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Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder In a Low Birth Weight Cohort: Evidence for a Shared Familial Risk Factor

Friday, October 19, 2012
Room R02-R05 (Morial Convention Center)
Catherine B. Christman, MD1, Agnes H. Whitaker, MD2, Judith F. Feldman, PhD1, Jennifer A. Pinto-Martin, PhD, MPH3, Susan E. Levy, MD, FAAP4, Anna Silberman, MS2, Nigel Paneth, MD, MPH5 and John M. Lorenz, MD1, (1)Neonatology, New York Presbyterian-Columbia University Medical Center, New York, NY, (2)Department of Child Psychiatry, New York Psychiatric Institute, New York, NY, (3)Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing and School of Medicine, Philadelphia, PA, (4)Division Child Development, Rehabilitation and Metabolism, Children's Hospital of Pennsylvania, Philadelphia, PA, (5)Departments of Epidemiology and Pediatrics and Human Development, Michigan State University, East Lansing, MI

Background:  Family and twin studies have suggested that Autism Spectrum Disorders (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) may have familial risk factors in common. Also, both disorders have elevated prevalence among those born at low birth weight (LBW).  A LBW cohort having retrospective data on maternal childhood ADHD symptoms and diagnosed ADHD and ASD provides an opportunity to test the hypothesis of common familial risk for both disorders.

Purpose: The purpose of this study was to determine whether diagnoses of ASD and ADHD were associated with mothers' recall of ADHD symptoms in their own childhood.    

Methods:   This study is based on a LBW (< 2000 g) cohort, born 1984-1987 (N=1105) screened with serial neonatal head ultrasound for perinatal brain injury. At the age 16 follow-up, mothers completed (1) the Wender Utah Rating Scale (WURS), a retrospective measure of childhood ADHD, on themselves (2) a parental report research psychiatric diagnostic interview covering a range of DSM IV diagnoses on their adolescent (3) a screen for ASD on their adolescent.  At age 21, ASD was rigorously diagnosed for screen positives and a systematic sample of screen negatives. An ADHD score was derived from the WURS using items that discriminate between adults with and without ADHD.

 Results: The table below shows the WURS scores in relation to the three diagnostic groups of interest. 

Maternal Wender 25-Item Total Scores by ASD, ADHD, and Any Other Diagnosis


Positive for Diagnosis

Negative for Diagnosis




Mean (± SD)


Mean (± SD)


Adjusted b



21.23 (±15.78)


11.23 (±11.77)





19.09 (±11.61)


11.44 (±12.54)



Other a


13.03 (±9.57)


10.08 (±12.56)



aAll other assessed diagnoses combined, exclusive of ASD and ADHD bAdjusted for gender and neonatal head ultrasound abnormalities

Conclusions:  In a LBW population, retrospectively assessed maternal childhood ADHD symptoms are selectively associated with offspring diagnoses of ASD and ADHD, suggesting that these diagnoses may have a common familial risk factor.