Monday, January 12, 2015

ASD and Co-Occurring ADHD

Children diagnosed with Autism Spectrum Disorder (ASD) often have co-occurring conditions including ADHD and anxiety. In fact, it is estimated that over 30% of children with high functioning ASD meet criteria for ADHD and an additional 25% exhibit some ADHD symptoms.

A study by Dr. Yerys of the Center for Autism Research showed that children diagnosed with ASD and ADHD had more problems with executive function (EF) skills compared to children diagnosed with ASD or children who were developing typically. EF is a set of skills that help children complete everyday tasks and goals. This includes the ability to follow multiple-step directions, wait their turn, transition between activities, organize their desk/room, or proof their work for mistakes. Furthermore, parents reported more problems with daily living skills, such as feeding, dressing, toileting, cleaning, cleaning room/home, and knowing how to purchase needed goods or services (make change for a dollar, buy groceries or clothes). Finally, the children diagnosed with ASD and ADHD were observed by parents to have more difficulty with easily visible or externalizing behaviors (attention problems, physical aggression, and disobeying rules) than not easily visible or internalizing behaviors (social withdrawal and feelings of loneliness, guilt, or sadness).

The study found that the presence of ADHD symptoms in children with ASD increased their impairments in several areas as compared to the ASD group and the typically developing group. The ASD+ADHD group received higher autism symptom ratings. They also exhibited more difficulty with the adaptive behaviors related to daily living skills. Finally, they received higher ratings for externalizing problems, but not internalizing problems.

Dr. Yerys’s study was replicated recently by the Autism Speaks’ Autism Treatment Network (ATN) with more than 2000 children. The ATN found that the children who had ASD and ADHD had more problems with adaptive function behaviors, which includes daily living skills.

These findings are significant because they show clearly for the first time that children with ASD who also have ADHD have greater difficulties adapting successfully at both school and home. They suggest that the ADHD symptoms should be prioritized for treatment.

Source: Yerys, B. E., Wallace, G. L., Sokoloff, J. L., Shook, D. A., James, J. D., & Kenworthy, L. (2009). Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders. Autism Research, 2(6), 322–333. doi:10.1002/aur.103


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