Atomoxetine, Parent Training, and Their Combination in Children With Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
Open accessAbstract
Objective Impairments associated with attention-deficit/hyperactivity disorder (ADHD) and noncompliance are prevalent in children with autism spectrum disorder (ASD). However, ADHD response to stimulants is well below rates in typically developing children, with frequent side effects. Group studies of treatments for noncompliance are rare in ASD. We examined individual and combined-effectiveness of atomoxetine (ATX) and parent training (PT) for ADHD symptoms and noncompliance.Method In a 3-site, 10-week, double-blind, 2 × 2 trial of ATX and PT, 128 children (ages 5-14 years) with ASD and ADHD symptoms were randomized to ATX, ATX+PT, placebo+PT, or placebo. ATX was adjusted to optimal dose (capped at 1.8 mg/kg/day) over 6 weeks and maintained for 4 additional weeks. Nine PT sessions were provided. Primary outcome measures were the parent-rated DSM ADHD symptoms on the Swanson, Nolan and Pelham (SNAP) scale and Home Situations Questionnaire (HSQ).Results On the SNAP, ATX, ATX+PT and placebo+PT were each superior to placebo (effect sizes 0.57-0.98; p values of .0005, .0004, and .025, respectively). For noncompliance, ATX and ATX+PT were superior to placebo (effect sizes 0.47-0.64; p values .03 and .0028, respectively). ATX was associated with decreased appetite but was otherwise well tolerated.Conclusion Both ATX and PT resulted in significant improvement on ADHD symptoms, whereas ATX (both alone and combined with PT) was associated with significant decreases on measures of noncompliance. ATX appears to have a better side effects profile than psychostimulants in the population with ASD.Clinical trial registration information Atomoxetine, Placebo and Parent Management Training in Autism; http://clinicaltrials.gov/; NCT00844753.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A pilot study of intranasal vasopressin suggested possible benefit in people with ASD, although this study was underpowered.
“a pilot study of intranasal vasopressin suggested possible benefit in people with ASD, although this study was underpowered 211 .”
From Autism spectrum disorder (2020) · cites this paper as [211]
The Introduction and Discussion describe a trial of atomoxetine and parent training in children with ASD, not intranasal vasopressin. A search for vasopressin and an underpowered pilot study found no passage addressing the claimed treatment or its possible benefit. The Discussion’s concern about statistical power applies to comparisons among this trial’s treatment arms, not to a vasopressin study. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 44 · Cited by 147
Research works printed but not linked: 4
- [10]Arnold LE Contemporary Diagnosis Management ADHD Handbooks in Health Care Co 2004 3rd edition Newtown, PA 93
- [35]Barkley RA Edwards GH Robin AL Defiant Teens: A Clinician’s Manual for Assessment and Intervention 1999 New York Guilford Press 196Y198.
- [40]Arnold LE Aman MG Cook AM Atomoxetine for hyperactivity in autism spectrum disorders: Placebo-controlled crossover pilot trial J Am Acad Child Psychiatry 2006 45 1196 1205 17003665
- [43]The MTA Cooperative Group A 14-Month randomized clinical trial of treatment Strategies for attention-deficit/hyperactivity disorder (ADHD) Arch General Psychiat 1999 56 1073 1086 10591283
- Authors
- Handen, B. L., Aman, M. G., Arnold, L. E., Hyman, S. L., Tumuluru, R. V., Lecavalier, L., Corbett-Dick, P., Pan, X., Hollway, J. A., Buchan-Page, K. A., Silverman, L. B., Brown, N. V., Rice, R. R., Hellings, J., Mruzek, D. W., McAuliffe-Bellin, S., Hurt, E. A., Ryan, M. M., Levato, L., & Smith, T.
- Affiliations
- University of Pittsburgh (US)
- The Ohio State University (US)
- University of Rochester Medicine (US)
- Corresponding author
- Handen, Benjamin L.
- ORCID
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2015-11
- Volume
- 54
- Issue
- 11
- Pages
- 905-915
- ISSN
- 0890-8567 (ISSN-L)
- PMC
- PMC4625086
- OpenAlex
- W1931362782
- Cited by
- 147
- References
- 44
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 14 · 2023: 6 · 2022: 15 · 2021: 18 · 2020: 16 · 2019: 10 · 2018: 16 · 2017: 13 · 2016: 15 · 2015: 2 · 2013: 1
- FWCI
- 12.43
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR001070)
- National Institute of Mental Health (R01MH079080, R01MH083247, R01MH079082)
- National Center for Research Resources (UL1RR024160)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- atomoxetine, parent training, autism spectrum disorder, attention deficit hyperactivity disorder, non-compliance, stimulant medication, combined psychotherapy and pharmacotherapy, children, appetite suppression, treatment side effects
- MeSH terms
- Behavior Rating Scale, Autism Spectrum Disorder, Atomoxetine Hydrochloride, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Double-Blind Method, Female, Humans, Male, Parents, Psychiatric Status Rating Scales, Surveys and Questionnaires, Severity of Illness Index, United States, Treatment Outcome, Adrenergic Uptake Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
