Abstract
Comorbidity between attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) is a frequently reported condition. However, the clinical overlaps between the two disorders are not well characterized. The Child Behavior Checklist (CBCL) is a well-documented measure of emotional and behavioral problems in children and adolescents. The aim of the present study was to evaluate whether CBCL scales were able to detect psychopathological comorbidities as well as emotional and behavioral profiles across three groups of children with ASD, ADHD, and with the co-occurrence of both disorders. The results show that around 30% of participants with ASD exhibited internalizing problems, which was in line with previous findings. Co-occurrence condition showed a clinical intermediate phenotype: relative to ADHD and ASD, youths with co-occurrence of ADHD and ASD phenotype showed respectively lower (p < 0.000) and higher externalizing problems (p < 0.000). No differences emerged in internalizing problems (p > 0.05) across groups. CBCL is a useful measure to study the psychopathological conditions as well as emotional and behavioral profiles associated with ASD, ADHD, and the co-occurrence of ADHD and ASD. The identification of psychopathological and behavioral profiles associated with ASD and ADHD is crucial to perform specific and individualized treatments. Our preliminary findings suggested the existence of an intermediate and independent phenotype between ADHD and ASD that seems to be defined by the externalizing problems. Internalizing problems do not significantly differ between the combined phenotype and the two groups.
Highlights
Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common neurodevelopmental disorders (American Psychiatric Association [APA], 2013) that frequently co-occur (Lai et al, 2019).Attention deficit/hyperactivity disorder is a prevalent and persistent psychiatric disorder that emerges in childhood as a complex of symptoms characterized by developmentally inappropriate and impairing levels of hyperactivity, impulsivity, and/or inattention (American Psychiatric Association [APA], 2013). Polanczyk et al (2015) estimated that the worldwide prevalence in childhood population studies is around 5%
As concerns the cognitive measures used for the assessment of the ADHD group, 14 out of 26 youths (54%) were evaluated by means of the WISC-IV, seven (27%) by means of Colored Progressive Matrices (CPM), and the remaining five (19%) by means of Leiter3, whereas 23 out of 30 youths (77%) belonging to the ASD groups were evaluated by means of Leiter-3, five (17%) were evaluated by means of WISC-IV, and only two children were evaluated through CPM and Griffiths III
Our preliminary findings revealed that the externalizing symptom scales of the Child Behavior Checklist (CBCL) scores significantly differed between the co-occurring ADHD–ASD group and the other two groups
Summary
Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common neurodevelopmental disorders (American Psychiatric Association [APA], 2013) that frequently co-occur (Lai et al, 2019).Attention deficit/hyperactivity disorder is a prevalent and persistent psychiatric disorder that emerges in childhood as a complex of symptoms characterized by developmentally inappropriate and impairing levels of hyperactivity, impulsivity, and/or inattention (American Psychiatric Association [APA], 2013). Polanczyk et al (2015) estimated that the worldwide prevalence in childhood population studies is around 5%. Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common neurodevelopmental disorders (American Psychiatric Association [APA], 2013) that frequently co-occur (Lai et al, 2019). Attention deficit/hyperactivity disorder is a prevalent and persistent psychiatric disorder that emerges in childhood as a complex of symptoms characterized by developmentally inappropriate and impairing levels of hyperactivity, impulsivity, and/or inattention (American Psychiatric Association [APA], 2013). Autism spectrum disorder is characterized by persistent deficits in social communication and social interaction across multiple contexts as well as restricted, repetitive patterns of behavior, interests, or activities (American Psychiatric Association [APA], 2013). Differences in prevalence estimates vary by methodological approach, demographic factors, geographical area, and time (Lyall et al, 2017)
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