The Hidden Impact of ADHD Symptoms in Preschool Children with Autism: Is There a Link to Somatic and Sleep Disorders?

Overview

Journal Behav Sci (Basel)

Date 2024 Mar 28

PMID 38540514

Authors

Dario Esposito

Katerina Bernardi

Arianna Belli

Valentina Gasparri

Sara Romano

Letizia Terenzi

Maria Elena Zanatta

Sara Iannotti

Mauro Ferrara

Affiliations

Soon will be listed here.

Abstract

Neurodevelopmental disorders, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), do often present in comorbidity among them and with other medical conditions, including sleep and gastrointestinal (GI) disorders and somatic complaints. An anonymous online survey based on standardized questionnaires (SDSC, KL-ASD, APSI, ROME V CRITERIA, CPRS, CBCL) was completed by the parents of 46 preschoolers diagnosed with ASD. A high prevalence (47%) of ADHD symptoms in this population was found, surpassing previous estimates. Sleep disturbances, especially difficulties in initiating and maintaining sleep and sleep-wake transition, are more pronounced in ASD patients with comorbid ADHD. Additionally, in patients over 4 years old, there is a high prevalence of functional GI symptoms (Rome V criteria: 38%). Parental stress is significantly associated with ADHD symptoms, sleep disorders, and GI symptoms. Comprehensive assessments considering both core symptoms of neurodevelopmental disorders and associated comorbidities are crucial for more effective treatment strategies and improved wellbeing in affected individuals and their families.

References

Bruni O, OTTAVIANO S, Guidetti V, Romoli M, Innocenzi M, Cortesi F . The Sleep Disturbance Scale for Children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996; 5(4):251-61. DOI: 10.1111/j.1365-2869.1996.00251.x. View

Melegari M, Sacco R, Manzi B, Vittori E, Persico A . Deficient Emotional Self-Regulation in Preschoolers With ADHD: Identification, Comorbidity, and Interpersonal Functioning. J Atten Disord. 2016; 23(8):887-899. DOI: 10.1177/1087054715622015. View

Silva L, Schalock M . Autism Parenting Stress Index: initial psychometric evidence. J Autism Dev Disord. 2011; 42(4):566-74. DOI: 10.1007/s10803-011-1274-1. View

Farhat L, Brentani H, de Toledo V, Shephard E, Mattos P, Baron-Cohen S . ADHD and autism symptoms in youth: a network analysis. J Child Psychol Psychiatry. 2021; 63(2):143-151. DOI: 10.1111/jcpp.13436. View

Fulceri F, Morelli M, Santocchi E, Cena H, Del Bianco T, Narzisi A . Gastrointestinal symptoms and behavioral problems in preschoolers with Autism Spectrum Disorder. Dig Liver Dis. 2016; 48(3):248-54. DOI: 10.1016/j.dld.2015.11.026. View

Austerman J . ADHD and behavioral disorders: Assessment, management, and an update from DSM-5. Cleve Clin J Med. 2015; 82(11 Suppl 1):S2-7. DOI: 10.3949/ccjm.82.s1.01. View

Ferguson B, Dovgan K, Takahashi N, Beversdorf D . The Relationship Among Gastrointestinal Symptoms, Problem Behaviors, and Internalizing Symptoms in Children and Adolescents With Autism Spectrum Disorder. Front Psychiatry. 2019; 10:194. PMC: 6465634. DOI: 10.3389/fpsyt.2019.00194. View

Silvestri R, Gagliano A, Arico I, Calarese T, Cedro C, Bruni O . Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep Med. 2009; 10(10):1132-8. DOI: 10.1016/j.sleep.2009.04.003. View

Souto-Souza D, Mourao P, Barroso H, Douglas-de-Oliveira D, Ramos-Jorge M, Falci S . Is there an association between attention deficit hyperactivity disorder in children and adolescents and the occurrence of bruxism? A systematic review and meta-analysis. Sleep Med Rev. 2020; 53:101330. DOI: 10.1016/j.smrv.2020.101330. View

10.

Olczyk A, Rosen P, Alacha H, Flynn M . Indirect effect of ADHD on parenting stress through increased child anxiety and decreased emotional regulatory coping. Eur Child Adolesc Psychiatry. 2023; 33(5):1407-1417. DOI: 10.1007/s00787-023-02246-0. View

11.

Chang L, Wang M, Tsai P . Diagnostic Accuracy of Rating Scales for Attention-Deficit/Hyperactivity Disorder: A Meta-analysis. Pediatrics. 2016; 137(3):e20152749. DOI: 10.1542/peds.2015-2749. View

12.

Musetti A, Zagaria A, Pezzi M, Fante C, Dioni B, Raffin C . Parental quality of life, child adjustment and adult attachment in parents of children and adolescents with Autism Spectrum Disorder. Res Dev Disabil. 2024; 146:104684. DOI: 10.1016/j.ridd.2024.104684. View

13.

Okoye C, Obialo-Ibeawuchi C, Obajeun O, Sarwar S, Tawfik C, Waleed M . Early Diagnosis of Autism Spectrum Disorder: A Review and Analysis of the Risks and Benefits. Cureus. 2023; 15(8):e43226. PMC: 10491411. DOI: 10.7759/cureus.43226. View

14.

Yoon S, Jain U, Shapiro C . Sleep in attention-deficit/hyperactivity disorder in children and adults: past, present, and future. Sleep Med Rev. 2011; 16(4):371-88. DOI: 10.1016/j.smrv.2011.07.001. View

15.

Maski K, Kothare S . Sleep deprivation and neurobehavioral functioning in children. Int J Psychophysiol. 2013; 89(2):259-64. DOI: 10.1016/j.ijpsycho.2013.06.019. View

16.

Madra M, Ringel R, Margolis K . Gastrointestinal Issues and Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am. 2020; 29(3):501-513. PMC: 8608248. DOI: 10.1016/j.chc.2020.02.005. View

17.

Bougeard C, Picarel-Blanchot F, Schmid R, Campbell R, Buitelaar J . Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review. Front Psychiatry. 2021; 12:744709. PMC: 8579007. DOI: 10.3389/fpsyt.2021.744709. View

18.

Zlatnik K, Milliken A, Weaver M, Sideridis G, Harris H, Harstad E . Gastrointestinal and Sleep Issues in Toddlers With Autism Versus Other Neurodevelopmental Disorders. Clin Pediatr (Phila). 2023; 62(11):1335-1341. DOI: 10.1177/00099228231156774. View

19.

Galloway H, Newman E, Miller N, Yuill C . Does Parent Stress Predict the Quality of Life of Children With a Diagnosis of ADHD? A Comparison of Parent and Child Perspectives. J Atten Disord. 2016; 23(5):435-450. DOI: 10.1177/1087054716647479. View

20.

Hayes S, Watson S . The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder. J Autism Dev Disord. 2012; 43(3):629-42. DOI: 10.1007/s10803-012-1604-y. View