ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD)
Open accessAbstract
Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning.
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In three studies, prevalence of social phobia and separation anxiety disorder in ASD children was 24.00, 6.00, 9.20% and 15.00, 1.00, 3.10%, respectively.
“However, all three authors reported prevalence for social phobia and separation anxiety disorder of 24.00, 6.00, 9.20, and 15.00, 1.00, 3.10% respectively.”
From Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review (2021) · cites this paper as [36]
In three studies, the prevalence of ADHD subtypes in ASD children was reported as inattentive subtype 11.00, 21.00, and 40.00%; impulsive subtype 4.00, 1.00, and 23.10%; and both subtypes combined 62.00, 64.00, and 18.50%.
“Prevalence was further described by ADHD subtypes in Brookman-Frazee et al. (37), Mansour et al. (36), and Skwerer et al. (38) with a prevalence of 11.00, 21.00, and 40.00% respectively for the inattentive subtype, 4.00, 1.00, and 23.10% for the impulsive subtype and 62.00, 64.00, and 18.50% for both subtypes combined.”
From Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review (2021) · cites this paper as [36]
Prevalence of ADHD in ASD children ranged from 0.00% in children aged 3-4y to 86.00%.
“Prevalence for ADHD in ASD children ranged from 0.00% in children aged 3–4y (35) to 86.00% (Figure 3 and Supplementary Material 6) (36).”
From Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review (2021) · cites this paper as [36]
ADHD was found to be associated with a greater risk of having other psychiatric comorbidities in addition to lower cognitive functioning, more severe social impairment, and greater delays in adaptive functioning.
“ADHD was found to be associated with a greater risk of having other psychiatric comorbidities in addition to lower cognitive functioning, more severe social impairment and greater delays in adaptive functioning (36).”
From Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review (2021) · cites this paper as [36]
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- Authors
- Mansour, R., Dovi, A. T., Lane, D. M., Loveland, K. A., & Pearson, D. A.
- Affiliations
- The University of Texas Health Science Center at Houston (US)
- University of Houston (US)
- Rice University (US)
- Corresponding author
- Mansour, Rosleen
- Venue
- Research in Developmental Disabilities
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 60
- Pages
- 52-64
- ISSN
- 0891-4222 (ISSN-L)
- PMC
- PMC5441885
- OpenAlex
- W2556382226
- Cited by
- 101
- References
- 60
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 16 · 2023: 9 · 2022: 11 · 2021: 9 · 2020: 22 · 2019: 6 · 2018: 7 · 2017: 3
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research in Developmental Disabilities (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH072263)
- 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
- attention deficit hyperactivity disorder, autism spectrum disorder, comorbidities, psychiatric symptoms, ADHD symptom severity, ASD severity, children, parent-reported symptoms, Child Behavior Checklist, Conners' Parent Rating Scale
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Child Behavior, Female, Humans, Male, Obsessive-Compulsive Disorder, Phobic Disorders, Regression Analysis, Severity of Illness Index, Comorbidity, Attention Deficit and Disruptive Behavior Disorders, Checklist
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