Behavioral characteristics of toddlers later identified with an autism diagnosis, ADHD symptoms, or combined autism and ADHD symptoms.
ADHD
Autism
preschool children
screening
Journal
Journal of child psychology and psychiatry, and allied disciplines
ISSN: 1469-7610
Titre abrégé: J Child Psychol Psychiatry
Pays: England
ID NLM: 0375361
Informations de publication
Date de publication:
03 Sep 2024
03 Sep 2024
Historique:
accepted:
30
05
2024
medline:
4
9
2024
pubmed:
4
9
2024
entrez:
3
9
2024
Statut:
aheadofprint
Résumé
Autism commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of toddlers later identified with autism diagnosis, ADHD symptoms, combined autism and ADHD symptoms, or neither condition. Participants were 506 toddlers who were part of a longitudinal study of children's behavioral development. Parents completed questionnaires about their children's behavior at two time points. Four groups were identified based on study measures or medical record: autism diagnosis (n = 45), elevated ADHD symptoms (n = 70), autism and ADHD symptoms (n = 30), or neurotypical development (n = 361). Relationships between early parent report of autism- and ADHD-related behaviors, social-emotional and behavioral functioning, and caregiver experience and subsequent group designation were evaluated with adjusted linear regression models controlling for sex. Significant group differences were found in measures of autism-related behaviors, ADHD-related behaviors, externalizing and internalizing behaviors, and parent support needs (p < .0001). Pairwise comparisons indicated toddlers later identified with combined autism diagnosis and ADHD symptoms had higher levels of autism-related behaviors, externalizing and internalizing behaviors, and autism-related parent support needs compared to the other groups. Toddlers with subsequent elevated ADHD symptoms or combined autism diagnosis and ADHD symptoms exhibited similar levels of ADHD-related behaviors, while both groups displayed more ADHD-related behaviors than toddlers subsequently identified with autism or those with neither condition. In this community sample, toddlers for whom combined autism diagnosis and ADHD symptoms were subsequently identified showed a distinct presentation characterized by higher early autism-related behaviors, broader behavioral concerns, and higher parent support needs. Presence of ADHD symptoms (alone or in combination with autism) was associated with higher parent-reported ADHD-related behaviors during toddlerhood. Results indicate that ADHD-related behaviors are manifest by toddlerhood, supporting screening for both autism and ADHD during early childhood.
Sections du résumé
BACKGROUND
BACKGROUND
Autism commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of toddlers later identified with autism diagnosis, ADHD symptoms, combined autism and ADHD symptoms, or neither condition.
METHODS
METHODS
Participants were 506 toddlers who were part of a longitudinal study of children's behavioral development. Parents completed questionnaires about their children's behavior at two time points. Four groups were identified based on study measures or medical record: autism diagnosis (n = 45), elevated ADHD symptoms (n = 70), autism and ADHD symptoms (n = 30), or neurotypical development (n = 361). Relationships between early parent report of autism- and ADHD-related behaviors, social-emotional and behavioral functioning, and caregiver experience and subsequent group designation were evaluated with adjusted linear regression models controlling for sex.
RESULTS
RESULTS
Significant group differences were found in measures of autism-related behaviors, ADHD-related behaviors, externalizing and internalizing behaviors, and parent support needs (p < .0001). Pairwise comparisons indicated toddlers later identified with combined autism diagnosis and ADHD symptoms had higher levels of autism-related behaviors, externalizing and internalizing behaviors, and autism-related parent support needs compared to the other groups. Toddlers with subsequent elevated ADHD symptoms or combined autism diagnosis and ADHD symptoms exhibited similar levels of ADHD-related behaviors, while both groups displayed more ADHD-related behaviors than toddlers subsequently identified with autism or those with neither condition.
CONCLUSIONS
CONCLUSIONS
In this community sample, toddlers for whom combined autism diagnosis and ADHD symptoms were subsequently identified showed a distinct presentation characterized by higher early autism-related behaviors, broader behavioral concerns, and higher parent support needs. Presence of ADHD symptoms (alone or in combination with autism) was associated with higher parent-reported ADHD-related behaviors during toddlerhood. Results indicate that ADHD-related behaviors are manifest by toddlerhood, supporting screening for both autism and ADHD during early childhood.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIH HHS
ID : P50HD093074
Pays : United States
Informations de copyright
© 2024 Association for Child and Adolescent Mental Health.
Références
Achenbach, T.M., & Rescorla, L.A. (2000). Manual for the ASEBA preschool forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.
Allen, K., Harrington, J., Quetsch, L.B., Masse, J., Cooke, C., & Paulson, J.F. (2023). Parent‐child interaction therapy for children with disruptive behaviors and autism: A randomized clinical trial. Journal of Autism and Developmental Disorders, 53, 390–404.
American Psychiatric Association, D. (2013). Diagnostic and statistical manual of mental disorders: DSM‐5 (Vol. 5). Washington, DC: American Psychiatric Association.
Antshel, K.M., & Russo, N. (2019). Autism spectrum disorders and ADHD: Overlapping phenomenology, diagnostic issues, and treatment considerations. Current Psychiatry Reports, 21, 34.
Antshel, K.M., Zhang‐James, Y., Wagner, K.E., Ledesma, A., & Faraone, S.V. (2016). An update on the comorbidity of ADHD and ASD: A focus on clinical management. Expert Review of Neurotherapeutics, 16, 279–293.
Berry, J.O., & Jones, W.H. (1995). The Parental Stress Scale: Initial psychometric evidence. Journal of Social and Personal Relationships, 12, 463–472.
Carta, A., Fucà, E., Guerrera, S., Napoli, E., Valeri, G., & Vicari, S. (2020). Characterization of clinical manifestations in the co‐occurring phenotype of attention deficit/hyperactivity disorder and autism Spectrum disorder. Frontiers in Psychology, 11, 861.
Cerrillo‐Urbina, A.J., García‐Hermoso, A., Martínez‐Vizcaíno, V., Pardo‐Guijarro, M.J., Ruiz‐Hermosa, A., & Sánchez‐López, M. (2018). Prevalence of probable attention‐deficit/hyperactivity disorder symptoms: Result from a Spanish sample of children. BMC Pediatrics, 18, 111.
Charach, A., Carson, P., Fox, S., Ali, M.U., Beckett, J., & Lim, C.G. (2013). Interventions for preschool children at high risk for ADHD: A comparative effectiveness review. Pediatrics, 131, e1584–e1604.
Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic‐spectrum disorders. The British Journal of Psychiatry, 191, 554–559.
Childress, A.C., Kollins, S.H., Foehl, H.C., Newcorn, J.H., Mattingly, G., Kupper, R.J., & Adjei, A.L. (2020). Randomized, double‐blind, placebo‐controlled, flexible‐dose titration study of methylphenidate hydrochloride extended‐release capsules (Aptensio XR) in preschool children with attention‐deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 30, 58–68.
Committee on Practice and Ambulatory Medicine; Bright Futures Periodicity Schedule Workgroup. (2023). 2023 recommendations for preventive pediatric health care. Pediatrics, 151, e2023061451. https://doi.org/10.1542/peds.2023‐061451
Constantino, J.N., & Gruber, C.P. (2012). The Social Responsiveness Scale Manual, Second Edition (SRS‐2). Los Angeles, CA: Western Psychological Services.
Davis, N.O., Carpenter, K.L.H., & Dawson, G. (2022). Autism spectrum disorder versus attention‐deficit/hyperactivity disorder. In K. Stavropoulos & J. McPartland (Eds.), Differential diagnosis of autism spectrum disorder. New York: Oxford University Press.
Dow, D., Holbrook, A., Toolan, C., McDonald, N., Sterrett, K., Rosen, N., … & Lord, C. (2022). The Brief Observation of Symptoms of Autism (BOSA): Development of a new adapted assessment measure for remote telehealth administration through COVID‐19 and beyond. Journal of Autism and Developmental Disorders, 52, 5383–5394.
Gadow, K.D., DeVincent, C.J., & Pomeroy, J. (2006). ADHD symptom subtypes in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 36, 271–283.
Guthrie, W., Wallis, K., Bennett, A., Brooks, E., Dudley, J., Gerdes, M., … & Miller, J.S. (2019). Accuracy of autism screening in a large pediatric network. Pediatrics, 144, e20183963. https://doi.org/10.1542/peds.2018‐3963
Harris, P., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. (2009). Research electronic data capture (REDCap): A metadata‐driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42, 377–381.
Hong, J.S., Singh, V., & Kalb, L. (2021). Attention deficit hyperactivity disorder symptoms in young children with autism spectrum disorder. Autism Research, 14, 182–192.
Hyman, S.L., Levy, S.E., Myers, S.M., & AAP Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145, e20193447. https://doi.org/10.1542/peds.2019‐3447
Jahromi, L.B., Kasari, C.L., McCracken, J.T., Lee, L.S., Aman, M.G., McDougle, C.J., … & Posey, D.J. (2009). Positive effects of methylphenidate on social communication and self‐regulation in children with pervasive developmental disorders and hyperactivity. Journal of Autism and Developmental Disorders, 39, 395–404.
Johnson, C.P., & Myers, S.M. (2007). Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183–1215.
Julvez, J., Forns, M., Ribas‐Fitó, N., Torrent, M., & Sunyer, J. (2011). Attention behavior and hyperactivity and concurrent neurocognitive and social competence functioning in 4‐year‐olds from two population‐based birth cohorts. European Psychiatry, 26, 381–389.
Kaplan, A., & Adesman, A. (2011). Clinical diagnosis and management of attention deficit hyperactivity disorder in preschool children. Current Opinion in Pediatrics, 23, 684–692.
Kentrou, V., de Veld, D.M., Mataw, K.J., & Begeer, S. (2019). Delayed autism spectrum disorder recognition in children and adolescents previously diagnosed with attention‐deficit/hyperactivity disorder. Autism, 23, 1065–1072.
Kollins, S., Greenhill, L., Swanson, J., Wigal, S., Abikoff, H., Mc, C.J., … & Bauzo, A. (2006). Rationale, design, and methods of the Preschool ADHD Treatment Study (PATS). Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1275–1283.
Lahey, B.B., Lee, S.S., Sibley, M.H., Applegate, B., Molina, B.S.G., & Pelham, W.E. (2016). Predictors of adolescent outcomes among 4‐6‐year‐old children with attention‐deficit/hyperactivity disorder. Journal of Abnormal Psychology, 125, 168–181.
Lai, M.C., Kassee, C., Besney, R., Bonato, S., Hull, L., Mandy, W., … & Ameis, S.H. (2019). Prevalence of co‐occurring mental health diagnoses in the autism population: A systematic review and meta‐analysis. Lancet Psychiatry, 6, 819–829.
Lecavalier, L., Gadow, K.D., Devincent, C.J., Houts, C.R., & Edwards, M.C. (2011). Validity of DSM‐IV syndromes in preschoolers with autism spectrum disorders. Autism, 15, 527–543.
Lecavalier, L., Smith, T., Johnson, C., Bearss, K., Swiezy, N., Aman, M.G., … & Scahill, L. (2017). Moderators of parent training for disruptive behaviors in young children with autism spectrum disorder. Journal of Abnormal Child Psychology, 45, 1235–1245.
Leitner, Y. (2014). The co‐occurrence of autism and attention deficit hyperactivity disorder in children – What do we know? Frontiers in Human Neuroscience, 8, 268.
Lord, C., & Bishop, S.L. (2015). Recent advances in autism research as reflected in DSM‐5 criteria for autism spectrum disorder. Annual Review of Clinical Psychology, 11, 53–70.
Lord, C., Rutter, M., DiLavore, P.C., Risi, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule (2nd edn). Torrance, CA: Western Psychological Services.
Manohar, H., Kuppili, P.P., Kandasamy, P., Chandrasekaran, V., & Rajkumar, R.P. (2018). Implications of comorbid ADHD in ASD interventions and outcome: Results from a naturalistic follow up study from south India. Asian Journal of Psychiatry, 33, 68–73.
May, T., & Williams, K. (2022). Mother and child mental health over time in children with autism and/or ADHD in the longitudinal study of Australian children. Development and Psychopathology, 1‐11, 1–11.
McGoey, K.E., DuPaul, G.J., Haley, E., & Shelton, T.L. (2007). Parent and teacher ratings of attention‐deficit/hyperactivity disorder in preschool: The ADHD rating scale‐IV preschool version. Journal of Psychopathology and Behavioral Assessment, 29, 269–276.
Miller, M. (2022). Editorial: Are we there yet? Identification and intervention for attention‐deficit/hyperactivity disorder in the first years of life. Journal of the American Academy of Child and Adolescent Psychiatry, 61, 122–124.
Miodovnik, A., Harstad, E., Sideridis, G., & Huntington, N. (2015). Timing of the diagnosis of attention‐deficit/hyperactivity disorder and autism spectrum disorder. Pediatrics, 136, e830–e837.
Rad, F., Mihailescu, I., Nedelcu, M.C., Buica, A., Stancu, M., Andrei, E., … & Dobrescu, I. (2019). The outcome of a sample of pre‐schoolers diagnosed with ASD comorbid with ADHD after one year of applied behavioural analysis. Journal of Evidence‐Based Psychotherapies, 19, 109–118.
Riddle, M.A., Yershova, K., Lazzaretto, D., Paykina, N., Yenokyan, G., Greenhill, L., … & Posner, K. (2013). The Preschool Attention‐Deficit/Hyperactivity Disorder Treatment Study (PATS) 6‐year follow‐up. Journal of the American Academy of Child and Adolescent Psychiatry, 52, 264–278.e262.
Robins, D.L., Casagrande, K., Barton, M., Chen, C.M., Dumont‐Mathieu, T., & Fein, D. (2014). Validation of the Modified Checklist for Autism in Toddlers, Revised with Follow‐up (M‐CHAT‐R/F). Pediatrics, 133, 37–45.
Rommelse, N.N., Franke, B., Geurts, H.M., Hartman, C.A., & Buitelaar, J.K. (2010). Shared heritability of attention‐deficit/hyperactivity disorder and autism spectrum disorder. European Child & Adolescent Psychiatry, 19, 281–295.
Ronald, A., Edelson, L.R., Asherson, P., & Saudino, K.J. (2010). Exploring the relationship between autistic‐like traits and ADHD behaviors in early childhood: Findings from a community twin study of 2‐year‐olds. Journal of Abnormal Child Psychology, 38, 185–196.
Salazar, F., Baird, G., Chandler, S., Tseng, E., O'Sullivan, T., Howlin, P., … & Simonoff, E. (2015). Co‐occurring psychiatric disorders in preschool and elementary school‐aged children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 2283–2294.
Schopler, E., Van Bourgondien, M.E., Wellman, G.J., & Love, S. (2010). Childhood Autism Rating Scales, Second Edition (CARS2). Torrence, CA: Western Psychological Services.
Sheehan, D.V., Sheehan, K.H., Shytle, R.D., Janavs, J., Bannon, Y., Rogers, J.E., … & Wilkinson, B. (2010). Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI‐KID). The Journal of Clinical Psychiatry, 71, 313–326.
Shephard, E., Milosavljevic, B., Pasco, G., Jones, E.J., Gliga, T., Happé, F., … & Charman, T. (2017). Mid‐childhood outcomes of infant siblings at familial high‐risk of autism spectrum disorder. Autism Research, 10, 546–557.
Sikora, D.M., Vora, P., Coury, D.L., & Rosenberg, D. (2012). Attention‐deficit/hyperactivity disorder symptoms, adaptive functioning, and quality of life in children with autism spectrum disorder. Pediatrics, 130(Suppl 2), S91–S97.
Silva, L.M., & Schalock, M. (2012). Autism Parenting Stress Index: Initial psychometric evidence. Journal of Autism and Developmental Disorders, 42, 566–574.
Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population‐derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929.
Tandon, M., Si, X., & Luby, J. (2011). Preschool onset attention‐deficit/hyperactivity disorder: Course and predictors of stability over 24 months. Journal of Child and Adolescent Psychopharmacology, 21, 321–330.
van der Meer, J.M., Oerlemans, A.M., van Steijn, D.J., Lappenschaar, M.G., de Sonneville, L.M., Buitelaar, J.K., & Rommelse, N.N. (2012). Are autism spectrum disorder and attention‐deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population‐based sample. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 1160–1172.e1163.
Wagner, L., Corona, L.L., Weitlauf, A.S., Marsh, K.L., Berman, A.F., Broderick, N.A., … & Warren, Z. (2021). Use of the TELE‐ASD‐PEDS for autism evaluations in response to COVID‐19: Preliminary outcomes and clinician acceptability. Journal of Autism and Developmental Disorders, 51, 3063–3072.
Weitzman, C., & Wegner, L. (2015). Promoting optimal development: Screening for behavioral and emotional problems. Pediatrics, 135, 384–395.
Wolraich, M.L., Hagan, J.F., Jr., Allan, C., Chan, E., Davison, D., Earls, M., … & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention‐deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144, e20192528. https://doi.org/10.1542/peds.2019‐2528
Yerys, B.E., Bertollo, J.R., Pandey, J., Guy, L., & Schultz, R.T. (2019). Attention‐deficit/hyperactivity disorder symptoms are associated with lower adaptive behavior skills in children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 58, 525–533.e523.
Zachor, D.A., & Ben‐Itzchak, E. (2019). From toddlerhood to adolescence: Which characteristics among toddlers with autism spectrum disorder predict adolescent attention deficit/hyperactivity symptom severity? A long‐term follow‐up study. Journal of Autism and Developmental Disorders, 49, 3191–3202.