The relationship of sensory processing with ADHD and its co-occurring behavioural symptoms based on both undirected...

Attention-deficit hyperactivity/impulsivity disorder (ADHD) commonly co-occurs with sensory processing (SP), autistic traits (ATs), and oppositional defiant disorder (ODD). Our aim is to explore the relationships among SP, ADHD symptoms, ATs, and ODD symptoms in a large sample of children with ADHD and elucidate the potential role of sensory dysfunction in ADHD comorbidity patterns using symptomatic network analyses.

A total of 2676 children with ADHD aged 6 to 11 years were recruited from Peking University Sixth Hospital. For all subjects, the ADHD symptom severity was rated using the ADHD Rating Scale, ODD symptom severity using the related items in the Children's Clinical Diagnostic Interview Scale, SP symptom severity using the Child Sensory Integration Scale, and ATs using related items in the CBCL. R 4.2.1 packages including mgm, qgraph, and bnlearn were used for network analysis.

In the Graphical Gaussian Model (GGM), the SP items were connected with ATs and ADHD core symptoms and positioned relatively high in the directed acyclic graph (DAG). ATs_S, located higher in the DAG, played an important role in communication in the network as a node for SP and ODD to exert their influence on ADHD, and ADHD items were downstream nodes seemingly dependent on SP nodes and ATs_S in the network.

SP may be fundamental to the complex manifestations in children with ADHD, especially given its close relationship with ATs profiles. ATs_S might play an essential role in communication in this symptomatic network. These findings may help clarify possible relationships of different symptoms in ADHD and provide potential targeted interventions to improve core symptoms of ADHD as well as ATs and ODD symptoms.

Not applicable.