Parent and Teacher Ratings of Executive Function Deficits Related to ADHD--Not Autistic--Symptomatology

Background: Many children with autism have significant symptoms of ADHD (i.e., inattention, hyperactivity, impulsivity).  Given that executive functioning (EF) deficits are associated with ADHD, children with autism who also have significant ADHD symptomatology may be at high risk for EF deficits.  If these EF deficits exist, it is not known whether or not they would be more closely associated with the child’s ADHD symptoms or with his or her autistic symptomatology. 
Objectives: The purpose of this study was to examine the relationships between behavioral ratings of 1) executive functioning (EF) deficits, 2) autistic symptomatology, and 3) ADHD symptomatology in children with autism.
Methods: Participants were 56 children (42 boys; mean age=9.3 yrs; mean IQ=80) who met DSM-IV criteria for autism on the ADI-R and the ADOS. For both parents and teachers, relationships between the following measures were assessed using correlational methods: The Behavior Rating Inventory of Executive Function (BRIEF), the Social Communication Questionnaire (SCQ; autistic symptoms), and the Conners Rating Scales (ADHD symptoms).
Results: Children with autism who had more severe ADHD symptomatology were found to be at significantly higher risk for a broad spectrum of EF deficits, relative to those with milder ADHD symptomatology.  In contrast, more severe levels of autistic symptoms were generally not associated with an increased risk for EF deficits.   These findings were similar for parent and teacher ratings.
Conclusions:

Findings suggest that children with autism and significant ADHD symptoms—as opposed to children with autism alone—are at high risk for executive function deficits, and their associated academic and social sequelae.  Given that EF deficits associated with ADHD in the general school age population are often successfully treated with stimulant medication, it may be the case that the EF deficits associated with ADHD in children with autism may also be responsive to similar treatments.