ADHD symptoms common and problematic in children with autism - West Palm Beach Autism & Education |

ADHD symptoms common and problematic in children with autism - West Palm Beach Autism & Education |

One of the most frequently discussed issues related to autism spectrum disorder (ASD) is the co-occurrence (comorbidity) of attention-deficit/hyperactivity disorder (ADHD).
Comorbidity refers to the presence of more than one diagnosis occurring
in an individual at the same time. Although there continues to a debate
about ADHD comorbidity in ASD, research, practice and theoretical
models suggest that comorbidity between these disorders is relevant and
occurs frequently. Moreover, a significant change in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5;
APA, 2013) is the removal of the DSM-IV-TR (APA, 2000) hierarchical
rules prohibiting the concurrent diagnosis of ASD and ADHD. When the
criteria for both ASD and ADHD are met, both may be diagnosed.

A study published in the journal Pediatrics
evaluated the frequency of co-occurring ADHD symptoms in a group of
children with ASD and examined the relationship between ADHD symptoms
and both adaptive functioning and health-related quality of life as
reported by parents or other primary caregivers. Results indicated that
41% of the participants had ADHD-related symptoms. The ASD/ADHD group
had greater impairment in adaptive functioning and lower scores in all
health-related areas measured (School Functioning, Physical Functioning,
Emotional Functioning, and Social Functioning) in comparison to the ASD
group with few or no ADHD symptoms. This supports previous research on
the negative relationship between ADHD symptoms and the development of
functional life and other adaptive skills and provides further
documentation regarding the relationship between comorbid symptoms and
overall health-related quality of life.

This study has important implications for practitioners in health
care, mental health, and educational contexts. Externalizing behavior
problems, including ADHD symptoms, have been found to have a strong
negative relationship with family functioning and parenting stress in
children with ASD.

Improving adaptive functioning is especially important in that a
child’s level of adaptive functioning can directly influence their type
of educational setting and future adjustment. Children with better
adaptive skills have more opportunity to participate in grade-level
activities with typical peers. Consequently, clinicians and health-care
professionals should screen for symptoms of ADHD in children with ASD
and, if present, consider these symptoms when developing interventions
and treatment protocols.

Lee A. Wilkinson, PhD, NCSP, CPsychol, AFBPsS is the is author of the award-winning book, A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools,
published by Jessica Kingsley Publishers. He is also editor of a recent
volume in the American Psychological Association (APA) School
Psychology Book Series, Autism Spectrum Disorder in Children and Adolescents: Evidence-Based Assessment and Intervention in Schools and author of the new book, Overcoming Anxiety and Depression on the Autism Spectrum: A Self-Help Guide Using CBT.


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