Autistic Spectrum Disorder Symptoms in Children and Adolescents with ADHD: a Meta-Analytical Review

Autistic Spectrum Disorder Symptoms in Children and Adolescents with Attention Deficit/Hyperactivity Disorder: a Meta-Analytical Review

Hollingdale J, Woodhouse E, Young S, Fridman A, Mandy W.

Psychol Med. 2019 Sep 18:1-14.

doi: 10.1017/S0033291719002368.


Commentary* by Dr. Margaret Weiss: One in five children with ADHD has ASD. The comorbid condition presents particular management challenges. Understanding the clustering of neurodevelopmental disorders together is important to optimizing appropriate treatment services.


BACKGROUND: Research identifies highly variable prevalence estimates for autism spectrum disorder (ASD) in children and adolescents with attention deficit hyperactivity disorder (ADHD), particularly between community and clinical samples, warranting quantitative meta-analyses to investigate the true prevalence of ASD in children and adolescents with ADHD.

METHODS: Studies were identified through a systematic literature search of PsycINFO, MEDLINE and Web of Science through January 2018. Twenty-two publications met inclusion criteria (total N = 61 985). Two random effects meta-analyses were conducted: (1) to identify the proportion of children and adolescents with ADHD that met criteria for ASD; and (2) to compare the severity of dimensionally-measured ASD symptomology in children and adolescents with and without ADHD.

RESULTS: The overall pooled effect for children and adolescents with ADHD who met threshold for ASD was 21%. There was no significant difference between community samples (19%) and clinical samples (24%) or between US studies v. those from other countries. Children and adolescents with ADHD had substantially more dimensionally-measured ASD traits compared with those who did not have ADHD (d = 1.23).

CONCLUSION: The findings provide further evidence that ADHD and ASD are associated in nature.


 * Abstracts are selected for their clinical relevance by Dr. Margaret Weiss, Director of Clinical Research, Child Psychiatry, Cambridge Health Alliance, Harvard University. Her commentary reflects her own opinion.  It is not approved or necessarily representative of the CADDRA board.


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