ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Neurology
This article is part of the Research TopicNew Insights into Pediatric Neurodevelopmental Disorders: Autism Spectrum Disorder and its ComorbiditiesView all 8 articles
The Unique Cognitive Phenotype of ASD+ADHD Co-occurrence: Evidence for Planning and Attention Deficits as Differentiating Approach
Provisionally accepted
- 1Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin University, Changchun, China
- 2The First Hospital of Jilin University, Changchun, China
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Abstract Purpose: This study sought to assess the cognitive processing of children with autism spectrum disorder (ASD) without co-occurring attention-deficit/hyperactivity disorder (ADHD) (ASD-alone), children with ADHD without co-occurring ASD (ADHD-alone), and children with ASD with co-occurring ADHD (ASD+ADHD). Methods: Children were divided into 4 groups: ASD-alone (n = 57), ADHD-alone (n = 89), ASD+ADHD (n = 56), and typical development (TD) (n = 58). The Das-Naglieri Cognitive Assessment System (D-N CAS) was applied to evaluate planning-attention-simultaneous-successive cognitive processes. Results: Children with ASD-alone scored less on planning processing. Children with ADHD-alone scored lower on planning and attention processing. Children with ASD+ADHD scored lower scores on all four processes. The planning and attention exhibited satisfactory stratification precision in identifying ASD+ADHD among children with ASD providing area under the curve (AUC) of 0.7426 and 0.8061, respectively. Successive processing had medium diagnostic value in diagnosing ASD+ADHD among children with ADHD with an AUC of 0.618. Inattention symptoms were associated with planning and attention processing. Social affects and inattention symptoms were associated with total score of D-N CAS. Conclusion: Children with ASD-alone, ADHD-alone and ASD+ADHD exhibited distinct cognitive profiles. The D-N CAS, particularly its planning and attention scales, provided an approach for differential diagnosis in the clinics.
Keywords: Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Cognitive Assessment System, Cognitive Function, Co-Occurrence
Received: 11 Sep 2025; Accepted: 16 Dec 2025.
Copyright: © 2025 Wang, Bai, Zhang and Jia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Feiyong Jia
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