Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5.
Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5.
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家长报告及临床医生观察到的注意缺陷/多动障碍（ADHD）儿童的自闭症谱系障碍（ASD）症状：对《精神疾病诊断与统计手册》第五版（DSM - 5）下临床实践的启示
DOI：
10.1186/s13229-016-0072-1
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发表时间：
2016
期刊：
影响因子：
6.2
通讯作者：
Bishop S
中科院分区：
文献类型：
--
作者：
Grzadzinski R;Dick C;Lord C;Bishop S
注意力缺陷/多动障碍（ADHD）的儿童经常出现社交困难，尽管这些与自闭症谱系障碍（ASD）症状的重叠程度尚不清楚。我们探讨了父母报告的和直接观察到的ASD症状的自闭症诊断访谈修订版（ADI-R）和自闭症诊断观察时间表（ADOS）的儿童被转介到ASD专科诊所接受ADHD（n = 48）或ASD（n = 164）的诊断。在ADHD样本中，21%符合ADOS的ASD截止值，30%符合ADI-R所有领域的ASD截止值。四个社会沟通ADOS项目（社会主动性的质量，不寻常的眼神接触，面部表情指向考官，和互惠的社会沟通的数量）充分区分的群体，而没有一个项目的ADI-R符合充分的歧视的标准。这项工作的结果突出了临床医生和研究人员在区分语言流利的学龄儿童的ASD与其他疾病时所面临的挑战。
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. 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). 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. Results of this work highlight the challenges that clinicians and researchers face when distinguishing ASD from other disorders in verbally fluent, school-age children.