A pair of new studies has provided new insight into the challenges faced by children on the autism spectrum who exhibit symptoms of attention deficit/hyperactivity disorder (ADHD). These children are unable to exhibit adaptive behavior, which is an important indicator of independence, according to researchers at Children’s Hospital of Philadelphia.
Researchers also identified weaker functional connections within two large brain networks among children with ADHD symptoms and on the autism spectrum.
The first study was published in Journal of the American Academy of Child and Adolescent Psychiatry, analysed adaptive behavior, which is a key measure of a person’s ability to function independently at home and school. Adaptive behavior can be described as communication skills, self care skills, and social skills. Many of these skills are often impaired by children on the autism spectrum. The gap between children with autism spectrum and children who develop normally is widens in adolescence. It may be possible to identify the key factors that contribute to adaptive behavior impairments and provide recommendations for intervention.
Prior research has shown that autistic children with co-occurring ADHD diagnoses are more likely to exhibit adaptive behavior impairments than children without ADHD. There are many children with autism who don’t have ADHD but exhibit some ADHD behaviors. Researchers suspected that these behaviors could impact how a child functions at home and school.
“Using a controlled study, we wanted the ability to determine if ADHD symptoms are associated with adaptive behavior, regardless of whether children diagnosed with ADHD.” Benjamin Yerys, PhD is a psychologist at CHOP’s Department of Child and Adolescent Psychiatry and Behavioral Sciences. He was also the principal author of the study. Yerys was also a child psychologist at CHOP’s Center for Autism Research. “This study is the first to examine whether ADHD symptoms and adaptive behavior are also present in a school setting. This relationship must be shown in multiple settings to demonstrate the profound effects ADHD symptoms have on a child’s functioning.
Researchers found that ADHD symptoms can predict adaptive behaviors in children with autism spectrum disorders, even when other factors are considered such as age, gender, IQ and autism symptoms. This relationship was evident in both the school and home settings.
The study also showed that ADHD symptoms could be related to adaptive behaviors even if the child was diagnosed as being on the autism spectrum but not given an ADHD diagnosis. This is a significant finding, as ADHD symptoms may be less important than treatment goals for children on the autism spectrum who do not meet the clinical criteria for ADHD.
Robert Schultz, PhD is the director of the Center for Autism Research, and the senior author of the study.
Yerys and his collaborators also published a study in Biological Psychiatry: Neuroscience and Neuroimaging. They found evidence that ADHD symptoms are associated with weaker functional connections in the brain networks responsible for higher-order thinking. This is the first study that links ADHD symptoms to brain networks in children with autism. It builds on previous studies of neural networks in children with ADHD and autism.
Yerys stated, “To move this study forward, we need to define brain and behavior profiles related to cognitive control as well as other key brain processes that underlie ADHD syndromes in the contexts of autism.” “By doing this, we can create different treatments or treatment packages to address the different ADHD profiles in the autism population. Our field hopes that a personalized approach to treatment will lead to better long-term outcomes. Treatment packages may include medication and behavior therapies.
Materials provided by Children’s Hospital of Philadelphia. Note: Content can be edited for style or length.