ADHD and ASD

What are the key characteristics of Autism Spectrum Disorder (ASD)?

Persistent deficits in social communication and social interaction across multiple contexts, along with at least 2 restrictive, repetitive patterns of behavior, interests, or activities.

What are the deficits in social-emotional reciprocity associated with ASD?

Abnormal social approach, failure of normal back-and-forth communication, reduced sharing of interests/emotions/affect, and failure to initiate or respond to social interactions.

What are the deficits in non-verbal communicative behaviors in individuals with ASD?

Poorly integrated verbal and non-verbal communication, abnormalities in eye contact and body language, deficits in understanding and using gestures, and lack of facial expressions.

What difficulties do individuals with ASD face in developing and maintaining relationships?

Difficulties adjusting behavior to suit various social contexts, sharing imaginative play, making friends, and a lack of interest in peers.

What are the types of restrictive, repetitive patterns of behavior seen in ASD?

Stereotyped or repetitive motor movements, insistence on sameness, inflexible adherence to routines, and highly restricted, fixated interests.

What sensory-related symptoms may be present in individuals with ASD?

Hyper- or hypoactivity to sensory input or unusual interest in sensory aspects of the environment.

When do symptoms of ASD typically present?

Symptoms must be present in the early developmental period.

What is the impact of ASD symptoms on functioning?

Symptoms must cause clinically significant impairment in social, occupational, or other important areas of current functioning.

What is required for a diagnosis of Autism Spectrum Disorder (ASD)?

Individuals need symptoms from both categories: social communication difficulties and restricted or repetitive behaviors.

What is the prevalence of ASD in relation to gender?

ASD appears more often in men, with a ratio of approximately 3 to 1.

What are some genetic and neurobiological theories related to ASD?

Theories include the male brain theory and the female protective effect theory.

At what age can ASD be diagnosed?

ASD cannot be diagnosed before the age of 3.

What percentage of individuals with ASD have an intellectual disability?

40-60% of individuals with ASD have an intellectual disability.

What are common language difficulties associated with ASD?

Language difficulties occur more often in ASD (91%) compared to control groups.

What are some environmental factors associated with ASD?

Older parental age, low birth weight, and adverse effects during pregnancy or birth.

What brain characteristics are often found in individuals with ASD?

Larger brain volumes, disruption in prenatal processes, insufficient pruning, and less efficient connectivity.

What is the heritability percentage range for ASD?

Heritability for ASD is estimated at 64-90%.

What is the 'Theory of Mind' in relation to ASD?

It refers to understanding others as individuals with their own desires and beliefs, developing between ages 3-5.

What are precursors to the development of Theory of Mind?

Face perception, gaze following, joint attention, pretence play, and visual perspective taking.

What is the definition of Attention-Deficit/Hyperactivity Disorder (ADHD)?

A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

What are the symptoms of inattention in ADHD?

Symptoms include careless mistakes, difficulty sustaining attention, not listening, failing to follow through on instructions, and being forgetful.

What are the symptoms of hyperactivity and impulsivity in ADHD?

Symptoms include fidgeting, leaving seat, running in inappropriate situations, excessive talking, and interrupting others.

What is the age criterion for ADHD symptoms?

Several inattentive or hyperactive-impulsive symptoms must be present prior to age 12.

What is savant syndrome in relation to ASD?

A condition where individuals with ASD may exhibit extraordinary abilities in a specific area.

How do girls with ASD typically differ in behavioral traits compared to boys?

Girls often have more subtle social communication problems, better compensate, and exhibit less stereotyped behaviors.

What is the significance of prenatal and birth complications in ASD?

They are often associated with an increased risk of developing ASD.

What is the trend in the prevalence rate of ASD?

There has been an increase in the prevalence rate of ASD over time.

What role does sensory information processing play in ASD?

It interacts with executive functions and is a significant area of difficulty for individuals with ASD.

What is the impact of brain connectivity in individuals with ASD?

There is hyper-connectivity in toddlers/children and hypo-connectivity in adolescents/adults.

What is the importance of executive functions in ASD?

Executive functions are crucial for managing tasks, attention, and social interactions, and are often impaired in ASD.

What are the requirements for diagnosing ADHD in terms of symptom presence?

Several inattentive or hyperactive-impulsive symptoms must be present in two or more settings.

What evidence is needed to support an ADHD diagnosis?

There must be clear evidence that the symptoms interfere with or reduce the quality of social, academic, or occupational functioning.

What conditions must be ruled out for an ADHD diagnosis?

The symptoms must not occur exclusively during the course of schizophrenia or another psychotic disorder and should not be better explained by another mental disorder.

What is ADHD-C?

ADHD-C refers to Combined ADHD, which includes both inattentive and hyperactive-impulsive symptoms.

What is ADHD-A?

ADHD-A refers to the Hyperactive subtype of ADHD.

What is ADHD-I?

ADHD-I refers to the Inattentive subtype of ADHD.

What trend has been observed in the prevalence of ADHD?

The prevalence of ADHD has increased over the years due to a better diagnostic process and higher societal demands.

In which gender is ADHD more often diagnosed?

ADHD is more often diagnosed in boys.

Why might ADHD symptoms be less visible in girls?

Girls often present different symptoms that are less disruptive, leading to less visibility of ADHD.

How do the DSM-5 criteria for ADHD affect diagnosis in girls?

The criteria are based primarily on studies with boys, which may overlook the different symptoms girls present.

What is a common comorbidity with ADHD related to reading?

Dyslexia is a common comorbidity with ADHD, characterized by problems in accurate and fluent reading and/or spelling.

What behavioral symptoms are associated with oppositional defiant disorder comorbid with ADHD?

Symptoms include a pattern of angry/irritable mood, argumentative/defiant behavior, and often losing temper.

What percentage of ADHD diagnoses persist into adulthood?

About 1/3 of ADHD diagnoses persist into adulthood.

What happens to the other 2/3 of children diagnosed with ADHD?

1/3 have a diagnosis of ADHD that is partial in remission, and 1/3 are free from ADHD symptoms.

What is the estimated heritability of ADHD in the general population?

The estimated heritability in general population twin samples is 74%.

How do genetic contributions to ADHD relate to other conditions?

Genetic contributions to ADHD overlap with contributions to other neurodevelopmental conditions, most prominently with major depression.

What environmental factors are associated with the etiology of ADHD?

Maternal pre- and perinatal factors, such as pre-pregnancy obesity.

How do environmental risk factors relate to ADHD?

Environmental risk factors are not specific to ADHD.

What is a common issue in diagnosing ADHD in individuals with ASD?

The presence or absence of specific symptoms is usually based on parent reports.

How does clinician report of psychiatric comorbidity in ASD compare to parent interviews?

Clinician reports of psychiatric comorbidity, especially ADHD, are lower than diagnoses generated by structured parent interviews.

What is a diagnostic challenge when assessing ASD in individuals with ADHD?

Without base rate data on ADHD symptoms in ASD, it is unclear which symptoms and thresholds enhance the predictive validity of ADHD diagnostic instruments.

What theoretical model describes ADHD's neurocognitive pathways?

The Neurocognitive Model, which includes multiple pathways or dual pathways.

What does the heterogeneity of ADHD imply about its pathways?

It suggests there are multiple pathways instead of a single pathway associated with different neural substrates.

What are the two main pathways identified in the dual pathway model of ADHD?

Pathway I: Cognition - Attention; Pathway II: Delay Aversion.

What are the components of Pathway I related to cognition and attention in ADHD?

Orienting/selective attention, alerting/sustained attention, and executive control attention.

What is the core problem identified in Pathway II of ADHD?

The core problem is motivational rather than cognitive, characterized by delay aversion and impulsivity.

What does the Delay Aversion theory suggest about ADHD behavior?

It suggests that individuals with ADHD have trouble waiting and often act impulsively to avoid delays.

What is the Executive Dysfunction hypothesis in relation to ASD?

It explains atypical executive function processes in ASD, including difficulties in set shifting, response inhibition, and working memory.

What does the Excitation/Inhibition Hypothesis propose about ASD?

It suggests that an imbalance between neural excitation and inhibition contributes to ASD symptoms and impairments.

What is the Splitter Model's view on ADHD and ASD?

It posits that ADHD and ASD are two distinct, non-overlapping diagnoses.

What does Baddeley's model focus on in relation to executive functions?

It focuses on attentional systems.

What does the Delis-Kaplan model propose regarding executive functions?

It proposes nine executive functions sensitive to frontal lobe damage.

What are the five executive function factors defined by Barkley?

Time management, problem solving and organizing, ability to exercise restraint, self-motivation, and regulating emotions.

What does Gioia's model encompass regarding self-regulatory processes?

It involves the selection, initiation, execution, and monitoring of cognition and behavior.

What does Luria's model suggest about brain regions involved in executive functions?

It suggests broader engagement of various brain regions, with frontal lobes directing complex problem solving.

Which neurotransmitter is associated with moderating hot reward processes in executive functions?

Dopamine.

How does norepinephrine influence executive functions?

Norepinephrine circuits are associated with cognitive executive functions due to their influence on arousal and attentional systems.

What role does serotonin play in executive functions?

Serotonin modulates response inhibition through its action in the orbitofrontal cortex.

What is the role of the cholinergic system in executive functions?

It mediates set shifting.

How is GABA associated with executive functions?

GABA is increasingly linked to mediating processes in the neural circuitry of the prefrontal cortex.

What percentage of children receiving school-based services have ASD and ADHD?

Children with ASD (8%) and children with ADHD (13%) account for nearly 1/4 of all children receiving school-based services.

How often do ASD and ADHD co-occur?

ASD and ADHD often co-occur.

What percentage of children with ADHD are diagnosed with comorbid ASD according to a large epidemiological study?

13% of children with ADHD were diagnosed with comorbid ASD.

What is the ratio of youths with ADHD that have ASD?

1 in 8 youths with ADHD have ASD.

What is the most common comorbidity in children with ASD?

ADHD is the most common comorbidity in children with ASD, with rates between 40-70%.

How much later are youth with ADHD diagnosed with ASD compared to those without a pre-existing ADHD diagnosis?

Youth with ADHD are diagnosed with ASD approximately 2 years later than children with ASD without a pre-existing ADHD diagnosis.

What is the relationship between ADHD and ASD symptoms in youth?

Youth with ADHD who do not have an ASD diagnosis still have elevated levels of ASD symptoms, and vice versa.

What is the impact of ADHD presence on ASD severity?

The presence of ADHD in ASD is associated with increased ASD severity and a significantly increased risk for a third condition, especially anxiety and mood disorders.

What relationship exists between increasing ADHD severity and comorbid psychiatric diagnoses in children with ASD?

Increasing ADHD severity, yet not increasing ASD severity, is associated with the number of additional comorbid psychiatric diagnoses in children with ASD.

What type of disorders are ASD and ADHD considered?

Both are considered neurodevelopmental disorders that onset in childhood.

What is the heritability of ASD and ADHD?

Both disorders have a heritability of approximately the same rate.

What is the relationship between ASD and ADHD in twin pairs?

When one twin has ASD, the unaffected twin has a higher likelihood of exhibiting symptoms of ADHD.

How do family members of individuals with ASD relate to ADHD diagnoses?

Family members of individuals with ASD have elevated rates of ADHD diagnoses and vice versa.

Have specific gene variations been found linking ASD and ADHD?

No specific gene variations have been identified that link ASD and ADHD.

What evidence suggests shared genetic pathways between ADHD, ASD, and other disorders?

Increases in rare copy number at similar loci among individuals with ADHD, ASD, intellectual disability, and schizophrenia provide preliminary evidence of shared genetic pathways.

What are some limitations in neuro-imaging studies of ASD and ADHD?

Limitations include small sample sizes, heterogeneity of symptom presentations, differences in methodologies, and a wide range of ages complicating findings.

What specific brain area shows dysconnectivity in children with ADHD and ASD?

Children with ADHD and both disorders show connectome-wide dysconnectivity in the precuneus.

What social difficulties are required for an ASD diagnosis?

Social difficulties are a requirement for an ASD diagnosis and often factor into ADHD diagnoses.

How do social communication skills impact social perception in ASD and ADHD?

Social communication skills/deficits impact social perception similarly, regardless of diagnostic label.

What is the Eye Test, and how do ASD and ADHD participants score?

The Eye Test assesses mental state based on pictures of eyes; ASD participants show the greatest deficits, while ADHD participants score intermediate.

What type of behavior negatively affects social perception scores in ADHD?

Hyperactivity, not inattention, negatively affects social perception scores.

What is a common feature of social interactions in individuals with ADHD and ASD?

Low levels of reciprocal friendships are a shared feature between ADHD and ASD.

How do typically developing peers react to individuals with ASD?

Typically developing peers are less willing to engage with individuals with ASD, often making quick decisions based on initial exposure.

What deficits do individuals with ASD have that affect their social skills?

Individuals with ASD have knowledge deficits and are more likely to respond to clinic-based social skills training interventions.

What type of social interaction deficits are observed in individuals with ADHD?

Individuals with ADHD have intact social knowledge but impaired social interactions, indicating a performance deficit.

What executive function challenges are more severe in ADHD compared to ASD?

Executive dysfunction is more severe in ADHD.

What are the three pathways associated with ASD and ADHD?

1. Impulsivity + social information processing difficulties, 2. Hyperactivity + restricted and repetitive behaviors, 3. Inattention + verbal IQ + social information processing difficulties.

What is the recommended focus for treatment of school-aged children with ASD?

The focus should be on social, adaptive, and academic skills acquisition.

What treatments are recommended for ADHD in school-aged children?

Organizational interventions and parent/teacher training in contingency management.

What are the most widely used medications for ADHD?

The most widely used medications are psychostimulants, specifically methylphenidate and amphetamines.