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Comorbid Anxiety and ADHD in Children With ASD: Prevalence, Presentation, and School Placement

Abstract

According to the Center for Disease Control (CDC; 2014), the prevalence rate of autism spectrum disorders (ASD) is now 1 in 68. Among children with ASD, 50-80% meet criteria for ADHD (van der Meer, 2014) and about 40-50% experience clinical levels of anxiety (White et al., 2009). This study examined the prevalence of ADHD and anxiety, the ways in which ADHD and anxiety manifest (as reported by parents and teachers), and the special education placement of a sample of young children on the spectrum transition to school. Participants in this study included 180 children with ASD ages 4 to 7 years old and their parents and teachers. Behavior problems were measured using parent and teacher report on the Child Behavior Checklist – Parent Report and the Teacher Report Form (CBCL and C-TRF; Achenbach & Rescorla, 2001). Clinically significant symptoms of anxiety were reported by parents for 31% for preschool children (ages 4-5) and 50% for school-aged children (ages 6-7). Clinically significant symptoms of ADHD were reported by parents for 22% for preschool children and 45% for school-aged children. There was a disparity between parent- and teacher-reported anxiety and ADHD problems, with teachers reporting fewer problem behaviors overall. Specific behaviors endorsed more and less frequently by parents and teachers are discussed. Finally, this study found that children whose teachers reported clinically elevated ADHD symptoms were less likely to be placed in general education settings. Implications of these findings in the schools are discussed.

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