Co-occurrence of motor problems and autistic symptoms in attention-deficit/hyperactivity disorder
ABSTRACT To investigate the relation between parent reports of motor problems and clinically significant autistic symptoms in children with and without attention-deficit/hyperactivity disorder (ADHD).
Subjects were male (n = 521) and female (n = 330) twins from an epidemiological study of ADHD, ages 7 to 19 years at assessment using the Child Behavior Checklist and semistructured psychiatric diagnostic interviews. Parent-rated Social Responsiveness Scale questionnaires were returned for 62% of 1,647 individuals who participated in interviews. After exclusion of subjects with incomplete data or evidence of mental retardation, 851 subjects (52%) were available for the present study analysis. Each subject was classified by DSM-IV ADHD subtype and assigned to one of seven population-defined ADHD subtypes based on latent class analysis of DSM-IV ADHD symptoms. Within each ADHD subtype, we examined the relation between Child Behavior Checklist motor problem endorsement and elevated autistic symptoms on the Social Responsiveness Scale.
Motor problems and high levels of autistic traits were most common in individuals with combined-type ADHD. Within each of the clinically relevant DSM-IV and latent class ADHD subtypes, individuals with the combination of motor problems and ADHD were more likely to have high levels of autistic traits than those with ADHD alone.
Children with the combination of ADHD and parent-reported motor coordination deficits have elevated levels of autistic symptoms. Targeted treatment and prevention interventions may be warranted. The exclusion criteria for DSM-IV ADHD should be revised to reflect these population-based findings.
SourceAvailable from: Susanne Bejerot[Show abstract] [Hide abstract]
ABSTRACT: The purpose of this study was to examine the role of humor style and motor skills in vulnerability to bullying. 729 adults responded to the Humor Style Questionnaire (HSQ) and items retrospectively addressing their motor skills and bullying experiences during childhood. Consistent with recent research, poorer motor skills were associated with a greater extent of having been bullied. An association between stronger motor skills and affiliative humor was found, lending support to a shared biological basis theory underlying social and motor competency processes. Most importantly, being bullied was associated with higher self-defeating humor and lower affiliative humor. This supports earlier theoretical work by Klein and Kuiper (2006) and highlights the role that humor styles play in social interactions that can promote positive peer acceptance and wellbeing.
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ABSTRACT: Background: Although existing literature demonstrates the association of attention-deficit/hyperactivity disorder (ADHD) with both substance use (SU) and autism spectrum disorder (ASD), few studies have examined rates of SU among adolescents with elevated ASD symptoms, with or without comorbid ADHD. Clinic-based studies suggest a possible protective effect of ASD against SU, but this has not been confirmed in population-based studies. Objective: We examined alcohol, tobacco, and drug use in adolescents with either ADHD, elevated autistic traits, or both as compared with controls. Methods: Subjects (N = 2937) who were 13 to 17 years old from a Missouri population-based large sibship sample were assessed for ADHD, autistic traits, and SU with the use of parent-report questionnaires. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ADHD symptom criterion (Criterion A) was applied to the Strengths and Weaknesses of ADHD-symptoms and Normal-behavior (SWAN) questionnaire item responses to determine ADHD diagnosis. The presence of elevated autistic traits was defined as a raw Social Responsiveness Scale (SRS) score of 62 (95 th percentile for this sample) or higher. SU was determined with the use of three items from the Child Behavior Checklist (CBCL). Statistical methods used included logistic and fractional polynomial regression. Results: As compared with controls, adolescents with ADHD were at increased risk for alcohol, tobacco, and drug use whether or not they had elevated autistic traits. Adolescents with elevated autistic traits were at significantly increased risk for drug use other than alcohol and tobacco, even if they did not have ADHD. Among those with raw SRS scores in the range of about 20 (normal) to 80 (consistent with mild to moderate ASD), adolescents with ADHD had higher levels of SU than control individuals with similar levels of autistic traits. However, strong conclusions cannot be drawn regarding individuals with very low or very high SRS scores as a result of sparse data. Conclusions: This study confirms previous research showing an increased risk of SU among adolescents with ADHD. It also provides new information indicating that adolescents with high levels of autistic traits are at elevated risk for alcohol and tobacco use if they have comorbid ADHD; in addition, they may be at high risk for other drug use, even if they do not have comorbid ADHD. Therefore, it should not be assumed that adolescents with mild to moderate ASD have a low risk of SU, especially if ADHD is also present.
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ABSTRACT: The current diagnostic manuals, DSM-IV-TR and ICD-10, do not allow the diagnosis of ADHD to be made separately in the presence of autism (pervasive developmental disorder). However, the characteristics of ADHD are very common in autism, occurring in around 30 to 70%. Surveys of children with ADHD also reveal a high proportion of features of Autism Spectrum Disorder (ASD). Furthermore, treatment of ADHD in the presence of autism is of benefit in a large proportion. The inconsistency in the diagnostic manuals should be resolved in the forthcoming DSM-5 and ICD-11. The results of twin studies have been consistent with the sharing of genetic influences between autism and ADHD symptoms. Genome-wide studies have also shown shared chromosomal regions of interest for susceptibility sites for both conditions. There is an overlap between the executive function deficits in both conditions, although the details of the dysfunction may be different. There is evidence that all the standard treatments for ADHD can be effective in the presence of autism (though to a lesser extent than in pure ADHD): methylphenidate, amphetamines, atomoxetine, clonidine and guanfacine. Atypical antipsychotics such as risperidone and aripiprazole may be of specific importance in managing ASD with irritability, aggression and hyperactivity. The idea that ADHD cannot be diagnosed or treated successfully in those with ASD is a myth that should be dispelled; many of those who have both autism spectrum disorder and ADHD can benefit greatly from the treatment of the ADHD.