Autism spectrum disorder (autism) and attention-deficit hyperactivity disorder (ADHD) are two well-known mental health conditions that begin in childhood and continue to have an impact in later life. At one point, mental health professionals generally viewed these two conditions as separate problems, and doctors were specifically prohibited from diagnosing ADHD in children affected by autism. However, current evidence supports a strong degree of overlap between the two disorders.
In fact, according to the results of a study published in June 2013 in the journal Autism, almost 30 percent of the children who receive an autism diagnosis also have prominent ADHD symptoms. In addition, children with both conditions experience significantly greater levels of impairment than children only affected by autism.
What Exactly Is Autism?
Autism spectrum disorder is the newly established term used by the American Psychiatric Association (APA) to describe a range of conditions that produce certain characteristic impairments in the ability to participate fully in social situations, communicate effectively with others, or exhibit socially appropriate behavior. It appears for the first time in the 2013 edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders, and replaces five previously listed conditions: autistic disorder, Asperger’s disorder (commonly known as Asperger’s syndrome), Rett’s disorder, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. The American Psychiatric Association decided to combine the definitions for these conditions because current scientific evidence does not fully support a strict separation between their symptoms or effects in any given individual.
ADHD’s Different Forms
In any given situation, an ADHD diagnosis can point to the presence of any one of three groups of symptoms. Some children develop a form of the disorder that features six or more symptoms of unusually hyperactive or impulsive behavior. Others develop a form of the disorder that features six or more symptoms of an unusual inability to maintain focus or attention. Still others develop a form of ADHD that combines six or more hyperactive/impulsive symptoms with six or more symptoms of impaired attention or focus. As of 2013, doctors can officially diagnose ADHD in children before the age of 12; previous guidelines limited diagnosis to children younger than age seven. Doctors can now also use slightly altered criteria to diagnose ADHD in adults who did not receive a diagnosis during childhood.
Overlapping Effects Of Autism And ADHD
In its early stages, autism can produce symptoms of hyperactivity and poor attention focusing that strongly resemble the symptoms of ADHD. However, as time passes, additional symptoms emerge that make it relatively easy for doctors to distinguish between the two conditions. Despite this, prior to 2013, the ADHD guidelines in the Diagnostic and Statistical Manual specifically stated that doctors could not issue an ADHD diagnosis to a child already diagnosed with one of the five separate autism-related conditions then listed in the manual. The 2013 edition of the guide (known informally as DSM 5) eliminates this prohibition.
In the study published in Autism, a team of researchers from the Kennedy Krieger Institute in Baltimore, Maryland studied the overlapping effects of autism spectrum disorder and ADHD in a group of 162 children between the ages of 4 and 8. Of these children, 63 had an autism diagnosis, while the remaining 99 did not. After reviewing their findings, the study’s authors concluded that 29 percent of the children diagnosed with autism also had significant symptoms of ADHD-related hyperactivity/impulsivity or inattention.
The authors of the study also concluded that the presence of ADHD symptoms worsens the outcomes for children affected by autism spectrum disorder. Specific examples of this worsening included a reduced ability to function socially, a reduced ability to think clearly and a reduced ability to appropriately negotiate social situations. Children affected by both conditions also tend to have more extreme forms of the disruptive behavioral patterns associated with autism, and also have more than a 100 percent greater chance of experiencing certain developmental delays in their thought processes.
Continued Research For Autism/ADHD
The authors of the study in Autism believe that their findings may point to a need for specially developed treatments for children simultaneously affected by autism spectrum disorder and ADHD. However, they also emphasize the need for further research that can expand upon their results and more fully explore the combined negative mental health effects of the two disorders.
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