This article thus aims to recall the attentional features inherent to ASD to describe and analyze the variability of data reported in the literature and finally, to draw on studies of factors related to attention, such as memory, sensorimotor function, executive functioning, and intellectual disability, for a better understanding of the role these variables play in the expression of cognitive capacity within the ASD population. Yet, in part, what may be described as “bias” could betray an unsound theoretical foundation, accommodating a multitude of experimental paradigms measuring what is thought to be the same phenomenon. In the logic of meta-analysis, variation is often explained through methodological arguments: studies diverging from the mean are said to describe different populations, apply less valid methods of measurement, or gather their data in atypical ways. Indeed, reported rates of comorbidity range from 10 to 90%. It is important to note the variability of findings between studies-more than a mean prevalence, a precise yet illusory value reflecting the view that this comorbidity is a clearly measurable entity-because it admits an alternative interpretation of the phenomenon in question. This figure is the product of meta-analyses. Where does this figure come from? How was it obtained, which studies and semiological criteria were applied, and how were the relevant clinical data collected? The prevalence of ADHD in people with ASD ranges from 50 to 70%, according to the literature ( 1). Both fall into the wider category of neurodevelopmental disorders, within which “comorbidities” are considered relatively frequent. Children with ASD can be identified before they are 3 years old, while ADHD is diagnosed later on. Their diagnoses are made at different ages. Whereas, children with ADHD tend to be relatively boisterous and talkative, and eager rather than apprehensive of interactions with peers or adults, autistic children may be distinguished by their repetitive and less coordinated motor function, difficulty communicating, emotions in sync with their sensory reality more than with their social setting, and uniform behaviors that keep the unpredictable at bay.Įpidemiologically, these two disorders also differ in their incidence. In the second case, we are talking about children who seldom associate with others, have a hard time interacting and communicating, and may display unique motor or verbal behaviors, including stereotypies, echolalia, and idiosyncratic language.

In the first case, we are primarily describing distracted children who pay little attention in academic settings, lose their belongings, and have difficulty sustaining mental effort.

The semiology of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) presented in current nosography, which helps clinicians to identify these disorders, makes it clear that they are different entities, affecting children and their developmental histories in ways that are clearly distinct. Consequently, does a dual diagnosis, notwithstanding its currency in the literature, prevent us from shedding sufficient light on major physiopathologic questions raised by the clinical picture of ASD? What is the real significance of this dual diagnosis? Is ADHD in fact always present in such cases? Might the attentional impairment reported among our ASD patients actually be a distinct trait of their ASD-namely, impaired joint attention-rather than an ADHD attention deficit? Could their agitation be the consequence of this joint attention impairment or related to a physical restlessness etiologically very different from the agitation typical of ADHD? The neurobiological reality of ASD-ADHD comorbidity is a subject of debate, and amphetamine-based treatment can have paradoxical or undesirable effects in the ASD population. From a clinical perspective, this high rate of comorbidity is intriguing.

Service universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre hospitalier Intercomunal de Créteil, Créteil, FranceĪccording to the scientific literature, 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD).Camille Hours * Christophe Recasens Jean-Marc Baleyte

ASD icd 10 dsm 5