Harkness Kelsey, Bray Signe, Durber Chelsea M, Dewey Deborah, Murias Kara
Faculty of Graduate Studies, University of Calgary, Calgary, AB, Canada.
Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
J Autism Dev Disord. 2025 Apr;55(4):1353-1364. doi: 10.1007/s10803-024-06275-9. Epub 2024 Mar 13.
Attention and executive function (EF) dysregulation are common in a number of disorders including autism and attention-deficit/hyperactivity disorder (ADHD). Better understanding of the relationship between indirect and direct measures of attention and EF and common neurodevelopmental diagnoses may contribute to more efficient and effective diagnostic assessment in childhood. We obtained cognitive (NIH Toolbox, Little Man Task, Matrix Reasoning Task, and Rey Delayed Recall) and symptom (CBCL, and BPMT) assessment data from the Adolescent Brain and Cognitive Development (ABCD) database for three groups, autistic (N = 110), ADHD (N = 878), and control without autism or ADHD diagnoses (N = 9130) and used ridge regression to determine which attention and EF assessments were most strongly associated with autism or ADHD. More variance was accounted for in the model for the ADHD group (31%) compared to the autism group (2.7%). Finally, we ran odds ratios (using clinical cutoffs where available and 2 standard deviations below the mean when not) for each assessment measure, which generally demonstrated a greater significance within the indirect measures when compared to the direct measures. These results add to the growing literature of symptom variably across diagnostic groups allowing for better understanding of presentations in autism and ADHD and how best to assess diagnosis. It also highlights the increased difficulty in differentiating autism and controls when compared to ADHD and controls and the importance of indirect measures of attention and EF in this differentiation.
注意力和执行功能（EF）失调在包括自闭症和注意力缺陷多动障碍（ADHD）在内的多种疾病中很常见。更好地理解注意力和执行功能的间接和直接测量方法与常见神经发育诊断之间的关系，可能有助于提高儿童诊断评估的效率和效果。我们从青少年大脑与认知发展（ABCD）数据库中获取了三组人群的认知（美国国立卫生研究院工具箱、小人任务、矩阵推理任务和雷伊延迟回忆）和症状（儿童行为检查表和行为问题评定量表）评估数据，这三组分别是自闭症组（N = 110）、ADHD组（N = 878）和无自闭症或ADHD诊断的对照组（N = 9130），并使用岭回归来确定哪些注意力和执行功能评估与自闭症或ADHD最密切相关。与自闭症组（2.7%）相比，ADHD组模型中的方差解释率更高（31%）。最后，我们对每个评估指标计算了优势比（在有临床临界值时使用临床临界值，无临床临界值时使用低于均值2个标准差的值），结果通常表明，与直接测量指标相比，间接测量指标具有更大的显著性。这些结果进一步丰富了关于不同诊断组症状差异的文献，有助于更好地理解自闭症和ADHD的表现以及如何进行最佳诊断评估。它还凸显了与ADHD和对照组相比，区分自闭症和对照组的难度增加，以及注意力和执行功能间接测量指标在这种区分中的重要性。
