Attention/Deficit Hyperactivity Disorder in Adolescent and Young Adult Males With Fragile X Syndrome.
Jessica Klusek, Shannon L O'Connor, Alexandra Hickey and 3 others
PMID 35443049WHAT IT FOUND
42% of adolescent and young adult males with Fragile X Syndrome met DSM-5 criteria for ADHD, mostly the inattentive type.
The CBCL rating scale missed nearly 20% of these cases, so relying on it alone can lead to under-diagnosis in this group.
Key findings
0141.9% of participants met DSM-5 diagnostic criteria for ADHD, with the inattentive presentation being the most common among those diagnosed.
02The CBCL ADHD scale had only fair agreement with the diagnostic interview, missing 19.4% of individuals who actually met DSM-5 criteria for ADHD.
03Neither ASD symptom severity nor nonverbal cognitive ability predicted ADHD diagnoses or symptoms, suggesting ADHD should not be dismissed as a feature of intellectual disability alone.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was small (n=31) and limited to males, so findings may not generalize to females with Fragile X Syndrome. The CBCL 6-18 form was used for all participants, including 13 who were older than 18, which may affect the validity of standard scores for the older group. Diagnosis relied on parent report and a single interview method, whereas clinical diagnosis typically involves multiple sources and professional judgment. The study was cross-sectional, so it cannot track how ADHD symptoms change within individuals over time.
The easy way to misread this
Do not assume that a low or normal score on the CBCL ADHD scale rules out ADHD in patients with Fragile X Syndrome. The study showed that the CBCL missed nearly 20% of individuals who met formal diagnostic criteria, meaning reliance on this scale alone can lead to under-diagnosis and missed treatment opportunities.