2016 Gatlinburg Conference Poster
PS-45
Title: Writing Achievement in Higher-Functioning, School-Age Children with Attention-Deficit/Hyperactivity Disorder or Autism
Spectrum Disorders with High and Low ADHD Symptomatology
Authors: Matthew C. Zajic, Nancy McIntyre, Lindsay Swain-Lerro, Tasha Oswald, Peter Mundy
Introduction: Higher functioning children with autism spectrum disorders (HFASD) or attention-deficit/hyperactivity disorder
(ADHD) often find writing challenging. However, writing research has not focused on children at-risk for comorbid ASD and
ADHD. Exploring comorbidity's impact can help better understand writing difficulties faced by children with HFASD and/or ADHD.
Methods: A total of 116 children (between 8 and 16 years old) participated: 51 with HFASD, 29 with ADHD, and 36 with typical
development (TD). A planned-comparison-group analysis was used with a three-diagnostic-group split (3DX)--HFASD, ADHD, and
TD--and a four-diagnostic-group split (4DX)--HFASD with high ADHD symptomatology (HFASD-H), HFASD with low ADHD
symptomatology (HFASD-L), ADHD, and TD. The 4DX had 34 children with HFASD-H and 17 with HFASD-L. No groups in either
split differed on age or grade.
All children came into the study with community diagnoses. Diagnoses were confirmed using ASD (ADOS-2, ASSQ, SCQ, and SRS)
and ADHD (Conners-3 Parent Report) diagnostic assessments, which confirmed expected differences in both splits. The 4DX
HFASD-H group composed of children with HFASD with elevated averaged inattentive and hyperactive-impulsive Conners-3
symptom scales t-scores greater than 70 (two SDs above the mean). FIQ was assessed with the Wechsler Abbreviated Scales of
Intelligence-2; due to a main effect of FIQ in both splits, writing analyses covaried for FIQ.
Writing achievement was measured with the Wechsler Individual Achievement Test-III, an expository writing task that provides
age-standardized scores for overall writing, word count, and thematic content. Five trained research assistants coded writing
samples, including overlapping subsets (N=16-45). Intraclass correlation coefficients ranged between 0.87 and 1.00,
demonstrating high reliability.
Results: A main effect of diagnostic group on overall writing scores occurred in the 3DX, F(2,112)=3.559,p=.032,η_p^2=.06, and
the 4DX, F(3,111)=5.217,p=.002,η_p^2=.124. For the 3DX, the TD group was higher than the two clinical groups (who did not
differ). For the 4DX, the HFASD-L group scored higher than the HFASD-H group, the ADHD and HFASD groups did not differ, and
the TD group differed only from the HFASD-H and ADHD groups.
A main effect of diagnostic group on word count score occurred in the 3DX, F(2,112) =4.891,p=.009,η_p^2=.08, and the 4DX,
F(3,111)=3.970,p=.010,η_p^2=.097. Group differences were similar to the overall writing scores' results.
A main effect of diagnostic group on the thematic score did not occur in the 3DX, F(2,112)=1.564,p=.21,η_p^2=.027, but did
occur in the 4DX, F(3,111)=3.876,p=.011,η_p^2=.095. The HFASD-L group differed from the HFASD-H and ADHD groups but not
the TD group, while the HFASD-H group differed from the TD group but not the ADHD group.
Discussion: The 3DX supported prior research in showing that clinical groups struggled with writing. However, accounting for
ADHD symptomatology, the 4DX demonstrated that children with HFASD-H performed the lowest on thematic content, while
children with HFASD-L performed more similar to TD peers. These findings are useful for identifying writing difficulties faced by
children with HFASD and better isolating struggling and achieving subgroups with implications for writing interventions.
References/Citations:
• DuPaul, G.J., & Langberg, J. (2015). Educational impairments in children with ADHD. In R.A. Barkley (Ed.), Attentiondeficit hyperactivity disorder: A handbook for diagnosis and treatment (Fourth ed.).
• Keen, D., Webster, A., & Ridley, G. (2015). How well are children with autism spectrum disorder doing academically at
school? An overview of the literature. Autism, 10.1177/1362361315580962
• Mayes, S.D., & Calhoun, S.L. (2008). WISC-IV and WIAT-II profiles in children with high-functioning autism. Journal of
Autism and Developmental Disorders, 10.1007/s10803-007-0410-4
2016 Gatlinburg Conference Poster
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PS-45
Murray, M.J. (2010). Attention-deficit/hyperactivity disorder in the context of autism spectrum disorders. Current
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