Co-occurring medical and behavioural conditions in children with Down syndrome with or without ADHD symptom presentation

A J Esbensen; L B Vincent; J N Epstein; K Kamimura-Nishimura; S Wiley; K Angkustsiri; L Abbeduto; D Fidler; J S Anixt; T E Froehlich

doi:10.1111/jir.12911

Co-occurring medical and behavioural conditions in children with Down syndrome with or without ADHD symptom presentation

J Intellect Disabil Res. 2022 Mar;66(3):282-296. doi: 10.1111/jir.12911. Epub 2021 Dec 23.

Authors

A J Esbensen^{1

2}, L B Vincent³, J N Epstein^{1

4}, K Kamimura-Nishimura^{1

2}, S Wiley^{1

2}, K Angkustsiri^{5

6}, L Abbeduto^{5

7}, D Fidler⁸, J S Anixt^{1

2}, T E Froehlich^{1

2}

Affiliations

¹ Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
² Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ School of Human Services, University of Cincinnati, Cincinnati, OH, USA.
⁴ Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
⁵ MIND Institute, University of California, Davis, Davis, CA, USA.
⁶ Department of Pediatrics, University of California, Davis, Davis, CA, USA.
⁷ Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis, CA, USA.
⁸ Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA.

Abstract

Background: Co-occurring attention deficit hyperactivity disorder (ADHD) is a challenge to characterise in the presence of other medical conditions commonly present in children with Down syndrome (DS). The current study examined differences among children with DS with or without ADHD symptomatology in terms of demographics, developmental level, co-occurring medical conditions, and parent and teacher ratings of behaviour and executive functioning.

Methods: Parents and teachers of 108 school-age children with DS provided ratings of ADHD symptoms, behaviour problems and executive functioning skills. Children with DS and ADHD symptom presentation, as identified by a scoring algorithm, were compared with those without ADHD symptom presentation on demographic characteristics, developmental level, co-occurring medical conditions and parent-report and teacher-report measures of behaviours and executive functioning.

Results: Sleep disorders, disruptive behaviour disorder, allergies and seizures were more common in children with DS and ADHD symptom presentation than in children without ADHD symptom presentation. After controlling for ADHD medication use, children with DS and ADHD symptom presentation had poorer performance than those without ADHD symptom presentation on parent behaviour ratings, teacher behaviour ratings and parent but not teacher ratings of executive functioning. No significant group differences in demographic characteristics or developmental level were identified.

Conclusions: Higher rates of co-occurring medical conditions present in children with DS and ADHD symptom presentation support the need for thorough differential diagnoses. The different pattern of group differences between parent-report and teacher-report has implications for diagnostic practices across settings as well as for treatment.

Keywords: ADHD; Behaviour; Co-occurring medical conditions; Down syndrome; Symptoms; Trisomy 21.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Attention Deficit Disorder with Hyperactivity* / complications
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / epidemiology
Attention Deficit and Disruptive Behavior Disorders
Child
Down Syndrome* / epidemiology
Humans
Parents
Problem Behavior*

Abstract

Publication types

MeSH terms

Grants and funding