Lindsey W. Williams

The relationship between autism spectrum disorders and attention-deficit/hyperactivity disorder: An overview

The autism spectrum has become a highly studied topic, perhaps the most researched of all developmental disorders. A host of related topics are being studied, with one of the most common being comorbidity of autism with other conditions such as epilepsy, sleep, and anxiety disorders. One of the most prevalent of these comorbid conditions is attention-deficit/hyperactivity disorder (AD/HD). A considerable amount of research has appeared on this topic with respect to symptom expression, prevalence of overlap, type of symptom overlap, and the effect of these two conditions co-occurrence on other symptoms and disorders. Given the substantial data base that has accrued, review and synthesis of these data are in order. This is the purpose of the present manuscript.

Rates of comorbid symptoms in children with ASD, ADHD, and comorbid ASD and ADHD

The current diagnostic criteria do not allow co-diagnosis of autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD). As a result, there has been little research on how these two disorders co-occur in the ASD population. The current study aimed to extend the literature in this area by examining comorbid rates in three different diagnostic groups (ASD, ADHD, and comorbid ASD+ADHD) using the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC). Children with comorbid ASD and ADHD evinced higher rates of comorbid symptoms than children with ASD or ADHD alone. Additionally, children with comorbid ASD and ADHD endorsed more severe comorbid symptoms. Implications regarding these findings are discussed.

The making of a field: the development of comorbid psychopathology research for persons with intellectual disabilities and autism.

Knowledge in the area of developmental disabilities has been expanding rapidly. One area that has received particular attention is the topic of related comorbid conditions. This phenomenon is not exclusive to the field of developmental disabilities. However, research with this population is of recent origin. The purpose of this paper is to review the origins of this field including some of the notable developments and potential future trends.

Examination and validation of a measure of anxiety specific to children with autism spectrum disorders

Objective: Investigated the use of a combined scale (Worry/Depressed and Avoidant scales) from the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC) as a measure of anxiety. Alternative methods of measuring anxiety were examined using the ASD-CC in an ASD population. Methods: Participants included 147 children, age 2–16 years, evincing a mixture of behavior problems. Comparisons between scores on the ASD-CC and Behavior Assessment System for Children, Second Edition (BASC-2) were examined to determine the most efficacious method of measuring anxiety and to establish convergent and discriminant validity. Results: The worry/depressed subscale was the most effective subscale of the ASD-CC to measure anxiety with proven incremental validity over the combined scale. Conclusion: The worry/depressed subscale is the best measure of anxiety utilizing the ASD-CC in children with an ASD. Additionally, convergent and discriminant validity was demonstrated by comparing the scale with similar and dissimilar scales of the BASC-2.

The relationship of early communication concerns to developmental delay and symptoms of autism spectrum disorders

Objective: Parental concerns related to communication are an oft-cited reason that children present to early intervention clinics. We examine the relationship between early communication first concerns (FCs) and symptoms of ASD. Methods: The present study included 3173 toddlers at risk for developmental delay. The Battelle Developmental Inventory, 2nd edition and the Baby and Infant Screen for Children with aUtIsm Traits (BISCUIT) were used to examine developmental quotient scores and autism symptoms. Results: Significant results were observed with respect to FC group and gender. A significant effect of FC-Communication group was observed with respect to developmental quotient overall and subscale scores, as well as autism symptom scores. Conclusion: Those with communication disorders are a heterogeneous population and do not account for all children who will meet criteria for a diagnosis of an ASD.

Stereotyped behaviours in children with autism spectrum disorders and atypical development as measured by the BPI-01

Objective: As repetitive behaviours in children with autism spectrum disorders (ASDs) can significantly interfere with ones daily functioning, continued research on these behaviours is needed. Methods: This study examined the occurrence of repetitive motor movements in toddlers (17–37 months) with ASD and atypical development and the relationship between stereotypies and sensory impairment. Results: Children with ASD (n = 13) exhibited significantly more repetitive behaviours than the non-ASD group (n = 12). Greater percentages of endorsement were evident for the ASD group on nearly all items of the Behaviour Problems Inventory-01 (BPI-01) Stereotypy subscale. More repetitive behaviours tended to co-occur with other stereotypies for the ASD group. A moderate correlation was found between stereotypy severity and sensory deficits. Conclusion: These findings suggest that stereotyped behaviours can be identified at very young ages, negatively affect the behavioural presentation of those with ASDs and should be considered when developing treatment plans.

Co-occurring disorder clusters in adults with mild and moderate intellectual disability in residential treatment settings.

In the typically developing population, co-occurring psychopathology is not uncommon and is a topic of importance among psychologists. It is only recently that the psychopathology in individuals with intellectual disability (ID) has become an area of significant clinical and research interest. Individuals with ID are believed to be at a greater risk for co-occurring disorders compared to the typical population. By definition, ID involves deficits in adaptive behavior, which necessitates the use of community services, or specialized services at residential facilities to manage severe challenging behaviors or psychiatric disorders. The presence of co-occurring disorders in addition to ID can complicate treatment, limit available services, and restrict opportunities for individuals with ID. The present study examines the prevalence of co-occurring psychiatric disorders and ID in a sample of 78 individuals with mild to moderate ID living in a long-term residential treatment facility diagnosed with psychiatric disorders. Certain psychiatric disorders were more likely to co-occur together in this population. Identifying and treating individuals with multiple psychopathologies in addition to ID poses challenges unique to the population.

Socialization and nonverbal communication in atypically developing infants and toddlers.

Emphasis on early identification of atypical development has increased as evidence supporting the efficacy of intervention has grown. These increases have also directly affected the availability of funding and providers of early intervention services. A majority of research has focused on interventions specific to an individuals primary diagnoses. For example, interventions for those with cerebral palsy (CP) have traditionally focused on physiological symptoms, while intervention for individuals with Autism Spectrum Disorder (ASD) focus on socialization, communication, and restricted interests and repetitive behaviors. However deficits in areas other than those related to their primary diagnoses (e.g., communication, adaptive behaviors, and social skills) are prevalent in atypically developing populations and are significant predictors of quality of life. Therefore, the purpose of the current study was to examine impairments in socialization and nonverbal communication in individuals with Downs syndrome (DS), CP, and those with CP and comorbid ASD. Individuals with comorbid CP and ASD exhibited significantly greater impairments than any diagnostic group alone. However, individuals with CP also exhibited significantly greater impairments than those with DS. The implications of these results are discussed.

Functional Assessment of Challenging Behavior

Challenging behaviors (CB) in the form of self-injurious behaviors, aggression, property destruction, tantrums, pica, and other disruptive activities are common among persons with intellectual disabilities. Lack of social and communication skills, temperament issues, and other symptoms that characterize these persons contribute to the high rates of CB. In recent years, applied behavior analysis (ABA) has proven to be a particularly effective treatment for these issues. Functional assessment is a foundational strategy for such intervention. The methods most commonly used to achieve this goal include interviews and observations, experimental functional analysis, in vivo assessment, and standardized tests. The purpose of this group of techniques is to establish the variables that maintain the behavior, and treatment then flows from these data. This paper reviews the current state of the art in the area of functional assessment.