Diagnosis and Treatment of ADHD Symptoms In Autism

While DSM-IV (APA, 2000) specifically excludes a comorbid diagnosis of ADHD for children diagnosed with a Pervasive Developmental Disorder, a significant number of children with PDD display symptoms of overactivity, impulsivity, and inattention. In fact, in a recent survey of behavioral and emotional problems in children and adolescents with PDD, the most frequently endorsed symptoms were those related to ADHD (Lecavalier, 2006). Surveys of psychopharmacology prescribing rates have found that over 10% of children with PDD are prescribed medication to treat the constellation of ADHD symptoms (Aman et al., 2003). This presentation will first review our current knowledge regarding the rate of ADHD symptoms in the PDD population and how frequently clinicians appear to be targeting these symptoms for treatment. Second, diagnostic considerations will be discussed, with a focus on differentiating between symptoms suggestive of a comorbid diagnosis of ADHD and the core features of PDD. Third, an overview of the literature will be provided on pharmacologic treatment of ADHD symptoms in this population, including the use of stimulants, atomoxetine, alpha-two agonists, and atypical antipsychotics. Finally, research on psychosocial treatments of ADHD symptoms in PDD will be reviewed, with an emphasis on recent data regarding the use of parent training in children with PDD.