NOV 24, 2016 5:25 AM PST

ADHD, Autism and Screening: Could There Be a Problem?

When screening children for attention-deficit hyperactivity disorder (ADHD) there are established rating scales, diagnostic criteria and information on clinical interpretation for health care providers. While the most commonly used tool to screen for ADHD, the ADHD-RS-IV  has lots of information on the disorder it turns out it might not be the best screening tool for children who are also on the autism spectrum.
 
Children who have an autism spectrum disorder (ASD) have social integration impairments and other characteristics of the disease that can be mistaken for the problems children who have ADHD suffer with. In both cases, ADHD and autism, early intervention is crucial and misidentification can delay this.
 
A new study from researchers at the Children’s Hospital of Philadelphia, the Perelman School of Medicine at the University of Pennsylvania, and Baylor University, appeared online Oct. 13 in the Journal of Autism and Developmental Disorders and their results suggest that ADHD-RS-IV screening tool could be responsible for some children with an ASD being incorrectly diagnosed with an attention deficit issue.
 
Study leader Benjamin E. Yerys, PhD, a researcher in the Center for Autism Research at Children’s Hospital of Philadelphia (CHOP) said in a press release, “One of our best current screening measures for ADHD may be over-diagnosing ADHD in children with autism. This is important because medications that work for ADHD may be less effective for a child on the autism spectrum.”
 
It’s not that the screening tool currently used by most practitioners is wrong, it’s the issue of comorbidity. Autism experts report that about 30% of children on the autism spectrum also have ADHD as a co-morbid condition. It’s not uncommon to see the two disorders in the same child. While the ADHD-RS-IV is very efficient when it comes to screening children with attention problems and hyperactivity, in children on the spectrum it can result in an overestimate of ADHD diagnoses.
 
The study at CHOP analyzed ratings of 386 children, between the ages of 7 to 17, who had been diagnosed with an ASD without intellectual disability. They noted that some of the questions on the rating scale resulted in a higher ADHD rating in children with autism than they did in children with ADHD.
 
Dr. Yerys explained that it might be how the questions are formed. “One underlying problem,” he said, “may be in how we ask these questions.” As an example he pointed to one question on the scale that parents and teachers are asked, “Does the child respond when spoken to directly?” A child who has ADHD and a child on the autism spectrum are both likely to have issues responding directly to questions, however in one situation it could be a result of inattention and in another it could be the difficulty an autistic child has in reading social cues that is responsible for how they behave when asked a direct question. A simple yes or no answer does nothing to indicate ADHD or autism in the case of that question. Staying on task is another issue that presents in both children with an ASD and those with ADHD. The reasons for it are different however. ASD children have difficulty with social play, and children who have ADHD have trouble focusing for longer periods.
 
The study team suggested that the scale be modified to reflect possible ASDs in children being screened as well as clinicians following up with parents and teachers to get more specific information. Thomas J. Power, PhD, director of CHOP’s Center for Management of ADHD, helped develop the ADHD-RS-IV in the 1990s and was a co-author on the study. He stated, “I’m excited to be involved in this study, and in efforts to refine our screening tools especially since few researchers have previously investigated using this scale in children with ASD. Our research raises questions not only about this rating tool, but all such measures that rely on parent and teacher ratings to assess ADHD in children with ASD.” Check out the video below for more information.

Sources Journal of Autism and Developmental DisordersUPI HealthADHD InstituteChildren’s Hospital of Philadelphia 
About the Author
  • I'm a writer living in the Boston area. My interests include cancer research, cardiology and neuroscience. I want to be part of using the Internet and social media to educate professionals and patients in a collaborative environment.
You May Also Like
JAN 13, 2021
Drug Discovery & Development
Could Rotten Egg Gas Reverse Alzheimer's?
JAN 13, 2021
Could Rotten Egg Gas Reverse Alzheimer's?
Researchers from Johns Hopkins University have found that hydrogen sulfide, a gas that smells like rotten eggs, may prot ...
FEB 06, 2021
Neuroscience
Chronic Depression Linked to Reduced Support Cell Function in Brain
FEB 06, 2021
Chronic Depression Linked to Reduced Support Cell Function in Brain
Researchers from Canada have found that people with chronic depression who ultimately commit suicide have significantly ...
MAR 09, 2021
Cannabis Sciences
Cannabis Alleviates Neuropathic Pain from Chemotherapy
MAR 09, 2021
Cannabis Alleviates Neuropathic Pain from Chemotherapy
Neuropathic pain from oxaliplatin-based chemotherapy regimens occurs in up to 90% of patients, and continued exposure to ...
MAR 24, 2021
Genetics & Genomics
Some 'Zombie' Genes Ramp Up Activity in the Brain After Death
MAR 24, 2021
Some 'Zombie' Genes Ramp Up Activity in the Brain After Death
The brain is an organ that needs oxygen to survive, but it's been known that some brain cells can remain active afte ...
MAR 24, 2021
Cardiology
Supplement Can Prevent Strokes in Patients with Rare Disease
MAR 24, 2021
Supplement Can Prevent Strokes in Patients with Rare Disease
Scientists have found that it may be possible for people with a rare genetic disorder to prevent fatal strokes by taking ...
MAY 06, 2021
Drug Discovery & Development
Are Hallucinations Necessary for Psychedelics to Treat Depression?
MAY 06, 2021
Are Hallucinations Necessary for Psychedelics to Treat Depression?
Many who work with psychedelics say that hallucinations, or psychedelic experiences, are an integral part of psychedelic ...
Loading Comments...