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American Academy of Pediatrics
Article

Timing of the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder

Amir Miodovnik, Elizabeth Harstad, Georgios Sideridis and Noelle Huntington
Pediatrics October 2015, 136 (4) e830-e837; DOI: https://doi.org/10.1542/peds.2015-1502
Amir Miodovnik
aDivision of Developmental Medicine, and
bHarvard Medical School, Boston, Massachusetts
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Elizabeth Harstad
aDivision of Developmental Medicine, and
bHarvard Medical School, Boston, Massachusetts
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Georgios Sideridis
aDivision of Developmental Medicine, and
bHarvard Medical School, Boston, Massachusetts
cClinical Research Center, Boston Children’s Hospital, Boston, Massachusetts; and
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Noelle Huntington
aDivision of Developmental Medicine, and
bHarvard Medical School, Boston, Massachusetts
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Abstract

BACKGROUND AND OBJECTIVE: Symptoms of inattention, hyperactivity, and impulsivity are core features of attention-deficit/hyperactivity disorder (ADHD). However, children with autism spectrum disorder (ASD) often present with similar symptoms and may receive a diagnosis of ADHD first. We investigated the relationship between the timing of ADHD diagnosis in children with ASD and the age at ASD diagnosis.

METHODS: Data were drawn from the 2011–2012 National Survey of Children's Health, which asked parents to provide the age(s) at which their child received a diagnosis of ADHD and/or ASD. Using weighted prevalence estimates, we examined the association between a previous diagnosis of ADHD and the age at ASD diagnosis, while controlling for factors known to influence the timing of ASD diagnosis.

RESULTS: Our study consisted of 1496 children with a current diagnosis of ASD as reported by parents of children ages 2 to 17 years. Approximately 20% of these children had initially been diagnosed with ADHD. Children diagnosed with ADHD before ASD were diagnosed with ASD ∼3 years (95% confidence interval 2.3–3.5) after children in whom ADHD was diagnosed at the same time or after ASD. The children with ADHD diagnosed first were nearly 30 times more likely to receive their ASD diagnosis after age 6 (95% confidence interval 11.2–77.8). The delay in ASD diagnosis was consistent across childhood and independent of ASD severity.

CONCLUSION: To avoid potential delays in ASD diagnosis, clinicians should consider ASD in young children presenting with ADHD symptoms.

  • Accepted July 6, 2015.
  • Copyright © 2015 by the American Academy of Pediatrics

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Pediatrics
Vol. 136, Issue 4
1 Oct 2015
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Timing of the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder
Amir Miodovnik, Elizabeth Harstad, Georgios Sideridis, Noelle Huntington
Pediatrics Oct 2015, 136 (4) e830-e837; DOI: 10.1542/peds.2015-1502

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Timing of the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder
Amir Miodovnik, Elizabeth Harstad, Georgios Sideridis, Noelle Huntington
Pediatrics Oct 2015, 136 (4) e830-e837; DOI: 10.1542/peds.2015-1502
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