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Clinical research: Attention deficit adds to autism tantrums

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Jessica Wright
26 July 2013

Acting out: Children who have both attention deficit disorder and autism tend to become easily upset or angry, according to their parents.

Children who meet the criteria for both autism and attention deficit hyperactivity disorder (ADHD) have more severe behavioral problems than do children with either disorder alone, according to three studies published in the past few months.

Autism and ADHD were mutually exclusive diagnoses in the DSM-IV, the previous edition of the Diagnostic and Statistical Manual of Mental Disorders. The DSM-5, released in May, allows a child to be diagnosed with both disorders simultaneously.

Some studies report that as many as 80 percent of children with autism also have ADHD.

Two studies, published in the August and September issues of Research in Developmental Disabilities, each looked at more than 200 children with autism, about 40 children with ADHD and about 40 children with both disorders1, 2. All were between 2 and 16 years of age.

In both studies, parents filled out the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC), a 39-item questionnaire that assesses the severity of symptoms that often accompany autism, such as tantrums.

Children with both disorders have more severe tantrums and general behavioral problems than those with either disorder alone, the studies found. They are also slightly more likely to be anxious than are children with a single diagnosis.

Children who have both ADHD and autism are similar to those with autism alone in almost all aspects of tantrum behavior. One difference is that children with autism are more likely to finish assigned tasks than are children with both disorders.

Overall, children with ADHD alone have less severe symptoms than the other two groups, including how often they become upset or damage property. This suggests that the autism diagnosis is the primary contributor to tantrums, the researchers say.

This finding bolsters another result, published 25 April in European Child Adolescent Psychiatry. That study finds that among 711 children with ADHD, those with the most features of autism — as identified by the Social Communication Questionnaire — are the most likely to have behavioral problems and anxiety3.

News and Opinion articles on SFARI.org are editorially independent of the Simons Foundation.


1: Jang J. et al. Res. Dev. Disabil. 34, 2369-2378 (2013) PubMed

2: Goldin R.L. et al. Res. Dev. Disabil. 34, 2669-2675 (2013) PubMed

3: Cooper M. et al. Eur. Child Adolesc. Psychiatry Epub ahead of print (2013) PubMed


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Name: Jean
1 August 2013 - 1:55PM

Sorry, why is this news? Anyone who has a child with both adhd and autism, or has worked with them, knows their behavior issues are more difficult than if they have just adhd or autism.

Name: Steph
2 August 2013 - 11:35AM

I was thinking the same thing. I could have written this article. I lived it. Nothing in it would have helped either with my son's situation. But now that there is research it must be true!

Name: Jessica Wright
6 August 2013 - 2:20PM

Hi Jean and Steph,

Thank you for your comments and for reading SFARI.

Often the value of a large study over anecdotal evidence is that it shows whether certain experiences are relatively unique, or part of a more significant trend. It can also achieve a more subtle understanding of certain questions.

For example, these articles show that the traits of autism play a more significant role in behavior problems than the traits of ADHD. This may be helpful in understanding which interventions might help these behaviors.



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