Delayed autism spectrum disorder recognition in children and adolescents previously diagnosed with attention-deficit/hyperactivity disorder.
Vasiliki Kentrou, Danielle Mj de Veld, Kawita Jk Mataw and 1 others
PMID 30244604WHAT IT FOUND
Children and adolescents with autism who had ADHD first were diagnosed with autism later, and girls showed a larger delay.
Adults with prior ADHD did not show this timing difference.
Key findings
01Among children and adolescents, 12.1% had an ADHD diagnosis before autism.
02Boys with prior ADHD were diagnosed with autism 1.52 years later than boys without prior ADHD, and girls with prior ADHD were diagnosed 2.64 years later than girls without prior ADHD.
03Adults with prior ADHD did not differ in age of autism diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The diagnostic history was retrospective and self-reported, so earlier ADHD diagnoses were not verified. The paper did not record age at ADHD diagnosis or ADHD severity, and it did not consider other earlier diagnoses. The AQ-Short was used to control autistic traits, but it is not a diagnostic measure and assumes reading comprehension. No medication data were available, so ADHD medication could have affected ASD symptoms and diagnosis timing. The child sample was reported as 80% male, and diagnostic criteria may favour male presentations, so girls may be underrepresented. The adult sample had very late autism diagnoses overall, which may limit how well it represents other adults. The paper gives different child and adult counts in different parts of the report, so the analysed sample is unclear.
Declared interests
The authors reported no financial support for the research, authorship, or publication.
The easy way to misread this
Do not conclude that every ADHD diagnosis in children with autism was a misdiagnosis. Among 242 participants with prior ADHD, 144 reported a current co-occurring ASD/ADHD diagnosis, and the study did not verify the original diagnoses.