Related Experiment Video
Updated: Oct 10, 2026

Comparing Eye-tracking Data of Children with High-functioning ASD, Comorbid ADHD, and of a Control Watching Social Videos
Published on: December 7, 2018
Treatment Patterns and Clinical Outcomes in Youth With Attention-Deficit/Hyperactivity Disorder and Autism Spectrum
Raman Baweja1, Daniel A Waschbusch1, Narpinder Malhi2
1Penn State College of Medicine, Hershey, Pennsylvania.
Objective:
The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) is common and associated with greater clinical complexity. This study evaluated real-world treatment patterns and outcomes among children and adolescents with ADHD, comparing those with and without comorbid ASD.
Method:
A retrospective comparative cohort study analyzed electronic health records from the TriNetX Research Network, including 869,510 children and adolescents aged 3 to 18 years with ADHD, of whom 155,543 (17.9%) had ASD. Outcomes included treatment patterns and clinical outcomes. Analyses used propensity score matching and Cox proportional hazards models adjusted for sociodemographic and psychiatric factors, estimating relative risks (RRs), hazard ratios (HRs), and 95% confidence intervals over 1 year.
Results:
Children and adolescents with ADHD+ASD had higher psychiatric comorbidity and health care use than those without ASD. They received fewer CNS stimulant prescriptions (RR = 0.82, 95% CI = 0.81-0.83) but a higher proportion of non-stimulant prescriptions (RR = 1.52, 95% CI = 1.50-1.54) compared with those without ASD. Slightly higher ADHD prescribing occurred among Hispanic youth (RR = 1.03) and preschoolers (RR = 1.23) with ASD compared to those without ASD. Within the ADHD+ASD cohort, CNS stimulants were associated with the most favorable outcomes, including reduced hospitalization, emergency visits, suicidal behaviors, and subsequent antipsychotic/mood stabilizer initiation (adjusted HRs 0.33-0.83). Atomoxetine showed relatively favorable outcomes among non-stimulants.
Conclusion:
Comorbid ASD in children and adolescents with ADHD increases clinical burden and shifts treatment from CNS stimulants to non-stimulants and other psychotropics. Despite lower use, CNS stimulants are associated with improved outcomes, underscoring the need for prospective studies examining the risk-to-benefit ratio in this population.
Related Concept Videos
Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
Modeling in Therapy
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in situations...
Attention-Deficit/Hyperactivity Disorder
Diagnostic Criteria and Symptoms
To diagnose ADHD, symptoms must manifest before age 12 and be evident across multiple settings.
Operant Conditioning Intervention
In operant conditioning, behaviors that are...
Conduct Disorder
Oppositional Defiant Disorder
Diagnostic Criteria and...
