ADHD and autism spectrum conditions: could new brain scans improve diagnosis?

Professor Patrick Bolton, of King’s College London, aims to improve life for children with attention deficit hyperactivity disorder (ADHD) and children with an autism spectrum condition (ASC). Estimates suggest two to five in every 100 children in the UK have ADHD and at least one in every 100 has an ASC.^1-5 There is no simple medical test for either condition. Diagnosis can take a long time, and there can be a period of uncertainty in a child’s early years when it is unclear whether he or she is affected. Professor Bolton is investigating whether new brain scans might allow earlier, more accurate diagnosis.

How are children’s lives affected now?

“Children with ADHD are hyperactive, impulsive and easily distracted,” says Professor Bolton. “They have difficulty sticking at a task and following classroom routines.”

“Children who have an ASC have difficulties interacting and communicating effectively with other people,” continues Professor Bolton. “They also develop ritualistic and repetitive behaviours, and find it hard to adjust to changes in their daily routine.”

The process of diagnosing ASCs and ADHD can be lengthy and distressing for families. It typically involves an initial evaluation, followed by a period of observation, with input from doctors, speech and language therapists, parents and teachers.

“ADHD and ASCs often occur together,” says Professor Bolton. “The presence of one may partially mask the presence of the other, making diagnosis more difficult. Many children have a learning difficulty too, which also complicates diagnosis.”

Without a correct diagnosis, it can be difficult for children and their families to access the care and support they need.

How could this research help?

“We are investigating whether it’s possible to improve diagnosis of ADHD and ASCs using state-of-the-art new brain scans,” says Professor Bolton. “We are using a technique called EEG. This cost-effective technique, which detects children’s brain waves, is suitable for children of all abilities and ages, including babies.”

Evidence suggests that the wiring, or circuitry, of the brain is different in both children with ADHD, and children with an ASC, when compared with other children. The researchers are investigating whether it’s possible to detect these differences with the new brain scans.

“Further studies would be needed, but we hope our work will eventually improve diagnosis,” says Professor Bolton. “The new brain scans could be particularly helpful if children’s behaviour is affected only subtly, if children have learning disabilities, and if children have both ADHD and an ASC. They may also allow earlier diagnosis, so children can access the care and support they need sooner.”

References

1. Baird G et al. Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP) Lancet 2006; 368: 210–15.

2. Office for National Statistics. Mental health of children and young people in Great Britain, 2004. Palgrave Macmillan 2005. http://www.esds.ac.uk/doc/5269/mrdoc/pdf/5269technicalreport.pdf Website accessed 5 June 2013.

3. NICE Clinical Guidline 128. Autism diagnosis in children and young people. Issued September 2011. http://www.nice.org.uk/guidance/cg128/resources/guidance-autism-diagnosi... Website accessed 28 September 2014.

4. NHS Choices. Autism spectrum disorder. http://www.nhs.uk/conditions/autistic-spectrum-disorder/Pages/Introducti... Website accessed 13 September 2014.

5. NHS Choices. Attention deficit hyperactivity disorder (ADHD). http://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder/pa... Website accessed 13 September 2014.