Treatment for Co-Occurring Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder

Abstract

Interest in the co-occurrence of attention deficit/ hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) has grown in the last decade. Research on clinical populations supports the frequent co-occurrence of ADHD traits (e.g., hyperactivity) in individuals with ASD and ASD traits (e.g., social communication deficits) in individuals with ADHD. Similar trends in co-occurring traits have been observed in population-based samples, as well as family and genetic studies of affected individuals. Despite increased interest in co-occurring ADHD and ASD, relatively little research has been devoted to treatment considerations. The vast majority of intervention research has examined pharmacological treatment using traditional ADHD medications. Relatively few psychosocial interventions have directly addressed co-occurring symptoms. Treatment development will benefit from enhanced understanding of the phenomenon of co-occurring ADHD and ASD. Key topics for future research include examining developmental trajectories of co-occurring disorders, comorbid psychiatric conditions, deficits in social skills, and the nature of executive functioning impairment in individuals with cooccurring ADHD and ASD. In the current review, research in these areas is reviewed along with recommendation for future study. Given that clinicians are routinely observing and treating individuals with co-occurring symptoms, further research will yield needed information to inform intervention development and maximize benefits for affected individuals.

The relationship between autism spectrum disorder and attention-deficit hyperactivity disorder: A critical review of the effects of DSM 5 criteria and the implications for treatment

“…In other studies co-occurring ADHD and ASD seem to be less responsive to standard treatments for either disorder than individuals with "pure" forms of the disorders 19 .…”

“…A small placebo-controlled efficacy trial indicated positive effects in terms of the reduction of hyperactivity and impulsivity, but not inattention in youth with ASD, with fewer adverse events as compared to stimulant trials 26 . Additional research using parents and teachers as informants showed significant reductions in ADHD symptoms among children with ADHD and ASD and side effects were rated as "minimally present" 19 .…”

“…Despite these promising findings, atomoxetine effectiveness may vary as a function of level of impairment: positive results for atomexetine are more evident among children with ASD who are cognitively higher functioning (defined as IQ >70) 19,23 .…”

This Issue: Case Challenges in Autism Spectrum Disorder

“…4 The first challenge, presented by Amar Mehta, MD, explores the impact an ASD diagnosis may have on a patient's family, and the importance of establishing a strong alliance with caregivers, as denying the truth of a diagnosis can deprive a child of much needed early intervention. Attendance to caregiver strain can also improve the outcome of the entire family.…”

New Directions for Therapeutics in ADHD

“…The need for effective interventions in these populations is just starting to be addressed. Davis and Kollins [15] review pharmacological and psychosocial interventions, (this issue), and suggest future research areas based on current gaps in the knowledge regarding the co-occurrence of ADHD and ASD symptoms.…”