Assessment & Research

Prevalence of co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder among children in the United States.

Casseus (2022) · Autism : the international journal of research and practice 2022
★ The Verdict

One in 80 US children live with both ASD and ADHD—expect deeper social, adaptive, and emotional needs.

✓ Read this if BCBAs completing intake assessments or writing treatment plans for school-age clients.
✗ Skip if Clinicians who only serve single-diagnosis populations with no overlap.

01Research in Context

01

What this study did

Casseus (2022) asked parents across the United States if their child had both autism and ADHD.

The survey covered 88,051 children.

Parents answered yes or no to each diagnosis.

02

What they found

About 1 child in every 80 had parent-reported ASD plus ADHD.

Rates were higher in boys, older kids, and children with public insurance.

Rates were lower in Black and multi-racial non-Hispanic children.

03

How this fits with other research

Rosello et al. (2022) pooled 34 studies and found the same group shows steeper cognitive, language, and behavior problems.

Fombonne et al. (2021) used a similar large survey and added that these children also have more anxiety, depression, and medicine use.

Dellapiazza et al. (2021) zoomed in on social skills and showed the combo creates more social impairment than ADHD alone.

Ohan et al. (2015) earlier showed adaptive living skills, especially social routines, are lower in the ASD+ADHD group.

04

Why it matters

If you assess for one condition, always screen for the other.

Expect wider skill gaps and plan more supports.

Watch for under-identification in Black and multi-racial families and advocate for fair evaluation.

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Add a quick parent questionnaire that asks about both ASD and ADHD symptoms during intake.

02At a glance

Intervention
not applicable
Design
survey
Sample size
88051
Population
autism spectrum disorder, adhd
Finding
not reported

03Original abstract

Autism spectrum disorder and attention deficit/hyperactivity disorder are neurodevelopmental disorders that often co-occur in children. However, there are few large, nationally representative studies examining the prevalence of co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder in children. The aim of this study was to estimate the prevalence of parent-reported co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder in the United States and examine associations between having co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder and sociodemographic and household factors. Data were analyzed from the 2016-2018 National Survey of Children's Health. A total of 88,051 children aged 3-17 years old were included in the analysis. Statistical analyses were conducted to assess the associations between sociodemographic and household characteristics and current co-occurrence of autism spectrum disorder and attention deficit/hyperactivity disorder. Approximately 1.2% of children (740,816) aged 3-17 years had co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder. Children who were male, older, reported poor health, or had public or combined public and private health insurance were more likely to have co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder. Conversely, children who were Black, non-Hispanic or multi-racial/other, non-Hispanic were less likely to report co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder than White non-Hispanics. Findings suggest implementing early developmental screening and surveillance for co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder, and coordinating strategies that optimize early identification and intervention for all children suspected of having co-occurring autism spectrum disorder and attention deficit/hyperactivity disorder, particularly those from underrepresented groups.

Autism : the international journal of research and practice, 2022 · doi:10.1177/13623613221083279