Cognitive Disengagement Syndrome in Young Autistic Children, Children with ADHD, and Autistic Children with ADHD

ABSTRACT

Objective

Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive subdomain) and slowed motor behavior (hypoactive). While there are a number of studies linking CDS traits to greater global impairment in children with attention-deficit/hyperactivity disorder (ADHD) and autistic children, there are few studies examining the prevalence and impact of CDS traits in autistic children with co-occurring ADHD (Autistic+ADHD). The current study explored CDS traits in autistic children with and without co-occurring ADHD, children with ADHD, and neurotypical children.

Methods

Participants were 196 children between 3- and 7-years-of-age comprising four groups: Neurotypical (N = 44), ADHD (N = 51), Autistic (N = 55), and Autistic+ADHD (N = 46). CDS traits, social and communication skills, repetitive behaviors, and sensory processing were all assessed via parent report.

Results

Children diagnosed with ADHD, autistic children, and Autistic+ADHD children exhibited similar levels of overall CDS traits. However, when explored separately, Autistic+ADHD children had higher cognitive CDS trait scores compared to children with ADHD alone. Both overall CDS traits and the cognitive subdomain were associated with greater social difficulties, particularly social withdrawal, higher levels of repetitive behaviors, and more sensory sensitivities, regardless of diagnosis.

Conclusions

Findings suggest that CDS traits may be an additional factor directly impact functional outcomes in both autistic and ADHD children. As such, clinicians should be assessing CDS traits in addition to other clinical domains associated with ADHD and autism when developing intervention plans for young neurodiverse children.

Disclosure Statement

Dr. Dawson is on the Scientific Advisory Boards of Akili, Inc, Nonverbal Learning Disability Project, and Tris Pharma, Inc., and received book royalties from Guilford Press, Oxford University Press, Springer Nature Press. Drs. Carpenter and Dawson developed technology, data, and/or products unrelated to the current manuscript that have been licensed to Apple, Inc. and Carpenter, Dawson, and Duke University have benefited financially. Dr. Sabatos- DeVito consults with and receives personal fees from New Frontiers in Learning.

Supplementary Material

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2024.2361715.

Additional information

Funding

This work was funded by an Autism Center of Excellence (ACE) grant from the Eunice Kennedy Shriver National Institute for Child Health and Human Development (NICHD; P50-HD093074; PI: Dawson, Geraldine) and by NICHD under Award Number [R01HD101440] (PI: Carpenter, Kimberly). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.