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Calls to Action

IAN Research Findings: Attention and Mood - Children with ASDs and Their Siblings

December 06, 2007


The Interactive Autism Network (IAN), a project collecting information online from families of children with Autism Spectrum Disorders (ASDs) all over the United States, reports that children with ASDs are diagnosed with or treated for ADHD, Anxiety, and Bipolar Disorder far more often than their siblings. However, unaffected brothers and sisters are diagnosed with or treated for Depression about as often as children with Autism.

Please Note: These Findings Are Preliminary
The analysis presented here by the Interactive Autism Network (IAN) is preliminary. It is based on information submitted over the internet by parents of children with autism spectrum disorders (ASDs) from the United States who choose to participate. The data have not been peer reviewed -- that is, undergone evaluation by researchers expert in a particular field -- or been submitted for publication. IAN views participating families as research partners, and shares such preliminary information to thank them and to demonstrate the importance of their ongoing involvement.

We encourage autism researchers investigating these topics to apply for access to the IAN database. Contact

researchteam@ianproject.org.



Attention and Mood: Children with ASDs and Their Siblings

The initial IAN questionnaires for both children with ASDs and their siblings asked about the treatment or diagnosis of major disorders of attention and mood. How often do children with ASDs receive diagnoses in addition to Autistic Disorder, Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS), or Asperger's Syndrome? Do they receive such diagnoses more frequently than other children?

IAN looked specifically at four disorders known to co-occur with ASDs:

  • Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) – These are disorders involving inattention and, in the case of ADHD, hyperactivity or impulsivity.
  • Anxiety – This class of disorders involves excessive fearfulness or worry, and includes things like panic attacks and phobias.
  • Depression – This is an illness characterized by a sad or empty mood, diminished interest or pleasure in life, and physical symptoms like sleeplessness, fatigue, restlessness, or loss of appetite.
  • Bipolar Disorder – In this illness, formerly called manic-depression, periods of sadness and low energy alternate with periods of elevated, silly, or irritable mood, sometimes combined with inflated self-esteem, a decreased need for sleep, racing thoughts, or out-of-control risk taking behavior.

IAN found that the frequency of these disorders of attention and mood varied a great deal, not just between children with ASDs and their siblings, but among children with different ASD diagnoses. This was true when considering children of all ages, but especially true when only children age 10 and over were taken into account. (It is much more likely that an older child will have been diagnosed with or treated for a disorder of mood or attention than a very young child, so including younger children tends to “wash down” the final results.)

As shown in Figure 1, below, children with Asperger's Syndrome appear to be the group most impacted by all of the four conditions. Children with PDD-NOS come next, followed by children with Autism or Autistic Disorder. Siblings had lower levels of these types of diagnoses, with one exception: Depression. Siblings were as frequently diagnosed with or treated for Depression as children with Autism.

Figure 1. Children with ASDs and Their Siblings, Age 10 - 17: Issues of Attention and Mood


We do not yet know what these numbers truly represent. Do children receive a series of misdiagnoses on the path to a correct autism-related diagnosis? (The path to a correct diagnosis for children with Asperger's is, after all, known to be a particularly long one. According to the IAN data, the gap between a parent's first concern and a child's ASD diagnosis is 1.6 years for a child with Autism, but 4.2 years for a child with Asperger's.) Or do these other conditions truly co-occur this commonly with ASDs? If they do occur this commonly, at what point would they be considered not “co-occurring” or “comorbid,” but potential core symptoms of one or all of the ASDs?

Whether considered part of ASD or separate but parallel conditions, these issues of inattention, impulsivity, irritability, unstable mood, sadness, or excessive fear are important. They will likely have a significant impact on the daily functioning of a child and that child's family. They will also likely be a major consideration in deciding everything from a child's ideal school setting to appropriate treatments.



What About Parents?

If these issues of attention and mood are truly present in so many children with ASDs, it will be important to find out to what extent they also occur in the children's families. Focusing on Depression, IAN found that the amount of depression reported by participating mothers and fathers was much higher than 16.6% --the estimated lifetime prevalence for major depressive disorders in the United States. [i] (See Table 1.)

Table 1. Parents Diagnosed With or Treated for Depression
Based on IAN data as of 12/5/07



It is interesting to note that the parents of children with Asperger's had the highest reported histories of Depression of all the parents participating in IAN. In this, they resembled their children who, when compared to children with other ASD diagnoses, were the most frequently “diagnosed with or treated for Depression.”

Mothers and fathers with more than one child on the spectrum had also been diagnosed with or treated for Depression with great frequency. In fact, except for fathers of children with PDD-NOS, far more mothers and fathers of children all across the autism spectrum had a much higher rate of Depression than that in the general population.

IAN is currently developing a detailed Maternal/Paternal Depression Questionnaire. The data collected via the new questionnaire will provide more in depth answers to our questions about depression in parents of children with ASDs. How many parents suffer from true clinical depression? How much of parental depression is accounted for by the stresses involved in raising a child with an ASD, especially a child with an ASD who has additional issues? How much is associated with genetic factors, such that the condition runs in families? Do the additional stressors faced by families make a genetic predisposition to depression more likely to lead to the actual condition? Hopefully, we will have more in depth answers in the very near future.

It is important to learn more about these issues, and to empower families to get any assistance they need in addressing them. Helping any family member struggling with one or more issues of attention or mood is likely to help the entire family system to function better, to the benefit of all.




To Share Your Thoughts About These Findings…


If you have comments and insights about these preliminary findings, please share them in the research-focused IAN Community Discussion Forum under “IAN Research Reports: Weight and Height Findings – November, 2007”. (Link: http://www.iancommunity.org/cs/discussion) Your feedback may influence future research.

(Any member of the public may view these discussions, but to post you must join IAN Community. Go to http://www.iancommunity.org and click “JOIN NOW.”)

What is IAN?
The primary goal of the Interactive Autism Network (IAN) is to accelerate the pace of autism research. Families affected by autism answer questionnaires over the internet, from the comfort of home. Researchers apply to IAN to use the resulting data, or to find participants for their local studies. The IAN Community (http://www.iancommunity.org/ ), meanwhile, provides evidence-based basic information on Autism Spectrum Disorders, articles by leading researchers in the field, and reports on IAN's latest findings.

To learn more about the IAN Project, please go to http://www.ianproject.org/.
To join the IAN research project, please go to IANresearch.org.



[1] Kessler, R.C., Berglund, P., Demler, O., Jin, R., Merikangas, K.R., & Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62(6), 593-602. View article.