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.

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Available from: Rebecca Grzadzinski, Mar 29, 2014
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    • "). 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. "
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    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.
    Full-text · Article · Aug 2015 · Brain Connectivity
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    • "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. "
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    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.
    Full-text · Article · Apr 2014 · Frontiers in Human Neuroscience
    • "Whereas the majority of the items was deduced from DSM- IV-TR autism symptoms, several items were selected additionally as non-specific but frequently observed symptoms in children and adolescents with ASD (Bölte and Poustka 2008; Grzadzinski et al. 2011). The SRS demonstrated good psychometric properties and cross-cultural validity (Bölte et al. 2008; Wang et al. 2012). "
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    ABSTRACT: Autism spectrum disorder (ASD) as well as social phobia (SP), and selective mutism (SM) are characterised by impaired social interaction. We assessed the validity of the Social Responsiveness Scale (SRS) to differentiate between ASD, and SP/SM. Raw scores were compared in 6–18 year old individuals with ASD (N = 60), SP (N = 38), SM (N = 43), and typically developed (N = 42). Sensitivity and specificity were examined. The three disorders showed overlapping SRS scores. Especially in boys with SM (ROC–AUC = .81), presence of ASD was overestimated by the SRS. A combination of three disorder specific questionnaires resulted in marginally improved diagnostic accuracy. For the clinically very relevant differential diagnosis of SP/SM, SRS results must be interpreted with caution.
    No preview · Article · Oct 2013 · Journal of Autism and Developmental Disorders
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