Stronger links between autism and ADHD found in a study -how to treat this dual diagnosis

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Almost 20 percent of children with ADHD exhibit autistic traits, reports a study published  in Pediatrics. Furthermore, these children‘s ADHD (attention deficit hyperactivity disorder) symptoms are more severe and disabling, concludes researcher Amelia Kotte, Ph.D., from Massachusetts General Hospital (MGH) in Boston and her colleagues.
The researchers examined over 400 children including 242 with ADHD and 227 without the disorder. None of the participants without ADHD had autism. The researchers assessed the children in the areas of psychiatric, psychosocial, educational, and cognitive functioning. One in every five children showed autistic traits “such as slow language development, difficulty interacting with others and problems with emotional control, said study co-author Dr. Joseph Biederman of MGH.” The study found that children with ADHD and autistic traits were more likely to:
  • have problems in school
  • get involved in fights
  • experience problems in relationships with their peers and siblings
  • have language disorders
  • suffer from other psychiatric conditions including anxiety and mood disorders
"These children are not having the full diagnosis of autism, but they have symptoms of autism," Biederman said. "It may be important to screen children with ADHD for autistic traits because they may need more support, particularly in the educational and interpersonal domains."
Other studies on the co-occurrence of ADHD and autism
Prior studies discussed a possible link between the two disorders and Biederman commented on this association. "The genetic markers for ADHD have also been associated with autism," he said. "These autistic traits may be present in other conditions as well. I am quite convinced that these traits may be present in children with mood and anxiety disorders."
Researchers from the Kennedy Krieger Institute reached similar conclusions in their study. One third of the children with autism in this study, also had "clinically significant" ADHD symptoms. These researchers also concluded that children with both ADHD and autism “were significantly more impaired” than those children with autism alone.
Treatment for children with a dual diagnosis of autism and ADHD
Until the publication of the revised Diagnostic and Statistical Manual of Mental Disorders (DSM) in May, a formal diagnosis of co-occurring ADHD and autism was not recognized. This prohibition limited research into effective treatments for people with co-occurring ADHD and autism. Recent research indicates that stimulant medication should be used to try to manage ADHD symptoms. Once ADHD symptoms are controlled, interventions for autistic symptoms may be more effective. Other recommended therapies are:
  • behavioral training for parents
  • non-stimulant medications for children
  • behavioral interventions for children
  • social skills training for children
This latest study, “Autistic Traits in Children With and Without ADHD,” involved researchers from MGH, Harvard Medical School and the State University of New York (SUNY) Upstate Medical University.
More information on autism and ADHD is available on the website of the National Institute for Mental Health.

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©Mary M Conneely T/A Advocacy in Action

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