Abstract
Background: Autism spectrum disorder (ASD) often co-exists with attention deficit/hyperactivity disorder (ADHD), which may aggravate functional impairment. However, it is unclear how comorbid ADHD symptoms influence the adaptive behavior and social interaction deficits of children with ASD.Methods: The study enrolled 340 children (ranging from 2 to 14 years) with ASD, with comorbid ASD and ADHD, or with typical development (TD). A psychological evaluation involving adaptive behavior and social function was conducted using the Vineland Adaptive Behavior Scale, Second Edition (VABS-II) and the Social Responsiveness Scale (SRS).Results: There was a high prevalence of ADHD symptoms (46.6%) in children with ASD, and children with ASD + ADHD presented the worse profile of ASD symptoms. The ASD + ADHD group had higher scores on VABS and lower scores on SRS in comparison with the ASD alone group and TD group. The regression analysis revealed that ASD symptoms and ADHD symptoms were significantly associated with greater impairments in adaptive behavior and social function. The ADHD symptoms were responsible for an additional 0.8% of the variance in adaptive behavior, and 9.5% of the variance in social function.Conclusions: More severe ASD symptoms and greater impairment in adaptive function and social ability were found in children with ASD and comorbid ADHD, highlighting the need to identify ADHD comorbidities early on in children with ASD and to reduce their negative impact on functioning.
Highlights
Autism spectrum disorders (ASD) are behaviorally defined as neurodevelopmental disabilities, which are characterized by deficits in reciprocal social interaction and communication as well as by restricted, repetitive patterns of behavior or interests [1, 2]
intelligence quotients (IQ) was significantly different among the groups (χ2 = 143.574; p < 0.001), and the post-hoc analyses showed that IQ was significantly lower in the ASD + attention deficit/hyperactivity disorder (ADHD) group, compared with the typically developing (TD) group (p < 0.001) and the ASD group (p < 0.013)
The ASD diagnosis (β = 0.316; p < 0.001) and ADHD diagnosis (β = 0.347; p < 0.001) were significantly positively correlated with the Social Responsiveness Scale (SRS) score. In this population-based case-control study, we found a high prevalence of ADHD symptoms (46.6%) in children with ASD
Summary
Autism spectrum disorders (ASD) are behaviorally defined as neurodevelopmental disabilities, which are characterized by deficits in reciprocal social interaction and communication as well as by restricted, repetitive patterns of behavior or interests [1, 2]. ASD often co-exists with other neuropsychiatric diseases [5, 6], such as attention deficit/hyperactivity disorder (ADHD), epilepsy, anxiety disorders, affective disorders, gastrointestinal symptoms, and sleep problems These comorbidities have complex clinical manifestations and high lifetime prevalence, which could aggravate functional impairment and increase the burden of disease. According to the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) in 2013, clinicians are able to make a diagnosis of ADHD in the context of ASD This has led to increasing interest in the overlap of the clinical presentations of ASD and ADHD symptoms. Autism spectrum disorder (ASD) often co-exists with attention deficit/hyperactivity disorder (ADHD), which may aggravate functional impairment
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