Attention-Deficit/Hyperactivity Disorder in Medication Treated Preschool-Age Children Without and With Autism Spectrum Disorder: A Developmental-Behavioral Research Network Study

Abstract

Abstract: Objectives: The study objective was to compare preschool children with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHD − ASD) with those with ADHD and ASD (ADHD + ASD), treated with stimulant or alpha-2-agonist (A2A) medications. Methods: Retrospective electronic health record review of 497 children from 7 developmental behavioral pediatrics research network sites. Children were younger than 72 months when treated with medication for ADHD from January 1, 2013, to January 7, 2017. We analyzed differences in children with ADHD − ASD versus ADHD + ASD treated with stimulants or A2As, including demographics, coexisting conditions, medication effectiveness, medication, discontinuation factors, and adverse effects. Results: Of the 497 preschool-age children with ADHD, 389 had ADHD − ASD and 108 had ADHD + ASD. No statistically significant differences were found in demographics between the groups. At baseline, ADHD + ASD group reported more sleep problems. For the ADHD − ASD group, stimulant medication was significantly more effective than A2As; no significant differences were found in medication effectiveness of stimulants versus A2As for the ADHD + ASD group. Children with ADHD − ASD experienced more appetite suppression and stomachaches on stimulants. No associations were found between ASD status and rates of common adverse effects for children initiated on A2As. Conclusion: We found more similarities than differences when comparing ADHD − ASD preschool-age children with those with ADHD + ASD. For children with ADHD − ASD, stimulant medications were significantly more effective than A2As. Overall, there was notable overlap in presentation, response to medication, coexisting conditions, and effectiveness of medication classes.