Visual search in ADHD, ASD and ASD + ADHD: overlapping or dissociating disorders?

Eur Child Adolesc Psychiatry. 2021 Apr;30(4):549-562. doi: 10.1007/s00787-020-01535-2. Epub 2020 Apr 20.

Abstract

Recent debates in the literature discuss commonalities between Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) at multiple levels of putative causal networks. This debate requires systematic comparisons between these disorders that have been studied in isolation in the past, employing potential markers of each disorder to be investigated in tandem. The present study, choose superior local processing, typical to ASD, and increased Intra-Subject Variability (ISV), typical to ADHD, for a head-to-head comparison of the two disorders, while also considering the comorbid cases. It directly examined groups of participants aged 10-13 years with ADHD, ASD with (ASD+) or without (ASD-) comorbid ADHD and a typically developing (TD) group (total N = 85). A visual search task consisting of an array of paired words was designed. The participants needed to find the specific pair of words, where the first word in the pair was the cue word. This visual search task was selected to compare these groups on overall search performance and trial-to-trial variability of search performance (i.e., ISV). Additionally, scanpath analysis was also carried out using Recurrence Quantification Analysis (RQA) and the Multi-Match Model. Results show that only the ASD- group exhibited superior search performance; whereas, only the groups with ADHD symptoms showed increased ISV. These findings point towards a double dissociation between ASD and ADHD, and argue against an overlap between ASD and ADHD.

Keywords: Attention-deficit/hyperactivity disorder (ADHD); Autism spectrum disorder (ASD); Intra-subject variability (ISV); Local processing; Visual search.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Autism Spectrum Disorder / diagnosis*
  • Child
  • Dissociative Disorders / diagnosis*
  • Female
  • Humans
  • Male