# Impact of co-occurring ADHD symptoms on early risk factors and routine screening for ASD in primary care

> **NIH NIH P50** · DUKE UNIVERSITY · 2020 · $484,258

## Abstract

ABSTRACT – Project 1: Impact of co-occurring ADHD symptoms on early risk factors and routine screening
 for ASD in primary care
Approximately 40-60% of children with autism spectrum disorder (ASD) also have co-occurring attention deficit
hyperactivity disorder (ADHD) or elevated symptoms of ADHD, which are associated with a range of adverse
clinical outcomes compared to those of children with ASD alone. These impairments include greater emotional
difficulties, tantrums, conduct problems, more severe ASD symptoms, greater difficulty interacting with peers,
and poorer adaptive behavior. Critically, the presence of co-occurring ADHD symptoms is also associated with
later diagnosis of ASD, thus limiting access to crucial early intervention. Despite these adverse trajectories of
children with ASD+ADHD, very little is known about how the co-occurrence of these clinical conditions
develops in early childhood. The overall goal of Project 1 is to characterize both the risk factors for and the
early emergence of co-occurring ADHD symptoms in young children at risk for ASD and to understand how
these symptoms impact early detection and progression of ASD. This is significant from a public health
perspective since this knowledge could help reduce existing disparities in access to early diagnosis and
treatment. This project will take advantage of existing infrastructure and expertise to screen and monitor the
population of young children seen in pediatric primary care clinics within the Duke University Health System (N
~ 2800 patients annually). In doing so, we will be able to prospectively identify children at risk for ASD and
simultaneously collect data on ADHD and related behaviors starting as young as 18 months. Information
related to pre- and post-natal risk factors will be obtained from children's electronic health records. We will then
monitor and characterize the progression of both ASD and ADHD symptoms across development, identifying
how ADHD symptoms impact ASD screening and diagnosis and later developmental outcomes. Data from
Project 1 will enable the development of more effective strategies for early detection of children with ASD and
co-occurring ADHD symptoms, which could reduce the delay in early detection and increase access to early
treatment.

## Key facts

- **NIH application ID:** 9985157
- **Project number:** 5P50HD093074-04
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** SCOTT H KOLLINS
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $484,258
- **Award type:** 5
- **Project period:** 2017-09-07 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985157

## Citation

> US National Institutes of Health, RePORTER application 9985157, Impact of co-occurring ADHD symptoms on early risk factors and routine screening for ASD in primary care (5P50HD093074-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9985157. Licensed CC0.

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