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The broader area of neurodevelopmental diseases includes conditions like ADHD and autism spectrum disorders. ADHD is a typical neurodevelopmental condition frequently found in kids. Children that have ADHD have difficulties focusing, paying attention, and sometimes even learning. As they grow older, certain kids’ symptoms will significantly lessen. Some people will experience symptoms of ADHD throughout their adolescence and into adulthood. Different degrees of impulsivity, hyperactivity, and inattention are hallmarks of ADHD (American Psychiatric Association, 2000). ADHD. It is brought on by an imbalance of the brain’s neurotransmitters, or chemical messengers, particularly dopamine. Although there is a large hereditary component to the disorder, environmental variables like preterm labor, low birth weight, brain traumas, and alcohol or tobacco use during pregnancy can also contribute to its development.

A group of diverse neurodevelopmental diseases known as autism spectrum disorders (ASD) influence behavior, development, and communication. This could be due to early onset social communication issues, an abnormally small range of interests and activities, or both (American Psychiatric Association, 2000). For stereotyped behaviors, rigid and unbending rituals and routines, severely constrained interests, and hyper- or hypo-reactivity to sensory inputs, see repetitive and rigid behaviors (American Psychiatric Association, 2013). Around 1% of the population is affected. Children with autism spectrum disorder (ASD) make up a sizeable portion of those who also exhibit signs of inattentiveness and hyperactivity, frequently to the point where a clinical diagnosis of ADHD (attention deficit/hyperactivity disorder) is made. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published, and the American Psychological Association (APA) claims that the two illnesses can be diagnosed in the same person. Genetics may play a role in both illnesses. A uncommon gene that may be connected to both diseases was discovered by one study. This discovery might help to understand why certain illnesses frequently affect the same person. Among boys, the autism spectrum disorder is very common. They have a four and a half times higher chance than females of receiving an autism diagnosis.

Prevalence of ADHD & ASD among males

The trends in prevalence of American children aged 4 to 17 who have ever received an ADHD diagnosis from a healthcare professional are based on parent-reported data from the National Survey of Children’s Health (NSCH). From 2003 to 2011, men continuously had a higher prevalence of ADHD than women. According to diagnostic interview data from the National Comorbidity Survey-Adolescent Supplement (NCS-A), 13.0% of male adolescents and 4.2% of female adolescents had ADHD. Prevalence was higher in men (5.4%) than in women (3.2%), according to diagnostic interview data from the National Comorbidity Survey Replication (NCS-R). Obviously, based on the surveys above, men are more likely than women to have ADHD. Below are some of the factors;

Physical symptoms: Boys are three times more often than girls to be diagnosed with ADHD, according to the National Center for Birth Defects and Developmental Disorders (2022). This discrepancy results from how ADHD symptoms manifest in girls. The signs are frequently subtler and so more difficult to spot. Males with ADHD frequently exhibit externalized symptoms like impulsivity and running. Females with ADHD, however, frequently exhibit internalized symptoms. Low self-esteem and inattentiveness are among these symptoms. In addition, boys are more likely to be physically hostile than girls are to be verbally confrontational. Girls with ADHD experience difficulties that are frequently disregarded since they frequently exhibit fewer behavioral issues and less obvious signs. They are not given a referral for an examination or medical care as a result. This might result in further issues along the road.

Prenatal testosterone Transfer: According to Wikipedia (2022), prenatal testosterone transfer refers to the phenomenon where testosterone produced by a developing male fetus transfers to one or more developing fetuses inside the womb and influences development. It is also referred to as prenatal androgen transfer or prenatal hormone transfer. Research showing a connection between early autistic-like behaviors and fetal testosterone detected in amniotic fluid (Lutchmaya, Baron-Cohen, & Raggatt, 2002). There is a masculine bias in the prevalence of ASD and ADHD. In fact, it has been suggested that both illnesses may have been somewhat influenced by excessive intrauterine testosterone levels. It was proposed that prenatal testosterone stimulation may contribute to a “extreme masculine brain” in ASD in particular.It was discovered that the amount of autistic features in children at 18 to 24 months, restricted interests at 4 years old, and gender-typical play at 6 to 9 years old may all be predicted by the testosterone levels in the amniotic fluid. The 2D:4D finger ratio, or the ratio between the lengths of the second and fourth digits, is a peripheral indication of the exposure to prenatal testosterone in the central nervous system. Hence, the likelihood of developing a decreased 2D:4D ratio increases with increased exposure and sensitivity to prenatal testosterone and concomitant decreases in estrogen. In multiple investigations, it was discovered that the 2D:4D ratio was lower in those with ASD, indicating greater prenatal priming. To the best of our knowledge, no research have specifically looked at prenatal testosterone (such as that found in amniotic fluid) in relation to signs of hyperactivity (or ADHD). In contrast to children with anxiety problems, a study found that children with ADHD had a smaller 2D:4D ratio more frequently. According to some studies, testosterone levels may actually be higher in people with ASD. Salivary testosterone levels and behavioral indicators of ADHD and hyperactivity have been shown to be positively correlated. Salivary testosterone levels and hyperactive/ADHD-related behaviors, such as aggression in disruptive children, have been found to positively correlate. The concepts of “empathizing” and “systemizing” as sex-differentiated behavior are the foundation of the extreme male brain theory (EMB) of ASD (Baron-Cohen, 2002). According to Baron-Cohen, “systemising” is the process of analyzing the underlying structures of a system and applying this knowledge to understand circumstances, while “empathizing” is the recognition and handling of another person’s emotions (Baron-Cohen, 2002). According to the idea, people with ASD exhibit extremely excessive “systemizing” behavioral patterns and a “extreme masculine brain” (Baron-Cohen, 2002). According to the related androgen or fetal testosterone theory of ASD (Baron-Cohen, Knickmeyer, & Belmonte, 2005, 2011; Knickmeyer & Baron-Cohen, 2006), exposure to higher testosterone levels in utero affects the fetal brain’s development, masculinizing it to display “systemizing” behaviors and resulting in ASD (Baron-Cohen, 2002).

According to the extreme male brain idea, increased testosterone levels at key times can affect early brain development, exerting organizational effects on the brain’s structure and influencing subsequent behavior. This could lead to increased’male’ biological traits including bigger brain weight, atypical pubertal timing, and increased’male’ behaviors like play, empathy, quality of social interactions, and language (Baron-Cohen, 2002; Baron-Cohen et al., 2011).

High Androgens production:  Male fetuses produce more androgens than female fetuses do, and these hormones have been linked to sex-specific behaviors (Arnold & Gorski, 1984; Berenbaum & Hines, 1992). Studies on animals have demonstrated that changes in sex steroid levels throughout fetal and neonatal development can affect the way the brain develops and later behavior (Gorski, 1973; McCarthy, 1994). According to the related androgen or fetal testosterone theory of autism spectrum disorder (ASD) (Baron-Cohen, Knickmeyer, & Belmonte, 2005, 2011; Knickmeyer & Baron-Cohen, 2006), exposure to higher levels of testosterone in utero affects the development of the fetal brain, masculinizing it to display “systemizing” behaviors. There are a number of theories that assert a connection between sex hormones and autism. An implausible biological risk factor for both illnesses is higher testosterone exposure. The maternal ovary is the primary site of increased androgen synthesis during pregnancy, although the adrenal glands of both the mother and the fetus also play a role in this healthy rise in androgen levels. In addition to real testosterone levels, the sensitivity of an androgen receptor, which is governed by the number of CAG repeats in the first exon of the gene encoding the androgen receptor, also affects the androgen activity of testosterone (AR). With a mean of 22, triplets often have between 11 and 35 repetitions [32]. The transcriptional activity of androgen-dependent genes is inversely correlated with the length of this polymorphism chain. Hence, the increased transactivation activity of AR that enhances the androgenic impact is caused by the decreased number of CAG repeats. Moreover, it has been noted that a polymorphic CAG sequence in the gene for AR co-varies with the amplitude of 2D:4D. A reduced number of CAG repeats in the AR gene (greater sensitivity of AR) has been linked to ASD, ADHD, conduct disorder, oppositional defiant disorder, and violent criminal behavior in several human studies.

To the best of our knowledge, no studies have looked at complex androgen activity (including AR sensitivity and testosterone levels) in relation to comorbid hyperactivity symptoms in kids with ASD, despite the fact that these symptoms are frequently present in people with ASD and have clinical significance.

Children with ASD are overwhelmingly male, and elevated testosterone activity may play a role in the etiopathogenesis of the disorder. In neurotypical groups, the symptoms of ADHD and hyperactivity are predominately male and frequently associated with elevated androgen activity.

The influence of ADHD & ASD on personality

Individuals with ADHD and ASD disorders are known for having gifted traits such as spirited, creative, intelligent, and excellent problem solvers. Despite this, individuals struggle to remain in the present, foresee the results of their current acts, and draw lessons from the past. They frequently take risks due to their impulsive behavior without taking other aspects into account..

CREATIVITY AND SPONTANEITY: Individuals with ADHD are incredibly imaginative and adaptable. One of their biggest assets is their capacity to “think outside the box.” They struggle to control the uncontrollable clouds of invention and imagination that are generated by their “default mode network,” which lacks a functioning switch-off button. Their overactive imaginations are virtually constantly exploring amazing and fascinating concepts. They typically don’t feel bound by one plan because of their spontaneity and “go with the flow” character. In addition, they are more than prepared to supply a backup plan if it sounds interesting.

ASTOUNDING PROBLEM-SOLVING SKILLS; They frequently have a talent for solving issues. If they become fixated on a difficult problem, they may overcompensate in order to solve it, in addition to the possibility that the scenario will grow tedious to them once it is no longer a struggle. They occasionally have a tendency to offer a straightforward yet efficient answer to a conundrum or issue that would stump someone else with an ordinary Intellect. Perhaps this explains why those with higher IQs are more likely to get ADHD. In reality, scientific researchers have noted that having a high IQ has “a few drawbacks, one of which is ADHD.”

HAVING ENDLESS AMOUNTS OF ENERGY; Some people with ADHD are frequently very active. They can accomplish practically everything they set their minds to if they can focus their limitless energy on what they love.

HYPERFOCUS; Although distractibility is their defining characteristic, people with ADHD can also lose themselves in the things they love to the point where they are no longer bothered by any outside distractions. Although being hyper-focused causes them to lose track of time and become unaware of their surroundings, it also empowers them to take any necessary steps to complete the task.

EASILY DISTRACTED: Their overactive minds constantly shift between tasks. They just are unable to understand how to start a task and how to finish it. They might suddenly jump into the middle of a project and begin working simultaneously in all directions. When forced to concentrate on things that look tedious, they have a defective off-switch for mind-wandering. As a result, completing tasks that call for planning and organization may be put on the back burner and meeting deadlines becomes a significant challenge. One can help them develop their positive traits and show them how to control their negative ones. With the aid of this strategy, we will be better able to assist people with ADHD in excelling in all areas of their lives.

Little empirical attention has been paid to the distinctive qualities of people with ASD as they are expressed in their fundamental personality traits. Autism has never been researched as a moderator of accuracy in rating one’s own personality, despite the assumption that people with ASD are unaware of their peculiar features and generally lack self-insight (Frith & Happé, 1999; Raffman, 1999). (i.e., trait self-knowledge).

“In my experience, people with autism are extremely likely to be dedicated and hard workers, sincere and enthusiastic, courteous and respectful, kind and caring, and polite and respectful. They are terrific people, good friends, and good employees because of these attributes.

Brain development has been impacted in some way by ASD or ADHD. Most significantly, that comprises executive functioning, which is in charge of impulse control, decision-making, time management, focus, and organizational abilities. Social skills are also impacted for many kids. ADHD is frequently linked to a number of personality disorders, particularly the Cluster B disorders, which include Borderline, Antisocial, Narcissistic, and Histrionic Personality Disorders. As the term suggests, those who have ADHD struggle to focus their attention and remain on task. Both men and women can suffer from attention-deficit hyperactivity disorder (ADHD), although research suggests that men are more likely than women to have it. Yet, compared to boys, girls with ADHD are more frequently identified as being predominately inattentive.

In general, ADHD profiles are not sex specific and show more similarities than differences between boys and girls. The prevalence of sadness and anxiety may be higher, although physical violence and other externalizing behaviors are less common in girls and women with ADHD. Adolescent females with ADHD also have lower self-efficacy and less effective coping mechanisms than teenage boys with ADHD. When compared to women with ADHD, men appear to be locked up more frequently. Small sample sizes, referral biases, disparities in diagnostic techniques, and potential rater impacts are problems in many research, too.

The information now available leads one to believe that both boys and girls are likely to benefit equally from treatment. Referral bias, on the other hand, is a concern since women with ADHD are less likely than men to receive treatment referrals.

SOCIALIZATION CHALLENGES; According to Wing and Gould (1979), individuals with ASD are prone to anxiety, resistant to change their routines, and socially withdrawn or averse. They also tend to prioritize social interactions on par with other social stimuli (Mundy, Gwaltney, & Henderson, 2010). Even if they are interested in social interactions, people with ASD may not have the necessary social skills to carry them off successfully (Bauminger, Shulman, & Agam, 2003). The crippling interpersonal impairments that persons with ASD experience are thought to be caused by a neurocognitive deficit in the ability to understand other people’s thoughts, feelings, and behaviors, possibly even their own (Baron-Cohen, 2009; Chevallier et al., 2012; Perner et al., 1989; Hobson, 1993).Given the distinctive attributes of people with ASD, it is reasonable to assume that their personality profile, or the distinctive set of traits defining their usual patterns of thinking, feeling, and behaving, would differ significantly from the modal personality. Due to their issues with communication and social interaction, as well as their propensity to avoid social contact rather than view it as rewarding, people with ASD will have lower levels of extraversion (Mundy et al., 2010; Volkmar & Klin, 2000).

ADHD & ASD Impacts on careers, interpersonal relations, and health 

Interpersonal Relation: The talents and abilities of people with ADHD may differ from those of their neurotypical counterparts in a number of ways. Hyperfocus, fortitude, creativity, conversational prowess, spontaneity, and an abundance of energy are a few examples.

Interpersonal relationships: Due to their impulsivity, hyperactivity, and lack of focus, people with ADHD frequently struggle with social challenges, rejection from others, and interpersonal relationships. Such unfavorable interpersonal consequences result in emotional sorrow and pain.

Career: ADHD can make it challenging to perform job-related tasks. One may struggle to keep concentrate, finish projects, maintain interest, or fulfill deadlines, depending on the diagnosis and the severity of the disease. Moreover, boredom can be a problem, which can impair one’s capacity for work as well as their general health and wellbeing. According to Roberts, many persons with ADHD succeed as business owners, computer programmers, and in the creative sectors because of their special capacity to solve issues and develop solutions when engaged in their work.

Health: ADHD is a common condition that might affect your ability to focus, maintain your composure, or consider your actions before acting. Individuals with features that fall under both the autism and ADHD diagnoses frequently encounter more severe difficulties than those with only one of the disorders: They may have more severe social and cognitive problems as well as significant deficits in adaptive functioning, which is a phrase for daily living and self-care abilities. regular medication use Medication is typically used as part of ADHD treatment. Children with ASD may respond better to non-drug alternatives, however, as there are still few pharmacological options available. They might include behavioral treatment to help with symptom management and skill development to help with day-to-day coping. The importance of eating for a kid with ASD cannot be overstated because sensory-based food restriction can lead to nutritional deficiencies. Stimulant drugs for ADHD sufferers may experience appetite loss, which has an impact on their physical vitality and looks.

CONCLUSIONS

Despite the fact that conditions like ADHD are incurable, persons who have been diagnosed with them can have happy lives if given the right resources and assistance. The goal of treatment is to lessen your child’s symptoms and support them in leading a contented, well-adjusted life. Although more modern techniques include food and activity changes, traditional therapy methods still include drugs and behavior management. Behavioral intervention is another name for behavioral therapy. It aids those who have ADHD of the inattentive type in functioning at work, school, or home. For people with inattentive type ADHD, eliminating distractions and unpredictability is essential to leading effective lives.

The criteria for ASD in the recently published DSM 5 have been regarded as an effective framework to boost the homogeneity of study samples and motivate researchers to find potential subtypes within ASD. According to behavioral/emotional issues, a research by Lecavalier cluster analysis identified many subtypes of ASD, one of which was distinguished by higher rates of hyperactivity as assessed by teachers. In contrast to the other subtypes of the spectrum, ASD accompanied with hyperactivity may be one of the subtypes, with distinct biological bases and needing particular behavioral and pharmaceutical interventions. It is crucial to have a better knowledge of the causes of ASD and hyperactivity. It might show shared causative pathways and give hints for better treatment alternatives, such as counseling for comorbid symptoms rather than treating each disorder separately.

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