Assessment of Attention-Deficit/Hyperactivity Disorder in Young Autistic Children

Area of Science:

• Neurodevelopmental Disorders
• Child Psychiatry
• Clinical Psychology

Background:

• Co-occurring attention-deficit/hyperactivity disorder (ADHD) is common in autistic children, leading to increased impairments and unique treatment needs.
• Diagnosing ADHD in preschool and early school-aged autistic children presents significant clinical challenges.

Purpose of the Study:

• To describe a clinically informed diagnostic framework for assessing ADHD in young autistic children.
• To illustrate diagnostic complexities using descriptive data and explore factors influencing clinician confidence.

Main Methods:

• Descriptive data from caregiver and clinician ratings of ADHD symptoms in autistic children with and without ADHD.
• Logistic regression analysis to examine clinician confidence in diagnostic decision-making.

Main Results:

• Caregiver-rated ADHD symptoms were elevated in both autistic and autistic+ADHD groups, highlighting diagnostic overlap.
• Clinician-caregiver agreement varied, with more disagreement on inattention symptoms.
• Clinician confidence in ADHD diagnosis was higher for girls, older children, and those with higher developmental levels.

Conclusions:

• Evaluating young autistic children for ADHD is clinically complex.
• Practical strategies are provided to address diagnostic challenges.
• Refining and validating the diagnostic framework can improve ADHD assessment in this population.