Inattention and hyperactivity in association with autism spectrum disorders in the CHARGE study
Open accessAbstract
Background Attention deficits in young children with autism spectrum disorder (ASD) are not well understood. This study sought to determine: 1) the prevalence of ADHD symptoms in young children with ASD, typical development (TD), and developmental delay (DD) and 2) the association between ADHD symptoms and cognitive and behavioral functioning in children with ASD.Method ADHD symptoms, defined according to Aberrant Behavior Checklist (ABC) hyperactivity subscale scores, were compared across children aged 2-5 from a large case-control study with ASD (n=548), TD (n=423), and DD (n=180). Inattention and hyperactivity items within this subscale were also explored. Within the ASD group, linear and logistic regression were used to examine how ADHD symptoms were associated with cognition as assessed by the Mullen Scales of Early Learning and adaptive functioning as assessed by the Vineland Adaptive Behavior Scales.Results Mean hyperactivity subscale scores were lowest in children with TD (mean=3.19), higher in children with DD (12.3), and highest in children with ASD (18.2; between-group p<0.001). Among children with ASD, significant associations were observed with higher ADHD symptoms and poorer adaptive and cognitive functioning (adjusted beta for hyperactivity score in association with: Vineland composite = -5.63, p=0.0005; Mullen visual reception scale = -2.94, p=0.02; for the highest vs. lowest quartile of hyperactivity score, odds of lowest quintile of these scores was approximately doubled). Exploratory analyses highlighted associations with inattention-related items specifically.Conclusion These results suggest ADHD symptoms may play a key role in the functioning of young children with ASD.
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The adaptive and social functioning of people with ASD are affected by inattention and hyperactivity/impulsivity symptoms.
“The adaptive and social functioning of people with ASD are also affected by the inattention and hyperactivity/impulsivity symptomatology (Ashwood et al., 2015;Jang et al, 2013;Lyall et al., 2017;Rao and Landa, 2014;Sikora et al., 2012;Tureck et al., 2013;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 Lyall et al., 2017
Comorbid ASD+ADHD adversely affects academic capabilities.
“and academic capabilities (Lyall et al., 2017)”
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 Lyall et al., 2017
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Abed, A. S. A., Allen, T. V., Ahmed, N. Y., Sellami, A., Sontani, Y., Rawlinson, E. C., Marighetto, A., Desmedt, A., & Dehorter, N. (2024) · iScience · doi:10.1016/j.isci.2024.109747 · Cited by 17 · see citing works
Simmons, G. L., Hilton, D. C., Jarrett, M. A., Tomeny, T. S., & White, S. W. (2019) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2019.83.3.278 · Cited by 12 · see citing works
Reetzke, 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 16 · see citing works
Zhao, Z., Tang, H., Alviar, C., Kello, C. T., Zhang, X., Hu, X., Qu, X., & Lu, J. (2021) · Autism Research · doi:10.1002/aur.2646 · Cited by 11 · see citing works
Oh, J., Schweitzer, J. B., Buckley, J. P., Upadhyaya, S., Kannan, K., Herbstman, J. B., Ghassabian, A., Schmidt, R. J., Hertz‐Picciotto, I., & Bennett, D. H. (2024) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2024.114377 · Cited by 8 · see citing works
Alosaimi, M. E., Abduljabbar, M. H., Alzhrani, R. M., Saeed, S., Ramzy, S., & Almalki, A. H. (2024) · Spectrochimica Acta Part A Molecular and Biomolecular Spectroscopy · doi:10.1016/j.saa.2024.124793 · Cited by 7 · see citing works
Choi, J. W., Bennett, D. H., Calafat, A. M., Tancredi, D. J., Miller, M. R., Schmidt, R. J., & Shin, H. (2024) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2024.114483 · Cited by 6 · see citing works
Early postnatal development of the MDGA2+/- mouse model of synaptic dysfunction
Fertan, E., Wong, A. A., Montbrun, T. G.-D., Purdon, M. K., Roddick, K. M., Yamamoto, T., & Brown, R. E. (2023) · Behavioural Brain Research · doi:10.1016/j.bbr.2023.114590 · Cited by 6 · see citing works
Impacts of Co-Occurring ADHD Symptoms on Critical Markers of Outcome for Autistic AdultsPreprint
Yerys, B. E., McQuaid, G. A., Lee, N., & Wallace, G. L. (2021) · doi:10.31234/osf.io/zwjp7 · Cited by 5 · see citing works
Nauman, J., & Ingersoll, B. R. (2022) · Research in Autism · doi:10.1016/j.rasd.2022.102091 · Cited by 4 · see citing works
Augé, P., Maruani, A., Humeau, É., Ellul, P., Cartigny, A., Lefebvre, A., Dellapiazza, F., Delorme, R., & Peyre, H. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06385-4 · Cited by 3 · see citing works
Goodrich, A. J., Tancredi, D. J., Ludeña, Y., Roudneva, E., Schmidt, R. J., Hertz‐Picciotto, I., & Bennett, D. H. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22071149 · Cited by 2 · see citing works
Al‐Beltagi, M., Mani, B. S., Hantash, E. M., Zahrani, A. A. A., & Toema, O. (2025) · World Journal of Clinical Pediatrics · doi:10.5409/wjcp.v14.i4.111684 · Cited by 2 · see citing works
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Predicting later ADHD presentation types from early childhood autism and intellectual disability
Ren, Y., Mlodnicka, A., Calub, C. A., Hertz‐Picciotto, I., & Schweitzer, J. B. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02805-7 · Cited by 1 · see citing works
Sturm, A., & Kasari, C. L. (2023) · Issues in clinical child psychology · doi:10.1007/978-3-031-20006-9_9 · Cited by 1 · see citing works
ADHS und hochfunktionale Autismus-Spektrum-Störungen
Schöttle, D., SCHIMMELMANN, B. G., & van Elst, L. T. (2019) · Nervenheilkunde · doi:10.1055/a-0959-2034 · Cited by 1 · see citing works
Parvalbumin Interneuron Activity Underlies Vulnerability to Post-Traumatic Stress Disorder in AutismPreprint
Abed, A. A., Allen, T. V., Ahmed, N. Y., Sellami, A., Sontani, Y., Marighetto, A., Desmedt, A., & Dehorter, N. (2021) · bioRxiv · doi:10.1101/2021.01.18.427217
Diagnosis of Co-occurring Autism and Attention Deficit Hyperactivity Disorder
Sainsbury, W. J. (2023) · doi:10.26686/wgtn.22584664
Trémaud, M. (2021) · doi:10.70675/7d346d1dz627bz4cb9zba44z1aabbccdf0d6
Ji, X., Meng, H., Liu, Q. Y., Li, Y., & Wang, X. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1838844
- Authors
- Lyall, K., Schweitzer, J. B., Schmidt, R. J., Hertz-Picciotto, I., & Solomon, M.
- Affiliations
- University of California, Davis (US)
- Corresponding author
- Lyall, Kristen
- Venue
- Research in Autism Spectrum Disorders
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 35
- Pages
- 1-12
- ISSN
- 1878-0237 (ISSN-L)
- 1750-9467
- PMC
- PMC5738931
- OpenAlex
- W2564632590
- Cited by
- 42
- References
- 69
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 8 · 2023: 4 · 2022: 4 · 2021: 9 · 2020: 1 · 2019: 8 · 2018: 3
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research in Autism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Environmental Health Sciences (R01 ES015359, P01 ES11269)
- Environmental Protection Agency STAR (R829388, R833292)
- National Institute of Mental Health (5-T32 MH073124)
- National Institutes of Child Health and Human Development and the MIND Institute Intellectual and Developmental Disabilities Research Center (U54 HD079125)
- 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, ADHD symptoms, inattention, hyperactivity, young children, developmental delay, cognitive function, adaptive behavior, Aberrant Behavior Checklist, CHARGE study
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.
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