Assessment & Research

The Clinical Features of Comorbid Pediatric Bipolar Disorder in Children with Autism Spectrum Disorder.

Sapmaz et al. (2018) · Journal of autism and developmental disorders 2018
★ The Verdict

Autistic kids with bipolar swing in short manic bursts followed by near-normal lulls, so assess mood over time, not in one visit.

✓ Read this if BCBAs who assess or write behavior plans for school-age or teen clients with ASD and possible mood swings.
✗ Skip if Practitioners working solely with adults or with clients who have no mood concerns.

01Research in Context

01

What this study did

Sapmaz et al. (2018) watched kids who had both autism and bipolar disorder.

They wrote down when the children showed manic highs and calm lows.

The team wanted to see what bipolar looks like inside an ASD day-to-day picture.

02

What they found

The kids did not stay manic all the time.

Mood shot up in short spikes, then slid back to a quiet, almost normal baseline.

Those lulls can fool you; the child may look fine while bipolar signs are simply resting.

03

How this fits with other research

Chien et al. (2021) counted a whole nation and agreed: bipolar is common in ASD.

Their big numbers extend Dicle’s small picture, showing the same link happens everywhere.

Kleinert et al. (2007) earlier said "watch for mood problems"; Dicle now shows exactly what to watch.

Ghumman et al. (2026) did the same case-control trick for depression, proving the method works for mood checks in autistic youth.

04

Why it matters

If you only observe during the calm lull you can miss bipolar completely.

Track mood across weeks, note sudden energy bursts, decreased sleep, fast speech, then the drop-back.

Share this pattern with parents and psychiatrists so medication and behavior plans match the cycle, not the quiet day you happened to assess.

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→ Action — try this Monday

Start a simple daily mood log with the parent: rate energy, sleep, talkativeness 1-5 for two weeks, then look for spike-lull-spike pattern.

02At a glance

Intervention
not applicable
Design
case control
Sample size
80
Population
autism spectrum disorder
Finding
not reported

03Original abstract

The aim of this study was to describe clinical features of PBD comorbidity in children with ASD. Forty children with ASD and PBD aged 6-18 years, and 40 age- and sex-matched ASD subjects with no affective episodes were included in the study. Autism Behavior CheckList, Abberant Behavior CheckList, and Young Mania Rating Scale-Parent Version were completed. This study shows that PBD comorbidity in children with ASD involves a highly episodic course, with manic episodes, subsyndromal symptoms and interepisodic periods commonly being described in the manic symptom profile of these children. These findings need to be repeated with large samples, together with controlled studies concerning therapeutic interventions directed toward PBD comorbidity in children with ASD.

Journal of autism and developmental disorders, 2018 · doi:10.1007/s10803-018-3541-x