Evidence map›Paper›PMID 39227035›Full record

ArticleJournal of child psychology and psychiatry, and allied disciplines2025

Behavioral characteristics of toddlers later identified with an autism diagnosis, ADHD symptoms, or combined autism and ADHD symptoms.

Naomi O Davis, Reginald Lerebours, Rachel E Aiello, Kimberly L H Carpenter, Scott Compton, Lauren Franz, Scott H Kollins, Maura Sabatos-DeVito, Marina Spanos, Geraldine Dawson

Abstract read
In one paragraph

Article in Journal of child psychology and psychiatry, and allied disciplines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Patterns of Early Development in Children with ADHD.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 · 2026
    Article
  2. Article
  3. The challenge and promise of disentangling neurodevelopmental conditions a commentary on Davis et al. (2024).Journal of child psychology and psychiatry, and allied disciplines · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Naomi O DavisDuke ADHD Program, Duke University School of Medicine, Durham, NC, USA.
Reginald LereboursDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
Rachel E AielloDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.
Kimberly L H CarpenterDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.
Scott ComptonDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.
Lauren FranzDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.
Scott H KollinsDuke ADHD Program, Duke University School of Medicine, Durham, NC, USA.
Maura Sabatos-DeVitoDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.
Marina SpanosDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.
Geraldine DawsonDuke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC, USA.

Funding

Support for QA/QC for Prior Approval ProcessUL1TR002553 · NCATS · DUKE UNIVERSITY · PI LI, JENNIFER S, MCNAMARA, JAMES O. · 2018 to 2023
$58.5M
Recruitment and Assessment CoreP50HD093074 · NICHD · DUKE UNIVERSITY · PI SCOTT N COMPTON · 2017 to 2026
$27.6M
NCATS NIH HHS UL1 TR002553NICHD NIH HHS P50 HD093074NIH HHS P50HD093074
6 · The paper itself

Abstract

backgroundAutism commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of toddlers later identified with autism diagnosis, ADHD symptoms, combined autism and ADHD symptoms, or neither condition.

methodsParticipants were 506 toddlers who were part of a longitudinal study of children's behavioral development. Parents completed questionnaires about their children's behavior at two time points. Four groups were identified based on study measures or medical record: autism diagnosis (n = 45), elevated ADHD symptoms (n = 70), autism and ADHD symptoms (n = 30), or neurotypical development (n = 361). Relationships between early parent report of autism- and ADHD-related behaviors, social-emotional and behavioral functioning, and caregiver experience and subsequent group designation were evaluated with adjusted linear regression models controlling for sex.

resultsSignificant group differences were found in measures of autism-related behaviors, ADHD-related behaviors, externalizing and internalizing behaviors, and parent support needs (p < .0001). Pairwise comparisons indicated toddlers later identified with combined autism diagnosis and ADHD symptoms had higher levels of autism-related behaviors, externalizing and internalizing behaviors, and autism-related parent support needs compared to the other groups. Toddlers with subsequent elevated ADHD symptoms or combined autism diagnosis and ADHD symptoms exhibited similar levels of ADHD-related behaviors, while both groups displayed more ADHD-related behaviors than toddlers subsequently identified with autism or those with neither condition.

conclusionsIn this community sample, toddlers for whom combined autism diagnosis and ADHD symptoms were subsequently identified showed a distinct presentation characterized by higher early autism-related behaviors, broader behavioral concerns, and higher parent support needs. Presence of ADHD symptoms (alone or in combination with autism) was associated with higher parent-reported ADHD-related behaviors during toddlerhood. Results indicate that ADHD-related behaviors are manifest by toddlerhood, supporting screening for both autism and ADHD during early childhood.

Indexed as

Attention Deficit Disorder with HyperactivityAutism Spectrum DisorderChild BehaviorChild, PreschoolComorbidityFemaleHumansInfantLongitudinal StudiesMaleADHDAutismpreschool childrenscreening

Identifiers

PMID39227035
PMCPMC11757087

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.