Anxiety symptoms in boys with autism spectrum disorder, attention-deficit hyperactivity disorder, or chronic multiple tic disorder and community controls.

The team compared anxiety levels in 6- to young learners boys. Four groups were studied: autism plus ADHD, ADHD plus tics, autism only, and boys without diagnoses. Parents and teachers each filled out the same anxiety checklist. The goal was to see which group showed the worst anxiety and whether adults agreed.

Boys who had ADHD on top of autism or tics scored highest on anxiety. Parent and teacher reports did not match; parents saw more worry, teachers saw more social fear. The mix of ADHD with any other condition drove the numbers up, not the autism or tics alone.

Green et al. (2015) and Reus et al. (2013) also found that ADHD boosts problem scores in kids with autism. They showed more ASD symptoms and higher parent ratings when ADHD is present.

McGonigle et al. (2014) looked even younger and found that high ADHD symptoms raised depressive and body complaints in preschoolers with autism. Together these studies build a timeline: ADHD worsens internalizing problems from age 3 through adolescence.

Tonizzi et al. (2022) adds a twist: ADHD plus autism hurts working memory and adaptive skills more than anxiety alone. So the same combo that raises worry also dulls day-to-day functioning.

If you see a child with both ADHD and autism, plan for stronger anxiety than the autism label alone suggests. Collect ratings from both parents and teachers; they catch different sides of worry. Use this info to write realistic goals and to choose calming strategies before problem behavior starts.