IAN Research Findings: Issues of Attention and Mood in Children with ASDs, Their Siblings, and parents

Date First Published: December 7, 2007
Date Updated: May 30, 2008

New data from the Interactive Autism Network (IAN), a project collecting information online from families of children with Autism Spectrum Disorders (ASDs) from throughout the United States, show that children with ASDs are diagnosed with or treated for Attention Deficit Hyperactivity Disorder (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 are children with Autism.

Attention and Mood: Children with ASDs and Their Siblings

The initial IAN questionnaires, both for 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:

• 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 also among children with different ASD diagnoses. This was true when considering children of all ages, but especially true when only children ages 10 and older 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 will have 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 affected 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 were children with Autism.

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

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 of major depressive disorders in the United States. (See Table 1.)

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 with children with other ASD diagnoses, were the most frequently "diagnosed with or treated for Depression."

Mothers and fathers in families with more than one child on the spectrum also had been diagnosed with or treated for Depression with great frequency. In fact, except for fathers of children with PDD-NOS, 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.

Thank You, Families, Supporters, Researchers

We would like to thank all individuals with an ASD, family members, and researchers who have made the IAN project's success possible. Your contributions have been invaluable, and we appreciate your feedback, suggestions, and input. Please keep it coming! You can reach us at: researchteam@kennedykrieger.org.

Spread the Word About IAN

Please remember: we have still reached relatively few of the families affected by ASDs in the United States. You can help! Spread the word about IAN to families and the professionals who work with them.

View the IAN brochure (PDF) and order free brochures to share.

Disclaimer -- Please Note: These Findings Are Preliminary

The analyses presented here by the Interactive Autism Network (IAN) are preliminary. They are 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.

Related IAN Research Questions

• Has this child with ASD been diagnosed with or treated for Depression?
• Has this unaffected sibling been diagnosed with or treated for Depression?
• Has this mother been diagnosed with or treated for Depression?
• Has this father been diagnosed with or treated for Depression?