Examining autistic traits in children with ADHD: Does the Autism Spectrum Extend to ADHD?

Phyllis Green and Randolph Cōwen Institute for Pediatric Neuroscience, Child Study Center of the NYU Langone Medical Center, 215 Lexington Avenue, New York, NY 10016, USA.
Journal of Autism and Developmental Disorders (Impact Factor: 3.06). 11/2010; 41(9):1178-91. DOI: 10.1007/s10803-010-1135-3
Source: PubMed


We examined to what extent increased parent reports of autistic traits in some children with Attention Deficit Hyperactivity Disorder (ADHD) are the result of ADHD-related symptoms or qualitatively similar to the core characteristics of autism spectrum disorders (ASD). Results confirm the presence of a subgroup of children with ADHD and elevated ratings of core ASD traits (ADHD(+)) not accounted for by ADHD or behavioral symptoms. Further, analyses revealed greater oppositional behaviors, but not greater ADHD severity or anxiety, in the ADHD(+) subgroup compared to those with ADHD only. These results highlight the importance of specifically examining autistic traits in children with ADHD for better characterization in studies of the underlying physiopathology and treatment.

Download full-text


Available from: Rebecca Grzadzinski, Mar 29, 2014
1 Follower
82 Reads
  • Source
    • "). Third, these disorders share symptomatology, showing considerable overlap in the core and associated symptoms , that is, issues with attention, impulsivity, repetitive behaviors , impairments in socialization and communication, anxiety, sleep disturbance, obsessive compulsive behaviors, sensory processing abnormalities, depression, and ritualistic behaviors, such as counting, repeating, or ordering and arranging (see Table 1 for a comparison of the shared symptomatology) (Grzadzinski et al., 2011; Hariz and Robertson, 2010; Hattori et al., 2006; Taylor, 2009; Terband et al., 2014; Tourette Syndrome Fact Sheet, 2013). Fourth, these disorders share neuropathology. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of neurodevelopmental disorders, including autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), and Tourette syndrome (TS), has increased over the past two decades. Currently, about 1 in 6 children in the United States is diagnosed with a neurodevelopmental disorder. Evidence suggests that ASD, ADHD, and TS have similar neuropathology, which includes long-range under-connectivity and short-range over-connectivity. They also share similar symptomatology, with considerable overlap in their core and associated symptoms and a frequent overlap in their comorbid conditions. Consequently, it is apparent that ASD, ADHD, and TS diagnoses belong to a broader spectrum of neurodevelopmental illness. Biologically, long-range under-connectivity and short-range over-connectivity are plausibly related to neuronal insult (e.g., neurotoxicity, neuroinflammation, excitotoxicity, sustained microglial activation, proinflammatory cytokines, toxic exposure, oxidative stress, etc.). Therefore, these disorders may a share a similar etiology. The main purpose of this review is to critically examine the evidence that ASD, ADHD, and TS belong to a broader spectrum of neurodevelopmental illness, an abnormal connectivity spectrum disorder (ACSD), which results from neural long-range under-connectivity and short-range over-connectivity. The review also discusses the possible reasons for these neuropathological connectivity findings. In addition, this review examines the role and issue of axonal injury and regeneration in order to better understand the neuropathophysiological interplay between short- and long-range axons in connectivity issues.
    Brain Connectivity 08/2015; 5(6):321-35. DOI:10.1089/brain.2014.0324
  • Source
    • "Other studies have also pointed at the increased rate of autistic symptoms in samples of children with ADHD. Grzadzinski et al. (2011) confirmed the presence of a sub group of children with ADHD and elevated ratings of core ASD traits not accounted for by ADHD or behavioral symptoms. The ADHD group with AT revealed greater ODD behaviors than those with ADHD-only. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Symptoms of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD) often co-occur. The DSM-IV had specified that an ASD diagnosis is an exclusion criterion for ADHD, thereby limiting research of this common clinical co-occurrence. As neurodevelopmental disorders, both ASD and ADHD share some phenotypic similarities, but are characterized by distinct diagnostic criteria. The present review will examine the frequency and implications of this clinical co-occurrence in children, with an emphasis on the available data regarding pre-school age. The review will highlight possible etiologies explaining it, and suggest future research directions necessary to enhance our understanding of both etiology and therapeutic interventions, in light of the new DSM-V criteria, allowing for a dual diagnosis.
    Frontiers in Human Neuroscience 04/2014; 8(1):268. DOI:10.3389/fnhum.2014.00268 · 3.63 Impact Factor
  • Source
    • "Although historically, diagnostic manuals have not allowed for a joint diagnosis of ADHD and ASD, with an ASD diagnosis trumping and excluding a diagnosis of ADHD (DSM-IV & ICD-10), the observed co-occurrence has prompted changes to these diagnostic exclusions for the DSM-5. Overlap of the two conditions is found at the diagnostic level and at the level of symptoms below diagnostic thresholds in referred children and in the general population (Grzadzinski et al. 2011; Reiersen et al. 2007; Rommelse et al. 2010; Ronald et al. 2008). Moreover, given the high heritability of both conditions (Faraone et al. 2005; Freitag 2006), it is of note that family and twin studies show co-heritability (Lichtenstein et al. 2010; Lundström et al. 2011; Mulligan et al. 2009a; Nijmeijer et al. 2009; Taylor et al. 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often co-occur. Factor analyses of ASD traits in children with and without ASD indicate the presence of social and restrictive-repetitive behaviour (RRB) factors. This study used exploratory factor analyses to determine the structure of ASD traits (assessed using the Social Communication Questionnaire) in children with ADHD. Distinct factors were observed for 'social' and 'rigidity' traits, corresponding to previous factor analyses in clinical ASD and population samples. This indicates that the split between social-communicative and RRB dimensions is unaffected by ADHD in children. Moreover, the study also finds that there is some overlap across hyperactive-impulsive symptoms and RRB traits in children with ADHD, which merits further investigation.
    Journal of Autism and Developmental Disorders 06/2013; 44(1). DOI:10.1007/s10803-013-1865-0 · 3.06 Impact Factor
Show more