Original articleComparison of the strengths and difficulties questionnaire (SDQ) scores between children with high-functioning autism spectrum disorder (HFASD) and attention-deficit/hyperactivity disorder (AD/HD)
Introduction
Recently, with the increased recognition of developmental disorders in homes and schools, the number of children who visit pediatric neurologists and child psychiatrists is increasing in Japan. Most of them have difficulty in functioning in daily school life and some have developmental disorders, such as high-functioning autistic disorder (HFASD) and attention-deficit/hyperactivity disorder (AD/HD). These two groups have a different diagnostic axis; HFASD is classified as one of the pervasive developmental disorders, while AD/HD can be grouped into attention-deficit and disruptive disorders. If the patients have overlapping symptoms of AD/HD and HFASD, the diagnosis of HFASD takes precedence in DSM-IV [1]. However, there are often behavioral and emotional similarities: e.g., attention deficits, impulsive behavior, peer problems, conduct problems, etc. Some researchers have observed symptoms related to AD/HD in patients with HFASD [2], [3], [4]. Recently, we reported the scale properties of the Japanese version of the Strengths and Difficulties Questionnaire (SDQ) in community subjects 4–12 years old [5]. The SDQ is a brief screening instrument used to assess positive and negative aspects of the behavior of children and adolescents which can be easily filled out by parents and teachers or as a self-report by children. It was first presented to the scientific public by Robert Goodman [6]. The SDQ is a short, modified version of the Elander and Rutter parent questionnaire [7] that asks about 25 attributes, some considered “strengths” and others “difficulties”. The clinical usefulness of SDQ has been confirmed in the field of child psychiatry and child psychology [8], [9], [10], [11]; however, there have been no reports on SDQ scales evaluated by both parents and teachers to investigate the differences in behavioral and social abilities between clinically diagnosed children with HFASD and those with AD/HD. We compared the parent- and teacher-assessed SDQ subscales in patients with HFASD or AD/HD who had been diagnosed by several pediatric neurologists (CI, SN, YY, and TM) using diagnostic interviews, DSM-IV criteria, and neurological examinations.
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Patients
Children who were referred to the Department of Pediatrics & Child Health, Kurume University School of Medicine from 2000 to 2007 were enrolled in this study. A full diagnostic battery was performed, consisting of direct diagnostic interviews and neurological examinations by the licensed Japanese pediatric neurologists, DSM-IV criteria, and the Wechsler Intelligence Scale for Children third edition (WISC-III). In addition, SDQ was performed by both parents and teachers; pediatric neurologists
Results
The mean ages were as follows: 9.1 ± 1.7 years old, 8.9 ± 1.7 years old, and 8.4 ± 1.4 years old in community sample, HFASD, and AD/HD, respectively. The mean IQ was 95.4 ± 11.8 and 96.8 ± 11.6 for HFASD and AD/HD, respectively. Both IQs were within the normal range, and there was no significant difference between the two groups. We cited our community sample data with permission from Elsevier Science Co., Ltd. Of all 1112 children in the community samples, 856 (77%) were within the designated normal range
Discussion
Some papers have reported the usefulness of SDQ as a screening tool for mental problems in child mental health clinics [6], [8], [9], [10], [11], [12] or pediatic clinics [13]; however, there have been no reports describing its use in the clinical setting of pediatric neurology. This is the first study comparing multi-informant SDQ scores in children with a final diagnosis of HFASD or AD/HD confirmed by several pediatric neurologists. We were able to show that children with HFASD or AD/HD had
Acknowledgement
This study was partly supported by a Grant for Research on Psychiatric and Neurological Diseases and Mental Health (#19-8), and a Grant for Research on Learning Disorders (#19-6) from the Ministry of Health, Labour and Welfare of Japan, and was also partly supported by a Grant-in-Aid for Scientific Research C (#18591172), from the Ministry of Education, Culture, Sports, Science & Technology (MEXT) of Japan.
References (16)
- et al.
Symptoms related to ADHD observed in patients with pervasive developmental disorder
Brain Dev
(2005) - et al.
Scale properties of the strengths and difficulties questionnaire (SDQ): A study of infant and school children in community samples
Brain Dev
(2008) Psychometric properties of the strengths and difficulties questionnaire
J Am Acad Child Adolesc Psychiatry
(2001)- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text revision....
- et al.
Autistic symptoms in children with attention deficit-hyperactivity disorder
Eur Child Adolesc Psychiatry
(1999) - et al.
The metaphor and sarcasm scenario test: a new instrument to help different high functioning pervasive developmental disorder from attention deficit/hyperactivity disorder
Brain Dev
(2003) The strengths and difficulties questionnaire: a research note
J Child Psychol Psychiatry
(1997)- et al.
Use and development of the Rutter parents’ and teachers’ scale
Int J Methods Psychiatric Res
(1996)
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