Abstract
BackgroundThe presence of attention-deficit/hyperactive disorder (ADHD) symptoms and impaired attention performance are commonly noted in individuals with autism spectrum disorder (ASD). However, little is known about attention performance in their unaffected siblings. This study aimed to investigate the ADHD-related traits and attention performance in unaffected siblings of probands with autism and Asperger syndrome (AS), as well as the clinical correlates of ADHD-related traits.MethodsWe assessed the intention, hyperactivity-impulsivity, and oppositional symptoms, and attention profiles of 199 probands with a diagnosis of ASD (122 autism, 77 AS), their unaffected siblings, and 196 typically developing controls (TD) by their parents’ reports on the ADHD-related symptoms and the Connors' Continuous Performance Test (CCPT), respectively.ResultsCompared to TD, unaffected siblings of ASD probands were more hyperactive/impulsive and oppositional, particularly unaffected siblings of AS probands. In CCPT, unaffected siblings of AS have intermediate levels of performance between probands with AS and TD on focused attention and sustained attention but were not statistically different from AS probands or TD in these attention profiles. In contrast, unaffected siblings of autism probands have significantly better CCPT performance when compared to autism probands but not to TD. In addition, stereotyped behaviors predicted ADHD-related traits in both sibling groups, but distinctive patterns of other correlates for ADHD-related traits were found between the two sibling groups.ConclusionsThis work suggested that unaffected siblings of AS, but not autism, have more hyperactive/impulsive traits and a trend of pervasive attention deficits assessed by CCPT which might serve as potential endophenotypes for genetic studies in AS.Trial registrationClinicalTrials.gov, NCT01582256
Highlights
The presence of attention-deficit/hyperactive disorder (ADHD) symptoms and impaired attention performance are commonly noted in individuals with autism spectrum disorder (ASD)
Both proband groups had more autistic symptoms than their unaffected siblings and typically developing controls (TD) assessed by the Chinese Social Communication Questionnaire (SCQ)
ADHD and oppositional traits When autism and Asperger syndrome (AS) were lumped together for three group comparison, probands had significantly higher ADHD and oppositional traits than unaffected siblings and TD, while unaffected siblings were only different from TD by more severe oppositional trait
Summary
The presence of attention-deficit/hyperactive disorder (ADHD) symptoms and impaired attention performance are commonly noted in individuals with autism spectrum disorder (ASD). Oppositional defiant disorder (ODD), though relatively less studied, was more prevalent in youth with ASD than in controls [16, 17] These symptoms may persist into adolescence [12], implying that ADHD-related symptoms could be a trait rather than state phenomenon. Individuals with ASD showed a higher prevalence of ADHD-related symptoms [13, 15,16,17,18,19,20,21] and demonstrated worse performance on the attention tasks such as the Continuous Performance Test (CPT) [22, 23]. Whether the “unaffected siblings” of probands with ASD share the similar ADHD-related symptoms and attention deficits has not been well explored yet
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