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AADPA Conference 2024
'Collaborative Care: The Future of ADHD'

 

Hello and welcome!

I'm Rebecca Gannon. You must have followed the QR code on my conference poster. Good on you, now strap yourself in for an infodump!

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Before we get to that though, allow me to clarify that I am not a researcher. This poster is best interpreted as a yarn or a conversation, it is not data heavy or very technical. 

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References (annotated, because #nerd). 

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Information on ADHD/Autism co-occurrence rates 

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  • Kentrou, V., de Veld, D. M. J., Mataw, K. J. K., & Begeer, S. (2019). Delayed Autism Spectrum Disorder recognition in children and adolescents previously diagnosed with Attention-Deficit/Hyperactivity Disorder. Autism, 23 (4), 1065-1072. doi: 10.1177/1362361318785171

    • There is a delay from childhood in identifying co-occurring Autism when ADHD has been identified first. 

    • The authors recommended that children referred for/diagnosed with ADHD should be evaluated for (or at the very least screened for) Autism.

    • Approximately 40% of the total sample did not maintain their initial diagnosis of ADHD as a co-occurring condition after they were subsequently found to meet Autism criteria.

    • Majority of participants (59.5%) nevertheless met criteria for co-occurring ADHD/Autism.

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  • Lietner, Y. (2014). The co-occurrence of Autism and Attention Deficit Hyperactivity Disorder in children: What do we know? Frontiers in Human Neuroscience, 8, 268. doi: 10.3389/fnhum.2014.00268

    • 30-50% of Autistic people may exhibit ADHD traits and two thirds of people with ADHD may have Autistic features. 

    • Social problems are not part of the core diagnostic criteria for ADHD, but children with ADHD experience significant social difficulties due to impacts of executive dysfunction (e.g. attention difficulty leading to missing social cues, impulsive behaviour upsetting peers and hyperactivity annoying peers). 

    • Autism differs to this though (e.g. differences in reciprocity and engagement, social interest and social motivation). 

 

  • Rong, Y., Yang, C. J., Jin, Y., & Wang, Y. (2021). Prevalence of Attention-Deficit/Hyperactivity Disorder in individuals with Autism Spectrum Disorder: A meta-analysis. Research in Autism Spectrum Disorders, 83, 101759. doi: 10.1016/j.rasd.2021.101759

    • Pooled estimate of current prevalence of ADHD in Autism was 38.5%; lifetime 40.2%. 

    • Conclusion: Autism has considerable high current or lifetime prevalence rates of co-occurring ADHD. The findings demonstrated that clinicians should consider the high prevalence of ADHD in Autism and especially stay alert to possible ADHD diagnoses in school-age Autistic children and adolescents. Medical institutions should improve the assessment and tracking system of ADHD co-occurrence for Autistic people and maximise the diagnostic accuracy for better treatment. 

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  • Stevens, T., Peng, L., & Barnard-Brak, L. (2016). The comorbidity of ADHD in children diagnosed with Autism Spectrum Disorder. Research in Autism Spectrum Disorders, 31, 11-18. doi: 10.1016/j.rasd.2016.07.003

    • Autism and ADHD co-occurred in 59% of children diagnosed with Autism. 

    • Autism diagnosis occurred significantly later for children first diagnosed with ADHD. 

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  • Zhong, Q., & Porter, M. (2024). Autism Spectrum Disorder symptoms in individuals with a primary diagnosis of Attention Deficit/Hyperactivity Disorder: A systematic review. Review Journal of Autism and Developmental Disorders, doi: 10.1007/s40489-024-00443-4

    • ​​Higher levels of Autism traits were found in ADHDers (15 to 64.3%) compared to the general population.

    • Combined and Primarily Inattentive Presentations of ADHD were overrepresented compared to Predominantly Hyperactive/Impulsive Presentation. Averaging across ADHD subtypes may mask important distinctions in Autistic traits. 

    • Conclusion: The high rates of co-occurence and frequency of overlap between ADHD and Autistic traits indicate that it is a necessity to consider the presence of Autistic traits (and a possibly co-occurring Autism identification) for ADHDers.

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Information on life outcomes for Autistic people 

 

  • Catala-Lopez, F., Hutton, B., Page, M. J., Driver, J. A., Ridao, M., Alonso-Arroyo, A., Valencia, A., Saint-Gerons, D. M. & Tabares-Seisdedos, R. (2022). Mortality in persons with Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder: A systematic review and meta-analysis. JAMA Pediatrics, 176 (4), e216401. doi: 10.1001/jamapediatrics.2021.6401

    • ​​Autism and ADHD were associated with higher mortality risk due to unnatural (external) causes, but only Autism had an increased risk of mortality from natural causes of death (e.g. disease, chronic health conditions). 

 

  • Hwang, Y. I., Srasuebkul, P., Foley, K., Arnold, S., & Trollor, J. N. (2019). Mortality and cause of death of Australians on the Autism spectrum. Autism Research, 12 (5), 806-815. doi: 10.1002/aur.2086

    • ​​Early mortality rates for Autistic individuals living in NSW, Australia, were 2.06 times that of the general population.

    • This is higher still for Autistic individuals who have additional mental and physical health conditions.

    • The leading causes of death for Autistic individuals with and without Intellectual Disability are 'nervous system and sense disorders', which includes epilepsy, injury and poisoning.

 

  • Jokiranta-Olkoniemi, E., Gillenberg, D., Sucksdorff, D., Suominen, A., Kronstrom, K., Chudal, R., & Sourander, A. (2021). Risk for premature mortality and intentional self-harm in Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 51, 3098-3108. doi: 10.1007/s10803-020-04768-x

    • Findings aligned with wider research outcomes - Autistic people are at higher risk for premature mortality.

    • The increased risk was due to natural causes of death, but not for other causes examined.

    • Autistic people appear to die by suicide and to engage in self-harming behaviours than non-Autistic people, however this association seems explained by co-occurring psychiatric disorders/mental illness.

    • Conclusions include the need to more efficiently recognise and treat mental illness in Autistic people (do not fall into diagnostic overshadowing traps). 

 

  • Lietner, Y. (2014). The co-occurrence of Autism and Attention Deficit Hyperactivity Disorder in children: What do we know? Frontiers in Human Neuroscience, 8, 268. doi: 10.3389/fnhum.2014.00268​​

    • Having co-occuring ADHD and Autism is associated with lower quality of life and poorer adaptive conditions than in any either alone. 

    • AuDHD children had lower scores in all areas: Psychosocial health, school functioning, physical functioning, emotional, and social functioning scores were all lower than those of Autistic children.

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  • Senate Select Committee on Autism. (2022). Services, support and life outcomes for Autistic Australians. Parliament of Australia. https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Autism/autism/Report

    • ​​Provides information on life outcomes for Autistic people across a number of domains including health, education, employment, housing, justice and social inclusion. 

    • Outcomes across all of these domains appear poorer for Autistic people compared to non-Autistic populations.

    • Drawn from national and international data, and local/national submissions from individuals, organisations and associations. 

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Resources for Upskilling in Autism Assessment

 

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Resources about Autism for Adult Clients 

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