Association of schizophrenia spectrum and autism spectrum disorder (ASD) symptoms in children with ASD and clinic controls.
Schizophrenia-spectrum signs overlap with autism most in the negative/disorganized zone, and ADHD makes the overlap look bigger on parent forms.
01Research in Context
What this study did
Abbott (2013) compared kids with autism to other clinic kids. They looked for schizophrenia-type signs like social withdrawal, odd speech, and brief hallucinations.
They asked parents, teachers, and the kids themselves. Then they checked if ADHD changed the picture.
What they found
Negative and disorganized symptoms (flat face, odd word use) overlapped a lot with autism traits. Hallucinations and delusions barely showed up.
When ADHD was also present, the overlap got stronger. Parent and teacher scores differed more than the kids’ own answers.
How this fits with other research
Reus et al. (2013) saw the same inflation: kids with ASD+ADHD scored higher on parent ASD scales than ASD-only kids. Both studies warn that ADHD can exaggerate parent-report severity.
Green et al. (2015) extended the idea into regular schools. They found medium-size ASD trait elevations in community kids with ADHD, showing the overlap is not just a clinic quirk.
Ng et al. (2019) adds a twist: direct tests found social gaps but no attention gaps, while parent ratings flipped the pattern. This supports D’s warning that informant choice changes results.
Why it matters
Before you write “severe ASD” in a report, rule out ADHD. Use at least two informants and keep an eye on negative symptoms like flat affect—they may be part of the autism picture, not psychosis. If both conditions are present, plan interventions for attention and social skills together.
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02At a glance
03Original abstract
OBJECTIVE: This study examines relations between the severity of specific symptoms of schizophrenia spectrum disorder (SSD) and severity of the three defining symptom domains of autism spectrum disorder (ASD) in children with ASD (N=147) and child psychiatry outpatient referrals (Controls; N=339). METHOD: Participants were subdivided into four groups depending on ASD status (±) and whether they met symptom criteria for attention-deficit/hyperactivity disorder (±ADHD). Their mothers and teachers evaluated them with a DSM-IV-referenced rating scale. RESULTS: Correlations between schizoid personality symptoms and ASD social skills deficits were moderate to large, and this was true for children with ASD and Controls, regardless of ADHD status, and for mother's and teachers' ratings. Conversely, severity of hallucinations, delusions, and disorganized thinking were minimally correlated with ASD severity with the exception of Controls with ADHD. The disorganized behavior and negative symptoms of schizophrenia evidenced the strongest pattern of associations with ASD symptoms, and this was particularly true for children with co-morbid ADHD (±ASD, all three ASD symptom dimensions), and for teachers' ratings of all four groups. Nevertheless, there was considerable variability in relations for specific symptoms across informants and groups. Correlations between SSD symptom severity and IQ were generally low, particularly among the ASD Only group and for all teacher-rated symptoms. CONCLUSION: Associations between ASD and SSD symptoms were often dimension-specific, and this was particularly evident in children without ADHD (±ASD; mothers' ratings). Findings were interpreted as supporting the deconstruction of complex clinical phenotypes as a means of better understanding interrelations among psychiatric syndromes.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.01.011