Skip to main content

Advertisement

SpringerLink
Log in

Differentiation between attention-deficit/hyperactivity disorder and autism spectrum disorder by the Social Communication Questionnaire

  • Original Article
  • Published:
ADHD Attention Deficit and Hyperactivity Disorders

Abstract

The differentiation of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) poses a clinical challenge. In children, overlap of psychopathological and cognitive findings has been found for both disorders. In addition, some children suffer from both disorders. The Social Communication Questionnaire (SCQ) is a screening instrument for ASD symptoms which indicates the presence of ASD in a rapid and economic way. However, validity to differentiate ASD and ADHD as differential or comorbid diagnoses has not been studied. Here, the differential validity was compared in groups of children with ASD, ADHD, ASD + ADHD, and typically developing (TD) children and IQ > 70. ROC analyses indicated an excellent differentiation between ASD and TD with ROC–AUC = .941 and between ASD + ADHD with ROC–AUC = .993. The optimal cutoff was below the originally recommended one of 15. The differentiation between children with ASD with (ROC–AUC = .982) or without ADHD (ROC–AUC = .864) and ADHD alone also showed acceptable differential validity, and here, the optimal cutoff corresponded to the recommended. Taken together, the SCQ can be recommended as a screening instrument for a first differentiation between children with ASD and typically developing children as well as children with ADHD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Achenbach TM (1991) Manual for the child behavior checklist/4–18 and 1991 profile. University of Vermont, Burlington

    Google Scholar 

  • Allen CW, Silove N, Williams K, Hutchins P (2006) Validity of the social communication questionnaire in assessing risk of autism in preschool children with developmental problems. J Autism Dev Disord 37:1272–1278. doi:10.1007/s10803-006-0279-7

    Article  PubMed  Google Scholar 

  • American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (DSM-IV), 4th edn. American Psychiatric Press, Washington

    Google Scholar 

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5), 5th edn. American Psychiatric Publishing, Arlington

    Google Scholar 

  • Berument SK, Rutter M, Lord C et al (1999) Autism screening questionnaire: diagnostic validity. Br J Psychiatry 175:444–451

    Article  CAS  PubMed  Google Scholar 

  • Biederman J, Faraone SV (2005) Attention-deficit hyperactivity disorder. Lancet 366:237–248

    Article  PubMed  Google Scholar 

  • Bölte S, Poustka F (2006) Fragebogen zur sozialen Kommunikation (FSK). Huber, Bern

    Google Scholar 

  • Bölte S, Rühl D, Schmötzer G, Poustka F (2006) Diagnostisches interview für autismus-revidiert (ADI-R). Huber, Bern

    Google Scholar 

  • Brooks WT, Benson BA (2013) The validity of the social communication questionnaire in adults with intellectual disability. Res Autism Spectr Disord 7:247–255. doi:10.1016/j.rasd.2012.10.002

    Article  Google Scholar 

  • Bruin EI, Ferdinand RF, Meester S et al (2006) High rates of psychiatric co-morbidity in PDD-NOS. J Autism Dev Disord 37:877–886. doi:10.1007/s10803-006-0215-x

    Article  Google Scholar 

  • Chandler S, Charman T, Baird G et al (2007) Validation of the social communication questionnaire in a population cohort of children with autism spectrum disorders. J Am Acad Child Adolesc Psychiatr 46:1324–1332. doi:10.1097/chi.0b013e31812f7d8d

  • Christakou A, Murphy CM, Chantiluke K et al (2013) Disorder-specific functional abnormalities during sustained attention in youth with attention deficit hyperactivity disorder (ADHD) and with autism. Mol Psychiatry 18:236–244. doi:10.1038/mp.2011.185

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Cicchetti DV, Volkmar F, Klin A, Showalter D (1995) Diagnosing autism using ICD-10 criteria: a comparison of neural networks and standard multivariate procedures. Child Neuropsychol 1:26–37. doi:10.1080/09297049508401340

    Article  Google Scholar 

  • Corbett BA, Constantine LJ, Hendren R et al (2009) Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatr Res 166:210–222. doi:10.1016/j.psychres.2008.02.005

    Article  Google Scholar 

  • Demopoulos C, Hopkins J, Davis A (2013) A comparison of social cognitive profiles in children with autism spectrum disorders and attention-deficit/hyperactivity disorder: a matter of quantitative but not qualitative difference? J Autism Dev Disord 43:1157–1170. doi:10.1007/s10803-012-1657-y

    Article  PubMed  Google Scholar 

  • Demurie E, De Corel M, Roeyers H (2011) Empathic accuracy in adolescents with autism spectrum disorders and adolescents with attention-deficit/hyperactivity disorder. Res Autism Spectr Disord 5:126–134. doi:10.1016/j.rasd.2010.03.002

    Article  Google Scholar 

  • Döpfner M, Görtz-Dorten A, Lehmkuhl G et al (2008) Diagnostik-system für psychische störungen nach ICD-10 und DSM-IV für kinder und jugendliche-II (DISYPS-II). Huber, Bern

    Google Scholar 

  • Falkmer T, Anderson K, Falkmer M, Horlin C (2013) Diagnostic procedures in autism spectrum disorders: a systematic literature review. Eur Child Adolesc Psychiatry 22:329–340. doi:10.1007/s00787-013-0375-0

    Article  PubMed  Google Scholar 

  • Fluss R, Faraggi D, Reiser B (2005) Estimation of the Youden Index and its associated cutoff point. Biom J 47:458–472

    Article  PubMed  Google Scholar 

  • Gadow KD, DeVincent CJ, Pomeroy J (2006) ADHD symptom subtypes in children with pervasive developmental disorder. J Autism Dev Disord 36:271–283. doi:10.1007/s10803-005-0060-3

    Article  PubMed  Google Scholar 

  • Gadow KD, DeVincent CJ, Schneider J (2009) Comparative study of children with ADHD only, autism spectrum disorder + ADHD, and chronic multiple tic disorder + ADHD. J Atten Disord 12:474–485. doi:10.1177/1087054708320404

    Article  PubMed  Google Scholar 

  • Gargaro BA, Rinehart NJ, Bradshaw JL et al (2011) Autism and ADHD: how far have we come in the comorbidity debate? Neurosci Biobehav Rev 35:1081–1088. doi:10.1016/j.neubiorev.2010.11.002

    Article  PubMed  Google Scholar 

  • Ghaziuddin M, Welch K, Mohiuddin S et al (2010) Utility of the social and communication questionnaire in the differentiation of autism from ADHD. J Dev Phys Disabil 22:359–366. doi:10.1007/s10882-010-9199-8

    Article  Google Scholar 

  • Grzadzinski R, Di Martino A, Brady E et al (2011) Examining autistic traits in children with ADHD: does the autism spectrum extend to ADHD? J Autism Dev Disord 41:1178–1191. doi:10.1007/s10803-010-1135-3

    Article  PubMed Central  PubMed  Google Scholar 

  • Hanson E, Cerban BM, Slater CM et al (2012) brief report: prevalence of attention deficit/hyperactivity disorder among individuals with an autism spectrum disorder. J Autism Dev Disord 43:1459–1464. doi:10.1007/s10803-012-1677-7

    Article  Google Scholar 

  • Holtmann M, Boelte S, Poustka F (2007) Attention deficit hyperactivity disorder symptoms in pervasive developmental disorders: association with autistic behavior domains and coexisting psychopathology. Psychopathology 40:172–177. doi:10.1159/000100007

    Article  PubMed  Google Scholar 

  • Johnson S, Hollis C, Hennessy E et al (2010) Screening for autism in preterm children: diagnostic utility of the social communication questionnaire. Arch Dis Child 96:73–77. doi:10.1136/adc.2010.194795

    Article  PubMed  Google Scholar 

  • Kröger A, Hänig S, Seitz C et al (2011) Risk factors of autistic symptoms in children with ADHD. Eur Child Adolesc Psychiatry 20:561–570. doi:10.1007/s00787-011-0221-1

    Article  PubMed  Google Scholar 

  • Lee DO, Ousley OY (2006) Attention-deficit hyperactivity disorder symptoms in a clinic sample of children and adolescents with pervasive developmental disorders. J Child Adolesc Psychopharmacol 16:737–746

    Article  CAS  PubMed  Google Scholar 

  • Leyfer OT, Folstein SE, Bacalman S et al (2006) Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord 36:849–861. doi:10.1007/s10803-006-0123-0

    Article  PubMed  Google Scholar 

  • Lord C, Rutter M, DiLavore P, Risi S (2001) Autism diagnostic observation schedule (ADOS) manual. Western Psychological Services, Los Angeles

    Google Scholar 

  • Matson JL, Rieske RD, Williams LW (2013) The relationship between autism spectrum disorders and attention-deficit/hyperactivity disorder: an overview. Res Dev Disabil 34:2475–2484. doi:10.1016/j.ridd.2013.05.021

    Article  PubMed  Google Scholar 

  • McPheeters ML, Warren Z, Sathe N et al (2011) A systematic review of medical treatments for children with autism spectrum disorders. Pediatrics 127:e1312–e1321. doi:10.1542/peds.2011-0427

    Article  PubMed  Google Scholar 

  • Mulligan A, Anney RJ, O’Regan M et al (2009) Autism symptoms in attention-deficit/hyperactivity disorder: a familial trait which correlates with conduct, oppositional defiant, language and motor disorders. J Autism Dev Disord 39:197–209. doi:10.1007/s10803-008-0621-3

    Article  PubMed  Google Scholar 

  • Nydén A, Niklasson L, Stahlberg O et al (2010) Adults with autism spectrum disorders and ADHD neuropsychological aspects. Res Dev Disabil 31:1659–1668. doi:10.1016/j.ridd.2010.04.010

    Article  PubMed  Google Scholar 

  • Oosterling I, Rommelse N, de Jonge M et al (2010) How useful is the social communication questionnaire in toddlers at risk of autism spectrum disorder? J Child Psychol Psychiatry 51:1260–1268. doi:10.1111/j.1469-7610.2010.02246.x

    Article  PubMed  Google Scholar 

  • Pelham WE Jr, Fabiano GA, Massetti GM (2005) Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. J Clin Child Adolesc Psychol 34:449–476

    Article  PubMed  Google Scholar 

  • Rühl D, Bölte S, Feineis-Matthews S, Poustka F (2004) Diagnostische beobachtungsskala für autistische störungen (ADOS). Huber, Bern

    Google Scholar 

  • Rutter M, Bailey A, Lord C (2003a) Social communication questionnaire. Western Psychological Services, Los Angeles

    Google Scholar 

  • Rutter M, Le Couteur A, Lord C (2003b) ADI-R: autism diagnostic interview-revised. Western Psychological Services, Los Angeles

    Google Scholar 

  • Schachar R, Tannock R (1995) Test of four hypotheses for the comorbidity of attention-deficit hyperactivity disorder and conduct disorder. JAAC 34:639–648

    CAS  Google Scholar 

  • Schanding GT, Nowell KP, Goin-Kochel RP (2011) Utility of the social communication questionnaire-current and social responsiveness scale as teacher-report screening tools for autism spectrum disorders. J Autism Dev Disord 42:1705–1716. doi:10.1007/s10803-011-1412-9

    Article  Google Scholar 

  • Simonoff E, Pickles A, Charman T et al (2008) Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry 47:921–929. doi:10.1097/CHI.0b013e318179964f

    Article  PubMed  Google Scholar 

  • Sinzig J, Morsch D, Lehmkuhl G (2008) Do hyperactivity, impulsivity and inattention have an impact on the ability of facial affect recognition in children with autism and ADHD? Eur Child Adolesc Psychiatry 17:63–72. doi:10.1007/s00787-007-0637-9

    Article  PubMed  Google Scholar 

  • Snow AV, Lecavalier L (2008) Sensitivity and specificity of the modified checklist for autism in toddlers and the social communication questionnaire in preschoolers suspected of having pervasive developmental disorders. Autism 12:627–644. doi:10.1177/1362361308097116

    Article  PubMed  Google Scholar 

  • Steensel FJA, Bögels SM, Bruin EI (2013) Psychiatric comorbidity in children with autism spectrum disorders: a comparison with children with ADHD. J Child Fam Stud 22:368–376. doi:10.1007/s10826-012-9587-z

    Article  PubMed Central  PubMed  Google Scholar 

  • Taurines R, Schwenck C, Westerwald E et al (2012) ADHD and autism: differential diagnosis or overlapping traits? A selective review. Atten Defic Hyperact Disord 4:115–139. doi:10.1007/s12402-012-0086-2

    Article  PubMed  Google Scholar 

  • van der Meer JMJ, Oerlemans AM, van Steijn DJ et al (2012) Are autism spectrum disorder and attention-deficit/hyperactivity disorder different manifestations of one overarching disorder? Cognitive and symptom evidence from a clinical and population-based sample. JAAC 51:1160–1172. doi:10.1016/j.jaac.2012.08.024

    Google Scholar 

  • Witwer AN, Lecavalier L (2007) Autism screening tools: an evaluation of the social communication questionnaire and the developmental behaviour checklist-autism screening algorithm. J Intellect Dev Disabil 32:179–187. doi:10.1080/13668250701604776

    Article  PubMed  Google Scholar 

  • World Health Organization (1993) The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organization, Geneva

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe-University, Frankfurt am Main, Germany

    Christina Schwenck & Christine M. Freitag

  2. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany

    Christina Schwenck

Authors
  1. Christina Schwenck
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christine M. Freitag
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christina Schwenck.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schwenck, C., Freitag, C.M. Differentiation between attention-deficit/hyperactivity disorder and autism spectrum disorder by the Social Communication Questionnaire. ADHD Atten Def Hyp Disord 6, 221–229 (2014). https://doi.org/10.1007/s12402-014-0147-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12402-014-0147-9

Keywords

Search

Navigation