Abstract
Introduction: Autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD) are the two most common neurodevelopmental disorders observed in childhood. The DSM-5 accepts a combined diagnosis of ADHD and ASD, while the DSM-IV did not. The aim of this study was to identify and evaluate the adaptive profile of children and adolescents with a diagnosis of comorbid ADHD and ASD, in comparison with adaptive functioning in subjects with a diagnosis of only ASD or ADHD. Materials and Methods: Ninety-one children (77 boys, 14 girls), aging from 3.1 to 13.4 years (mean age: 8.3 ± 7.2), who met the criteria for a diagnosis of ASD and/or ADHD were enrolled. A neuropsychological evaluation involving cognitive and adaptive assessment was conducted using the Autism Diagnostic Observation Schedule – Second Edition (ADOS-2), the Conners’ Parent Rating Scale – Revised: Long Version (CPRS-R), the Wechsler Intelligence Scale – Fourth Edition or the Griffiths Mental Developmental Scales – Extended Revised, the Vineland Adaptive Behaviour Scale – Second Edition (VABS-II). Conclusion: As to the adaptive skills in the three groups evaluated, a worse general profile was ascertained in the ASD and in ASD plus ADHD groups in comparison with respect to the ADHD-only group. With VABS-II evaluation, we found significant differences among the three groups across all domains and combined scores: Communication (F = 18.960; p < 0.001), Socialization (F = 25.410; p < 0.001), Daily Living Skills (F = 19.760; p < 0.001), Motor (F = 9.615; p < 0.001), and Adaptive behavior composite [ABC] (F = 29.370; p < 0.001). Implications of neurodevelopmental double diagnosis such as ASD plus ADHD are discussed.
Highlights
Autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD) are the two most common neurodevelopmental disorders observed in childhood
The post-hoc analysis showed that IQ was significantly higher in the ADHD group, compared to the ASD (t = 4.232; p < 0.001) or to the ASD+ADHD group (t = 5.317; p < 0.001), while there was no significant difference between the ASD and the ASD+ADHD group (t = 1.048; p = 548)
In terms of parent ratings of children’s adaptive functioning, measured by means of the Vineland Adaptive Behaviour Scale – Second Edition (VABS-II), we found significant differences among the three groups across all domains and combined scores: Communication (F = 18.960; p < 0.001), Socialization (F = 25.410; p < 0.001), Daily Living Skills (F = 19.760; p < 0.001), Motor (F = 9.615; p < 0.001), and Adaptive behaviour composite (ABC) (F = 29.370; p < 0.001) (Table 3)
Summary
Autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD) are the two most common neurodevelopmental disorders observed in childhood [1, 2]. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. Current estimated prevalence is 5% of children and 2.5% in adults. ADHD is often first identified in school-aged children when it leads to disruption in the classroom and/or difficulties with school duties. It is more common among boys than girls (DSM-5) [1]
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