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Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders
Open accessAbstract
Recent estimates suggest that 31% of children with autism spectrum disorders (ASD) meet diagnostic criteria for attention deficit/hyperactivity disorder (ADHD), and another 24% of children with ASD exhibit subthreshold clinical ADHD symptoms. Presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, autistic traits, and adaptive/maladaptive behaviors including: exacerbating core ASD impairments; adding unique impairments specific to ADHD; producing new problems unreported in ASD or ADHD; having no clear impact; or producing some combination of these scenarios. Children with ASD and co‐morbid ADHD symptoms (ASD+ADHD; n =21), children with ASD without ADHD (ASD; n =28), and a typically developing control group ( n =21) were included in the study; all groups were matched on age, gender‐ratio, IQ, and socioeconomic status. Data were collected on verbal and spatial working memory, response inhibition, global executive control (EC), autistic traits, adaptive functioning, and maladaptive behavior problems. In this sample, the presence of ADHD symptoms in ASD exacerbated impairments in EC and adaptive behavior and resulted in higher autistic trait, and externalizing behavior ratings. ADHD symptoms were also associated with greater impairments on a lab measure of verbal working memory. These findings suggest that children with ASD+ADHD symptoms present with exacerbated impairments in some but not all domains of functioning relative to children with ASD, most notably in adaptive behavior and working memory. Therefore, ADHD may moderate the expression of components of the ASD cognitive and behavioral phenotype, but ASD+ADHD may not represent an etiologically distinct phenotype from ASD alone.
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“Impairments on tests intended to measure working memory remain notable among youth with ASD when controlling for symptoms of ADHD65 and among individuals without co-occurring ADHD.66 67”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [65]
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In the citing paper
“Similarly, children with ASD continue to show poor inhibitory control test performance after controlling for ADHD symptoms.65”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [65]
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In the citing paper
“When ADHD symptoms are controlled for among ASD samples, effect sizes remain medium for verbal (d=0.53) and spatial tests (d=0.50).42,65”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [65]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“children with ASD continue to show impaired performance on tests intended to measure set shifting compared to neurotypical individuals after controlling for co-occurring ADHD symptoms, with a medium effect size (d=0.61) across tasks.65”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [65]
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In the citing paper
“relates to worse adaptive function (Yerys et al., 2009)”
From Data‐driven identification of subtypes of executive function across typical development, attention deficit hyperactivity disorder, and autism spectrum disorders (2020) · cites this paper as Yerys et al., 2009
In the citing paper
“There is evidence that ADHD in ASD is associated with differences in autism symptomatology, executive functioning (Sinzig, Morsch, Bruning, Schmidt, & Lehmkuhl, 2008), and adaptive behaviors (Yerys et al., 2009)”
From WISC-IV profile in high-functioning autism spectrum disorders: Impaired processing speed is associated with increased autism communication symptoms and decreased adaptive communication abilities (2012) · cites this paper as Yerys et al., 2009
In the citing paper
“and profiles of executive impairment may differ between ASD individuals with and without ADHD (Sinzig, Morsch, Bruning, Schmidt, & Lehmkuhl, 2008; Yerys et al., 2009).”
From Atypical attentional networks and the emergence of autism (2013) · cites this paper as Yerys et al., 2009
In the citing paper
“Similarly, in autism, group differences on EF measures (compared to non-ASD mental age-matched controls) do not imply that all individuals with ASD have EF problems, particularly when considering the milder variants of the condition”
From Brain adaptation and alternative developmental trajectories (2015) · cites this paper as Yerys et al., 2009
In the citing paper
“Significant relationships between self-reported EF deficits and a variety of constructs that are associated with deficient implementation of EF in daily life have been reported, including academic procrastination (e.g., deficits in planning, organization, and initiation; Rabin et al. 2011), Attention Deficit Hyperactivity Disorder (ADHD; known to encompass multiple EF deficits, e.g., deficits in”
From Executive Function Deficits in Daily Life Prospectively Predict Increases in Depressive Symptoms (2014) · cites this paper as Yers et al. 2009
In the citing paper
“For example, difficulties in shifting are not usually found in the ASD+ADHD group, compared to the pure ASD group, on laboratory tasks, but they have been identified using parent reports (Yerys et al., 2009).”
From Children with autism and attention deficit hyperactivity disorder. Relationships between symptoms and executive function, theory of mind, and behavioral problems (2018) · cites this paper as Yerys et al., 2009
In the citing paper
“Inhibitory problems seem to be shared by the group with ASD+ADHD and the group with ADHD (Bühler et al., 2011;Chantiluke et al., 2014;Sinzig et al., 2008b;Tye et al., 2014), although sometimes no inhibitory deficits have been found in the comorbid group (Sinzig et al., 2008a;Van der Meer et al., 2012;Yerys et al., 2009).”
From Children with autism and attention deficit hyperactivity disorder. Relationships between symptoms and executive function, theory of mind, and behavioral problems (2018) · cites this paper as Yerys et al., 2009
In the citing paper
“Similar results were obtained by Yerys et al. (2009) when comparing the EF in children with TD, ASD, and ASD+ADHD, using the parent version of the BRIEF.”
From Children with autism and attention deficit hyperactivity disorder. Relationships between symptoms and executive function, theory of mind, and behavioral problems (2018) · cites this paper as Yerys et al., 2009
In the citing paper
“This is in accordance with the results of Yerys et al. [49] finding high levels of ADHD-like symptoms in children with HFA to be associated with impairment in verbal working memory.”
From Symptoms of ADHD in Children with High-Functioning Autism Are Related to Impaired Verbal Working Memory and Verbal Delayed Recall (2013) · cites this paper as [49]
In the citing paper
“Yerys et al. [115] found greater overall cognitive impairments, including poor overall global executive control, cognitive flexibility, and verbal working memory, in children with ASD who also had hyperactivity.”
From Treatment for Co-Occurring Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder (2012) · cites this paper as [115]
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Citations
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BackgroundInfluentialWhat about the girls? Sex-based differences in autistic traits and adaptive skills
Ratto, A. B., Kenworthy, L., Yerys, B. E., Bascom, J., Wieckowski, A. T., White, S. W., Wallace, G. L., Pugliese, C., Schultz, R. T., Ollendick, T. H., et al. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3413-9 · Cited by 342
“Additionally, the use of the continuous rating scale in the SRS, as opposed to the ordinal scale of the ADOS, allows for greater variability in scores, and potentially a stronger ability to capture more subtle sex-based differences in the intensity of autistic traits.”
BackgroundInfluentialSelf-citationRong, Y., Yang, C.-J., Jin, Y., & Wang, Y. (2021) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2021.101759 · Cited by 316
Sleep in Children with Autism Spectrum Disorder
Souders, M. C., Jackson, S. Z., Eriksen, W., Sinko, R., Connell, J. E., Kerns, C. M., Schaaf, R. C., & Pinto‐Martin, J. A. (2017) · Current Psychiatry Reports · doi:10.1007/s11920-017-0782-x · Cited by 335
Annual research review: re-thinking the classification of autism spectrum disorders
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“These include hyperactivity and attention difficulties (Keehn, Lincoln, Muller, & Townsend, 2010; Yerys et al., 2009), and general behavior problems including disruptive behaviors and aggression, anxiety, depression and obsessivecompulsive disorder (Gjevik, Eldevik, FjaeranGranum, & Sponheim, 2011;…”
BackgroundHill, A. P., Zuckerman, K. E., Hagen, A., Kříž, D., Duvall, S. W., van Santen, J. P. H., Nigg, J. T., Fair, D. A., & Fombonne, E. J. (2014) · Research in Autism · doi:10.1016/j.rasd.2014.05.006 · Cited by 316
“…greater sleep difficulties (Goldman, Richdale, Clemons, & Malow, 2012; Mayes & Calhoun, 2009; Mazurek et al., 2013), internalizing symptoms (Cervantes, Matson, Tureck, & Adams, 2013; Kim, Szatmari, Bryson, Streiner, & Wilson, 2000), and hyperactivity and attention deficits (Yerys et al., 2009).”
BackgroundInfluentialBarua, P. D., Vicnesh, J., Gururajan, R., Oh, S. L., Palmer, E., Azizan, M. M., Kadri, N. A., & Acharya, U. R. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031192 · Cited by 270
“The complex web of comorbidities between NDDs and MHDs can contribute to the severity of learning disabilities [11] in individual children and can further reduce the quality of life.”
BackgroundWallace, G. L., Kenworthy, L., Pugliese, C. E., Popal, H. S., White, E. I., Brodsky, E., & Martin, A. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2655-7 · Cited by 261
“This is perhaps unsurprising given the emerging literature demonstrating, for example, exacerbated adaptive functioning deficits among children with both ASD and ADHD when compared to childrenwith ASD alone (e.g., Yerys et al. 2009) or ADHD alone (e.g., Ashwood et al. 2015).”
ResultAn update on the comorbidity of ADHD and ASD: a focus on clinical management
Antshel, K. M., Zhang‐James, Y., Wagner, K. E., Ledesma, A., & Faraone, S. V. (2016) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2016.1146591 · Cited by 276
“Others have likewise demonstrated that ASD + ADHD is associated with more severe impairments in adaptive behavior when compared to children with ASD alone [111,137].”
ResultDefining the cognitive phenotype of autism
Charman, T., Jones, C. R. G., Pickles, A., Simonoff, E., Baird, G., & Happé, F. (2011) · Brain Research · doi:10.1016/j.brainres.2010.10.075 · Cited by 234
Contribution of Rating Scales to the Assessment of Executive Functions
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“In the first study to examine profiles in childhood conditions, parent ratings on the BRIEF were compared between groups of children diagnosed with reading disorders, ADHD-I, ADHD-C, ASD, and moderate TBI or severe TBI evaluated 5 years postinjury (Gioia et al., 2002).”
BackgroundInfluentialOliveras-Rentas, R. E., Kenworthy, L., Roberson, R. B., Martin, A., & Wallace, G. L. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1289-7 · Cited by 231
“There is evidence that ADHD in ASD is associated with differences in autism symptomatology, executive functioning (Sinzig, Morsch, Bruning, Schmidt, & Lehmkuhl, 2008), and adaptive behaviors (Yerys et al., 2009), although there are no studies of which we are aware that address the Wechsler IQ profile in ASD plus ADHD.”
Self-citationPugliese, C. E., Anthony, L. G., Strang, J. F., Dudley, K., Wallace, G. L., Naiman, D. Q., & Kenworthy, L. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-015-2584-5 · Cited by 218
“Yerys et al. (2009) reported that children with ASD and comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms had greater impairments in inhibition compared to children with ASD without ADHD as well as poorer adaptive behavior.”
Self-citationBrain adaptation and alternative developmental trajectories
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“Similarly, in autism, group differences on EF measures (compared to non-ASD mental age-matched controls) do not imply that all individuals with ASD have EF problems, particularly when considering the milder variants of the condition (Losh et al., 2009; Yerys et al., 2009).”
Developmental comorbidity in attention-deficit/hyperactivity disorder
Taurines, R., Schmitt, J., Renner, T., Conner, A. C., Warnke, A., & Romanos, M. (2010) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-010-0040-0 · Cited by 198
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“, 2007) and maladaptive behaviors (Yerys et al., 2009) in children with ASD comorbid with ADHD than children with ASD only.”
BackgroundResultInfluentialCraig, F., Lamanna, A. L., Margari, F., Matera, E., Simone, M., & Margari, L. (2015) · Autism Research · doi:10.1002/aur.1449 · Cited by 194
“The authors found that the ASD1ADHD group received significantly higher ratings for externalizing problems, attention problems, and hyperactivity than the ASD and Control groups [Yerys et al., 2009].”
BackgroundExecutive function and developmental disorders: the flip side of the coin
Johnson, M. H. (2012) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2012.07.001 · Cited by 190
Brief report: Cognitive flexibility in autism spectrum disorders: A quantitative review
Leung, R. C., & Zakzanis, K. K. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2136-4 · Cited by 192
“…and Pennington (2005) Goldberg et al. (2005) Kaufmann et al. (2013) Landa and Goldberg (2005) Ozonoff et al. (2000) HFA and ASP Sachse et al. (2013) Yerys et al. 2009 8 0.30 0.20 78.7 0.14 0.46 0.11 0.69 4 CANTAB ID/ED total number of trials to complete all 9 categories Roelofs et al.…”
InfluentialAttention-deficit/hyperactivity disorder in the context of autism spectrum disorders
Murray, M. J. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-010-0145-3 · Cited by 185
Hansen, B. H., Oerbeck, B., Skirbekk, B., Petrovski, B. É., & Kristensen, H. (2018) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2018.1444087 · Cited by 182
“cognitive impairment [2], reduced quality of life [3,4], and”
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Brookman-Frazee, L., Stadnick, N., Chlebowski, C., Baker-Ericzén, M., & Ganger, W. (2018) · Autism · doi:10.1177/1362361317712650 · Cited by 174
“These data are also consistent with prior research documenting higher problem behaviors in children with ASD and co-occurring ADHD compared with those with ASD alone (Yerys et al., 2009).”
BackgroundResultSikora, D. M., Vora, P., Coury, D. L., & Rosenberg, D. (2012) · Pediatrics · doi:10.1542/peds.2012-0900g · Cited by 187
The Co-Occurrence of Autism Spectrum Disorder in Children With ADHD
Zablotsky, B., Bramlett, M. D., & Blumberg, S. J. (2017) · Journal of Attention Disorders · doi:10.1177/1087054717713638 · Cited by 181
“It is possible that the presence of ADHD symptoms may further exacerbate symptoms of ASD (Yerys et al., 2009) which may translate to greater executive functioning deficits.”
BackgroundTreatment for Co-Occurring Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder
Davis, N. O., & Kollins, S. H. (2012) · Neurotherapeutics · doi:10.1007/s13311-012-0126-9 · Cited by 156
“[115] found greater overall cognitive impairments, including poor overall global executive control, cognitive flexibility, and verbal working memory, in children with ASD who also had hyperactivity.”
BackgroundRETRACTED: Rates of comorbid symptoms in children with ASD, ADHD, and comorbid ASD and ADHD
Jang, J., Matson, J. L., Williams, L. W., Tureck, K., Goldin, R. L., & Cervantes, P. E. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.04.021 · Cited by 158
RetractedTye, C., Asherson, P., Ashwood, K. L., Azadi, B., Bolton, P., & McLoughlin, G. (2014) · Psychological Medicine · doi:10.1017/s0033291713001049 · Cited by 158
“Higher ASD symptom scores were demonstrated in the ASD+ ADHD group, which may indicate exacerbation of autistic traits with co-morbid ADHD, in line with other findings (e.g. Yerys et al. 2009).”
ResultReichow, B., Volkmar, F. R., & Bloch, M. H. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1793-z · Cited by 134
“Regardless, ADHD symptoms in children with PDD cause significant obstacles to educational achievement, socialization, and behavioral management (Holtmann et al. 2007; Yerys et al. 2009), just as they do in children with typical development.”
BackgroundMcTighe, S. M., Webb, S. J. N., Lin, Q., Hughes, Z. A., & Smith, D. G. (2013) · PLoS ONE · doi:10.1371/journal.pone.0062189 · Cited by 139
Schroder, C. M., Malow, B. A., Maras, A., Melmed, R. D., Findling, R. L., Breddy, J., Nir, T., Shahmoon, S., Zisapel, N., & Gringras, P. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04046-5 · Cited by 140
“This is because presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, adaptive/maladaptive behavior (Murray 2010), verbal working memory (Yerys et al. 2009) motor problems (Murray 2010), resulting in a stronger severity of autistic symptoms (Sprenger et al.”
BackgroundVaidya, C. J., You, X., Mostofsky, S., Pereira, F., Berl, M. M., & Kenworthy, L. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13114 · Cited by 126
Self-citationMatson, J. L., Rieske, R. D., & Williams, L. W. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.05.021 · Cited by 124
Avni, E., Ben‐Itzchak, E., & Zachor, D. A. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00717 · Cited by 126
“The current research is in line with previous findings that individuals with ASD and ADHD have a tendency toward greater impairments in adaptive functioning in all the VABS subdomains as compared to those with only ASD (2, 37, 38).”
BackgroundResultAnxiety and Mood Disorder in Children With Autism Spectrum Disorder and ADHD
Gordon‐Lipkin, E. M., Marvin, A. R., Law, J. K., & Lipkin, P. H. (2018) · PEDIATRICS · doi:10.1542/peds.2017-1377 · Cited by 134
Commonly studied comorbid psychopathologies among persons with autism spectrum disorder
Matson, J. L., & Cervantes, P. E. (2014) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.02.012 · Cited by 133
The neurobiological link between OCD and ADHD
Brem, S., Grünblatt, E., Drechsler, R., Riederer, P., & Walitza, S. (2014) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-014-0146-x · Cited by 109
van den Bergh, S. F. W. M., Scheeren, A. M., Begeer, S., Koot, H. M., & Geurts, H. M. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2071-4 · Cited by 110
“This clearly shows that, although group differences exist between groups with ASD and TD (Boyd et al. 2009; Chan et al. 2009; Endedijk et al. 2011; Kalbfleisch and Loughan 2012; Winsler et al. 2007; Yerys et al. 2009; Zandt et al. 2007), not all individuals with ASD encounter EF problems in one or more EF domains.”
BackgroundResultInfluentialAutistic traits in children with ADHD index clinical and cognitive problems
Cooper, M., Martin, J., Langley, K., Hamshere, M. L., & Thapar, A. (2013) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-013-0398-6 · Cited by 119
Ghirardi, L., Pettersson, E., Taylor, M. J., Freitag, C. M., Franke, B., Asherson, P., Larsson, H., & Kuja-Halkola, R. (2019) · Psychological Medicine · doi:10.1017/s003329171800243x · Cited by 99
Granader, Y., Wallace, G. L., Hardy, K. K., Yerys, B. E., Lawson, R. A., Rosenthal, M., Wills, M. C., Dixon, E., Pandey, J., Penna, R., et al. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2169-8 · Cited by 106
“Impaired flexibility is reflected in core symptoms of insistence on sameness and inflexible patterns of behavior and thinking (D’Cruz et al. 2013; Lopez et al. 2005; Reed et al. 2013, 2011; Yerys et al. 2009a).”
BackgroundResultInfluentialSelf-citationImpact of ADHD symptoms on autism spectrum disorder symptom severity
Sprenger, L., Bühler, E., Poustka, L., Bach, C., Heinzel-Gutenbrunner, M., Kamp-Becker, I., & Bachmann, C. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.07.028 · Cited by 105
“These results are in accordance with Yerys et al. (2009), who also found children and adolescents with ASD+ to exhibit a higher severity of autistic symptoms as measured with the SRS.”
BackgroundResultInfluentialMansour, R., Dovi, A. T., Lane, D. M., Loveland, K. A., & Pearson, D. A. (2017) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2016.11.009 · Cited by 101
“, 2001), predict more difficulties with general life functioning (Goldstein and Schwebach, 2004; Ogino et al., 2005; Yerys et al., 2009), and are positively correlated with receiving mental health services (Bryson, et al.”
BackgroundSocial Attention in a Virtual Public Speaking Task in Higher Functioning Children With Autism
Jarrold, W., Mundy, P. C., Gwaltney, M., Bailenson, J. N., Hatt, N. V., McIntyre, N. S., Kim, K. K., Solomon, M., Novotny, S. E., & Swain, L. A. (2013) · Autism Research · doi:10.1002/aur.1302 · Cited by 107
“Attention deficit/hyperactivity disorder (ADHD) symptom ratings were included because children with HFASD may express symptoms of ADHD, and these are associated with differences in their cognitive performance, academic achievement, and social information processing [Ashburner et al., 2010; Lee & Ousley, 2006; Sinzig,…”
BackgroundMaladaptive Behaviors of Children with Autism: Parent Support, Stress, and Coping
Hall, H. R., & Graff, J. C. (2012) · Issues in Comprehensive Pediatric Nursing · doi:10.3109/01460862.2012.734210 · Cited by 112
“Parent reports reveal significant externalizing, and to a lesser degree, internalizing behavior problems, such as aggression, hyperactivity, and inattention in children with ADHD groups (Hudziak, Copeland, Stanger, & Wadsworth, 2004; Yerys et al., 2009).”
BackgroundParenting Stress in Families of Children with Autism Spectrum Disorder and ADHD
Miranda, A., Mínguez, R. T., Andrés, M. I. F., Diago, C. C., & Pastor, G. (2015) · Exceptional Children · doi:10.1177/0014402915585479 · Cited by 118
“Some examples would be an increased intensity of the ASD symptoms (Jang et al., 2013; Sprenger et al., 2013; Yerys et al., 2009), especially repetitive and stereotyped behaviors (Rao & Landa, 2014) and temper tantrums (Goldin, Matson, Tureck, Cervantes, & Jang, 2013), or deficits in social skills (Kotte et al.”
BackgroundAutism Spectrum Disorders: Translating human deficits into mouse behavior
Pasciuto, E., Borrie, S. C., Kanellopoulos, A. K., Santos, A. R. S., Cappuyns, E., D’Andrea, L., Pacini, L., & Bagni, C. (2015) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2015.07.013 · Cited by 103
Autism Spectrum Disorders: An Update on Oral Health Management
Gandhi, R., & Klein, U. (2014) · Journal of Evidence Based Dental Practice · doi:10.1016/j.jebdp.2014.03.002 · Cited by 108
the BASIS Team, Hendry, A. J., Jones, E. J. H., Bedford, R., Gliga, T., Charman, T., & Johnson, M. H. (2018) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-017-9219-4 · Cited by 99
“Estimates of co-occurrence of clinical levels of ASD and ADHD symptoms range from 28 to 80% [25], and the presence of ADHD (specifically predominantly inattentive or combined sub-types) symptoms in ASD has been linked with lower EF performance [26, 27].”
BackgroundThe influence of sex and age on prevalence rates of comorbid conditions in autism
Supekar, K., Iyer, T., & Menon, V. (2017) · Autism Research · doi:10.1002/aur.1741 · Cited by 90
Vivanti, G., Fanning, P. A. J., Hocking, D. R., Sievers, S. B., & Dissanayake, C. (2017) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-017-3106-4 · Cited by 103
“However, other studies do not report a specific deficit in sustained attention in ASD (Garretson et al. 1990; Johnson et al. 2007; Siegel 1995; Yerys et al. 2009).”
Viscidi, E. W., Johnson, A. L., Spence, S. J., Buka, S. L., Morrow, E. M., & Triche, E. W. (2014) · Autism · doi:10.1177/1362361313508027 · Cited by 82
“Hyperactivity is therefore an important behavioral feature in ASD, which has been linked to problems with executive function, autistic traits, adaptive function, and externalizing behaviors (Yerys et al., 2009).”
BackgroundTorske, T., Nærland, T., Øie, M. G., Stenberg, N., & Andreassen, O. A. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2017.00258 · Cited by 98
“Results from recent studies indicate that neuropsychiatric disorders overlap with respect to both symptoms and causes (Moreno-De-Luca et al., 2013), and it has been recognized by both clinicians and researchers for some time that ASD and ADHD often co-occur (Yerys et al., 2009).”
BackgroundBerenguer, C., Roselló, B., Colomer, C., Baixauli, I., & Miranda, A. (2018) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2018.10.001 · Cited by 85
Willard, S. S., & Koochekpour, S. (2013) · International Journal of Biological Sciences · doi:10.7150/ijbs.6475 · Cited by 86
“pression, bipolar disorder and recovery after traumatic CNS injury (for reviews, see [6, 35-43]).”
BackgroundBrief Report: Adaptive Functioning in Children with ASD, ADHD and ASD + ADHD
Ashwood, K. L., Tye, C., Azadi, B., Cartwright, S., Asherson, P. J., & Bolton, P. (2015) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-014-2352-y · Cited by 100
“These findings suggest that children with ASD who meet diagnostic criteria for ADHD have poorer adaptive functioning, which extends previous findings in children with ASD with subthreshold ADHD symptoms (Rao and Landa 2013; Sikora et al. 2012; Yerys et al. 2009).”
Andersen, P. N., Hovik, K. T., Skogli, E. W., Egeland, J., & Øie, M. (2013) · PLoS ONE · doi:10.1371/journal.pone.0064842 · Cited by 82
“[49] finding high levels of ADHD-like symptoms in children with HFA to be associated with impairment in verbal working memory.”
BackgroundDemopoulos, C., Hopkins, J., & Davis, A. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1657-y · Cited by 78
“Indeed, there is a considerable body of research that has identified symptom overlap between ADHD and ASD (Corbett and Constantine 2006; Goldstein and Schwebach 2004; Holtmann et al. 2007; Leyfer et al. 2006; Sturm et al. 2004; Yerys et al. 2009; Yoshida and Uchiyama 2004).”
BackgroundResultMcClain, M. B., Mills, A. M. H., & Murphy, L. E. (2017) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2017.09.009 · Cited by 83
Zajic, M. C., McIntyre, N. S., Lerro, L., Novotny, S. E., Oswald, T. M., & Mundy, P. C. (2016) · Autism · doi:10.1177/1362361316675121 · Cited by 66
“Furthermore, studies have shown that the presence of elevated ADHD symptoms in school-age children with HFASD moderates cognitive and social abilities that can directly impact their academic performance (Ashburner et al., 2010; Gadow et al., 2008; Mayes and Calhoun, 2007; Sinzig et al., 2009; Yerys et al., 2009) as we…”
Vahabzadeh, A. B. N., Keshav, N. U., Salisbury, J. P., & Sahin, N. T. (2018) · JMIR Mental Health · doi:10.2196/mental.9631 · Cited by 73
“The combination of ADHD and ASD has been linked not only to greater impairment [10,11] and psychopathology [12,13], but also reduced access and response to psychopharmacologic treatment for ADHD [15,25].”
BackgroundExecutive Function Deficits in Daily Life Prospectively Predict Increases in Depressive Symptoms
Letkiewicz, A. M., Miller, G. A., Crocker, L. D., Warren, S. L., Infantolino, Z. P., Mimnaugh, K. J., & Heller, W. (2014) · Cognitive Therapy and Research · doi:10.1007/s10608-014-9629-5 · Cited by 63
“…Hyperactivity Disorder (ADHD; known to encompass multiple EF deficits, e.g., deficits in attentional control and inhibition, poor judgment, etc.; Yers et al. 2009), and traumatic brain injury (associated with documented deficits in EF tasks; see Toplak et al. 2013, for a review of studies that…”
Chiang, H., & Gau, S. S. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12450 · Cited by 68
Hanson, E. M., Cerban, B. M., Slater, C. M., Caccamo, L. M., Bacic, J. D., & Chan, E. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1677-7 · Cited by 69
Dufault, R., Lukiw, W. J., Crider, R. A., Schnoll, R., Wallinga, D. B., & Deth, R. C. (2012) · Clinical Epigenetics · doi:10.1186/1868-7083-4-6 · Cited by 61
“Elevated blood Pb levels are indicative of Pb intoxication, which is found in some children diagnosed with autism and associated with the development of ADHD [33,34].”
BackgroundInfluentialYang, D. Y. ‐., Sukhodolsky, D. G., Lei, J., Dayan, E., Pelphrey, K. A., & Ventola, P. E. (2017) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-017-9183-z · Cited by 64
“anxiety disorder [7], attention-deficit/hyperactivity disorder (ADHD) [8], and oppositional defiant disorder (ODD) [9].”
BackgroundAdaptive behavior in youth with autism spectrum disorder: The role of flexibility
Bertollo, J. R., Strang, J. F., Anthony, L. G., Kenworthy, L., Wallace, G. L., & Yerys, B. E. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04220-9 · Cited by 58
Self-citationDiagnosing autism in neurobiological research studies
Jones, R. M., & Lord, C. (2013) · Behavioural Brain Research · doi:10.1016/j.bbr.2012.10.037 · Cited by 56
Kouklari, E.-C., Tsermentseli, S. K., & Monks, C. P. (2018) · Development and Psychopathology · doi:10.1017/s0954579418000081 · Cited by 67
“, 2016), the additive effect comorbid ADHD has been found to have on EF deficits such as working memory (Andersen et al., 2013; Yerys et al., 2009) and inhibition (Sinzig et al.”
BackgroundYerys, B. E., Bertollo, J. R., Kenworthy, L. E., Dawson, G., Marco, E. J., Schultz, R. T., & Sikich, L. (2018) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-018-3856-7 · Cited by 64
Self-citationLee, T., Kim, S. H., Katz, B., & Mather, M. (2020) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2020.00002 · Cited by 58
Eisenhower, A., Blacher, J., & Bush, H. H. (2014) · Research in Autism · doi:10.1016/j.rasd.2014.09.007 · Cited by 60
“It is well-documented that children with ASD, relative to TD children, show heightened rates of externalizing problems, which may include aggression, hyperactivity, and rule-breaking behavior (e.g., Kaat et al., 2013; Kanne, Abbacchi, & Constantino, 2009; Simonoff et al., 2008; Yerys et al., 2009).”
BackgroundComorbid psychiatric disorders in Arab children with Autism spectrum disorders
Amr, M., Raddad, D., El-Mehesh, F., Bakr, A., Sallam, K., & Amin, T. T. (2011) · Research in Autism · doi:10.1016/j.rasd.2011.05.005 · Cited by 66
Distinct Cytokine and Chemokine Profiles in Autism Spectrum Disorders
Han, Y. M. Y., Cheung, W. K., Wong, C. K., Sze, S. L., Cheng, T. W. S., Yeung, M. K.-C., & Chan, A. S.-Y. (2017) · Frontiers in Immunology · doi:10.3389/fimmu.2017.00011 · Cited by 55
Goldin, R. L., Matson, J. L., Tureck, K., Cervantes, P. E., & Jang, J. (2013) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2013.04.022 · Cited by 62
RetractedKurzius‐Spencer, M., Pettygrove, S. D., Christensen, D., Pedersen, A. L., Cunniff, C. M., Meaney, F. J., Soke, G. N., Harrington, R. A., Durkin, M. S., & Rice, S. A. (2018) · Research in Autism · doi:10.1016/j.rasd.2018.09.002 · Cited by 58
Identifying comorbid ADHD in autism: Attending to the inattentive presentation
Rau, S., Skapek, M., Tiplady, K., Seese, S., Burns, A., Armour, A. C., & Kenworthy, L. E. (2019) · Research in Autism · doi:10.1016/j.rasd.2019.101468 · Cited by 60
Self-citationYou, X., Norr, M. E., Murphy, E. R., Kuschner, E. S., Bal, E., Gaillard, W. D., Kenworthy, L. E., & Vaidya, C. J. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00482 · Cited by 55
Self-citationLukito, S., Jones, C. R. G., Pickles, A. R., Baird, G., Happe, F. G. E., Charman, T., & Simonoff, E. A. (2017) · Molecular Autism · doi:10.1186/s13229-017-0177-1 · Cited by 58
“ADHD: Attention-deficit/hyperactivity disorder; ADI-R: Autism Diagnostic Interview-Revised; ADOS-G: Autism Diagnostic Observation Schedule-Generic; AIC: Akaike information criterion; ASD: Autism spectrum disorder; AT: Animated triangle task; BIC: Bayesian information criterion; CAPA: Child and Adolescent Psychiatric A…”
BackgroundMethodResultInfluentialVisser, J. C., Rommelse, N., Vink, L., Schrieken, M., Oosterling, I. J., van der Gaag, R. J., & Buitelaar, J. K. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1678-6 · Cited by 50
“2008) and contribute to the phenotypic expression of ASD (Georgiades et al. 2011; Hoekstra et al. 2010; Leyfer et al. 2006; Matson et al. 2011; Matson et al. 2010; Reiersen et al. 2008; Ronald et al. 2010a; Yerys et al. 2009).”
BackgroundYerys, B. E., Tunç, B., Satterthwaite, T. D., Antezana, L., Mosner, M. G., Bertollo, J. R., Guy, L., Schultz, R. T., & Herrington, J. D. (2019) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2018.12.012 · Cited by 58
“There may be some concern that using the calibration severity score from the ADOS may not be an ideal symptom measure for correlations due to its ordinal, non-continuous nature; however, recent efforts have shown that other dimensional measures like the Social Responsiveness Scale are sensitive to ADHD symptoms in bot…”
Self-citationExecutive functions in youths with autism spectrum disorder and their unaffected siblings
Seng, G., Tseng, W., Chiu, Y., Tsai, W., Wu, Y., & Gau, S. S. (2020) · Psychological Medicine · doi:10.1017/s0033291720001075 · Cited by 52
Much ado about norming: The Behavior Rating Inventory of Executive Function
Roth, R. M., Erdődi, L. A., McCulloch, L. J., & Isquith, P. Κ. (2014) · Child Neuropsychology · doi:10.1080/09297049.2014.897318 · Cited by 47
The Impact of the Comorbidity of ASD and ADHD on Social Impairment
Harkins, C. M., Handen, B. L., & Mazurek, M. O. (2021) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05150-1 · Cited by 55
Ichikawa, H., Kitazono, J., Nagata, K., Akira, M., Shimamura, K., Sakuta, R., Okada, M., Yamaguchi, M. K., Kanazawa, S., & Kakigi, R. (2014) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2014.00480 · Cited by 50
“…interests, and repetitive behaviors (American Psychiatric Association, 2000), there is a large overlap of symptoms in ADHD and ASD patients such as hyperactivity, restlessness, and impairments in social cognitive abilities (Yerys et al., 2009; Taurines et al., 2012; van der Meer et al., 2012).”
BackgroundAbnormal behaviours relevant to neurodevelopmental disorders in Kirrel3-knockout mice
Hisaoka, T., Komori, T., Kitamura, T., & Morikawa, Y. (2018) · Scientific Reports · doi:10.1038/s41598-018-19844-7 · Cited by 45
The Specificity of Inhibitory Impairments in Autism and Their Relation to ADHD-Type Symptoms
Sanderson, C., & Allen, M. L. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1650-5 · Cited by 50
Patra, S., Nebhinani, N., Viswanathan, A., & Kirubakaran, R. (2019) · Autism Research · doi:10.1002/aur.2059 · Cited by 45
“Co-morbid ADHD often results in lower cognitive, adaptive, and social functioning [Rao & Landa, 2014; Yerys et al., 2009].”
BackgroundYerys, B. E., Bertollo, J. R., Pandey, J., Guy, L., & Schultz, R. T. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.08.017 · Cited by 47
Self-citationAssessment and Treatment of Executive Function Impairments in Autism Spectrum Disorder
Wallace, G. L., Yerys, B. E., Peng, C. S., Dlugi, E., Anthony, L. G., & Kenworthy, L. E. (2016) · International review of research in developmental disabilities · doi:10.1016/bs.irrdd.2016.07.004 · Cited by 51
Self-citationJiang, Y. V., Capistrano, C. G., & Palm, B. E. (2014) · Journal of Abnormal Psychology · doi:10.1037/a0035420 · Cited by 48
Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder
Kofler, M. J., Soto, E. F., Singh, L. J., Harmon, S. L., Jaisle, E. M., Smith, J. N., Feeney, K. E., & Musser, E. D. (2024) · Nature Reviews Psychology · doi:10.1038/s44159-024-00350-9 · Cited by 51
“Impairments on tests intended to measure working memory remained notable among youths with ASD when controlling for symptoms of ADHD 63 and among individuals without co-occurring ADHD 64,65 .”
InfluentialInattention and hyperactivity in association with autism spectrum disorders in the CHARGE study
Lyall, K., Schweitzer, J. B., Schmidt, R. J., Hertz-Picciotto, I., & Solomon, M. (2017) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2016.11.011 · Cited by 42
“Though not statistically significant for all subscales, higher overall ADHD symptoms corresponded to poorer adaptive functioning, and cognitive abilities, a finding also previously reported for older children (Yerys et al. 2009).”
ResultInhibitory Control in Autism Spectrum Disorders: Meta-analyses on Indirect and Direct Measures
Tonizzi, I., Giofrè, D., & Usai, M. C. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05353-6 · Cited by 39
Metadata
- Authors
- Yerys, B. E., Wallace, G. L., Sokoloff, J. L., Shook, D. A., James, J. D., & Kenworthy, L.
- Affiliations
- Children's National (US)
- National Institute of Mental Health (US)
- Georgetown University (US)
- Corresponding author
- Yerys, Benjamin E.
- Venue
- Autism Research
- Publisher
- Wiley
- Published
- 2009-12
- Volume
- 2
- Issue
- 6
- Pages
- 322-333
- ISSN
- 1939-3792 (ISSN-L)
- 1939-3806
- PMC
- PMC3012375
- OpenAlex
- W2023794469
- Cited by
- 299
- References
- 77
- Citations by year
- 2026: 7 · 2025: 18 · 2024: 11 · 2023: 9 · 2022: 21 · 2021: 23 · 2020: 14 · 2019: 25 · 2018: 25 · 2017: 23 · 2016: 13 · 2015: 21 · 2014: 30 · 2013: 24 · 2012: 21
- FWCI
- 5.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Autism Research (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (U54MH066417)
- National Center for Research Resources (M01RR013297)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD046388, U54HD061221, P30HD040677)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, attention deficit hyperactivity disorder, comorbidities, executive function, working memory, response inhibition, adaptive behavior, maladaptive behavior, autistic traits, externalizing problems, children
- MeSH terms
- Adaptation, Psychological, Adolescent, Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Child, Child Behavior Disorders, Child Development Disorders, Pervasive, Cognition Disorders, Female, Humans, Male, Memory, Short-Term, Neuropsychological Tests, Personality Assessment, Psychometrics, Social Adjustment, Comorbidity, Asperger Syndrome, Executive Function
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