played in this process. We examined parent- and teacher-rated questionnaires collected remotely and an on-site evaluation of intelligence quotients from 342 subjects (18% females), aged 3–16 years, and referred for suspected ADHD. An easily interpretable machine learning model—decision tree (DT)—was built to simulate the clinical process of classifying ADHD/non-ADHD based on collected data. Then, we tested the DT model’s predictive accuracy through a cross-validation approach. The DT classifier’s performance was compared with those that other machine learning models achieved, such as random forest and support vector machines. Differences in ASD symptoms in the DT-identified classes were tested to address their role in performing a diagnostic error using the DT model. The DT identified the decision rules clinicians adopt to classify an ADHD diagnosis with an 82% accuracy rate. Regarding the cross-validation experiment, our DT model reached a predictive accuracy of 74% that was similar to those of other classification algorithms. The caregiver-reported ADHD core symptom severity proved the most discriminative information for clinicians during the diagnostic decision process. However, ASD symptoms were a confounding factor when ADHD severity had to be established. Telehealth procedures proved effective in obtaining an automated output regarding a diagnostic risk, reducing the time delay between symptom detection and diagnosis. However, this should not be considered an alternative to on-site procedures but rather as automated support for clinical practice, enabling clinicians to allocate further resources to the most complex cases.

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Examining the Overlap Between ADHD and Autism Spectrum Disorder (ASD) Using Candidate Endophenotypes of ADHD

Abstract: Overall, we conclude that, within our limited but heterogeneous task battery, ISV and temporal processing deficits are most sensitive to ADHD symptomatology and that controlling for ADHD comorbidity is mandatory when assessing ISV in autism.

Cited by 23 publications

References 84 publications

Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders?

Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders?

Studying global processing in autism and attention-deficit/hyperactivity disorder with gaze movements: The example of a copying task

Exploring telediagnostic procedures in child neuropsychiatry: addressing ADHD diagnosis and autism symptoms through supervised machine learning

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