Autism Spectrum Disorder (ASD) Research Analysis

Q: Are ADHD and autism connected?

ADHD involves inattention, impulsivity, and hyperactivity, whereas autism is characterized by stereotyped behavior and impaired social and communication skills. On the surface, there seems to be little in common between these two disorders at first glance. One feature they do have in common is that they rarely present alone. In the words of two researchers:[12] “It is the exception, not the rule, to encounter cases with ‘pure’ ADHD”, and the same also seems to hold true for ASD. It’s not uncommon for attention issues and full-blown ADHD to be found[13] in children with ASD. The reason aspects of these conditions can overlap may come down to where they occur in the brain. Both involve some of the same regions of the brain, in what is known as the frontostriatal system. Disorders that arise from this region are thus known as frontostriatal disorders,[14] which include ADHD and ASD. Recent neuropsychological evidence[15] suggests that ADHD and ASD share some similar brain circuits and both involve problems with managing cognitive processes and emotions, self-control, and executing complex tasks (collectively known as executive dysfunction), implying that both disorders may have some underlying similarities.

Q: What other conditions are associated with autism spectrum disorder?

Individuals with ASD may have a variety of co-occurring conditions, including epilepsy,[26][27] bipolar-disorder,[28] and immunological problems,[29][30][31] such as asthma and atopic dermatitis. Other conditions associated with ASD are fragile-x-syndrome and rett-syndrome. Fragile X syndrome is a genetic condition that causes intellectual disability. Symptoms of Fragile X syndrome include ear, nose, and throat problems (ear infections or sinusitis), developmental delays, motor dysfunction, and the physical appearance of a long face with prominent forehead and protrusile ears.[32] These symptoms typically do not display until early childhood. Roughly 50% of individuals with Fragile X meet the diagnostic criteria for ASD and tend to have more severe developmental and behavioral problems.[33] Rett syndrome is a genetic disorder that occurs predominantly in girls. The first signs of Rett syndrome are a failure to meet development milestones, usually between 6 and 18 months of age. Active regression occurs between 1 and 4 years of age, in which there is a loss of motor function and language skills. Eventually, this loss plateaus, although some individuals experience improvements in ASD traits through early adulthood. About 50% of people with Rett syndrome meet the criteria for ASD during the regression period, but this decreases with time.[34]

Louie Neri

Autism Spectrum Disorder (ASD)

•Last Updated: August 16, 2022

Autism spectrum disorder (ASD) is a neurodevelopmental condition that begins in early childhood. It affects a person’s ability to interact socially, communicate, and learn. ASD comes with varying degrees of differences, which is why it is called a “spectrum” disorder.

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Autism Spectrum Disorder (ASD) falls under thePregnancy & ChildrenandBrain Healthcategories.

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Louie Neri, BSN, RN

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Meredith Yetter

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Nick Milazzo, MSc, MPH

Last Updated:August 16, 2022

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Frequently asked questions
References

What is autism spectrum disorder?

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that begins in early childhood. It’s characterized by difficulty with social communication and interaction, and patterns of repetitive behaviors, interests, and activities.^[1]

Are ADHD and autism connected?

What other conditions are associated with autism spectrum disorder?

What are the main signs and symptoms of autism spectrum disorder?

The main symptoms include problems with social communication and repetitive behaviors and may include the inability to maintain eye contact, not showing average communication skills expected by a specific age, repeating words or phrases, following specific routines, intense interests in a particular topic or activity, delayed language development, delayed cognitive development, seizures, gastrointestinal dysfunction, and sleep problems.^[2]

Do the effects of autism spectrum disorder differ by sex?

How is autism spectrum disorder diagnosed?

ASD symptoms are typically seen within the first two years of life. Because of this, it is recommended by the American Academy of Pediatrics that all children are screened by a healthcare provider at 18-month and 24-month check ups. During the screening, a questionnaire, clinical observations, and cognitive tests are usually done. Testing choices and diagnosis is up to the discretion of the healthcare provider.^[3]

What are the criteria for an ASD diagnosis?

What are some of the main medical treatments for autism spectrum disorder?

There are no standard treatments for ASD. Since ASD has varying effects on people, treatments are tailored to individual needs. Treatments include behavior management programs, cognitive behavioral therapy, occupational therapy, neurofeedback, symptom-specific medications (e.g., antipsychotics for irritability and certain selective serotonin reuptake inhibitors for repetitive behaviors in adults).^[4]

Have any supplements been studied for autism spectrum disorder?

Many dietary supplements have been investigated as potential treatments for ASD, including omega-3 fatty acids,^[5] melatonin,^[6] vitamin-d,^[7] and a combination of vitamin-b6 and magnesium.^[8] There appears to be little evidence for omega-3 supplementation and some conflicting evidence for vitamin B₆ and magnesium cosupplementation in treating the core symptoms of autism. However, correcting low vitamin D status through supplementation shows some promise, and melatonin appears to improve some sleep parameters, thus improving daytime behavior.

How could diet affect autism spectrum disorder?

A popular dietary approach that caregivers of children with ASD adopt is a gluten-free, casein-free diet, but the current evidence for this diet appears to be lacking. The specific carbohydrate diet has also been a suggested dietary intervention for ASD, but the evidence for its efficacy is also limited. The gaps-diet is based on a 2004 book and implicates certain foods, dysbiosis (an imbalanced microbiome), and “leaky gut” in the development of ASD but this diet has never been formally researched. Food selectivity has been associated with ASD, so it is important that parents work with their pediatrician or a dietitian to make sure their child’s nutritional needs are being met.^[9]

What nutrient deficiencies can arise from a gluten-free, casein-free (GFCF) diet?

Do elimination diets help people with autism spectrum disorder?

Can autism be helped by gluten-free, casein-free diets?

Are there any other treatments for autism?

The U.S. Food and Drug Administration warns against the use of a variety of products and therapies marketed to treat autism. These include chelation therapy, hyperbaric oxygen therapy, detoxifying baths, essential oils, raw camel milk, and chlorine dioxide. Always consult a healthcare provider before considering alternative treatments.

What causes autism?

Genetic and environmental influences appear to play a role in the etiology of autism, but the interplay between these factors is not fully understood and likely varies across individuals.^[10]

What are the factors that contribute to the development of autism spectrum disorder?

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References

^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine, Autism Spectrum Disorder, last updated October 13, 2016
^The Centers for Disease Control and Prevention, Autism Spectrum Disorder Signs and Symptoms, last updated March 28, 2022
^The content of this page was partially adapted from MedlinePlus Autism Spectrum Disorder (ASD) Screening; last updated 2022 April 21
^Genovese A, Butler MGClinical Assessment, Genetics, and Treatment Approaches in Autism Spectrum Disorder (ASD).Int J Mol Sci.(2020-Jul-02)
^James S, Montgomery P, Williams KOmega-3 fatty acids supplementation for autism spectrum disorders (ASD)Cochrane Database Syst Rev.(2011 Nov 9)
^Rossignol DA, Frye REMelatonin in autism spectrum disorders: a systematic review and meta-analysisDev Med Child Neurol.(2011 Sep)
^Mazahery H, Camargo CA Jr, Conlon C, Beck KL, Kruger MC, von Hurst PRVitamin D and Autism Spectrum Disorder: A Literature ReviewNutrients.(2016 Apr 21)
^Nye C, Brice ACombined vitamin B6-magnesium treatment in autism spectrum disorderCochrane Database Syst Rev.(2005 Oct 19)
^Marí-Bauset S, Zazpe I, Mari-Sanchis A, Llopis-González A, Morales-Suárez-Varela MFood selectivity in autism spectrum disorders: a systematic review.J Child Neurol.(2014-Nov)
^Chaste P, Leboyer MAutism risk factors: genes, environment, and gene-environment interactions.Dialogues Clin Neurosci.(2012-Sep)
^Ann M Neumeyer, Amy Gates, Christine Ferrone, Hang Lee, Madhusmita MisraBone density in peripubertal boys with autism spectrum disordersJ Autism Dev Disord.(2013 Jul)
^B Kadesjö, C GillbergThe comorbidity of ADHD in the general population of Swedish school-age childrenJ Child Psychol Psychiatry.(2001 May)
^C Gillberg, E BillstedtAutism and Asperger syndrome: coexistence with other clinical disordersActa Psychiatr Scand.(2000 Nov)
^J L Bradshaw, D M SheppardThe neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralizationBrain Lang.(2000 Jun 15)
^Belinda A Gargaro, Nicole J Rinehart, John L Bradshaw, Bruce J Tonge, Dianne M SheppardAutism and ADHD: how far have we come in the comorbidity debate?Neurosci Biobehav Rev.(2011 Apr)
^
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^Robinson EB, Lichtenstein P, Anckarsäter H, Happé F, Ronald AExamining and interpreting the female protective effect against autistic behavior.Proc Natl Acad Sci U S A.(2013-Mar-26)
^Skuse DHImprinting, the X-chromosome, and the male brain: explaining sex differences in the liability to autism.Pediatr Res.(2000-Jan)
^Migeon BRWhy females are mosaics, X-chromosome inactivation, and sex differences in disease.Gend Med.(2007-Jun)
^Knickmeyer R, Baron-Cohen S, Fane BA, Wheelwright S, Mathews GA, Conway GS, Brook CG, Hines MAndrogens and autistic traits: A study of individuals with congenital adrenal hyperplasia.Horm Behav.(2006-Jun)
^Schwarz E, Guest PC, Rahmoune H, Wang L, Levin Y, Ingudomnukul E, Ruta L, Kent L, Spain M, Baron-Cohen S, Bahn SSex-specific serum biomarker patterns in adults with Asperger's syndrome.Mol Psychiatry.(2011-Dec)
^Guyatt AL, Heron J, Knight Ble C, Golding J, Rai DDigit ratio and autism spectrum disorders in the Avon Longitudinal Study of Parents and Children: a birth cohort study.BMJ Open.(2015-Aug-25)
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^Keller R, Basta R, Salerno L, Elia MAutism, epilepsy, and synaptopathies: a not rare association.Neurol Sci.(2017-Aug)
^Anand V, Jauhari PAutism, Epilepsy and Intellectual Disability: A Clinical Conundrum.Indian J Pediatr.(2019-10)
^Ghaziuddin M, Ghaziuddin NBipolar Disorder and Psychosis in Autism.Psychiatr Clin North Am.(2021-03)
^Pan PY, Tammimies K, Bölte SThe Association Between Somatic Health, Autism Spectrum Disorder, and Autistic Traits.Behav Genet.(2020-07)
^Goines P, Van de Water JThe immune system's role in the biology of autism.Curr Opin Neurol.(2010-Apr)
^Onore C, Careaga M, Ashwood PThe role of immune dysfunction in the pathophysiology of autism.Brain Behav Immun.(2012-Mar)
^Stone WL, Basit H, Los EFragile X SyndromeStatPearls.(2022-06)
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Examine Database References

Autism Symptoms - Levine J, Aviram A, Holan A, Ring A, Barak Y, Belmaker RHInositol treatment of autismJ Neural Transm.(1997)
Autism Symptoms - Hardan AY, Fung LK, Libove RA, Obukhanych TV, Nair S, Herzenberg LA, Frazier TW, Tirouvanziam RA randomized controlled pilot trial of oral N-acetylcysteine in children with autismBiol Psychiatry.(2012 Jun 1)
Autism Symptoms - Ghanizadeh A, Moghimi-Sarani EA randomized double blind placebo controlled clinical trial of N-Acetylcysteine added to risperidone for treating autistic disordersBMC Psychiatry.(2013 Jul 25)
Autism Symptoms - Lee TM, Lee KM, Lee CY, Lee HC, Tam KW, Loh EWEffectiveness of -acetylcysteine in autism spectrum disorders: A meta-analysis of randomized controlled trials.Aust N Z J Psychiatry.(2021-Feb)
Autism Symptoms - Niederhofer HFirst preliminary results of an observation of Ginkgo Biloba treating patients with autistic disorderPhytother Res.(2009 Nov)
Autism Symptoms - Hasanzadeh E, Mohammadi MR, Ghanizadeh A, Rezazadeh SA, Tabrizi M, Rezaei F, Akhondzadeh SA double-blind placebo controlled trial of Ginkgo biloba added to risperidone in patients with autistic disordersChild Psychiatry Hum Dev.(2012 Oct)
Autism Symptoms - Saeid Doaei, Fatemeh Bourbour, Zohreh Teymoori, Faranak Jafari, Naser Kalantari, Saheb Abbas Torki, Narges Ashoori, Shiva Nemat Gorgani, Maryam GholamalizadehThe effect of omega-3 fatty acids supplementation on social and behavioral disorders of children with autism: a randomized clinical trialPediatr Endocrinol Diabetes Metab.(2021)
Autism Symptoms - Mousavinejad E, Ghaffari MA, Riahi F, Hajmohammadi M, Tiznobeyk Z, Mousavinejad MCoenzyme Q10 supplementation reduces oxidative stress and decreases antioxidant enzyme activity in children with autism spectrum disordersPsychiatry Res.(2018 Jul)
Autism Symptoms - Geier DA, Kern JK, Davis G, King PG, Adams JB, Young JL, Geier MRA prospective double-blind, randomized clinical trial of levocarnitine to treat autism spectrum disordersMed Sci Monit.(2011 Jun)
Autism Risk - Friel C, Leyland AH, Anderson JJ, Havdahl A, Borge T, Shimonovich M, Dundas RPrenatal Vitamins and the Risk of Offspring Autism Spectrum Disorder: Systematic Review and Meta-Analysis.Nutrients.(2021-Jul-26)

[ref-1] ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine, Autism Spectrum Disorder, last updated October 13, 2016

[ref-2] ^The Centers for Disease Control and Prevention, Autism Spectrum Disorder Signs and Symptoms, last updated March 28, 2022

[ref-3] ^The content of this page was partially adapted from MedlinePlus Autism Spectrum Disorder (ASD) Screening; last updated 2022 April 21

[ref-4] ^Genovese A, Butler MGClinical Assessment, Genetics, and Treatment Approaches in Autism Spectrum Disorder (ASD).Int J Mol Sci.(2020-Jul-02)

[ref-5] ^James S, Montgomery P, Williams KOmega-3 fatty acids supplementation for autism spectrum disorders (ASD)Cochrane Database Syst Rev.(2011 Nov 9)

[ref-6] ^Rossignol DA, Frye REMelatonin in autism spectrum disorders: a systematic review and meta-analysisDev Med Child Neurol.(2011 Sep)

[ref-7] ^Mazahery H, Camargo CA Jr, Conlon C, Beck KL, Kruger MC, von Hurst PRVitamin D and Autism Spectrum Disorder: A Literature ReviewNutrients.(2016 Apr 21)

[ref-8] ^Nye C, Brice ACombined vitamin B6-magnesium treatment in autism spectrum disorderCochrane Database Syst Rev.(2005 Oct 19)

[ref-9] ^Marí-Bauset S, Zazpe I, Mari-Sanchis A, Llopis-González A, Morales-Suárez-Varela MFood selectivity in autism spectrum disorders: a systematic review.J Child Neurol.(2014-Nov)

[ref-10] ^Chaste P, Leboyer MAutism risk factors: genes, environment, and gene-environment interactions.Dialogues Clin Neurosci.(2012-Sep)

[ref-11] ^Ann M Neumeyer, Amy Gates, Christine Ferrone, Hang Lee, Madhusmita MisraBone density in peripubertal boys with autism spectrum disordersJ Autism Dev Disord.(2013 Jul)

[ref-12] ^B Kadesjö, C GillbergThe comorbidity of ADHD in the general population of Swedish school-age childrenJ Child Psychol Psychiatry.(2001 May)

[ref-13] ^C Gillberg, E BillstedtAutism and Asperger syndrome: coexistence with other clinical disordersActa Psychiatr Scand.(2000 Nov)

[ref-14] ^J L Bradshaw, D M SheppardThe neurodevelopmental frontostriatal disorders: evolutionary adaptiveness and anomalous lateralizationBrain Lang.(2000 Jun 15)

[ref-15] ^Belinda A Gargaro, Nicole J Rinehart, John L Bradshaw, Bruce J Tonge, Dianne M SheppardAutism and ADHD: how far have we come in the comorbidity debate?Neurosci Biobehav Rev.(2011 Apr)

[ref-16] ^

[ref-17] ^,Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010.MMWR Surveill Summ.(2014-Mar-28)

[ref-18] ^Robinson EB, Lichtenstein P, Anckarsäter H, Happé F, Ronald AExamining and interpreting the female protective effect against autistic behavior.Proc Natl Acad Sci U S A.(2013-Mar-26)

[ref-19] ^Skuse DHImprinting, the X-chromosome, and the male brain: explaining sex differences in the liability to autism.Pediatr Res.(2000-Jan)

[ref-20] ^Migeon BRWhy females are mosaics, X-chromosome inactivation, and sex differences in disease.Gend Med.(2007-Jun)

[ref-21] ^Knickmeyer R, Baron-Cohen S, Fane BA, Wheelwright S, Mathews GA, Conway GS, Brook CG, Hines MAndrogens and autistic traits: A study of individuals with congenital adrenal hyperplasia.Horm Behav.(2006-Jun)

[ref-22] ^Schwarz E, Guest PC, Rahmoune H, Wang L, Levin Y, Ingudomnukul E, Ruta L, Kent L, Spain M, Baron-Cohen S, Bahn SSex-specific serum biomarker patterns in adults with Asperger's syndrome.Mol Psychiatry.(2011-Dec)

[ref-23] ^Guyatt AL, Heron J, Knight Ble C, Golding J, Rai DDigit ratio and autism spectrum disorders in the Avon Longitudinal Study of Parents and Children: a birth cohort study.BMJ Open.(2015-Aug-25)

[ref-24] ^Baron-Cohen S, Lombardo MV, Auyeung B, Ashwin E, Chakrabarti B, Knickmeyer RWhy are autism spectrum conditions more prevalent in males?PLoS Biol.(2011-Jun)

[ref-25] ^Lai MC, Lombardo MV, Ruigrok AN, Chakrabarti B, Auyeung B, Szatmari P, Happé F, Baron-Cohen S,Quantifying and exploring camouflaging in men and women with autism.Autism.(2017-08)

[ref-26] ^Keller R, Basta R, Salerno L, Elia MAutism, epilepsy, and synaptopathies: a not rare association.Neurol Sci.(2017-Aug)

[ref-27] ^Anand V, Jauhari PAutism, Epilepsy and Intellectual Disability: A Clinical Conundrum.Indian J Pediatr.(2019-10)

[ref-28] ^Ghaziuddin M, Ghaziuddin NBipolar Disorder and Psychosis in Autism.Psychiatr Clin North Am.(2021-03)

[ref-29] ^Pan PY, Tammimies K, Bölte SThe Association Between Somatic Health, Autism Spectrum Disorder, and Autistic Traits.Behav Genet.(2020-07)

[ref-30] ^Goines P, Van de Water JThe immune system's role in the biology of autism.Curr Opin Neurol.(2010-Apr)

[ref-31] ^Onore C, Careaga M, Ashwood PThe role of immune dysfunction in the pathophysiology of autism.Brain Behav Immun.(2012-Mar)

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Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD)

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