Attention Deficit Hyperactivity Disorder Symptoms in Young Children with Autism Spectrum Disorder.
Most toddlers with ASD already show strong ADHD signs, and the mix brings extra stress and later skill gaps.
01Research in Context
What this study did
The team asked parents of 979 toddlers and preschoolers with autism about ADHD behaviors. They used rating scales, not formal diagnoses, to see how many kids showed moderate or high ADHD symptoms.
Parents also answered questions about their own stress and any other behavior or mood problems.
What they found
Fifty-seven percent of the young children scored in the moderate-to-high ADHD range. Families of these children reported more parenting stress and more additional emotional or behavior issues.
How this fits with other research
Rosello et al. (2022) pooled 34 studies and found the same pattern: kids with both ASD and ADHD have tougher cognitive, adaptive, and emotional problems than kids with just one condition. The toddler numbers line up with their bigger picture.
Fombonne et al. (2021) surveyed over 100,000 children aged 3–18 and also saw higher anxiety, depression, and behavior troubles when ASD and ADHD overlap. Their wider age range shows the problem does not fade with time.
Dellapiazza et al. (2021) looked at elementary kids and linked the ADHD symptoms to worse social skills and more acting-out behaviors. Together, these papers trace a line from toddler hyperactivity to later social and adaptive struggles.
Why it matters
If you work with preschoolers with ASD, expect more than half to show ADHD-type behaviors. Build this into your assessment plan and parent training. Watch for rising parent stress and bring in extra support early. Tracking both sets of symptoms from the start lets you write goals that fit the whole child, not just the autism label.
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02At a glance
03Original abstract
The purpose of the current study was to examine the prevalence of attention deficit hyperactivity disorder (ADHD) symptoms among young children with autism spectrum disorder (ASD), child and parent-related demographic and clinical correlates of ADHD symptoms, and the relationships between co-occurring mental health problems and ADHD symptoms. Data for this cross-sectional study came from 979 toddlers and preschoolers, ages 1.5-5 years, with ASD. The primary outcome, ADHD symptoms, was measured using the Child Behavior Check List 1.5-5 (CBCL). Additional information from the medical record included demographics, parenting stress, and Autism Diagnostic Observation Schedule Second Edition. Descriptive and bivariate (ANOVA, Chi-Square) statistics and multivariate, multinomial regression analyses were used to examine demographic and clinical differences between low, moderate, and high ADHD symptom groups, as defined by 2 ADHD-related subscales. There were 418 (43%) children in the low ADHD symptom group, 294 (30%) in the moderate ADHD symptom group, and 267 (27%) in the high ADHD symptom group. Those with high ADHD symptoms were less likely to be Black or Hispanic and less likely to have parents with a graduate-level education compared to those with low ADHD symptoms. Parenting stress and all CBCL DSM-oriented subscales were positively associated with increasing ADHD symptoms. Among young children with ASD, ADHD symptoms were highly prevalent. The presence of ADHD symptoms was associated with increasing parenting stress and greater levels of other psychopathologies. These data suggest that young children with ASD should be evaluated for ADHD, and mental health as a whole. LAY SUMMARY: We investigated attention deficit hyperactivity disorder (ADHD) symptoms in toddlers and preschoolers with autism spectrum disorder (ASD) from a large sample with diverse race and socioeconomic background. In our study, we found that ADHD symptoms are highly prevalent in young children with ASD and are associated with increasing parenting stress and greater level of other psychopathologies, both internalizing and externalizing problems.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2414