Ren Yunyi, Mlodnicka Agnieszka, Calub Catrina Andaya, Hertz-Picciotto Irva, Schweitzer Julie B
Department of Public Health Sciences, University of California, Davis, Davis, CA, USA.
Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA.
Eur Child Adolesc Psychiatry. 2025 Jul 17. doi: 10.1007/s00787-025-02805-7.
Attention deficit/hyperactivity disorder (ADHD) and autism are both neurodevelopmental disorders associated with functional impairment in social, academic, and occupational domains.
This longitudinal study, a follow-up to the CHARGE Study (ReCHARGE), evaluated diagnosis of ADHD and its presentation type (Inattentive, Combined-Hyperactive/Impulsive), in a cohort of 8 to 20 year-olds from four developmental categories recruited at ages 2-5 years: Autism, developmental delay without autism (DD), other early concerns (OEC) or typical development (TD, controls from the general population) (n = 645). ADHD diagnosis was based on parent clinical interviews (DISC or MINI), observational methods and multiple rating scales. Multivariate Poisson log regression models were fit to estimate associations of early childhood neurodevelopment with later ADHD diagnoses. Adjusted confounding variables included child's age, sex, parental ADHD, socioeconomic indicators, and maternal prenatal conditions.
Of 645 participants, 213 (33.0%) met criteria for ADHD. Early childhood diagnosis was the strongest predictor. For Hyperactive/Impulsive or Combined presentation, relative risks (RRs [95% CI]) were 5.4 [3.0, 9.4] for autism, 4.4 [2.3, 8.4] for DD, and 3.1 [1.5, 6.1] for OEC. For Inattentive presentation, RRs were 2.6 [1.6, 4.2] for autism, 1.4 [0.7, 2.9] for DD, and 2.6 [1.4, 4.2] for OEC. For any ADHD presentation, RRs were 3.1 [2.2, 4.4] for autism, 2.4 [1.6, 3.6] for DD, and 2.4 [1.6, 3.6] for OEC.
This study reinforces the need for evaluation of ADHD and its presentation type in autistic children and other developmental delays, as these youth are at high risk for ADHD. Clinicians should assess the presence of ADHD-related challenges across development and service needs in individuals with autism and/or DD due to their high ADHD risk.
注意力缺陷多动障碍（ADHD）和自闭症均为神经发育障碍，与社交、学业及职业领域的功能损害相关。
本纵向研究是CHARGE研究（ReCHARGE）的随访，评估了2至5岁时招募的来自四个发育类别的8至20岁队列中ADHD的诊断及其表现类型（注意力不集中型、多动/冲动合并型）：自闭症、无自闭症的发育迟缓（DD）、其他早期问题（OEC）或典型发育（TD，来自普通人群的对照组）（n = 645）。ADHD诊断基于家长临床访谈（DISC或MINI）、观察方法及多个评定量表。采用多变量泊松对数回归模型来估计儿童早期神经发育与后期ADHD诊断之间的关联。调整后的混杂变量包括儿童年龄、性别、父母患ADHD情况、社会经济指标及母亲产前状况。
645名参与者中，213人（33.0%）符合ADHD标准。儿童早期诊断是最强的预测因素。对于多动/冲动或合并型表现，自闭症的相对风险（RRs [95% CI]）为5.4 [3.0, 9.4]，DD为4.4 [2.3, 8.4]，OEC为3.1 [1.5, 6.1]。对于注意力不集中型表现，自闭症的RRs为2.6 [1.6, 4.2]，DD为1.4 [0.7, 2.9]，OEC为2.6 [1.4, 4.2]。对于任何ADHD表现，自闭症的RRs为3.1 [2.2, 4.4]，DD为2.4 [1.6, 3.6]，OEC为2.4 [1.6, 3.6]。
本研究强化了对自闭症儿童及其他发育迟缓儿童进行ADHD及其表现类型评估的必要性，因为这些青少年患ADHD的风险很高。由于自闭症和/或DD患者患ADHD的风险很高，临床医生应评估其在整个发育过程中与ADHD相关的挑战以及服务需求。
