Abstract
BackgroundChildren with autism spectrum disorder (ASD) often have co‐occurring symptoms of attention‐deficit/hyperactivity disorder (ADHD) and/or anxiety. It is unclear whether these disorders arise from shared or distinct developmental pathways. We explored this question by testing the specificity of early‐life (infant and toddler) predictors of mid‐childhood ADHD and anxiety symptoms compared to ASD symptoms.MethodsInfants (n = 104) at high and low familial risk for ASD took part in research assessments at 7, 14, 24 and 38 months, and 7 years of age. Symptoms of ASD, ADHD and anxiety were measured by parent report at age 7. Activity levels and inhibitory control, also measured by parent report, in infancy and toddlerhood were used as early‐life predictors of ADHD symptoms. Fearfulness and shyness measured in infancy and toddlerhood were used as early‐life predictors of anxiety symptoms. Correlations and path analysis models tested associations between early‐life predictors and mid‐childhood ADHD and anxiety symptoms compared to mid‐childhood ASD symptoms, and the influence of controlling for ASD symptoms on those associations.ResultsIncreased activity levels and poor inhibitory control were correlated with ADHD symptoms and not ASD or anxiety; these associations were unchanged in path models controlling for risk‐group and ASD symptoms. Increased fearfulness and shyness were correlated with anxiety symptoms, but also ASD symptoms. When controlling for risk‐group in path analysis, the association between shyness and anxiety became nonsignificant, and when further controlling for ASD symptoms the association between fearfulness and anxiety became marginal.ConclusionsThe specificity of early‐life predictors to ADHD symptoms suggests early developmental pathways to ADHD might be distinct from ASD. The overlap in early‐life predictors of anxiety and ASD suggests that these disorders are difficult to differentiate early in life, which could reflect the presence of common developmental pathways or convergence in early behavioural manifestations of these disorders.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by social communication deficits, restricted and repetitive behaviours and sensory atypicalities (DSM-5; American Psychiatric Association, 2013)
(Taylor et al, 2013; Tick et al, 2016), while autism spectrum disorder (ASD) traits more strongly predict later anxiety traits than vice versa (Hallett et al, 2010; Tick et al, 2016). These findings suggest that attention-deficit/ hyperactivity disorder (ADHD) symptoms are not a secondary consequence of ASD traits, while this may be the case for anxiety
Correlations between early-life predictors and midchildhood ADHD, anxiety, and ASD symptoms are summarised in Table 2 and reported in the online Supporting Information
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by social communication deficits, restricted and repetitive behaviours and sensory atypicalities (DSM-5; American Psychiatric Association, 2013). 2010; Taylor et al, 2013; Tick et al, 2016), but beyond this, the reasons for the overlap between these disorders are not fully understood It is unclear if ADHD and anxiety in ASD reflect the coexistence of distinct disorders with independent causal pathways. Children with autism spectrum disorder (ASD) often have co-occurring symptoms of attention-deficit/ hyperactivity disorder (ADHD) and/or anxiety It is unclear whether these disorders arise from shared or distinct developmental pathways. We explored this question by testing the specificity of early-life (infant and toddler) predictors of mid-childhood ADHD and anxiety symptoms compared to ASD symptoms.
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