Date Presented 04/22/2023
This research study, a retrospective review, aimed to answer the following research question: ‘What is the prevalence of the co-occurring psychiatric diagnoses of attention deficit hyperactivity disorder (ADHD) and anxiety disorder for children with autism spectrum disorder (ASD) and a diagnosis of sensory processing disorder (SPD) between the ages of 5 and 13 years who received an interdisciplinary team evaluation from a pediatric outpatient clinic?’ Many of the findings of this study were significant and will contribute to those health care professionals treating children with ASD.
Primary Author and Speaker: Kaitlin Dierksheide
Additional Authors and Speakers: Mary Beth Kadlec
PURPOSE: The purpose of this study is to identify the prevalence of the common co-occurring psychiatric disorders of ADHD and anxiety compared with sensory processing disorders (SPD) in children with ASD. This information is important because it informs both the behavioral health professionals who are diagnosing and making therapeutic treatment recommendations (child and adolescent psychiatrists, psychologists, behavior analysts) and the allied health professionals who are classifying behaviors and treating this same group of children (occupational therapists, speech therapists).
DESIGN: The study is a retrospective review of medical record data from a sample of 37 children with ASD from an outpatient pediatric clinic who participated in interdisciplinary team evaluations consisting of child and adolescent psychiatrist, occupational therapist and speech language pathologist.
METHOD: Demographics and scores from select clinical measures were collected from each child’s electronic medical record and entered into a secured REDCap database for collection and analysis. The clinical measures consisted of: Vanderbilt ADHD Diagnostic Rating Scale (VADRS), Screen for Child Anxiety Related Emotional Disorders (SCARED), Child Behavior Checklist (CBCL), Aberrant Behavior Checklist (ABC), and Sensory Processing Measure (SPM). All of the clinical measures used for this study were completed by the child’s parent. Information was exported to R Studio for data analysis, including frequencies, chi-square, ANOVA, and Pearson’s correlation
RESULTS: The prevalence of a child with ASD with a diagnosis of SPD, that is, meeting the threshold for Some Problems or Definite Dysfunction on subscales of the SPM, ranged from 71.4% of the sample up to 94.3%, with 94.3% of the sample met clinical criteria for SPD for Total Sensory Systems. Results from the prevalence of a child with ASD with a diagnosis of ADHD (based on thresholds determined by the VADRS - Parent) ranged from 18.9% for Hyperactive/Impulsive Type of the sample, however the prevalence increased to 78.4% for Combined Type. Results from the prevalence of a child with ASD having a diagnosis of anxiety based on thresholds determined by the SCARED was 18.5% for Panic and Generalized Anxiety Disorder and 51% for Separation Anxiety, with 25.9% of the sample meeting criteria for the presence of an anxiety disorder based on the Total Score on the SCARED. Results from the correlation of a child meeting criteria for a diagnosis of SPD and anxiety was found to be statistically significant and borderline statistically significant (p< .05) between some of the subscales for the SPM and SCARED.
CONCLUSION: The research question was answered through the frequency analyses run based on scores from the VADRS, SCARED, and SPM to identify the presence of a diagnosis of ADHD, anxiety, and/or SPD, respectively. It is important to acknowledge the large prevalence of SPD and ADHD found in this sample of children with ASD and to consider the effect that these symptoms have on their participation in daily occupations. Although this study did not find a strong co-occurrence or statistical correlation between the common co-occurring psychiatric disorders of ASD with SPD, many of the findings are still significant and will contribute to those healthcare professionals treating children with ASD, including but not limited to child and adolescent psychiatrist, occupational therapists, and speech language pathologists. Additional studies are needed to better understand the similarities and differences of these symptoms and impact on participation in daily occupations.
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