ADHD News & Research

Some Autism Symptoms Linked to Poorer Functioning, Quality of Life in Children with ADHD

Children with ADHD who experience autism symptoms like repetitive behaviors and social interaction deficits are at greater risk for conduct, peer, and quality of life problems, according to an Australian study.

December 5, 2019

Some autism spectrum symptoms are associated with poorer functioning and other quality of life problems when present in children who also have attention deficit hyperactivity disorder (ADHD), according to a study published last month in the Journal of Attention Disorders.1

The Australian study examined which autism symptom domains — communication, social interaction, and repetitive behavior — impact areas like mental health, peer problems, and quality of life in children who also have ADHD. While autism and ADHD have been widely studied together, the researchers noted that little information is available on how specific autism symptoms influence functioning in these problem areas for children with ADHD.

The study included 164 children with ADHD (114 boys and 50 girls) between the ages of 6 and 10 who were recruited from schools in Melbourne over the course of several stages and years. Autism symptom severity and outcomes like social and emotional functioning were measured using questionnaires and inventories with parent-reported and, at times, teacher-reported answers.

The scientists found that the most impairing autism symptoms among these children were social reciprocity deficits and repetitive behaviors. Social interaction deficits, for instance, were associated with higher rates of peer problems, while repetitive behaviors appeared linked to greater conduct, emotional, and quality of life problems. Communication deficits, meanwhile, were not associated with any of the observed outcomes in the study.

The researchers pose that social interaction deficits have a “compounding effect” on documented, existing ADHD-linked difficulties associated with forming and maintaining friendships. “There is limited evidence that existing social skills interventions vastly improve social functioning in children with ADHD…” part of the study reads. “Considering the social difficulties experienced by children with ADHD through an ASD lens may be a productive avenue for future intervention research.”

The study’s documented link between repetitive behaviors and emotional problems is consistent with prior studies that tied repetitive behaviors to anxiety in children with ADHD. “In children with ADHD, it could be possible that the higher levels of restricted and stereotyped behaviors, such as repetitive thoughts or worries, may be resulting in the higher levels of emotional problems reported,” the scientists pose. “Alternatively, it may be that children with ADHD and ASD symptoms experience higher levels of emotional problems and use restricted and stereotyped behaviors as a way to reduce this.”

Given the many areas impacted by repetitive behavior, the study says more research is warranted on interventions that specifically target this autism symptom domain in children with ADHD.

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1 Stephens, K., O’Loughlin, R., Green, J. L., Anderson, V., et al. (2019). The Association Between Autism Symptoms and Child Functioning in a Sample With ADHD Recruited From the Community. Journal of Attention Disorders