Autistic traits in children with comorbid Specific Learning Disorder and Attention-Deficit/Hyperactivity Disorder: cognitive, behavioral, and teacher-reported predictors

Abstract

Background: Children with comorbid Specific Learning Disorder (SLD) and Attention-Deficit/Hyperactivity Disorder (ADHD) often show elevated autistic traits, yet contributing cognitive and behavioral factors remain underexplored. This study compared cognitive-behavioral profiles of ADHD-only and SLD+ADHD groups and identified key autistic trait predictors using a multi-informant approach.

Methods: The study included 150 children aged 8-12 years, equally divided into ADHD-only and SLD+ADHD groups. Assessments included the Social Responsiveness Scale (SRS) for autistic traits, the Strengths and Difficulties Questionnaire (SDQ) for emotional-behavioral problems, a teacher-rated SLD Symptom Checklist (SLD-SC), and a clinician-administered cognitive battery (SLD-Battery of Cognitive Skills [SLD-BC]).

Results: Controlling for ADHD medication, children with SLD+ADHD had significantly higher SRS scores (p < .001), greater impairments on SLD-SC and SLD-BC, and higher SDQ-impact scores (p = .046). Stepwise regression identified SLD diagnosis, SLD-SC motivation and hyperactivity, SLD-BC head test and motor skills, and SDQ peer problems and hyperactivity as significant predictors of SRS scores, explaining 48.0% of the variance (R2 = .480, F(7, 142) = 18.703, p < .001).

Conclusion: Autistic traits in children with neurodevelopmental comorbidity are closely tied to motivational, executive, and sensorimotor deficits. Findings emphasize the need for integrated cognitive, behavioral, and teacher-reported evaluations to guide targeted interventions in complex developmental profiles.