{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T07:40:14Z","timestamp":1793173214851,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T00:00:00Z","timestamp":1589414400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007269","name":"School of Medicine, Oregon Health and Science University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate if autism symptoms and diagnoses are more common in children with neurofibromatosis type 1 (NF1) than in typically developing children, to which levels, and to determine if co\u2010occurring attention\u2010deficit\/hyperactivity disorder (ADHD) symptomatology accounts for this increase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We searched hospital electronic medical records (EMR) for International Classification of Diseases, 10th Revision NF1 and co\u2010occurring diagnoses codes. We recruited a subsample of 45 children (mean age 9y 2mo; SD 2y 7mo; range 5\u201312y; 22 males, 23 females) and collected parental reports of autism symptomatology, adaptive behavior, and behavioral problems that were compared to those of 360 age\u2010 and sex\u2010matched controls from the Simons Simplex Collection (SSC) with autism spectrum disorder (ASD; SSC\u2010ASD) or typically developing (SSC\u2010TD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The EMR search identified 968 children with NF1; 8.8% had ADHD and 2.1% had ASD co\u2010occurring diagnoses. In the subsample, the mean autism scale score for participants with NF1 was below cut\u2010off for significant autism symptoms. Participants with NF1 had significantly more autism and behavioral symptoms than SSC\u2010TD participants, and significantly less than SSC\u2010ASD participants, with one exception: ADHD symptom levels were similar to those of SSC\u2010ASD participants. In analyses that controlled for internalizing, ADHD, and communication scores, the difference in autism symptom levels between participants with NF1 and typically developing controls disappeared almost entirely.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Our results do not support an association between NF1 and autism, both at the symptom and disorder levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Diagnoses of attention\u2010deficit\/hyperactivity disorder (ADHD) were more common in children with neurofibromatosis type 1 (NF1) than in the general child population.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Diagnoses of autism spectrum disorder were no more common in children with NF1 than in the general child population.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Increases in autism symptoms did not reach clinically significant thresholds.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Co\u2010occurring ADHD symptoms accounted for increased autism questionnaire scores.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Adaptive behavior in participants with NF1 showed normal socialization but lower communication proficiency.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14558","type":"journal-article","created":{"date-parts":[[2020,5,14]],"date-time":"2020-05-14T10:34:35Z","timestamp":1589452475000},"page":"226-232","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Autism and attention\u2010deficit\/hyperactivity disorders and symptoms in children with neurofibromatosis type 1"],"prefix":"10.1111","volume":"63","author":[{"given":"Hadley","family":"Morotti","sequence":"first","affiliation":[{"name":"Department of Molecular and Medical Genetics Oregon Health &amp; 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Science University Portland Oregon USA"},{"name":"Institute on Development &amp; Disability Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian J","family":"O'Roak","sequence":"additional","affiliation":[{"name":"Department of Molecular and Medical Genetics Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8605-3538","authenticated-orcid":false,"given":"Eric","family":"Fombonne","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Oregon Health &amp; Science University Portland Oregon USA"},{"name":"Institute on Development &amp; Disability Oregon Health &amp; Science University Portland Oregon USA"},{"name":"Department of Psychiatry Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,5,14]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"GeneReviews\u00ae [Internet]","author":"Friedman JM","year":"1993"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2017.00227"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.13526"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(99)70296-9"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.32095"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2012.04377.x"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-016-2789-2"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-016-2877-3"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199711000-00019"},{"key":"e_1_2_7_11_1","first-page":"15","article-title":"Neurofibromatosis in infantile autism and other types of childhood psychoses","volume":"55","author":"Mouridsen SE","year":"1992","journal-title":"Acta Paedopsychiatr"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-002748"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781108297769.003"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6706a1"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1868"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.32280"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12043"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12038"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.04.075"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.2600"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13229-016-0072-1"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2016.09.490"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2012.02589.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2010.10.006"},{"key":"e_1_2_7_25_1","volume-title":"Manual for the ASEBA school\u2010age forms & profiles","author":"Achenbach TM","year":"2001"},{"key":"e_1_2_7_26_1","volume-title":"Vineland Adaptive Behavior Scales (2nd edition)","author":"Sparrow SS","year":"2005"},{"key":"e_1_2_7_27_1","volume-title":"Social Responsiveness Scale (2nd edition)","author":"Constantino JN","year":"2012"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005596502855"},{"key":"e_1_2_7_29_1","volume-title":"Social communication questionnaire","author":"Rutter M","year":"2003"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.175.5.444"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-013-2755-z"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2018-300050"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000179303.72345.ce"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12941"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2018.28"}],"container-title":["Developmental Medicine &amp; 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