Changing ASD-ADHD Symptom Co-Occurrence Across the Lifespan With Adolescence as Crucial Time Window: Illustrating the Need to go Beyond Childhood

*Commentary by Dr. Margaret Weiss: Early identification and intervention has been a hallmark of ASD treatment. The demand for independent social functioning, abstraction and executive functioning peaks in early adolescence. Early intervention during adolescence and young adulthood for comorbid high functioning ASD/ADHD may be critical to optimizing the potential for successful adult functioning.

Changing ASD-ADHD symptom co-occurrence across the lifespan with adolescence as crucial time window: illustrating the need to go beyond childhood Hartman CA, Geurts HM, Franke B, Buitelaar JK, Rommelse NN.
Neurosci Biobehav Rev. 2016 Sep 11. pii: S0149-7634(16)30116-6. doi: 10.1016/j.neubiorev.2016.09.003. [Epub ahead of print]

Abstract
Literature on the co-occurrence between Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) is strongly biased by a focus on childhood age. A review of the adolescent and adult literature was made on core and related symptoms of ADHD and ASD. In addition, an empirical approach was used including 17,173 ASD-ADHD symptom ratings from participants aged 0 to 84 years. Results indicate that ASD/ADHD constellations peak during adolescence and are lower in early childhood and old age. We hypothesize that on the border of the expected transition to independent adulthood, ASD and ADHD co-occur most because social adaptation and EF skills matter most. Lower correlations in childhood and older age may be due to more diffuse symptoms reflecting respectively still differentiating and de-differentiating EF functions. We plea for a strong research focus in adolescence which may -after early childhood- be a second crucial time window for catching-up pattern explaining more optimal outcomes. A full lifespan approach into old age.
* Abstracts are selected for their clinical relevance by Dr. Margaret Weiss MD PhD FRCP, Margaret Weiss MD PhD FRCP(C), Director, Child and Adolescent Psychiatry; Child Study Centre, Little Rock, AR. Her commentary reflects her own opinion, is not approved, or necessarily representative, of the opinion of the CADDRA board.

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