Brief Report: Adaptive Functioning in Children with ASD, ADHD and ASD + ADHD.
When autism and ADHD travel together, expect the biggest lag in everyday social skills, and target those skills first.
01Research in Context
What this study did
The team looked at kids who had only ADHD, only autism, or both.
They used the Vineland Adaptive Behavior Scales to see how well each child could dress, talk, play, and make friends.
The goal was to learn if adding ADHD to autism makes daily-life skills even lower.
What they found
Children with both ASD and ADHD scored lowest, especially in the socialisation domain.
The autism symptoms, not the ADHD, drove most of the drop in adaptive skills.
In simple words, the double-diagnosis group needed more help with real-world tasks.
How this fits with other research
Rosello et al. (2022) pooled 34 studies and saw the same pattern: two diagnoses mean bigger trouble.
Dellapiazza et al. (2021) went further and showed the extra social hit comes with more externalizing behaviour, linking the ADHD part to acting-out and the autism part to withdrawal.
Demopoulos et al. (2013) once thought ADHD social deficits were just mild copies of autism; this paper proves the gap widens when both labels sit on the same child.
Mouga et al. (2015) found the socialisation dip is a signature of autism even when IQ is controlled, backing the idea that autism, not added ADHD, is the main driver.
Why it matters
If you assess a child who already carries both diagnoses, plan for lower adaptive scores and write goals that boost social participation first.
Use the Vineland early and re-check it yearly; small gains in socialisation can lift the whole profile.
Share the data with families so they understand why extra support at home, school, and in the community is needed from day one.
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02At a glance
03Original abstract
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and ASD + ADHD (n = 38). Results demonstrated lower socialisation and composite scores and greater discrepancy between cognitive and adaptive abilities in the ASD + ADHD group compared to the ADHD-only group. Significant associations were shown between reduced adaptive functioning and autism symptoms, but not ADHD symptoms. Children with ASD + ADHD present with exacerbated impairments in adaptive functioning relative to children with ADHD, associated with ASD symptoms. Disentangling variation in adaptive skills may aid the assessment of complex cases.
Journal of autism and developmental disorders, 2015 · doi:10.1007/s10803-014-2352-y