Researchers disentangle relationship between autism spectrum disorder, anxiety, and ADHD in children

Children with autism spectrum disorder (ASD) experience internalizing and externalizing problems at higher rates than typically developing children, which could worsen social impairment, according to researchers with the Virginia Tech Center for Autism Research.

The study, published in the Journal of Autism and Developmental Disorders, compared social impairment scores in 57 children (3-17 years, 82.5 percent male) with ASD, either with or without heightened levels of internalizing (anxiety) or externalizing (attention deficit hyperactivity or ADHD) symptoms.

Children with heightened anxiety problems showed higher impairment on social cognition, social communication, social motivation, and restricted interests/repetitive behavior. Children with heightened ADHD traits showed higher impairment on social communication and social awareness.

"These findings suggest similarities and differences in how social deficits in ASD may worsen with anxiety or ADHD symptoms," said Angela Scarpa, director of the Virginia Tech Center for Autism Research and an associate professor of psychology in the College of Science. "With co-occurring anxiety, physiological arousal dysregulation may underlie emotional problems that can heighten both social avoidance and cognitive rigidity in ASD, whereas co-occurring ADHD traits may reflect poor attentional control that diminishes social awareness."

In the paper, the researchers cite previous studies that found that approximately 40 percent of children with ASD also have anxiety, and about 38 percent have depression. A previous study also found that between 30 and 50 percent of children with ASD also have ADHD.

"Due to the fact that anxiety and ADHD have been found to occur at higher rates in individuals with ASD, it is important to note how these clinical symptoms may influence social deficits," said Reina Factor, of Los Angeles, California, a doctoral student in the Department of Psychology in the College of Science. "The results suggest that anxiety and ADHD should be routinely assessed in children with ASD and taken into consideration for treatment planning."