ADHD Symptoms Related to Poor Adaptive Behavior in Children With Autism Spectrum Disorder

ADHD symptoms appear to have a dimensional relationship to adaptive behavior in children with autism spectrum disorder, regardless of whether the children meet diagnostic criteria for a comorbid ADHD diagnosis.

Attention-deficit/hyperactivity disorder (ADHD) symptoms predict poor adaptive behavior for children with autism spectrum disorder (ASD), according to research published in the Journal of the American Academy of Child & Adolescent Psychiatry.

Researchers conducted a case study that included 347 children from specialty clinics, primary care, and the community. Researchers tested whether ADHD-IV Rating Scale scores on children with ASD were associated with poorer adaptive behavioral scores using linear regression and controlling for age, intelligence, sex, and ASD symptom severity. They measured adaptive behaviors using the Vineland Adaptive Behavior Scales, 2nd Edition. This relationship was assessed further in analyses of a subset of the ASD sample (179 participants) with subclinical ADHD symptoms per parent report, and another subset (153 participants) based on teacher ratings. Researchers assessed age as a moderator, replicating prior relationships between age, adaptive behaviors, and ADHD symptoms.

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Researchers found that ADHD symptoms predicted poor adaptive behavior scores in the full ASD sample and in the subset with subclinical ADHD symptoms after controlling for confounds. Age was negatively correlated with both ADHD symptoms and adaptive behaviors among children with ASD, and did not moderate the effect of ADHD symptoms on adaptive behaviors.

The study was limited by its reliance on informant reporting as well as a small number of female participants.

According to researchers, their findings “support a Research Domain Criteria framework that behavioral impairments and functional outcome measures exist along a continuum.”


Yerys BE, Bertollo JR, Pandey J, Guy L, Schultz RT. ADHD symptoms are associated with lower adaptive behavior skills in children with autism [published online February 19, 2019]. J Am Acad Child Adolesc Psychiatry. doi: