BackgroundAutism commonly co‐occurs with attention‐deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of toddlers later identified with autism diagnosis, ADHD symptoms, combined autism and ADHD symptoms, or neither condition.MethodsParticipants were 506 toddlers who were part of a longitudinal study of children's behavioral development. Parents completed questionnaires about their children's behavior at two time points. Four groups were identified based on study measures or medical record: autism diagnosis (n = 45), elevated ADHD symptoms (n = 70), autism and ADHD symptoms (n = 30), or neurotypical development (n = 361). Relationships between early parent report of autism‐ and ADHD‐related behaviors, social–emotional and behavioral functioning, and caregiver experience and subsequent group designation were evaluated with adjusted linear regression models controlling for sex.ResultsSignificant group differences were found in measures of autism‐related behaviors, ADHD‐related behaviors, externalizing and internalizing behaviors, and parent support needs (p < .0001). Pairwise comparisons indicated toddlers later identified with combined autism diagnosis and ADHD symptoms had higher levels of autism‐related behaviors, externalizing and internalizing behaviors, and autism‐related parent support needs compared to the other groups. Toddlers with subsequent elevated ADHD symptoms or combined autism diagnosis and ADHD symptoms exhibited similar levels of ADHD‐related behaviors, while both groups displayed more ADHD‐related behaviors than toddlers subsequently identified with autism or those with neither condition.ConclusionsIn this community sample, toddlers for whom combined autism diagnosis and ADHD symptoms were subsequently identified showed a distinct presentation characterized by higher early autism‐related behaviors, broader behavioral concerns, and higher parent support needs. Presence of ADHD symptoms (alone or in combination with autism) was associated with higher parent‐reported ADHD‐related behaviors during toddlerhood. Results indicate that ADHD‐related behaviors are manifest by toddlerhood, supporting screening for both autism and ADHD during early childhood.

中文翻译：

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后来被诊断为自闭症、多动症症状或自闭症和多动症综合症状的幼儿的行为特征


背景自闭症通常与注意力缺陷/多动障碍（ADHD）同时发生，但关于 ADHD 症状如何影响自闭症的早期表现，人们知之甚少。这项研究检查了社区幼儿样本的早期行为特征，这些幼儿后来被诊断为自闭症、注意力缺陷多动症症状、自闭症和注意力缺陷多动症综合症状，或两者都没有。方法参与者是 506 名幼儿，他们是儿童行为发展纵向研究的一部分。家长在两个时间点完成了有关孩子行为的调查问卷。根据研究措施或病历确定四组：自闭症诊断（n = 45）、ADHD 症状加重（n = 70）、自闭症和 ADHD 症状（n = 30）或神经典型发育（n = 361）。使用控制性别的调整线性回归模型评估了早期家长报告的自闭症和多动症相关行为、社会情绪和行为功能、照顾者经验和随后的分组指定之间的关系。结果在自闭症相关的测量中发现了显着的组间差异。行为、ADHD 相关行为、外化和内化行为以及父母支持需求 (p < .0001)。配对比较表明，与其他组相比，后来被诊断出患有自闭症和多动症症状的幼儿具有更高水平的自闭症相关行为、外化和内化行为以及自闭症相关的父母支持需求。随后出现 ADHD 症状加重或合并自闭症诊断和 ADHD 症状的幼儿表现出相似的 ADHD 相关行为水平，而两组儿童都比随后被诊断为自闭症或没有任何症状的幼儿表现出更多的 ADHD 相关行为。结论 在这个社区样本中，随后被诊断为自闭症和多动症症状的幼儿表现出明显的表现，其特征是早期自闭症相关行为较高、行为问题更广泛、父母支持需求更高。 ADHD 症状的存在（单独或与自闭症结合）与幼儿时期父母报告的 ADHD 相关行为较高相关。结果表明，与多动症相关的行为在幼儿期就已显现出来，这支持在儿童早期筛查自闭症和多动症。