Medication use in Australian children with attention-deficit/hyperactivity disorder and autism

2021 ◽  
Author(s):  
Olivia Mellahn ◽  
Rachael Knott ◽  
Jeggan Tiego ◽  
Kathryn Kallady ◽  
Katrina Williams ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Rating Scales ◽  
Medication Use ◽  
Treatment Strategies ◽  
Autism Spectrum ◽  
Hyperactivity Disorder ◽  
Current Medication ◽  
Comorbid Adhd ◽  
Symptom Rating

Attention-deficit/hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) are commonly treated with psychotropic medications. There is however a paucity of research examining the prevalence of pharmacotherapy and polypharmacy (>2 medications) in these groups. Caregivers of 505 children (2-18 years) with ADHD (n=239), ASD (n=117) or ADHD-ASD (n=149) reported on current medication use and completed symptom rating scales. ADHD was associated with the highest rate of psychotropic medication use (90%), followed by ADHD-ASD (86%) and ASD (39%). Children with ADHD-ASD reported the highest rate of polypharmacy (41%). Although ADHD was associated with the highest overall medication use, comorbid ADHD-ASD was associated with higher odds of experiencing polypharmacy. This research should help to inform treatment strategies for children with comorbid ADHD-ASD.

scholarly journals The Effect of Comorbid Attention-Deficit/Hyperactivity Disorder Symptoms on Face Memory in Children with Autism Spectrum Disorder: Insights from Transdiagnostic Profiles

2021 ◽  
Vol 11 (7) ◽  
pp. 859
Author(s):  
Qi Chen ◽  
Zengjian Wang ◽  
Bin Wan ◽  
Qingxin Chen ◽  
Kun Zhai ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Adhd Symptoms ◽  
Face Memory ◽  
Hyperactivity Disorder ◽  
Children With Asd ◽  
Lower Accuracy ◽  
Comorbid Adhd

Face memory impairments are common but heterogeneous in autism spectrum disorder (ASD), which may be influenced by co-occurrence with attention-deficit/hyperactivity disorder (ADHD). Here, we aimed to investigate the phenotype change of face memory in children with ASD comorbid ADHD symptoms, and discuss the potential role of executive function (EF). Ninety-eight children were analyzed in the present study, including ASD− (ASD-only, n = 24), ADHD (n = 23), ASD+ (with ADHD symptoms, n = 23) and neurotypical controls (NTC, n = 28). All participants completed two tests: face encoding and retrieving task and Wisconsin Card Sorting Test (WCST) for measuring face memory and EF, respectively. Results revealed that: compared with the NTC group, children with ASD− exhibited lower accuracy in both face encoding and retrieving, and participants with ASD+ showed lower accuracy only in the retrieving, whereas no differences were found among participants with ADHD. Moreover, in the ASD+ group, face encoding performance was correlated with response perseverative errors (RPE) and failure to maintain sets (FMS) of WCST; significantly, there were no group differences between ASD+ and NTC in these two indices. The transdiagnostic profiles indicated that comorbid ADHD symptoms could modulate the face encoding deficiency of ASD, which may be partially compensated by EF. Shared and distinct intervention strategies to improve social cognition are recommended for children undergoing treatment for each condition.

scholarly journals Attention Deficit/Hyperactivity Disorder Symptoms Impair Adaptive and Social Function in Children With Autism Spectrum Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Liu ◽  
Luxi Wang ◽  
Shu Xie ◽  
Shixu Pan ◽  
Jingyi Zhao ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Adaptive Behavior ◽  
Attention Deficit ◽  
Social Function ◽  
Autism Spectrum ◽  
Adhd Symptoms ◽  
Hyperactivity Disorder ◽  
Children With Asd ◽  
Comorbid Adhd

Background: Autism spectrum disorder (ASD) often co-exists with attention deficit/hyperactivity disorder (ADHD), which may aggravate functional impairment. However, it is unclear how comorbid ADHD symptoms influence the adaptive behavior and social interaction deficits of children with ASD.Methods: The study enrolled 340 children (ranging from 2 to 14 years) with ASD, with comorbid ASD and ADHD, or with typical development (TD). A psychological evaluation involving adaptive behavior and social function was conducted using the Vineland Adaptive Behavior Scale, Second Edition (VABS-II) and the Social Responsiveness Scale (SRS).Results: There was a high prevalence of ADHD symptoms (46.6%) in children with ASD, and children with ASD + ADHD presented the worse profile of ASD symptoms. The ASD + ADHD group had higher scores on VABS and lower scores on SRS in comparison with the ASD alone group and TD group. The regression analysis revealed that ASD symptoms and ADHD symptoms were significantly associated with greater impairments in adaptive behavior and social function. The ADHD symptoms were responsible for an additional 0.8% of the variance in adaptive behavior, and 9.5% of the variance in social function.Conclusions: More severe ASD symptoms and greater impairment in adaptive function and social ability were found in children with ASD and comorbid ADHD, highlighting the need to identify ADHD comorbidities early on in children with ASD and to reduce their negative impact on functioning.

scholarly journals Studying global processing in autism and attention-deficit/hyperactivity disorder with gaze movements: The example of a copying task

2019 ◽  
Author(s):  
D. Seernani ◽  
C. Ioannou ◽  
K Damania ◽  
K. Spindler ◽  
H. Hill ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Central Coherence ◽  
Global Processing ◽  
Hyperactivity Disorder ◽  
Diagnostic And Statistical Manual ◽  
Copying Task ◽  
Complex Stimuli ◽  
Comorbid Adhd

AbstractRecent discussions in the literature, along with the revision of the Diagnostic and Statistical Manual (DSM) [2], suggest aetiological commonalities between the highly comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Addressing this discussion requires studying these disorders together by comparing constructs typical to each of them. In the present study, we investigate global processing, known to be difficult for participants with ASD, and Intra-Subject Variability (ISV), known to be consistently increased in participants with ADHD, in groups, aged 10-13 years, with ADHD (n=25), ASD without comorbid ADHD (ASD-) (n=13) and ASD with ADHD (ASD+) (n=18) in comparison with a typically developing group (n=22). A Copying task, typically requiring global processing and in this case particularly designed using equally complex stimuli to also measure ISV across trials, was selected. Oculomotor measures in this task proved to be particularly sensitive to group differences. While increased ISV was not observed in the present task in participants with ADHD, both ASD groups needed to look longer on the figure to be drawn, indicating that global processing takes longer in ASD. However, the ASD+ group needed to fixate on the figure only between drawing movements, whereas the ASD-group needed to do this throughout the drawing process. The present study provides evidence towards ASD and ADHD being separate, not-overlapping, disorders. Since the pure ASD-group was affected more by central coherence problems than the ASD+ group, it may suggest that neuropsychological constructs interact differently in different clinical groups and sub-groups.

scholarly journals Autistic Traits and Empathy in Children With Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder and Co-occurring Attention Deficit Hyperactivity Disorder/Autism Spectrum Disorder

2021 ◽  
Vol 15 ◽  
Author(s):  
Stefania Aiello ◽  
David Vagni ◽  
Antonio Cerasa ◽  
Elisa Leonardi ◽  
Cristina Carrozza ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Clinical Phenotype ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Autism Traits ◽  
Hyperactivity Disorder ◽  
Children With Asd ◽  
Comorbid Adhd

Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD) are two of the most represented neurodevelopmental conditions in childhood. The diagnostic shift introduced by the DSM-5, allowing a combined diagnosis of ADHD and ASD, poses different clinical challenges related to diagnostic overshadowing, accuracy of clinical judgment and potential delay in an ASD diagnosis in children presenting with ADHD. Here we tried to disentangle the clinical phenotype and specificity of the two co-occurring conditions in relation to autism traits and empathy, by comparing children with ASD with and without comorbid ADHD with children presenting ADHD only and children with typical development. The child versions of the Autism Quotient (C-AQ) and Empathy Quotient (C-EQ) were administered to a total sample of 198 male children between 6 and 14 years old with age appropriate language skills and normal intelligence. Univariate analysis demonstrated no significant differences in the C-AQ total and subscale scores as well as the C-EQ between children with ASD and children with ASD + ADHD, while children with ADHD alone presented an intermediate phenotype between ASD and TD. Furthermore, a receiver operating characteristic (ROC) analysis was applied to discriminate among the different phenotypes. We found that the C-AQ and C-EQ were accurate at distinguishing with satisfactory reliability between: (a) ASD vs. non- ASD (N-ASD) groups comprising both ADHD and TD children (Area Under the Curve AUC 88% for C-AQ and 81% for C-EQ); (b) ASD and TD (AUC 92% for C-AQ and 95% for C-EQ); (c) ASD and ADHD (AUC 80% for C-AQ and 68% for C-EQ). Our data confirm the reliability of the C-AQ and C-EQ as behavioral markers to differentiate ASD (regardless of comorbid ADHD) from an ADHD condition and TD. Interestingly, in our sample an ADHD condition does not increase the severity of the clinical phenotype in terms of autism traits distribution and empathy, suggesting that the psychological measures detected by the two quantitative instruments are independent of ADHD traits. This evidence will contribute to the translational efforts in developing better tailored treatments and preventive strategies.

Assessment of Attention-Deficit/Hyperactivity Disorder: An Evaluation of Six Published Rating Scales

2003 ◽  
Vol 32 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Lisa Marie Angello ◽  
Robert J. Volpe ◽  
James C. DiPerna ◽  
Sammi P. Gureasko-Moore ◽  
David P. Gureasko-Moore ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Rating Scales ◽  
Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder in Autism Spectrum Disorder

2020 ◽  
pp. 158-176
Author(s):  
Karen Bearss ◽  
Aaron J. Kaat
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Autism Spectrum ◽  
Developmental Trajectory ◽  
Spectrum Disorder ◽  
Adhd Symptoms ◽  
Functional Impairments ◽  
Hyperactivity Disorder ◽  
Delayed Recognition

This chapter will review the available evidence on individuals with co-occurring diagnoses of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This chapter contends that children diagnosed with both disorders (ASD+ADHD) are a subset of the ASD population that is at risk for delayed recognition of their ASD diagnosis, poor treatment response, and poorer functional outcomes compared to those with ASD without ADHD. Specifically, the chapter highlights the best estimates of the prevalence of the comorbidity, the developmental trajectory of people with co-occurring ASD and ADHD, how ADHD symptoms change across development, overlapping genetic and neurobiological risk factors, psychometrics of ADHD diagnostic instruments in an ASD population, neuropsychological and functional impairments associated with co-occurring ASD and ADHD, and the current state of evidence-based treatment for both ASD and ADHD symptoms. Finally, the chapter discusses fruitful avenues of research for improving understanding of this high-risk comorbidity so that mechanism-to-treatment pathways for ADHD in children with ASD can be better developed.

scholarly journals Medications for attention-deficit/hyperactivity disorder in individuals with or without coexisting autism spectrum disorder: analysis of data from the Swedish prescribed drug register

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Viktoria Johansson ◽  
Sven Sandin ◽  
Zheng Chang ◽  
Mark J. Taylor ◽  
Paul Lichtenstein ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Clinical Studies ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Prescribing Patterns ◽  
Adhd Medication ◽  
Hyperactivity Disorder ◽  
Drug Register

Abstract Background Clinical studies found that medication for attention-deficit/hyperactivity disorder (ADHD) is effective in coexisting autism spectrum disorder (ASD), but current research is based on small clinical studies mainly performed on children or adolescents. We here use register data to examine if individuals with ADHD and coexisting ASD present differences in the prescribing patterns of ADHD medication when compared to individuals with pure ADHD. Methods Data with information on filled prescriptions and diagnoses was retrieved from the Swedish Prescribed Drug Register and the National Patient Register. We identified 34,374 individuals with pure ADHD and 5012 individuals with ADHD and coexisting ASD, aged between 3 and 80 years. The first treatment episode with ADHD medications (≥ 2 filled prescriptions within 90 days) and daily doses of methylphenidate during a 3-year period was measured. Odds ratios (ORs) were calculated for the likelihood of being prescribed ADHD medication in individuals with and without ASD and Wilcoxon rank-sum test was used to compare group differences in dose per day. Results Individuals with ADHD and coexisting ASD were less likely to start continuous treatment with ADHD medication (ADHD 80.5%; ADHD with ASD 76.2%; OR, 0.80; 95% confidence interval, 0.75-0.86), were less likely to be prescribed methylphenidate, and were more commonly prescribed second line treatments such as dexamphetamine, amphetamine, or modafinil. No group difference was observed for atomoxetine. In adults with ADHD and coexisting ASD, methylphenidate was prescribed in lower daily doses over three years as compared to individuals with pure ADHD. Conclusions The findings indicate that there are differences in the medical treatment of individuals with or without ASD. If these differences are due to different medication responses in ASD or due to other factors such as clinicians’ perceptions of medication effects in patients with ASD, needs to be further studied.

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