According to a new study, three-quarters of children (76.2%) diagnosed withautism they also had traits of other neurodivergent neurotypes, including traits associated with attention deficit hyperactivity disorder (ADHD), learning and motor differences.
The results of research were published in PLOS One.
Diagnose other types of neurodivergence in children with autism
Research conducted by the University of Glasgow found that more than half (55.6%) of children undergoing autism assessment may also meet the diagnostic threshold for ADHD and certainly have at least some significant ADHD traits.
The study looked at only a small selection of possible neurotypes, suggesting that the actual number of children with autism and other neurotypes may be higher.
This study is believed to be the first where the level of overlap of different neurodivergences in children is studied in Scotland, where services aim to move away from single neurotype assessments towards a more holistic assessment model, where all are explored and identified the possible overlapping neurotypes. .
The research showed that there was a positive association between the number of neurodivergences detected and an early reference age and also suggested that neurodivergent females were less likely than males to be identified before the age of five. However, despite the clinical overlap and co-occurrence of neurodivergence in children, only 26% of those in the study with other traits were investigated for further underlying diagnosis.
For the study, researchers evaluated the anonymized medical records of children between the ages of two and 17 who had been referred for an autism evaluation, using validated questionnaires to assess neurodivergent traits. Research suggests that validated questionnaires can help clinicians identify co-occurring neurodivergence at first assessment, allowing for early support and the development of insight into a child's neurotype.
Dr Jason Lang, Senior Clinical Lecturer in Neurodevelopment and Honorary Consultant in Child and Adolescent Psychiatry, said: “This study is extremely important, as it shows how vital it is to have a holistic approach to assessing children, to correctly identify possible neurotypes overlapping In addition to a better understanding of the neurodivergent population as a whole, precisely identifying a child’s “make and model” will help provide better, more personalized support to these children when needed.”
“It can be difficult, however, for professionals to work across various neurotypes. Therefore, more work needs to be done to ensure that services are truly holistic and that overlapping traits can be correctly identified. Our work suggests that one way to help is for services to use holistic questionnaires to collect this information.”
“And while this work is based on child services, we also recommend that similar studies be conducted in adult populations, where current approaches remain, to a large extent, isolated.”
Females are often underdiagnosed with autism because they often mask their symptoms more successfully than males. The key to understanding why may lie in a simple eye exam.
New research from the University of Waterloo's School of Optometry and Vision Science has discovered a difference between how females and males with high autistic traits process visual information. This provides researchers with a possible correlation to explain why some women are underdiagnosed and to help medical teams understand how a person's neurodivergent presentation is linked to how they process sensory information. This study examined differences based on sex assigned at birth.
The article, “Associations between autism spectrum quotient and integration of visual stimuli in 9-year-old children: preliminary evidence for sex differences,” was published in the Journal of Autism and Developmental Disorders.
“We found that someone's level of autism traits was significantly linked to their performance on various types of visual tasks,” said Andrew Silva, a postdoctoral researcher at the University of Waterloo's School of Optometry and Vision Sciences .
“Interestingly, this effect depended on the sex of the child. To be specific, males with high autistic traits tended to be worse on both object recognition and hand-eye coordination tests, while females with high autism were totally OK with object recognition. tests but showed the same association as males on hand-eye coordination tests.”
The researchers studied a group of 400 children aged 9 to 10 in New Zealand who showed a full range of possible autistic traits and conducted a series of tests with them on vision and visuomotor processing. They then examined the relationship between taking these tests and their autism traits.
In one test, children watched many dots moving in random directions on a computer screen and asked participants to determine whether the dots had a clear upward or downward motion. Another test asked children whether the display contained a circle or a square.
In both tests, the difficulty increased as the children got the correct answers. When maximum difficulty was reached, this was determined as a threshold value and was then correlated with the autism trait score.
“The part of the visual system that handles object recognition is also linked to facial recognition, recognizing nonverbal communication and facial expressions,” Silva said. “The fact that this system was not affected in our sample of women with elevated autism-related traits is consistent with the idea that this system allows women to better navigate social situations and mask neurodivergence.”
“However, what we don't yet know is whether this visual process is preserved due to differences in how males and females are raised in society or whether there is an inherent difference in the visual systems of neurodivergent children.”
“Ultimately, these findings highlight that human neurodiversity is not a unique concept: different genders, and indeed different people, express autistic traits in a unique way. Fortunately, this lesson is becoming better understood by both researchers and the general public.”
Dr. Raymond Chan's team at the Institute of Psychology of the Chinese Academy of Sciences recently developed an innovative eye-tracking interoceptive accuracy task (EIAT) that allows for simple and specific examination of interoceptive accuracy in children with autism.
Interoception refers to the awareness and integration of internal signals including heartbeats and breathing patterns. Empirical findings suggest that interoception is related to understanding the emotional state and learning of self and others. Interoception is therefore important for us to maintain a physiological balance to achieve optimal functioning in daily life.
Children with autism, including those with a high level of autism-related traits, are thought to have impaired interoceptive accuracy. However, the existing literature provides conflicting results and should be interpreted cautiously with different methodologies.
In this study, researchers administered EIAT to 30 children with ASD, 20 children with comorbid autism and attention-deficit/hyperactivity disorder (ADHD), and 63 typically developing children with high and low levels of autistic traits. They also collected subjective measures from the parents of these children.
According to the researchers, children with autism with and without comorbid ADHD showed lower interoceptive accuracy than typically developing children.
They also found that typically developing children with high-level autistic traits also showed reduced interoceptive accuracy compared to typically developing children with low-level autistic traits. Interoceptive accuracy has been found to be negatively correlated with symptoms of autism and ADHD. More importantly, they also found atypical cardiac interoception in children with ASD.
Taken together, these findings highlight that difficulties in perceiving and understanding internal bodily signals during childhood may be related to symptoms of both autism and ADHD. These findings have important implications for understanding the impaired sensory processing observed in children with ASD and ADHD.
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