Intersectionality in Neurodevelopmental Disorders: A Literature Review on Co-Occurrence of Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder – Examining Therapeutic Approaches and Interventions
DOI:
https://doi.org/10.47941/ijhs.1728Keywords:
Autism Spectrum Disorder, ADHD, Neurodevelopmental Disorders, TreatmentAbstract
Purpose: To examine the intersectionality between autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), focusing on the latest research into their co-occurrence, potential shared mechanisms, and implications for diagnosis and treatment.
Methodology: A comprehensive literature search was conducted, focusing on studies published within the last 3-4 years on the comorbidity and intersection of traits between ASD and ADHD.
Findings: Results reveal high rates of co-occurrence, with 30-80% of individuals with ASD also meeting criteria for ADHD. There appear to be shared genetic, environmental, cognitive, and neural mechanisms contributing to both disorders, potentially explaining this overlap. Despite the frequent co-occurrence, ASD and ADHD present distinct symptom profiles and behavioural challenges.
Unique Contribution to Theory, Practice, and Policy: Cognitive-behavioural therapy, social skills training, parental training programs, and stimulant medications are supported as evidence-based approaches for treating both ASD and ADHD. Targeting common mechanisms through combined treatment plans shows promise for improving outcomes. However, more research is needed to develop integrated, personalized treatment models tailored to the specific needs of this substantial subgroup of patients with neurodevelopmental disorders. The intersection between ASD and ADHD traits warrants deeper investigation to better characterize overlapping and disorder-specific phenotypes, guiding targeted treatments.
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References
Hours, C., Recasens, C., & Baleyte, J. (2022, February 28). ASD and ADHD Comorbidity: What Are We Talking About? Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2022.837424
Rong, Y., Yang, C. J., Jin, Y., & Wang, Y. (2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83, 101759.
Vora, P., and Sikora, D. (2011). Society for Developmental and Behavioral. San Antonio, TX: Pediatrics.
Gadow, K. D., DeVincent, C. J., Pomeroy, J., and Azizian, A. (2004). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. J. Autism Dev. Disord. 34, 379–393. doi:10.1023/B:JADD.0000037415.21458.93
Lee, D. O., and Ousley, O. Y. (2006). Attention-deficit hyperactivity disorder symptoms in a clinic sample of children and adolescents with pervasive developmental disorders. J. Child Adolesc. Psychopharmacol. 16, 737–746. doi:10.1089/cap.2006.16.737
Pelham, W. E., Bender, M. E., Caddell, J., Booth, S., and Moorer, S. H. (1985). Methylphenidate and children with attention deficit disorder. Dose effects on classroom academic and social behavior. Arch. Gen. Psychiatry 42, 948–952. doi:10.1001/archpsyc.1985.01790330028003
Williams, K., Brignell, A., Randall, M., Silove, N., and Hazell, P. (2013). Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database Syst. Rev. 8, doi:10.1002/14651858.CD004677.pub3
Young, S., Heptinstall, E., Sonuga-Barke, E. J., Chadwick, O., and Taylor, E. (2005). The adolescent outcome of hyperactive girls: self-report of psychosocial status. J. Child Psychol. Psychiatry 46, 255–262. doi:10.1111/j.1469-7610.2004.00350.x
Sinzig, J., Morsch, D., and Lehmkuhl, G. (2008). Do hyperactivity, impulsivity inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? Eur. Child Adolesc. Psychiatry 17, 63–72. doi:10.1007/s00787-007-0637-9
Holtmann, M., Bölte, S., and Poustka, F. (2007). Autism spectrum disorders: sex differences in autistic behavior domains and coexisting psychopathology. Dev. Med. Child Neurol. 49, 361–366. doi:10.1111/j.1469-8749.2007.00361.x
Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N. (2011). Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics, 127(3), 462-470.
Abdallah, M. W., Greaves-Lord, K., Grove, J., Nørgaard-Pedersen, B., Hougaard, D. M., & Mortensen, E. L. (2011). Psychiatric comorbidities in autism spectrum disorders: findings from a Danish Historic Birth Cohort. European child & adolescent psychiatry, 20, 599-601.
Thapar, A., Cooper, M., & Rutter, M. (2017). Neurodevelopmental disorders. The Lancet Psychiatry, 4(4), 339-346.
Nickels, K. C., Zaccariello, M. J., Hamiwka, L. D., & Wirrell, E. C. (2016). Cognitive and neurodevelopmental comorbidities in paediatric epilepsy. Nature Reviews Neurology, 12(8), 465-476.
Jacobs, H., Singhi, S., & Gladstein, J. (2016, February). Medical comorbidities in pediatric headache. In Seminars in Pediatric Neurology (Vol. 23, No. 1, pp. 60-67). WB Saunders.
Mazefsky, C. A., Schreiber, D. R., Olino, T. M., & Minshew, N. J. (2014). The association between emotional and behavioral problems and gastrointestinal symptoms among children with high-functioning autism. Autism, 18(5), 493-501.
Pan, PY., Taylor, M.J., Larsson, H. et al. Genetic and environmental contributions to co-occurring physical health conditions in autism spectrum condition and attention-deficit/hyperactivity disorder. Molecular Autism 14, 17 (2023). https://doi.org/10.1186/s13229-023-00548-3
American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American psychiatric association.
Mansour, R., Dovi, A. T., Lane, D. M., Loveland, K. A., & Pearson, D. A. (2017). ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD). Research in developmental disabilities, 60, 52-64.
Rommelse, N. N., Franke, B., Geurts, H. M., Hartman, C. A., and Buitelaar, J. K. (2010). Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. Eur. Child Adolesc. Psychiatry 19, 281–295. doi:10.1007/s00787-010-0092-x
Piven, J., Arndt, S., Bailey, J., and Andreasen, N. (1996). Regional brain enlargement in autism: a magnetic resonance imaging study. J. Am. Acad. Child Adolesc. Psychiatry 35, 530–536. doi:10.1097/00004583-199604000-00020
Baron-Cohen, S., Ring, H. A., Wheelwright, S., Bullmore, E. T., Brammer, M. J., Simmons, A., et al. (1999). Social intelligence in the normal and autistic brain: an fMRI study. Eur. J. Neurosci. 11, 1891–1898. doi:10.1046/j.1460-9568.1999.00621.x
Bathelt, J., Caan, M., Geurts, H. (2020). More similarities than differences between ADHD and ASD in functional brain connectivity. doi: 10.31234/OSF.IO/4TFMN
Amritha, Harikumar., David, W., Evans., Chase, C., Dougherty., Kimberly, L., H., Carpenter., Andrew, M., Michael. (2021). A Review of the Default Mode Network in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder.. Brain connectivity, doi: 10.1089/BRAIN.2020.0865
Rachael, Knott., Beth, Patricia, Johnson., Jeggan, Tiego., Olivia, J., Mellahn., Amy, Finlay., Kathryn, Kallady., Maria, Kouspos., Vishnu, Priya, Mohanakumar, Sindhu., Ziarih, Hawi., Aurina, Arnatkeviciute., Tracey, Chau., Dalia, N., Maron., Emily, Clare, Mercieca., Kirsten, Furley., Katrina, Harris., Katrina, Harris., Katrina, Williams., Alexandra, Ure., Alex, Fornito., Kylie, Megan, Gray., Kylie, Megan, Gray., David, Coghill., Ann, E., Nicholson., Dinh, Phung., Eva, Loth., Luke, Mason., Declan, G., Murphy., Jan, K., Buitelaar., Mark, A., Bellgrove. (2021). The Monash Autism-ADHD genetics and neurodevelopment (MAGNET) project design and methodologies: a dimensional approach to understanding neurobiological and genetic aetiology. Molecular Autism, doi: 10.1186/S13229-021-00457-3
Manxue, Zhang., Yan, Huang., Jian, Jiao., Dan, Yuan., Xiao, Hu., Ping, Yang., Rui, Zhang., Liang, Wen., Mingjing, Situ., Jialiang, Cai., Xueli, Sun., Kuifang, Guo., Xia, Huang., Yi, Huang. (2022). Transdiagnostic symptom subtypes across autism spectrum disorders and attention deficit hyperactivity disorder: validated by measures of neurocognition and structural connectivity. BMC Psychiatry, doi: 10.1186/s12888-022-03734-4
Anbo, Zhou., Xiaolong, Cao., Vaidhyanathan, Mahaganapathy., Marco, A., Azaro., Christine, Gwin., Sherri, Wilson., Steven, Buyske., Christopher, W., Bartlett., Judy, F., Flax., Linda, M., Brzustowicz., Jinchuan, Xing. (2022). Common genetic risk factors in ASD and ADHD co-occurring families. Human genetics, doi: 10.1007/s00439-022-02496-z
Ned, H., Kalin. (2023). Insights From Genetic, Neuroimaging, and Behavioral Neuroscience Studies.. American Journal of Psychiatry, doi: 10.1176/appi.ajp.20230127
(2023). Distinct frontoparietal brain dynamics underlying the co-occurrence of autism and ADHD. ENeuro, doi: 10.1523/eneuro.0146-23.2023
Stephanie, H., Ameis., Christine, M., Freitag., Antonio, Y., Hardan. (2022). Brain stimulation interventions in asd: efforts for the development of a promising intervention approach. Journal of the American Academy of Child and Adolescent Psychiatry, doi: 10.1016/j.jaac.2022.07.691
Wioletta, Karina, Ozga. "Review: An Integrative Perspective on Psychotherapy with Children and Adolescents with ASD." undefined (2022). doi: 10.18510/hssr.2022.1042
Alma, Y., Galvez-Contreras., Ivette, Vargas, de, la, Cruz., Beatriz, Beltrán-Navarro., Rocio, E., Gonzalez-Castaneda., Oscar, Gonzalez-Perez. (2022). Therapeutic Approaches for ADHD by Developmental Stage and Clinical Presentation. International Journal of Environmental Research and Public Health, doi: 10.3390/ijerph191912880
Zoe, Chadwick., Amanda, J., Edmondson., Sarah, McDonald. (2022). Engaging with animal‐assisted interventions (AAIs): exploring the experiences of young people with ASD/ADHD diagnoses. Support for Learning, doi: 10.1111/1467-9604.12394
Dejan, Stevanovic., Elisabet, Wentz., Salmir, Nasic., Rajna, Knez. (2022). ASD with ADHD vs. ASD and ADHD alone: a study of the QbTest performance and single-dose methylphenidate responding in children and adolescents. BMC Psychiatry, doi: 10.1186/s12888-022-03878-3
Subcommittee on Attention Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and ManagementWolraich, M., Brown, L., Brown, R. T., DuPaul, G., et al. (2011). ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 128, 1007–1022. doi:10.1542/peds.2011-2654
Canitano, R., and Scandurra, V. (2011). Psychopharmacology in autism: an update. Prog. Neuropsychopharmacol. Biol. Psychiatry 35, 18–28. doi:10.1016/j.pnpbp.2010.10.015
Santosh, P. J., Baird, G., Pityaratstian, N., Tavare, E., and Gringras, P. (2006). Impact of comorbid autism spectrum disorders on stimulant response in children with attention deficit hyperactivity disorder: a retrospective and prospective effectiveness study. Child Care Health Dev. 32, 575–583. doi:10.1111/j.1365-2214.2006.00631.x
MTA Cooperative Group. (2004). National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: 24-month outcomes of treatment strategies for attention-deficit/hyperactivity disorder. Pediatrics 113, 754–761. doi:10.1542/peds.113.4.754
Arnold, L. E., Aman, M. G., Li, X., Butter, E., Humphries, K., Scahill, L., et al. (2012). Research Units of Pediatric Psychopharmacology (RUPP) Autism Network randomized clinical trial of parent training and medication: one-year follow-up. J. Am. Acad. Child Adolesc. Psychiatry 51, 1173–1184. doi:10.1016/j.jaac.2012.08.028
Davis, N. O., and Kollins, S. H. (2012). Treatment for co-occurring attention deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics 9, 518–530. doi:10.1007/s13311-012-0126-9
Aman, M. G., McDougle, C. J., Scahill, L., Handen, B., Arnold, L. E., Johnson, C., et al. (2009). Medication and parent training in children with pervasive developmental disorders and serious behavior problems: results from a randomized clinical trial. J. Am. Acad. Child Adolesc. Psychiatry 48, 1143–1154. doi: 10.1097/CHI.0b013e3181bfd669
Anderson, D. K., Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., ... & Pickles, A. (2007). Patterns of growth in verbal abilities among children with autism spectrum disorder. Journal of consulting and clinical psychology, 75(4), 594.
Wodka, E. L., Mathy, P., & Kalb, L. (2013). Predictors of phrase and fluent speech in children with autism and severe language delay. Pediatrics, 131(4), e1128-e1134.
Ingersoll B et al. The effects of a developmental, social-pragmatic language intervention on rate of expressive language production in young children with autistic spectrum disorders. Focus Autism Other Dev Disabil. 2005;20(4):213–22.
Clark GJF, Schlabach TL. Systematic review of occupational therapy interventions to improve cognitive development in children ages birth-5 years. Am J Occup Ther. 2013;67(4):425–30.
Lovaas OI, Smith T. Early and intensive behavioral intervention in autism. In: Kazdin AE, Weisz JR, editors. Evidence-based psychotherapies for children and adolescents. New York: Guilford; 2003. p. 325–40.
Stevens-Long J., Lovaas OI. Research and treatment with autistic children in a program of behavior therapy. In: Child personality and psychopathology: current topics. Wiley: Oxford; 1974.
Remington B et al. Early intensive behavioral intervention: outcomes for children with autism and their parents after two years. Am J Ment Retard. 2007;112(6):418–38.
Granpeesheh D, Tarbox J, Dixon DR. Applied behavior analytic interventions for children with autism: a description and review of treatment research. Ann Clin Psychiatry. 2009;21(3):162–73.
Koegel RL, Koegel LK, Vernon TW, Brookman-Frazee LI. Empirically supported pivotal response treatment for children with autism spectrum disorders. In: Weisz JR, Kazdin AE, editors. Evidence-based psychotherapies for children and adolescents. 2nd ed. New York: Guilford; 2010. p. 327–44.
Koegel LK, Koegel BL, Koegel RL, Vernon TW. Pivotal response treatment. In: Luiselli JK, editor. Children and youth with autism spectrum disorder (ASD): recent advances and innovations in assessment, education, and intervention. New York: Oxford University Press; 2014. p. 134–44.
Rogers SJ, Dawson G. Early start Denver model for young children with autism: promoting language, learning, and engagement. New York: Guilford; 2010.
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23.
Eldevik S et al. Meta-analysis of early intensive behavioral intervention for children with autism. J Clin Child Adolesc Psychol. 2009;38(3):439–50.
Volkmar FR, Wiesner LA, Westphal A. Healthcare issues for children on the autism spectrum. Curr Opin Psychiatry. 2006;19(4):361–6.
Coury, D. L., Anagnostou, E., Manning-Courtney, P., Reynolds, A., Cole, L., McCoy, R., ... & Perrin, J. M. (2012). Use of psychotropic medication in children and adolescents with autism spectrum disorders. Pediatrics, 130(Supplement_2), S69-S76.
Leitner, Y. (2014). The Co-Occurrence of Autism and Attention Deficit Hyperactivity Disorder in Children – What Do We Know? Frontiers in Human Neuroscience, 8, 72005. https://doi.org/10.3389/fnhum.2014.00268
Cross-Disorder Group of the Psychiatric Genomics Consortium. (2013). Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nat. Genet. 45, 984–994. doi:10.1038/ng.2711
Gillberg, C. (2010). The ESSENCE in child psychiatry: early symptomatic syndromes eliciting neurodevelopmental clinical examinations. Res. Dev. Disabil. 31, 1543–1551. doi:10.1016/j.ridd.2010.06.002
Petti T, Gupta M, Fradkin Y, Gupta N. Management of sleep disorders in autism spectrum disorder with co-occurring attention-deficit hyperactivity disorder: update for clinicians. BJPsych Open. 2023 Dec 13;10(1):e11. doi: 10.1192/bjo.2023.589. PMID: 38088185; PMCID: PMC10755553.
Lebeña, A., Faresjö, Å., Faresjö, T. et al. Clinical implications of ADHD, ASD, and their co-occurrence in early adulthood—the prospective ABIS-study. BMC Psychiatry 23, 851 (2023). https://doi.org/10.1186/s12888-023-05298-3
Rege, S. (2023, November 24). Managing ADHD and Autism Comorbidity - A Comprehensive Guide. Psych Scene Hub. https://psychscenehub.com/psychinsights/adhd-and-autism-comorbidity-a-comprehensive-review/
Blain, T. (2022, March 31). What Are Neurodevelopmental Disorders? Verywell Mind. https://www.verywellmind.com/neurodevelopmental-disorders-definition-symptoms-traits-causes-treatment-5221231
Sherr, E. (2016, January 1). Neurodevelopmental Disorders, Causes, and Consequences. Elsevier eBooks. https://doi.org/10.1016/b978-0-12-800105-9.00036-6
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