From the Guidelines
Neuropsychological testing is not recommended as a diagnostic tool for children with suspected autism and ADHD, as it has not been found to improve diagnostic accuracy in most cases. According to the American Academy of Pediatrics guideline 1, the use of neuropsychological testing may have benefit in clarifying the child or adolescent’s learning strengths and weaknesses, but it is not a necessary step in the diagnosis of ADHD.
Key Points to Consider
- The DSM-5 criteria define 4 dimensions of ADHD, including attention-deficit/hyperactivity disorder primarily of the inattentive presentation (ADHD/I), attention-deficit/hyperactivity disorder primarily of the hyperactive-impulsive presentation (ADHD/HI), attention-deficit/hyperactivity disorder combined presentation (ADHD/C), and ADHD other specified and unspecified ADHD 1.
- A comprehensive diagnostic evaluation should include a thorough medical and psychological history, as well as behavioral observations and rating scales, such as the Conners' Rating Scales for ADHD symptoms 1.
- The diagnosis of ADHD should be based on the best available evidence, using the standard classification criteria most frequently used by clinicians and researchers 1.
Important Considerations
- While neuropsychological testing may provide additional information about a child's cognitive and behavioral profile, it is not a required component of the diagnostic evaluation for ADHD 1.
- Early intervention and treatment are crucial for improving outcomes in children with ADHD, and should be based on a comprehensive diagnostic evaluation and individualized treatment plan 1.
From the Research
Neuropsychological Testing for Children with Suspected Autism and ADHD
- Neuropsychological testing can be valuable for both diagnosis and assessment of treatment response in children with attention-deficit/hyperactivity disorder (ADHD) 2.
- A study found that group effects were found across objective social measures but not across related respondent-ratings, and group differences were observed in parent-ratings of attention difficulties, but not on standardized tests of attention or executive functioning in children with autism spectrum disorder (ASD), ADHD, or comorbid diagnosis 3.
- The use of standardized tests of intellectual, attention, social-affective/cognitive, and executive functioning, as well as semi-structured assessments, can help identify neuropsychological correlates of child patients diagnosed with ASD, ADHD, or comorbid diagnosis 3.
Importance of Integrating Objective and Functional Measures
- Findings underscore the importance of integrating objective and functional measures when assessing ASD and/or ADHD 3.
- A study highlighted the need for continued efforts regarding awareness of ASD in early childhood and targeted training in ASD for neuropsychologists and other disciplines who support families of young children with disabilities 4.
- Early identification of ASD is important to promote improved outcomes related to early intervention, and there are a variety of tools and practices available to support neuropsychologists in providing accurate early diagnosis and appropriate developmental monitoring for children suspected of ASD and related neurodevelopmental conditions 4.
Treatment of ADHD in Children with ASD
- A systematic review found that methylphenidate and atomoxetine can be effective in reducing ADHD symptoms in children with ASD 5.
- The review also found that indirect evidence supports the efficacy of second-generation antipsychotics in reducing hyperactivity in children with ASD 5.
- Another study found that extended-release methylphenidate and amphetamine formulations, atomoxetine, and extended-release guanfacine can improve symptoms of ADHD in adolescents 6.