ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD)

Abstract

Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n = 99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and Adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.

Severity of Autism Symptoms and Degree of Attentional Difficulties Predicts Emotional and Behavioral Problems in Children with High-Functioning Autism; a Two-Year Follow-up Study

“…It is also possible that the ARS-IV is not adequately designed to disentangle the inattention problems seen in ASD, and that the inattention problems captured in ARS-IV actually reflect the variability in ASD symptoms (Yerys et al, 2017 ). As ADHD manifests itself in settings requiring social and communication skills, ADHD together with ASD enhance vulnerability for EBP (Mansour et al, 2017 ). However, as respondents interpret questionnaires into the context in which they are given, answers may be given to questions accordingly.…”

“…The magnitude of core autism symptoms at baseline were expected to best predict degree of EBP at follow-up (Rosenberg et al, 2011 ; Yerys et al, 2017 ). We also expect higher attention symptoms to significantly predict elevated levels of EBP (Mansour et al, 2017 ). Based on previous research, we expect better verbal IQ to predict less EBP (Mayes et al, 2011 ; Lord et al, 2015 ).…”

“…Externalizing behavior problems in particular have been found to be elevated in children and adolescents with comorbid ASD and ADHD (Guttmann-Steinmetz et al, 2009 ; Mulligan et al, 2009 ; Jang et al, 2013 ). Mansour et al ( 2017 ) found that ADHD, but not ASD, was associated with more EBP as assessed by the Child Behavior Checklist (CBCL). Furthermore, children with ASD and concurrent ADHD symptoms had an increased prevalence of comorbid diagnoses, such as behavioral disorders, anxiety disorders and mood disorders.…”

Improved Socio-Emotional and Behavioral Functioning in Students with Autism Following School-Based Smartglasses Intervention: Multi-Stage Feasibility and Controlled Efficacy Study

“…Autism Spectrum Disorder (ASD) is a childhood onset neurodevelopmental disorder that is principally characterized by impairment in social communication, and the presence of a restricted/repetitive range of interests [ 1 ]. While decreased reciprocal social interaction is frequently seen among children with ASD, these individuals also commonly demonstrate irritability [ 2 ] and symptoms of attention-deficit/hyperactivity disorder (ADHD) [ 3 ], such as hyperactivity, inattention, and impulsivity. These symptoms not only burden individuals with ASD and their families, but they may jeopardize therapeutic and educational efforts [ 4 , 5 , 6 ].…”

Do Demographics and Comorbidities Act as Predictors of Co-diagnosis of Attention-deficit/Hyperactivity Disorder in Autism Spectrum Disorder?

“…It is estimated to affect 1% of the population and is more common in males. Many of them are afflicted by coexisting psychiatric conditions, further compromising the function and quality of life [2].…”