Autism & Developmental

Treatment of Attention-Deficit/Hyperactivity Disorder with Medication in Children with Autism Spectrum Disorder With and Without Intellectual Disability: A DBPNet Study.

Grater et al. (2023) · Journal of autism and developmental disorders 2023
★ The Verdict

Among kids with both autism and ADHD, doctors pick α-agonists over stimulants based on age, not intellectual disability.

✓ Read this if BCBAs working with school-age clients who have ASD plus ADHD and take ADHD meds.
✗ Skip if Clinicians serving only preschoolers or clients without ADHD.

01Research in Context

01

What this study did

The team looked at the kids with both autism and ADHD.

They checked who got stimulants versus α-agonists like clonidine.

They split the kids into two groups: with and without intellectual disability.

02

What they found

Older kids got α-agonists more often, not kids with ID.

Kids with ID did take more total meds and had more health issues.

But age alone explained the α-agonist choice, not the ID label.

03

How this fits with other research

Menezes et al. (2021) showed kids with ASD plus ID have twice the unmet mental-health needs.

Emerson et al. (2023) adds that when doctors do treat ADHD, they pick drugs based on age, not ID status.

Slaughter et al. (2014) and Kurokawa et al. (2021) both found kids with ASD and ID have more GI and sensory issues.

These extra issues likely drive the higher pill count E et al. saw, even though the ADHD drug choice stays age-driven.

04

Why it matters

If you serve kids with ASD and older child may be on clonidine while a younger one is on methylphenidate.

Check birth date before assuming ID drives the script.

Also screen for GI pain and sensory issues—they may be the hidden reasons for extra meds.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Look at each client's med list and birth year—note if older kids are on α-agonists and ask the prescriber why.

02At a glance

Intervention
not applicable
Design
other
Population
autism spectrum disorder, intellectual disability, adhd
Finding
not reported

03Original abstract

Children with autism spectrum disorder (ASD) and intellectual disability (ID)/global delay (GD) frequently have symptoms of attention-deficit/hyperactivity disorder (ADHD). We describe the practice patterns of developmental behavioral pediatricians (DBPs) in the treatment of children with ASD and coexisting ADHD and compare medication classes for children with and without intellectual disability. In bivariate analyses, we compared demographic characteristics, co-occurring conditions, and medication classes for children with and without intellectual disability. Significantly more patients with ID/GD were prescribed α-agonists than patients without ID/GD, but the difference was no longer significant when controlling for age in logistic regression children with ID/GD had more comorbidities and were more likely to be prescribed more than on psychotropic medication. In conclusion, age rather than ID/GD was associated with medication choice.

Journal of autism and developmental disorders, 2023 · doi:10.1111/j.1651-2227.2011.02263.x