Attention and inhibition in children with ASD, ADHD and co-morbid ASD + ADHD: an event-related potential study
Abstract
Background: Substantial overlap has been reported between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Deficits in executive function (EF) are characteristic of both disorders but these impairments have not been compared directly across pure and co-morbid cases using event-related potentials (ERPs). Method: Behavioural parameters and ERPs were recorded during a flankered cued-continuous performance test (CPT-OX) administered to 8–13-year-old boys with ASD ( n = 19), ADHD ( n = 18), co-morbid ASD + ADHD ( n = 29) and typically developing controls (TD; n = 26). Preparatory processing (contingent negative variation, CNV) and attentional orienting (Cue-P3) at cues, response execution at targets (Go-P3), inhibitory processing at non-targets (NoGo-P3) and conflict monitoring between target and non-target trials (Go-N2 v. NoGo-N2) were examined. Results: Categorical diagnoses and quantitative trait measures indicated that participants with ADHD (ADHD/ASD + ADHD) made more omission errors and exhibited increased reaction-time (RT) variability and reduced amplitude of the Cue-P3 and NoGo-P3 compared to TD/ASD participants. Participants with ASD (ASD/ ASD + ADHD) demonstrated reduced N2 enhancement from Go to NoGo trials compared to TD/ADHD participants. Participants with ASD-only displayed enhanced CNV amplitude compared to ASD + ADHD and TD participants. Conclusions: Children with ADHD show deficits in attentional orienting and inhibitory control whereas children with ASD show abnormalities in conflict monitoring and response preparation. Children with co-morbid ASD + ADHD present as an additive co-occurrence with deficits of both disorders, although non-additive effects are suggested for response preparation. Measuring ERPs that index attention and inhibition is useful in disentangling cognitive markers of ASD and ADHD and elucidating the basis of co-occurring ASD + ADHD to guide clinical assessment.
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ASD performance on continuous performance tasks is mixed, and individuals with ASD may use an alternative, possibly compensatory, strategy to perform similarly.
“suggesting that individuals with ASD may use an alternative, perhaps compensatory, strategy to perform similarly on CPTs.”
From Subtyping cognitive profiles in Autism Spectrum Disorder using a Functional Random Forest algorithm (2018) · cites this paper as [27]
The finding that subgroup differences were similar in both ASD and TD samples may appear inconsistent with prior studies showing an effect of ASD on the relationship between cognitive measures and task performance.
“Our finding that the differences between subgroups were similar in both ASD and TD samples may appear inconsistent with prior studies that show an effect of ASD on the relationship between cognitive measures and task performance12,27,37,38.”
From Subtyping cognitive profiles in Autism Spectrum Disorder using a Functional Random Forest algorithm (2018) · cites this paper as [27]
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- Authors
- Tye, C., Asherson, P., Ashwood, K. L., Azadi, B., Bolton, P., & McLoughlin, G.
- Affiliations
- King's College London (GB)
- Corresponding author
- Tye, C.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-05-15
- Volume
- 44
- Issue
- 5
- Pages
- 1101-1116
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2138328227
- Cited by
- 158
- References
- 23
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 6 · 2023: 7 · 2022: 13 · 2021: 20 · 2020: 13 · 2019: 20 · 2018: 15 · 2017: 13 · 2016: 20 · 2015: 6 · 2014: 7 · 2013: 1
- FWCI
- 8.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- National Institute for Health and Care Research (NF-SI-0510-10268)
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- autism spectrum disorder, attention deficit hyperactivity disorder, comorbidities, executive function, attention, inhibition, conflict monitoring, attentional orienting, response preparation, contingent negative variation, P3, N2, continuous performance test, children
- MeSH terms
- Adolescent, Attention, Attention Deficit Disorder with Hyperactivity, Child, Child Development Disorders, Pervasive, Contingent Negative Variation, Evoked Potentials, Humans, Inhibition, Psychological, Male, Psychomotor Performance, Comorbidity, Event-Related Potentials, P300
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