Children with both autism and ADHD more likely to bully

Children with both autism and attention deficit or attention deficit hyperactivity disorders are four times more likely to bully than children in the general population, according to a study released in the journal, Ambulatory Pediatrics.

However, the researchers caution against labeling these children simply as bullies.

"This is the first nationally representative study of bullying behaviors among children with autism. The majority of parents of children with autism and ADD or ADHD were concerned about their children's bullying behaviors, but there is much we do not yet understand. It is too early to label these children as bullies." said Guillermo Montes, Ph.D., senior researcher at Rochester, N.Y.-based Children's Institute. "These children may have pent up energy that needs to be properly channeled, or they may have other underlying behavioral or medical issues that have not been addressed."

The study pulled data from the 2003 National Survey of Children's Health conducted by the National Center for Health Statistics. The sample included 53,219 children ages 6 to 17. The researchers were interested in finding out whether children with autism were more likely to bully other children. They hypothesized that that children with autism may bully more often because they are more often male (who are more likely to bully); they are more likely to be bullied (and victims are more likely to bully); and many children with autism require treatment for aggression (which potentially includes bullying).

But the researchers did not find that children with autism had a higher rate of bullying unless they also had ADD or ADHD. Those with both disorders showed a rate four times higher than children with just autism and with children overall. They also had a higher rate of bullying than children with ADD or ADHD but no autism. This poses an important opportunity for health care providers who see children with autism and ADD or ADHD, which occurs in about half of children with autism spectrum disorders.

"It would be helpful for clinicians to be aware that so many parents of children with both autism and ADHD are describing bullying behaviors," said Jill Halterman, M.D., M.P.H., associate professor of Pediatrics at the University of Rochester Medical Center and second author of the paper. "These children may benefit from additional support services, such as from a behavioral or mental health specialist, depending on the severity of symptoms. These services may be available through community based organizations or from the broader health care system."