title: Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5.
abstract: BACKGROUND
  Children with attention deficit/hyperactivity disorder (ADHD) often present with social difficulties, though the extent to which these clearly overlap with symptoms of autism spectrum disorder (ASD) is not well understood.
  
  
  METHODS
  We explored parent-reported and directly-observed ASD symptoms on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) in children referred to ASD-specialty clinics who received diagnoses of either ADHD (n = 48) or ASD (n = 164).
  
  
  RESULTS
  Of the ADHD sample, 21 % met ASD cut-offs on the ADOS and 30 % met ASD cut-offs on all domains of the ADI-R. Four social communication ADOS items (Quality of Social Overtures, Unusual Eye Contact, Facial Expressions Directed to Examiner, and Amount of Reciprocal Social Communication) adequately differentiated the groups while none of the items on the ADI-R met the criteria for adequate discrimination.
  
  
  CONCLUSIONS
  Results of this work highlight the challenges that clinicians and researchers face when distinguishing ASD from other disorders in verbally fluent, school-age children.
authors.affiliation: Center for Autism and the Developing Brain, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA ; Teachers College, Columbia University, 525 West 120th Street, New York, NY 10027 USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Grzadzinski
authors.affiliation: Center for Autism and the Developing Brain, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dick
authors.affiliation: Center for Autism and the Developing Brain, Weill Cornell Medical College, NewYork-Presbyterian Hospital, 21 Bloomingdale Road, White Plains, NY 10605 USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lord
authors.affiliation: School of Medicine, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143 USA.
authors.forename: Somer
authors.initials: S
authors.lastname: Bishop
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis*; D000067877:Autism Spectrum Disorder / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005149:Facial Expression; D005260:Female; D005403:Fixation, Ocular; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D015588:Observer Variation; D010290:Parents / Q000523:psychology; D011570:Psychiatry; D011581:Psychological Tests; D011584:Psychology; D012720:Severity of Illness Index; D012919:Social Behavior; D063189:Symptom Assessment
keywords: Attention Deficit/Hyperactivity Disorder (ADHD); Autism; Autism Diagnostic Interview-Revised (ADI-R); Autism Diagnostic Observation Schedule (ADOS); Autism Spectrum Disorder (ASD); Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)