Processing speed as a marker to stimulant effect in clinical sample of children with high functioning autism spectrum disorder

Abstract

Background: Patients with co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) and ASD might benefit from stimulants. There is a progressive increase in prescribing ADHD aimed medications for children diagnosed with Autism Spectrum Disorder (ASD), despite scarce knowledge and no distinct clinical guidelines for that matter.

Aim: This study aims to analyze the effect of stimulant on processing speed performance and attention indices in children with ASD and ADHD.

Methods: Forty children aged 6–18 years diagnosed with ASD who also met the criteria for ADHD were recruited. All children performed a computerized performance test for the assessment of cognitive attention performance three times: twice while they are drug naïve and once an hour after taking a single dose of 10 mg. methylphenidate (MPH). This performance was compared to a group of children diagnosed with ‘ADHD only’ without ASD.

Results: A significant difference (p < 0.001) was found only in the parameter of measuring cognitive processing speed. This effect is significantly different from the response of the ‘ADHD only’ group.

Conclusions: The reaction to MPH among ASD children is different than among ADHD children. In ASD, MPH significantly improved cognitive processing speed without changing other measured attention parameters. Improving processing speed, might improve every day functioning in children with ASD who also met the criteria for ADHD, in other means than expected. This unique response suggests new research targets for treatment with stimulants in ASD and ADHD children and its influence on cognitive parameters.

Keywords:

• Autism spectrum disorder
• ADHD
• processing speed
• methylphenidate
• continuous performance test

Acknowledgments

The authors thank Ofra Haviv for excellent and very helpful assistance during the study. Parts of this work were performed as the requirement for MD degree (JP) under the supervision of HC and IB.

Disclosure statement

All authors report no conflicts of interest.

Additional information

Funding

This study was partly supported by IB internal research grant. This is an internal fund within Hadassah-Hebrew University Medical Center.

Notes on contributors

Julia Peled

Julia Peled, MD is a Resident physician in the pediatric department at Kaplan Medical Center. This paper is part of her MD thesis while she was a student at the Hebrew University.

Hanoch Cassuto

Hanoch Cassuto, MD, PhD is a specialist in Pediatric Neurology and Child Development.

Itai Berger

Itai Berger, MD is a specialist in Pediatric Neurology and Child Development serving as the Head of Pediatric Neurology at Assuta.