TDAH et comorbidités en pédopsychiatrie. Pathologies psychiatriques,affections médicales,troubles de l’apprentissage et de la coordination

ADHD is a common disorder for children and is highly comorbid with a number of psychiatric and somatic disorders, which leads to important social consequences. Therefore, it is important to screen for the presence of other disorders when a diagnosis of ADHD is considered. Because of the associated pathologies, the clinical picture of the ADHD is more complex and represents a diagnostic challenge. Furthermore, the prognostic and the future of children with a comorbid ADHD is much more unfavorable than that of children with ADHD only. It is thus necessary to recognize the presentation of ADHD associated with various and frequently comorbid pathologies knowing that those will change according to age and the developmental stage. The objective of this article is to describe these comorbidities. We are going to discuss pathologies most often associated with ADHD and the impact of its symptomatology on psychiatric disorders, medical affections and other disorders such as learning disorder and developmental coordination disorder. Along these lines, we carried out a mini review of ADHD and comorbidities. Results showed that comorbid psychiatric disorders such as conduct disorders, mood disorders and anxiety are among the most frequently associated with ADHD in clinical practice. Disruptive disorders are the most common comorbidities found with ADHD. Among these disorders, oppositional defiant disorder must be distinguished from conduct disorders. Conduct disorders are highly comorbid with ADHD (in more than a third of the cases) and increase the severity of the clinical picture. When children show at the same time ADHD and a conduct disorder, they are at risk to have an antisocial personality disorder as well as addictive disorders in adulthood. Depressive disorders can be triggered by ADHD since these young patients have to face numerous failures and difficulties in their family, social and school lives. With respect to bipolar disorders, links exist with ADHD. Bipolar disorder and ADHD treatment is complex: both thymoregulators and medication of ADHD are necessary. Finally, anxiety disorders are concomitant in 33 % of ADHD children, an association which deteriorates the symptoms of inattention and distractibility. Furthermore, there is also some overlap between ADHD and addictive behavior, obsessive-compulsive disorder, tics, sleeping disorder and specific learning disorder. There is a high prevalence of the association between ADHD and addictive behaviors in connection with impulsiveness, lack of control, automedication and similarity in the neurobiological circuits. Children with an obsessive-compulsive disorder have ADHD in 33 % of the cases. Although treatments of ADHD and obsessive-compulsive disorder differ, they must be taken simultaneously. It seems that sleeping disorders are not co-occurring with ADHD but intrinsic. Besides, sleeping disorders during childhood can mime an ADHD and complicate the diagnosis to be established, in particular when restless legs syndrome or sleep apnea is present. The comorbidity of ADHD and specific learning disorders is high. Children with specific learning disorders have difficulties staying attentive and their academic performance is often below their full potential, just like the ADHD children. Therefore, clinicians who assess patients for ADHD have to systematically screen for the presence of specific learning disorders and vice versa. Likewise, autistic spectrum disorder and eating disorder are more and more recognized as comorbid entities. The DSM-IV made impossible the concomitance between autism spectrum disorders and ADHD. However, the DSM-5 did recognize the existence of this comorbidity. The association of those two pathologies results in more severe dysfunction for the children, but the treatment of ADHD is going to facilitate the medical care of autism spectrum disorders. ADHD is described as a risk factor for eating disorders. Besides, the co-occurrence of obesity with ADHD is connected to impulsiveness and the tendency to addictive behaviors. Relationships of ADHD with posttraumatic stress disorder and attachment disorder have also been noted. Similarities between ADHD and posttraumatic stress disorder can cause diagnostic errors. Indeed, for both disorders we find the following: agitation, irritability, hypervigilance, sleeping disorders, attention disorders and disorders in the executive functions. Therefore, during the assessment of a child with a clinical picture of ADHD, anamnesis must be completed with the search of traumatic events. On the other hand, attachment disorder can also be confused with ADHD. Difficult temperament can disrupt the process of attachment and is associated with a bigger risk of ADHD. Finally, other medical issues should be considered in the assessment of ADHD: brain injury, epilepsy and obesity for example. ADHD children with a co-occurring condition may be severely impaired and treatment is more complex. ADHD is strongly comorbid with a large number of psychiatric and physical pathologies. It is probably more a set of affections than a homogeneous clinical entity. The longitudinal studies of children with one or several comorbidities showed that the outcome of these children was unfavorable, the association of pathologies causing an important dysfunction. The explanations proposed for this strong tendency of comorbidity with ADHD are that comorbidities have the same risk factors (genetic and environmental) and/or that one of the disorder is a subcategory of another. This leads us to conclude that a better comprehension of the high rates of comorbidities with ADHD is essential to optimize treatment of this condition and prevent some of the negative outcomes associated with comorbid ADHD.     

Comorbidité TDA/H (Trouble du Déficit de l’Attention avec ou sans Hyperactivité) et TSA (Troubles du Spectre autistique)

The publication of the fifth version of the DSM in May 2013 officially recognized comorbidity between Attention-Deficit Disorder with or without Hyperactivity (ADD/ADHD) and Autism Spectrum Disorders (ASD). Indeed, the DSM-IV didn’t allow concomitant diagnosis. However, there is a clinical, neuropsychological and genetic overlap between these two disorders. Thus, 30–80 % of patients with ASD fill criteria for ADD/ADHD and in 20–50 % of patients with ADD/ADHD are found the diagnostic criteria for ASD. These observations raise the question of the link between ADD/ADHD and ASD: Is ADD/ADHD a minor form of ASD? Are ASD and ADD/ADHD different manifestations from a single neurodevelopmental disorder? Finally, are they two distinct developmental disorders whose clinical expressions would approach? Recent studies seem to distinguish two types of situations: Comorbid patients with less severe symptoms of ASD do not differ qualitatively from ADD/ADHD patients alone, which argues for a continuum between ADD/ADHD and ASD. Patients with ASD symptoms predominate are qualitatively different subjects from ADD/ADHD alone, thus corresponds to the hypothesis of two distinct nosological entities. Anyway, when ADD/ADHD and ASD are associated, there are specific clinical expression of developmental pathways and prognosis. Thus, these comorbid patients suffer more frequently from other psychiatric disorders, have a poorer quality of life, poorer adaptive functioning and clinical expression is more persistent over time. The modalities of treatment of comorbid patients may associate psychoeducational, psychotherapeutic approaches and medication (methylphenidate, atomoxetine, guanfacine, risperidone, aripiprazole).     

Facial emotion recognition in children with or without Attention Deficit/Hyperactivity Disorder: Impact of comorbidity

ObjectivesThis study sought to assess facial emotion recognition deficit in children with Attention Deficit/Hyperactivity Disorder (ADHD) and to test the hypothesis that it is increased by comorbid features.MethodForty children diagnosed with ADHD were compared with 40 typically developing children, all aged from 7 to 11 years old, on a computerized facial emotion recognition task (based on the Pictures of Facial Affect). Data from parents’ ratings of ADHD and comorbid symptoms (on the Conners’ Revised Parent Rating Scale) were also collected.ResultsChildren with ADHD had significantly fewer correct answer scores than typically developing controls on the emotional task while they performed similarly on the control task. Recognition of sadness was especially impaired in children with ADHD. While ADHD symptoms were slightly related to facial emotion recognition deficit, oppositional symptoms were related to a decrease in the number of correct answers on sadness and surprise recognition.ConclusionFacial emotion recognition deficit in children with ADHD might be related to an impaired emotional process during childhood. Moreover, Oppositional Defiant Disorder seems to be a risk factor for difficulties in emotion recognition especially in children with ADHD.     

Perspective de prise en charge d’enfants atteints de troubles du spectre autistique par psychothérapie inspirée des thérapies basées sur la mentalisation

Mentalization is a process by which a subject makes sense of both his own mental representations and of those around him. Disturbances in the mentalization process are found in several psychiatric disorders, notably borderline personality disorders for which mentalization-based treatments (MBT) have been developed and evaluated. Children with Autism Spectrum Disorder (ASD) display a theory of mind impairments, which corresponds to disturbances in the mentalization process. Although no MBT protocol for patients with ASD has been described in the literature, such treatment appears promising to improve theory of mind and functional outcome of these children. In this paper, we propose to discuss the theoretical ground of MBT therapeutic effect in children with ASD without intellectual disabilities and to describe a clinical protocol to test this perspective.     

Cognition sociale dans la schizophrénie et les troubles du spectre de l’autisme : points de convergences et différences fonctionnelles

Introduction

Schizophrenia and autistic spectrum disorder (ASD) are two neurodevelopmental disorders that have different symptom presentations, ages of onset and developmental courses. Both schizophrenia and ASD are characterized by marked deficit in communication, social interactions, affects and emotions. Social cognitive impairments in ASD and schizophrenia were demonstrated separately in both disorders. It was reported that these impairments have direct relation with social deficits of both disorders. The apparent similarity between social cognition impairments in ASD and schizophrenia highlights questions about the existence of common or different neurocognitive mechanisms related to social dysfunctions. In order to examine these questions, the present article provides a comprehensive review of all published studies which directly compare individuals with ASD and schizophrenia on the same cognitive tasks of social cognition.

Transitioning from child and adolescent mental health services with attention‐deficit hyperactivity disorder in Ireland: Case note review

In a context of international concern about early adult mental health service provision, this study identifies characteristics and service outcomes of young people with attention‐deficit hyperactivity disorder (ADHD) reaching the child and adolescent mental health service (CAMHS) transition boundary (TB) in Ireland. The iTRACK study invited all 60 CAMHS teams in Ireland to participate; 8 teams retrospectively identified clinical case files for 62 eligible young people reaching the CAMHS TB in all 4 Health Service Executive Regions. A secondary case note analysis identified characteristics, co‐morbidities, referral and service outcomes for iTRACK cases with ADHD (n = 20). Two‐thirds of young people with ADHD were on psychotropic medication and half had mental health co‐morbidities, yet none was directly transferred to public adult mental health services (AMHS) at the TB. Nearly half were retained in CAMHS, for an average of over a year; most either disengaged from services (40%) and/or actively refused transfer to AMHS (35%) at or after the TB. There was a perception by CAMHS clinicians that adult services did not accept ADHD cases or lacked relevant service/expertise. Despite high rates of medication use and co‐morbid mental health difficulties, there appears to be a complete absence of referral to publicly available AMHS for ADHD youth transitioning from CAMHS in Ireland. More understanding of obstacles and optimum service configuration is essential to ensure that care is both available and accessible to young people with ADHD.     

Patients as parents and young people approaching adulthood: how should we manage the interface between mental health services for young people and adults?

PURPOSE OF REVIEW: The present review discusses critically recent research findings (published during the period 2003-2004) on the mental health needs of young people in transition (old adolescents and young adults), including those of young parents. Also, the evidence on effective interventions and service models is considered. RECENT FINDINGS: Emerging evidence indicates that young people have high rates of mental health needs (in addition to high prevalence of psychiatric disorders) that may be related to life transitions. These needs often fall between the remit of adolescent/adult and mental health/social care services, and therefore are not adequately met. With the exception of mental health interventions for early psychosis and psychosocial programmes for teenage parents, there is very limited knowledge on how best to meet the mental health needs of young people in transition. SUMMARY: It is widely recognized that young people in transition require services and interventions tailored to their characteristics, rather than a mere extension to either child/adolescent or adult services. Recent policies and research findings have led to the development of early psychosis interventions, with initial encouraging messages. Similar initiatives are required for young people with nonpsychotic disorders.     

Psychometric properties of the French Version of the Social Responsiveness Scale in autism spectrum disorder with or without attention deficit hyperactivity disorder

ObjectivesThe Social Responsiveness Scale (SRS) is an instrument that is commonly used to screen for Autism Spectrum Disorder (ASD). Attention Deficit Hyperactive Disorder (ADHD) frequently occurs with ASD and both disorders share some phenotypic similarities. In the present study, we aimed to determine the psychometric properties of the French version of the Social Responsiveness Scale (SRS) and its 5 subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerisms) to discriminate between children with ADHD and those with ASD (differential diagnosis) and children with ADHD from those with a dual diagnosis of ADHD and ASD (comorbid diagnosis).MethodSRS total scores and the 5 subscores of the SRS were compared between 4 groups of children: ADHD (n = 32), ASD + ADHD (n = 30), ASD (n = 31) and typical neurodevelopment (TD; n = 30) children. The discriminant validity was estimated using the Area Under the ROC Curves (AUC).ResultsSRS Social cognition (AUC = 0.73) and Autistic mannerisms (AUC = 0.70) subscores were the most discriminating for differential diagnosis of ASD and ADHD. SRS total scores (AUC = 0.70), and Social communication (AUC = 0.66) and Autistic mannerisms (AUC = 0.75) subscores were the most discriminating for comorbid diagnosis of ASD among ADHD children.ConclusionThe SRS autistic mannerisms subscore was found to be clinically relevant for both differential diagnosis of ASD and ADHD and comorbid diagnoses of ASD among ADHD children but with a modest discriminant power.     

Changing ASD-ADHD symptom co-occurrence across the lifespan with adolescence as crucial time window: Illustrating the need to go beyond childhood

Literature on the co-occurrence between Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) is strongly biased by a focus on childhood age. A review of the adolescent and adult literature was made on core and related symptoms of ADHD and ASD. In addition, an empirical approach was used including 17,173 ASD-ADHD symptom ratings from participants aged 0 to 84 years. Results indicate that ASD/ADHD constellations peak during adolescence and are lower in early childhood and old age. We hypothesize that on the border of the expected transition to independent adulthood, ASD and ADHD co-occur most because social adaptation and EF skills matter most. Lower correlations in childhood and older age may be due to more diffuse symptoms reflecting respectively still differentiating and de-differentiating EF functions. We plea for a strong research focus in adolescence which may –after early childhood– be a second crucial time window for catching-up pattern explaining more optimal outcomes. We discuss obstacles and oppportunities of a full lifespan approach into old age.     

Trouble déficit d’attention/hyperactivité (TDA/H) et émotions : de la labilité émotionnelle au trouble bipolaire

This article aims to review the literature about emotional symptoms associated with ADHD. Emotional symptoms are frequent in Attention Deficit Hyperactivity Disorder (ADHD) and range from mild/moderate to severe emotional lability, but are not specific to ADHD. Severe emotional lability in ADHD patients or association between emotional under-control and mood symptoms should urge clinicans to screen for co-occurring oppositional defiant disorder, mood disorders (depressive disorders, bipolar disorder) and disruptive mood dysregulation disorder. Although this latter diagnosis still lacks validity and may be difficult to differentiate from severe oppositionality in ADHD patients, it will draw attention to the emotional aspects of disruptive behavior disorders and the need to implement specific treatments for emotional hyperreactivity and under control. A better understanding of the relationships between behavior and mood and of the role of environmental stressors is needed to improve prevention of full-blown mood disorders in children with ADHD and emotional lability.     

Motor function and perception in children with neuropsychiatric and conduct problems: results from a population based twin study

Background

Children with early symptomatic psychiatric disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) have been found to have high rates of motor and/or perception difficulties. However, there have been few large-scale studies reporting on the association between Conduct Disorder (CD) and motor/perception functions. The aim of the present study was to investigate how motor function and perception relate to measures of ADHD, ASD, and CD.

Methods

Parents of 16,994 Swedish twins (ages nine and twelve years) were interviewed using the Autism-Tics, ADHD and other Comorbidities inventory (A-TAC), which has been validated as a screening instrument for early onset child psychiatric disorders and symptoms. Associations between categorical variables of scoring above previously validated cut-off values for diagnosing ADHD, ASD, and CD on the one hand and motor and/or perception problems on the other hand were analysed using cross-tabulations, and the Fisher exact test. Associations between the continuous scores for ADHD, ASD, CD, and the subdomains Concentration/Attention, Impulsiveness/Activity, Flexibility, Social Interaction and Language, and the categorical factors age and gender, on the one hand, and the dependent dichotomic variables Motor control and Perception problems, on the other hand, were analysed using binary logistic regression in general estimated equation models.

Results

Male gender was associated with increased risk of Motor control and/or Perception problems. Children scoring above the cut-off for ADHD, ASD, and/or CD, but not those who were ‘CD positive’ but ‘ADHD/ASD negative’, had more Motor control and/or Perception problems, compared with children who were screen-negative for all three diagnoses. In the multivariable model, CD and Impulsiveness/Activity had no positive associations with Motor control and/or Perception problems.

Conclusions

CD symptoms or problems with Impulsiveness/Activity were associated with Motor control or Perception problems only in the presence of ASD symptoms and/or symptoms of inattention. Our results indicate that children with CD but without ASD or inattention do not show a deviant development of motor and perceptual functions. Therefore, all children with CD should be examined concerning motor control and perception. If problems are present, a suspicion of ADHD and/or ASD should be raised.     

Does diagnosis affect the predictive accuracy of risk assessment tools for juvenile offenders: Conduct Disorder and Attention Deficit Hyperactivity Disorder

Studies have suggested an increased risk of criminality in juveniles if they suffer from co-morbid Attention Deficit Hyperactivity Disorder (ADHD) along with Conduct Disorder. The Structured Assessment of Violence Risk in Youth (SAVRY), the Psychopathy Checklist Youth Version (PCL:YV), and Youth Level of Service/Case Management Inventory (YLS/CMI) have been shown to be good predictors of violent and non-violent re-offending. The aim was to compare the accuracy of these tools to predict violent and non-violent re-offending in young people with co-morbid ADHD and Conduct Disorder and Conduct Disorder only. The sample included 109 White-British adolescent males in secure settings. Results revealed no significant differences between the groups for re-offending. SAVRY factors had better predictive values than PCL:YV or YLS/CMI. Tools generally had better predictive values for the Conduct Disorder only group than the co-morbid group. Possible reasons for these findings have been discussed along with limitations of the study.     

Final DSM-5 under-identifies mild Autism Spectrum Disorder: Agreement between the DSM-5, CARS,CASD, and clinical diagnoses

Agreement between the final DSM-5 ASD criteria, Childhood Autism Rating Scale (CARS), and Checklist for Autism Spectrum Disorder (CASD) was assessed in 143 children with ASD and other disorders (e.g., ADHD, intellectual disability, and oppositional defiant disorder). Diagnostic agreement between the CARS and CASD was high (94%), but their agreement with the DSM-5 was lower (84% and 88%). Agreement between the DSM-5 and both the CARS and CASD increased to 94% and diagnostic accuracy increased from 92% to 96% when one less DSM-5 social communication and interaction symptom was required for a diagnosis. Children with ASD not meeting DSM-5 criteria most often did not have criterion A2 (deficits in nonverbal social communication). Total scores on the DSM-5, CASD, and CARS were far higher for children with mild ASD (formerly PDDNOS) than no ASD, indicating that these children are clearly on the autism spectrum and are quite different from children with other disorders. However, only one child with mild ASD was identified by the DSM-5. This study and 11 others show that the DSM-5 under-identifies children with ASD, particularly children at the mild end of the spectrum. This can be rectified by requiring one less social communication and interaction symptom for a diagnosis.     

Quelle prise en charge du jeune présentant un premier épisode psychotique,quand la scolarité est mise à mal ?

Psychiatric disorders (more specifically mood disorders and psychosis) represent the 1st cause of disability among young people. Unemployment rate between 75 to 95% for the person with schizophrenia. It is correlated to poor social integration and bad economic status, worse symptomatology loss of autonomy as well as global bad functioning. It is responsible of more than half of the overall cost of psychosis. The onset of most of psychiatric disorders occur between the age of 25 and 35 years old, a critical time in young adult life when they should build their professional as well as social future. Without appropriate care, young adult are unable to build satisfactory emotional relationships, continue their studies, live independently or fit into life. They are frequently dependent on their environment. They also have an increased suicide rate and frequent comorbid substance abuse. Despite this context, their care pathway is often marked by a delay or premature stop of care, drug treatments not always suitable and a lack of specific relay post-hospitalization regarding continuity of professional training or studies. All factors impacting future employability of adolescents. Furthermore they spend most of their time in school and school plays a key part in an individual's development including peer relationships, social interactions, academic attainment, cognitive progress, emotional control, behavioral expectations and physical and moral development. These areas are also reciprocally affected by mental illness. The initial phases of FEP are characterized by impaired academic performance, change in social behaviors and increasing absences from school, reflecting the prodrome of the illness that leads to disengagement from education. Functional decline often precedes onset of clinical symptoms and many adolescents and young adults are therefore isolated from school before their illness is recognized. School support staff may fail to recognize those who are functionally impaired because of evolving FEP although school is a key setting for promoting positive mental health, fostering resilience, detecting and responding to emerging mental ill health. So, people with psychotic illness have low levels of secondary school completion. School dropout has been defined as leaving education without obtaining a minimal credential, most often a higher secondary education diploma. In France, the school is compulsory up to the age of 16. Consequences are significant: among young people without a degree out of initial training for one to four years and present on the labour market, 47% are unemployed. School dropout depends on a number of factors, including grades, family and social environment and the relationship with the school, but also the emergence of psychiatric disorders. For first episode psychotic patients, age of onset, lack of family support, longer duration of psychosis, levels of premorbid global functioning and education, negative and cognitive symptoms, addictions, depressive comorbidities and stigma plays an important role in school dropout. However, young adults have historically received less treatment than expected considering prevalence of mental illness at that age. In the last few decades, early intervention programs for psychosis have been developed all around the world in order to promote rehabilitation and prevent long-term disabilities. Early intervention programs focus on the special needs of young people and their families and engage in some form of assertive community treatment, which attempts to treat patients in the community rather than using inpatient services. For early intervention in psychosis programs, the goal is to keep patients engaged with treatment, prevent them from further psychotic episodes and hospitalizations and promote rehabilitation. The additional services of an early intervention program include staff specialized in psychosis treatment, family/group/individual counseling sessions, assertive case management, and low-dose second generation anti-psychotics. In these programs, psychiatric rehabilitation practitioners already use individual counseling and supported education programs (SEd) to improve postsecondary educational outcomes. The goals of SEd are for individuals with serious mental illness to successfully be able to set and achieve an educational goal (e.g., training certificate or degree), to improve educational competencies (literacy, study skills, time management), to navigate the educational environment (e.g., applications, financial assistance), and to improve motivation toward completing educational goals. These approaches are often combined with efforts to support transitions to sustainable employment. Current evidence of these interventions are weak with limited information on specific difficulties experienced by young adults with FEP in educational tasks. Adaptive strategies are needed by young adults with FEP to succeed in educational settings but most studies do not explore it with rigorous methodology. However, common SEd components emerge: specialized and dedicated staffing, one-on-one and group skill-building activities, assistance with navigating the academic setting and coordinating different services, and linkages with mental health counseling. Continued specification, and testing of SEd core components are still needed. It is important that occupational therapy researchers and practitioners develop, and evaluate effective interventions to improve education outcomes for young adults with FEP. The objective of this work is to define school dropout, assess causes and consequences of FEP. How to help young people to maintain education? We will detail measures to support the academic re-insertion in France.     

Dose-Response Effects of Long-Acting Liquid Methylphenidate in Children with Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD): A Pilot Study

Attention deficit/hyperactivity disorder (ADHD) symptoms are common in youth with autism spectrum disorders (ASD) and are frequently treated with stimulant medications. Twenty-seven children were randomized to different dose titration schedules, and ADHD symptoms, tolerability, and aberrant behaviors were assessed weekly during a 6-week trial with long-acting liquid methylphenidate (MPH). MPH at low to moderate doses was effective in reducing ADHD symptoms and was well tolerated in young children with ASD and ADHD. Future studies are needed to assess generalization and maintenance of efficacy.     

Parsing the phenotype of obsessive-compulsive tic disorder (OCTD): a multidisciplinary consensus

Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid conditions. Of note, the DSM-5 acknowledged a new ‘tic-related’ specifier for OCD, which might be referred to as Obsessive-Compulsive Tic Disorder (OCTD), raising new interest toward a better clinical characterisation of affected patients. Available literature indicates that early onset, male gender, sensory phenomena and obsessions of symmetry, aggressiveness, hoarding, exactness and sounds as well as comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) may be of more frequent observation in patients with OCTD. In order to share expertise in the field from different perspectives, a multidisciplinary panel of Italian clinicians, specifically involved in the clinical care of OCD and TD patients, participated into a consensus initiative, aimed to produce a shared document. As a result, after having examined the most relevant literature, authors sought to critically identify and discuss main epidemiologic, socio-demographic and clinical features characterising OCTD patients, along with other specific aspects including Health-Related Quality-of-Life (HRQoL), economic consequences related with the condition and its management, as well as treatment-related issues, that need to be further investigated.     

Cognitive and emotional intelligence in young adults with Autism Spectrum Disorder without an accompanying intellectual or language disorder

Research in the neurosciences has identified distinctions between neural structures that subserve cognitive intelligence (CI) and those subserving emotional intelligence (EI). This study explored the performance of young adults with Autism Spectrum Disorder (ASD) without an accompanying intellectual or language disorder relative to typically-developing peers, on indices of CI and EI. Both the ASD and age- and sex-matched typically-developing groups exhibited high average cognitive intellectual abilities. In contrast, the ASD group reported lower levels of EI relative to their typically-developing peers, as expected given the social and emotional challenges faced by individuals with ASD. Importantly, cognitive intelligence did not correlate with EI in either group. Taken together, these findings further support the theory of dissociable neural systems underlying CI and EI. These findings also highlight the need to address not only the intellectual aspects of cognition, but also the emotional components to increase understanding of, and improve treatment for individuals on the autism spectrum. This understanding would enhance our ability to assess and support young adults with ASD, and ultimately ease their transition into adulthood.     

Social Participation Among Young Adults with an Autism Spectrum Disorder

Investigating social participation of young adults with an autism spectrum disorder (ASD) is important given the increasing number of youth aging into young adulthood. Social participation is an indicator of life quality and overall functioning. Using data from the National Longitudinal Transition Study 2, we examined rates of participation in social activities among young adults who received special education services for autism (ASD group), compared to young adults who received special education for intellectual disability, emotional/behavioral disability, or a learning disability. Young adults with an ASD were significantly more likely to never see friends, never get called by friends, never be invited to activities, and be socially isolated. Among those with an ASD, lower conversation ability, lower functional skills, and living with a parent were predictors of less social participation.     

Health Care Transition Planning Among Adolescents with Autism Spectrum Disorder

Improving the health care transition process for youth with autism spectrum disorder (ASD) is critically important. This study was designed to examine the overall national transition core outcome among youth with ASD and each of the component measures of health care transition planning. Fewer than 10% of youth with ASD meet the national transition core outcome. Among youth with ASD, there is greater disparity in health care transition planning for non-Hispanic black youth, youth with family income <400% of the federal poverty line, and youth with more severe activity limitation. Continued advocacy, research, and training efforts are needed to reduce disparities in receipt of health care transition planning services for youth with ASD.