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Overlapping and Distinct Cognitive Impairments in Attention-Deficit/Hyperactivity and Autism Spectrum Disorder without Intellectual Disability
Open accessAbstract
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are commonly comorbid, share genetic liability, and often exhibit overlapping cognitive impairments. Clarification of shared and distinct cognitive effects while considering comorbid symptoms across disorders has been lacking. In the current study, children ages 7-15 years assigned to three diagnostic groups:ADHD (n = 509), ASD (n = 97), and controls (n = 301) completed measures spanning the cognitive domains of attention/arousal, working memory, set-shifting, inhibition, and response variability. Specific processes contributing to response variability were examined using a drift diffusion model, which separately quantified drift rate (i.e., efficiency of information processing), boundary separation (i.e., speed-accuracy trade-offs), and non-decision time. Children with ADHD and ASD were impaired on attention/arousal, processing speed, working memory, and response inhibition, but did not differ from controls on measures of delayed reward discounting, set-shifting, or interference control. Overall, impairments in the ASD group were not attributable to ADHD symptoms using either continuous symptom measures or latent categorical grouping approaches. Similarly, impairments in the ADHD group were not attributable to ASD symptoms. When specific RT parameters were considered, children with ADHD and ASD shared impairments in drift rate. However, children with ASD were uniquely characterized by a wider boundary separation. Findings suggest a combination of overlapping and unique patterns of cognitive impairment for children with ASD as compared to those with ADHD, particularly when the processes underlying reaction time measures are considered separately.
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“Studies in which ADHD and ASD traits were controlled indicate that, at least response inhibition and response variability, may be more strongly associated with ADHD than with ASD traits (Karalunas et al., 2018; Schachar et al., 2022).”
From Do ASD and ADHD Have Distinct Executive Function Deficits? A Systematic Review and Meta-Analysis of Direct Comparison Studies (2023) · cites this paper as Karalunas et al., 2018
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“These results indicate that while ASD and ADHD share some etiological basis, there may be more than one sole “cause” of any given phenotype (Musser et al., 2014; Reiersen & Todd, 2008) and such causes may also be shared and distinct, both between and within the disorders (Karalunas et al., 2018; Rommelse et al., 2017; Vaidya et al., 2020).”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
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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 [66]
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“Such studies suggest that impairments across ASD and ADHD are not entirely attributable to comorbid diagnoses (Karalunas et al., 2018; Vaidya et al., 2020).”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
In the citing paper
“A set of potentially shared mechanisms across ADHD and ASD instantiate atypical executive functioning (EF) (Karalunas et al., 2018).”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
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“The deficits in working memory and processing speed also persisted when compared to an ADHD sample (Karalunas et al., 2018).”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
In the citing paper
“This variability in the relationship between EF and ASD has also been demonstrated, but whether this is due to comorbid ASD+ADHD remains unclear (Karalunas et al., 2018).”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
In the citing paper
“Indeed the current study builds on a handful of recent studies that have employed transdiagnostic approaches (Dajani et al., 2019; Karalunas et al., 2018; Lecei et al., 2019; Vaidya et al., 2020).”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
In the citing paper
“those with ASD have shown differences in neuroimaging studies when compared to TD and ADHD groups (Karalunas et al., 2018; Ray et al., 2014; Rommelse et al., 2017)”
From Heterogeneity of executive function revealed by a functional random forest approach across ADHD and ASD (2020) · cites this paper as Karalunas et al., 2018
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“This was not unexpected, given the overlapping nature of how disabilities may affect individuals (Merikangas et al. , 2007; Karalunas et al. , 2018).”
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“It is also possible that standard cognitive performance metrics are too multi-factorially determined and use of computational parameters that distinguish different aspects of information processing would yield more informative profiles (47, 48).”
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“This variability in the relationship between EF and ASD has also been demonstrated, but whether this is due to comorbid ASD+ADHD remains unclear (Karalunas et al., 2018).”
InfluentialSelf-citationYerys, 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
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Self-citationNeural Substrates of the Drift-Diffusion Model in Brain Disorders
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ResultNejati, V., Rasanan, A. H. H., Rad, J. A., Alavi, M. M., Haghi, S., & Nitsche, M. A. (2021) · Neurophysiologie Clinique · doi:10.1016/j.neucli.2021.11.005 · Cited by 45
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“Nevertheless, to further examine how the LC-NE system modulates attention and task performance future studies should examine other, and more sensitive measures of (disorder-specific) response execution in addition to RT (Karalunas et al., 2018).”
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Williams, Z. J., Failla, M. D., Davis, S., Heflin, B. H., Okitondo, C. D., Moore, D., & Cascio, C. J. (2019) · Scientific Reports · doi:10.1038/s41598-019-49103-2 · Cited by 35
Non-decision time: The Higgs Boson of decision.
Bompas, A., Sumner, P., & Hedge, C. (2024) · Psychological Review · doi:10.1037/rev0000487 · Cited by 47
“…less systematic changes in RT, such as attention-de fi cit/hyperactivity disorder, also show less consistent changes in NDT, some reporting a decrease (see Karalunas et al., 2014, for instance), an increase (Merkt et al., 2013) or no changes (e.g., Fosco et al., 2017; Karalunas et al., 2018).”
Karalunas, S. L., Antovich, D. M., Goh, P. K., Martel, M. M., Tipsord, J. M., Nousen, E. K., & Nigg, J. T. (2021) · Development and Psychopathology · doi:10.1017/s0954579421000900 · Cited by 37
“In addition, the cognitive weaknesses observed in ADHD are commonly associated with multiple forms of psychopathology (Bloemen et al., 2018; Karalunas et al., 2018; Martel et al., 2017; White et al., 2017), yet it is not clear how strongly these impairments are correlated with disorders when ADHD is also controlled (N…”
BackgroundSelf-citationExamining reaction time variability on the stop-signal task in the ABCD study
Epstein, J. N., Karalunas, S. L., Tamm, L., Dudley, J. A., Lynch, J. D., Altaye, M., Simon, J. O., Maloney, T., & Atluri, G. (2022) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617722000431 · Cited by 31
“Overall, there is continued interest in cognitive performance measures and particularly computational performance parameters as potential transdiagnostic risk markers for psychopathology (Ferrante et al., 2019; Karalunas et al., 2018; Wiecki et al., 2015).”
Self-citationSchachar, R. J., Dupuis, A., Arnold, P. D., Anagnostou, E., Kelley, E., Georgiades, S., Nicolson, R., Townes, P., Burton, C. L., & Crosbie, J. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00958-6 · Cited by 30
“Only five studies reported performance on the stop-signal task (SST), a widely used measure of response inhibition (Albajara Sáenz et al., 2020; Karalunas et al., 2018; Kuijper et al., 2015, 2017; Van Hulst et al., 2018).”
BackgroundResultInfluentialSocial and delay discounting in autism spectrum disorder
Warnell, K. R., Maniscalco, S., Baker, S. M., Yi, R., & Redcay, E. (2019) · Autism Research · doi:10.1002/aur.2085 · Cited by 30
“…evidence for greater discounting of future rewards in ASD (e.g., Carlisi et al., 2017; Chantiluke et al., 2014; Murphy et al., 2017), but others have found no group differences (e.g., Antrop et al., 2006; Demurie et al., 2012; Karalunas et al., 2018 & Kouklari, Tsermentseli, & Monks, in press).”
BackgroundMa, S. L., Chen, L. H., Lee, C., Lai, K. Y. C., Hung, S., Tang, C.-P., Ho, T., Shea, C. K., Mo, F. Y. M., Mak, T. S. H., et al. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.649588 · Cited by 29
“…Working Group of The Psychiatric Genomics Consortium, 2017; Grove et al., 2019), despite the fairly well-replicated association of SHANK genes with ASD in previous association and animal studies, cited above (Peça et al., 2011; Won et al., 2012; Leblond et al., 2014; Connolly et al., 2017).”
ResultZhang, M., Huang, Y., Jiao, J., Yuan, D., Hu, X., Yang, P., Zhang, R., Wen, L., Situ, M., Cai, J., et al. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03734-4 · Cited by 29
“Previous studies have found a set of shared cognitive dysfunctions across ADHD and ASD, such as executive function (EF) and motor function [17].”
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Li, Y., Ma, S., Zhang, X., & Gao, L. H. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.02.012 · Cited by 29
Mansour, R., Ward, A. R., Lane, D. M., Loveland, K. A., Aman, M. G., Jerger, S. W., Schachar, R. J., & Pearson, D. A. (2021) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.103882 · Cited by 30
“Indeed, a recent study with a large sample using empirical methods to define diagnostic “classes” concluded some cognitive impairment was shared across both disorders while other cognitive deficits appeared to be unique to each diagnostic class (Karalunas et al. 2018).”
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“This result is in line with previous studies showing that individuals with ADHD had lower drift-rates than control participants in a range of tasks 44,64,109–111 .”
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“…and motivational inhibition would be more impaired among children with singular (ADHD group) and comorbid diagnosis of ADHD (ASD + ADHD), relative to TD children and children with a singular diagnosis of ASD (Bühler et al., 2011; Karalunas et al., 2018; Sonuga-Barke, 2002; Tye et al., 2014).”
BackgroundResultInfluentialPoly‐victimization of autistic adults: An investigation of individual‐level correlates
Gibbs, V., Hudson, J. L., & Pellicano, E. (2023) · Autism Research · doi:10.1002/aur.3031 · Cited by 27
“…in social, psychological and cognitive profiles found among autistic people and those with ADHD (Baribeau et al., 2015; de Boer & Pijl, 2016; Karalunas et al., 2018) and the association between ADHD features (inattention, impulsiveness and hyperactivity) and autistic traits (Panagiotidi et…”
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“Children presenting with both symptoms exhibit more EF deficits than those with a single diagnosis [31–33].”
BackgroundFace processing in autism spectrum disorder re-evaluated through diffusion models.
Powell, G., Jones, C. R. G., Hedge, C., Charman, T., Happe, F. G. E., Simonoff, E. A., & Sumner, P. (2019) · Neuropsychology · doi:10.1037/neu0000524 · Cited by 24
“…autistic individuals may also show increased intra-participant variability (Geurts et al., 2008; Karalunas et al., 2014) and a recent study that found lower drift-rates in autistic children (Karalunas et al., 2018), we anticipated that drift-rates may also be reduced in our autistic participants.”
InfluentialJiang, X., Liu, L., Ji, H., & Zhu, Y. (2018) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2018.00506 · Cited by 28
“Along with a significant development on neuroscience, the principles given underlie many indirect evidences for elaboration of etiology and pathogenesis of ADHD (Roohi-Azizi et al., 2017; Karalunas et al., 2018; Van Doren et al., 2018).”
BackgroundSelf-reported impulsivity does not predict response caution
Hedge, C., Powell, G., Bompas, A., & Sumner, P. (2020) · Personality and Individual Differences · doi:10.1016/j.paid.2020.110257 · Cited by 22
Childhood Metabolic Biomarkers Are Associated with Performance on Cognitive Tasks in Young Children
Shapiro, A. L. B., Wilkening, G. N., Aalborg, J., Ringham, B. M., Glueck, D. H., Tregellas, J. R., & Dabelea, D. (2019) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2019.03.043 · Cited by 24
“Delay or impairment of cognitive flexibility and inhibitory control processes are found in developmental disorders such as attention-deficit/ hyperactivity disorder [26, 27] and autism spectrum disorder [27, 28].”
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“For detailed description of this sample, see Karalunas et al. [44].”
BackgroundPolygenic risk for ADHD and ASD and their relation with cognitive measures in school children
Aguilar-Lacasaña, S., Vilor‐Tejedor, N., Jansen, P. R., López-Vicente, M., Bustamante, M., Burgaleta, M., Sunyer, J., & Alemany, S. (2020) · Psychological Medicine · doi:10.1017/s0033291720003189 · Cited by 22
“IP address: 207.241.231.83, on 07 Nov 2020 at 04:33:23, subject to the Cambridge Core terms of use, available at (Boxhoorn et al., 2018; Karalunas et al., 2018; Velikonja, Fett, & Velthorst, 2019; Willcutt, Sonuga-Barke, Nigg, & Sergeant, 2008).”
BackgroundInfluentialPatterns of objectively measured motor activity among infants developing ASD and concerns for ADHD
Reetzke, R., Iosif, A., Hatch, B., de la Paz, L., Chuang, A., Ozonoff, S. J., & Miller, M. R. (2021) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13504 · Cited by 23
Self-citationAutism and associated disorders: cannabis as a potential therapy
Babayeva, M., Assefa, H., Basu, P., & Loewy, Z. G. (2022) · Frontiers in Bioscience-Elite · doi:10.31083/j.fbe1401001 · Cited by 27
“Attention-deficit hyperactivity disorder (ADHD) and ASD are frequently comorbid, have similar genetics and cognitive deficits [182,183].”
BackgroundSolomon, M., Gordon, A., Iosif, A., Geddert, R., Krug, M. K., Mundy, P., & Hessl, D. (2021) · Autism Research · doi:10.1002/aur.2399 · Cited by 20
Openneer, T. J. C., Forde, N. J., Akkermans, S. E. A., Naaijen, J., Buitelaar, J. K., Hoekstra, P. J., & Dietrich, A. (2019) · Cortex · doi:10.1016/j.cortex.2019.11.007 · Cited by 20
Helfer, B., Boxhoorn, S., Songa, J., Steel, C., Maltezos, S., & Asherson, P. J. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.12.059 · Cited by 21
Morè, L., Lauterborn, J. C., Papaleo, F., & Brambilla, R. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.02.003 · Cited by 20
Leader, G., Dooley, E., Whelan, S., Gilroy, S. P., Chen, J. L., Barton, A. F., Coyne, R., & Mannion, A. (2021) · Developmental Neurorehabilitation · doi:10.1080/17518423.2021.1964005 · Cited by 23
“These co-occurring disorders can include sleep problems,(5) gastrointestinal (GI) symptoms,(6) toileting problems,(7) epilepsy,(8) behavior problems,(9,10) mood disorders,(11) fears and phobias,(12) anxiety disorders,(13) and Attention-Deficit/Hyperactivity Disorder (AD/HD).(14) Among co-occurring challenges, individu…”
BackgroundAl‐Saoud, S., Nichols, E. S., Brossard‐Racine, M., Wild, C. J., Norton, L. E., & Duerden, E. G. (2024) · Child Neuropsychology · doi:10.1080/09297049.2024.2364957 · Cited by 17
“…and attention (Follmer, 2018; Holmes et al., 2021; Landerl & Kölle, 2009; Peng & Fuchs, 2016; Peng et al., 2018; Yeniad et al., 2013), leading many children to experience significant challenges at school (Booth & Happé, 2010; Corbett et al., 2009; Karalunas et al., 2018; Rosello et al., 2022).”
Ging-Jehli, N. R., Arnold, L. E., Roley‐Roberts, M. E., & DeBeus, R. J. (2021) · Journal of Attention Disorders · doi:10.1177/10870547211020087 · Cited by 13
“…ADHD across a range of tasks such as those presumed to measure sustained attention (e.g., Baytunca et al., 2018; Huang-Pollock et al., 2012, 2020; Karalunas et al., 2018; Weigard et al., 2020), inhibitory control (e.g., Baytunca et al., 2018; Epstein et al., 2011; Fosco et al., 2018;…”
BackgroundDoi, H., Kanai, C., & Ohta, H. (2022) · Autism Research · doi:10.1002/aur.2712 · Cited by 14
Hennessy, A., Nichols, E. S., Al‐Saoud, S., Brossard‐Racine, M., & Duerden, E. G. (2024) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045241228889 · Cited by 19
“As such, there may be signi fi cant overlap in cognitive patterns between the diagnostic groups (Corbett et al., 2009; Karalunas et al., 2018).”
BackgroundHosozawa, M., Mandy, W., Cable, N., & Flouri, E. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04783-y · Cited by 18
AlBhaisi, I. N., Kumar, M. S. T. S., Engapuram, A., Shafiei, Z., Zakaria, A. S. I., Mohd-Said, S., & McGrath, C. P. J. (2022) · BMC Oral Health · doi:10.1186/s12903-022-02200-7 · Cited by 15
Talge, N. M., Adkins, M., Kileny, P. R., & Frownfelter, I. (2021) · Pediatric Research · doi:10.1038/s41390-021-01730-0 · Cited by 15
Miller, H. L., Thomi, M., Patterson, R. M., & Nandy, K. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05604-0 · Cited by 13
Mahajan, A., Anand, S., Kriti, Awinashe, V., Devanna, R., Alessa, N. A., & Babaji, P. (2023) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_259_23 · Cited by 12
“[1,2] There is a specific behavioral profile in children with autism.[3,4] Children suffering from autism spectrum disorders (ASD) often demonstrate prominent behavioral characteristics such as high aggressiveness, deficient attention, and unresponsiveness along with a few other associated medical problems that can hi…”
BackgroundReetzke, R., Singh, V., Hong, J. S., Holingue, C., Kalb, L. G., Ludwig, N. N., Menon, D. U., Pfeiffer, D. L., & Landa, R. J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.936392 · Cited by 20
“, 2019), and consistent with an extant and growing body of evidence suggesting that children with ASD plus high ADHD symptoms tend to present with generally lower developmental functioning (Karalunas et al., 2018; Antshel and Russo, 2019; Miller et al., 2020; Hong et al., 2021; Reetzke et al., 2021a).”
ResultLam, M., Chen, C.-Y., Hill, W. D., Xia, C., Tian, R., Levey, D. F., Gelernter, J., Stein, M. B., Biogen Biobank team, Hatoum, A. S., et al. (2021) · Nature Communications · doi:10.1016/j.euroneuro.2021.07.065 · Cited by 12
“(5) eQTL annotations used in the TranscriptomeWide Analysis as part of the current study is available at https://github.”
MethodKang, J., Haslam, N., & Conway, M. (2025) · Journal of Medical Internet Research · doi:10.2196/70914 · Cited by 11
Zhong, Q., & Porter, M. A. (2024) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-024-00443-4 · Cited by 13
“…conditions, several studies have also reported some overlap in symptoms between ADHD and ASD, including difficulties with attention, behaviour, social communication, sensory sensitivity, and cognitive flexibility/rigidity (Karalunas et al., 2018; Nijmeijer et al., 2009; Ronald et al., 2014).”
Guttentag, S., Bishop, S. L., Doggett, R. A., Shalev, R. A., Kaplan, M., Dyson, M. W., Cohen, M. T., Lord, C., & Martino, A. D. (2021) · Autism · doi:10.1177/13623613211030071 · Cited by 11
“From a research perspective, accurate sample characterization is essential to understanding distinct and common mechanism(s) underlying ASD and/or ADHD (e.g., Ameis et al., 2016; Aoki et al., 2017; Chantiluke et al., 2014; Chien et al., 2017; Karalunas et al., 2018; Ronald et al., 2008; Satterstrom et al., 2019).”
BackgroundResultInfluentialPeled, J., Cassuto, H., & Berger, I. (2019) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2019.1686063 · Cited by 10
“It is strongly suspected that the overlapping cognitive deficits in ASD and ADHD may further reveal shared etiology [11,15].”
BackgroundJertberg, R., Begeer, S., Geurts, H. M., Chakrabarti, B., & der Burg, E. V. (2025) · Autism Research · doi:10.1002/aur.70015 · Cited by 10
Suicide and Autism: A Lifespan Perspective
Hedley, D., Hayward, S. M., Clarke, A., Uljarević, M., & Stokes, M. A. (2022) · Springer eBooks · doi:10.1007/978-3-030-98697-1_3 · Cited by 9
Prepotent response inhibition in autism: Not an inhibitory deficit?
Torenvliet, C., Groenman, A. P., Lever, A. G., Ridderinkhof, K. R., & Geurts, H. M. (2023) · Cortex · doi:10.1016/j.cortex.2023.05.013 · Cited by 10
“However, we observed that unique features of timing may indicate differences across neurodevelopmental conditions, extending previous findings in children with ADHD/autism (Karalunas et al., 2018; Raymaekers et al., 2007).”
BackgroundResultInfluentialStevanović, D., Wentz, E., Nasic, S., & Knez, R. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03878-3 · Cited by 9
Kahathuduwa, C. N., West, B. D., & Mastergeorge, A. M. (2019) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04187-7 · Cited by 9
Nekar, D. M., Kang, H.-Y., Lee, J.-W., Oh, S.-Y., & Yu, J.-H. (2023) · Games for Health Journal · doi:10.1089/g4h.2023.0050 · Cited by 8
When 2 become 1: Autistic simultaneity judgements about asynchronous audiovisual speech
Poole, D., Gowen, E., Poliakoff, E., Lambrechts, A., & Jones, L. A. (2023) · Quarterly Journal of Experimental Psychology · doi:10.1177/17470218231197518 · Cited by 9
“To date, this has included the perception of orientation (Pirrone et al., 2017, 2020), motion (Manning et al., 2022), and faces (Powell et al., 2019), crossmodal selective attention (Poole et al., 2021), and inhibitory con-trol (Karalunas et al., 2018).”
BackgroundMoliadze, V., Brodski‐Guerniero, A., Schuetz, M., Siemann, J., Lyzhko, E., Schlitt, S., Kitzerow, J., Langer, A., Kaiser, J., Naumer, M. J., et al. (2020) · Brain Topography · doi:10.1007/s10548-020-00765-6 · Cited by 10
Edmunds, S. R., MacNaughton, G. A., Rueda, M. R., Cómbita, L. M., & Faja, S. (2022) · Autism Research · doi:10.1002/aur.2735 · Cited by 8
“Studies comparing EF profiles among children with ASD and ADHD directly have demonstrated that while both groups show EF impairment (Karalunas et al., 2018; Sinzig et al., 2008; Tye et al., 2014), those with ASD may display more profound and global EF deficits (Corbett et al., 2009; Verté et al.,…”
BackgroundPeterson, M., Whetten, C., Clark, A. M., & Nielsen, J. A. (2023) · Journal of Neurodevelopmental Disorders · doi:10.1186/s11689-023-09477-x · Cited by 7
“For example, one comparison study was unable to identify a reliable difference in cognitive abilities between autistic individuals and individuals with ADHD on measures such as attention and arousal, response inhibition, working memory, interference control, and processing speed [21].”
ResultManning, C., Hassall, C. D., Hunt, L. T., Norcia, A. M., Wagenmakers, E., Evans, N. J., & Scerif, G. (2021) · doi:10.31234/osf.io/s5r3m · Cited by 8
Domenico, C. D., Alito, A., Leonardi, G., Pironti, E., Cara, M. D., Piccolo, A., Settimo, C., Quartarone, A., Gagliano, A., & Cucinotta, F. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14114000 · Cited by 10
“Indeed, ADHD and ASD are neurodevelopmental conditions that often coexist and share neurocognitive pathways [71,72].”
Poole, D., Grange, J. A., & Milne, E. (2024) · Journal of Cognition · doi:10.5334/joc.369 · Cited by 9
“Increased boundary separation in autistic participants has previously been observed (Karalunas et al, 2018; Pirrone et al, 2017; Pirrone et al, 2020; although see Poole, Miles, Gowen & Poliakoff, 2021; Manning et al, 2022), as has a slower and more deliberate decision-making style (Brosnan, Lewton…”
BackgroundA Mini Review: Visual and Auditory Perception in Dyslexia
Ali, S. A., Fadzil, N. A., Reza, F., Mustafar, F., & Begum, T. (2021) · IIUM Medical Journal Malaysia · doi:10.31436/imjm.v20i4.1616 · Cited by 7
Rappaport, B. I., Shankman, S. A., Glazer, J. E., Buchanan, S. N., Weinberg, A., & Letkiewicz, A. M. (2024) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-024-01222-8 · Cited by 8
“ASDandanxiousworryon the other hand may share unique differences in boundary separation (i.e., wider boundaries indicative of greater responses caution, Karalunas et al., 2018; White et al., 2010a).”
Molecular architecture of the altered cortical complexity in autism
Mamat, M., Chen, Y., Shen, W., & Li, L. (2025) · Molecular Autism · doi:10.1186/s13229-024-00632-2 · Cited by 7
“Previous studies have demonstrated that individuals with ASD often exhibit difficulties in shifting attention and managing distractions, which are linked to abnormalities in the ventral attention network [60, 61].”
Development and Differentiation of Executive Function Structure
Yangüez, M., Bediou, B., Bavelier, D., & Chanal, J. P. (2025) · Journal of Cognition and Development · doi:10.1080/15248372.2025.2547621 · Cited by 9
“Thus, our results show that age-related improvements in RT-based tasks occur above and beyond potential confounds related with speed-accuracy tradeoffs, confirming previous findings (Karalunas et al., 2012, 2018).”
Profiles of School Refusal Among Neurodivergent Youth
Granieri, J. E., Morton, H. E., Romanczyk, R. G., & Mattson, J. G. (2023) · European Education · doi:10.1080/10564934.2023.2251013 · Cited by 14
Augmented Reality Based Learning Environment for Children with Special Needs
Shaltout, E. H., Afifi, A., & Amin, K. M. (2020) · International Conference on Computer Engineering & Systems (ICCES) · doi:10.1109/icces51560.2020.9334571 · Cited by 6
“Questions that concern confidence and safety of the application are for the Dependability scale, such as items 5, 16, 18, 21.”
BackgroundTornblad, M. K., Jones, K. S., & Inan, F. A. (2019) · Proceedings of the Human Factors and Ergonomics Society Annual Meeting · doi:10.1177/1071181319631423 · Cited by 6
“Individuals on the autism spectrum can also range from very high to very low functioning in many aspects of cognition, such as arousal, attention, and memory (Karalunas et al., 2018).”
BackgroundAutistic traits relate to speed/accuracy trade-off but not statistical learning and updating
Hann, F., Pesthy, O., Brezóczki, B., Vékony, T., Nagy, C. A., Sapey‐Triomphe, L., Tóth-Fáber, E., Farkas, B. C., Farkas, K., & Németh, D. (2025) · Scientific Reports · doi:10.1038/s41598-025-16138-7 · Cited by 5
Boxhoorn, S., Schütz, M., Mühlherr, A. M., Mössinger, H., Luckhardt, C., & Freitag, C. M. (2022) · Scientific Reports · doi:10.1038/s41598-022-25971-z · Cited by 4
Foundations of Neuropsychology: Collaborative Care in Neurosurgery
Cornwell, M. A., Kohn, A., Spat‐Lemus, J., Bender, H. A., Koay, J. M., McLean, E. A., Mandelbaum, S., Wing, H. M., & Sacks-Zimmerman, A. L. (2023) · World Neurosurgery · doi:10.1016/j.wneu.2022.09.106 · Cited by 6
Albores‐Gallo, L., Lopez, J. J. E., Torres-Suarez, G., Ruiz, B. C., Bravo, M. A. S., Guillen, L. G. T., Vargas-Rizo, T. L., Hernandez, E. S., Villarreal-Valdes, G., Miranda, F. R., et al. (2019) · Neuropsychiatry · doi:10.4172/neuropsychiatry.1000550 · Cited by 6
“The overlap between ASD and ADHD symptoms [47] makes discriminant validity of the instrument important since up to 60% of children with ADHD show symptoms of Autism [48] and the comorbidity of both disorders is between 2-78% [49].”
BackgroundCid-Duarte, S., Departamento de Psicología, U. D. O. (., Areces, D., Departamento de Psicología, U. D. O. (., Núñez, J. C., & Departamento de Psicología, U. D. O. (. (2022) · Revista de Psicología y Educación - Journal of Psychology and Education · doi:10.23923/rpye2023.01.232 · Cited by 6
Wang, Y., Lv, R., Jiang, Z. H. E. N. G. M., Liu, Y., Zhang, J., Zhao, Z., Liu, Y., Zheng, Y., Liu, B., Clauw, D., et al. (2026) · Molecular Psychiatry · doi:10.1038/s41380-026-03542-2 · Cited by 8
“…differences, they show signi fi cant symptom overlap, with comorbidity rates (30 – 80% of ASD children exhibit ADHD symptoms, and 30 – 65% of ADHD children present ASD symptoms) far exceeding random probability, suggesting potential associations in underlying pathological mechanisms [137, 138].”
Kouki, E., Tsagkaraki, A., Spanoudis, G. C., & Papadopoulos, T. C. (2025) · Applied Cognitive Psychology · doi:10.1002/acp.70078 · Cited by 4
Manning, C. (2024) · Quarterly Journal of Experimental Psychology · doi:10.1177/17470218241264627 · Cited by 4
“We also note that previous studies have reported differences in diffusion modelling parameters in autistic participants (Iuculano et al., 2020; Karalunas et al., 2018; Kirchner et al., 2012; Pirrone et al., 2017, 2020), and this discrepancy could be due to choice of task, task instructions about…”
ResultSingh, L. J., Floyd, R. G., Reynolds, M. R., Pike, N. M., & Huenergarde, M. C. (2025) · Child Neuropsychology · doi:10.1080/09297049.2024.2357376 · Cited by 4
“…rather than subtle neuropsychological deficits often characteristic of children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD; Karalunas et al., 2018; Kofler et al., 2020; Kofler et al., in press; Snyder et al., 2015).”
Related Disorders (Intellectual, Attention, and Language Disorders) and ASD
Dieckhaus, M. F. S., Thomas, R. P., Frisch, M., Moreno, M. P., Suh, J., & FEIN, D. A. (2024) · Autism and child psychopathology series · doi:10.1007/978-3-031-64499-3_4 · Cited by 4
Metadata
- Authors
- Karalunas, S. L., Hawkey, E., Gustafsson, H., Miller, M., Langhorst, M., Cordova, M., Fair, D., & Nigg, J. T.
- Affiliations
- Oregon Health & Science University (US)
- University of California, Davis (US)
- Corresponding author
- Karalunas, Sarah L.
- ORCID
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2018-02-15
- Volume
- 46
- Issue
- 8
- Pages
- 1705-1716
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC6093794
- OpenAlex
- W2788653795
- Cited by
- 148
- References
- 64
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 23 · 2023: 17 · 2022: 20 · 2021: 26 · 2020: 13 · 2019: 19 · 2018: 5
- FWCI
- 12.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (R01 MH096773, R00 MH091238, R01 MH086654, R37 MH059105 13, K23 MH108656)
- Simons Foundation (177894)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, autism spectrum disorder, comorbidities, cognitive impairment, response variability, drift-diffusion model, drift rate, boundary separation, non-decision time, processing speed, working memory, response inhibition, reaction time
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Reaction Time, Executive Function, Cognitive Dysfunction
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