الفهرس 
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Abstract
The current study aimed to detect the frequency of ADHD symptoms in children with ASD and its relation to the severity of autism and to assess behavioral problems in children with ASD. To obtain this aim, 150 patients with primary ASD diagnosis who were following up at Ain Shams University, Pediatric Department, Developmental and Behavioral clinic were included.
from the current study, we can sum up the following:
• Screening by Conners Parent Rating Scale for ADHD symptomatology found that the prevalence of ADHD is 100%. Patients were divided into two groups according to the degree of ADHD into 2 groups: group A: consists of 22 (14.6%) ASD patients with mild to moderate ADHD. group B: consists of 128 (85.3%) ASD patients with severe ADHD.
• The majority of studied patients (84.0%) were living in urban areas. Severe ADHD significantly associated with higher incidence of education at special needs school (P=0.000).
• Severe ADHD significantly associated with lower maternal education (P=0.035), higher incidence of jobless father (P=0.035), lower parity (P=0.047), higher incidence of prenatal problems (P=0.037), presence of family history (P=0.041), use of antipsychotics (P=0.001), and atomoxetine (P=0.017), higher CARS scores (P=0.000), higher incidence of severe CARS (P=0.001), higher VABS IQ scores (P=0.000), and significantly higher incidence of severe VABS IQ (P=0.000).
• CBCL scores among patients with severe CARS level indicate more severe behavioral and emotional difficulties compared to patients with mild to moderate CARS level. CBCL scoring is significantly lower in individuals with more severe deficits, indicating more pronounced behavioral and emotional challenges in this subgroup.
• Female patients had significantly higher levels of somatic complaints when compared to males. Urban residents showed significantly lower social interactions as well as significantly higher levels of ADHD problems when compared to rural residents. Significant differences were observed in various behavioral and emotional domains among children with different education levels. Patients with prenatal problems tend to display significantly higher levels of somatic complaints (P=0.003), and somatic problems (P=0.004). Children exposed to prenatal medication tend to exhibit higher levels of anxious-depressed behavior (p = 0.037) and internalizing problems (p = 0.03). Children with developmental delays exhibit significantly lower scores in school behavior (p = 0.019), as well as significantly higher levels of rule-breaking behavior (p = 0.007), aggressive behavior (p = 0.001), and externalizing problems (p = 0.001), and total scores across multiple scales (p = 0.009 for sum of (a) + (b) + (c); p = 0.037 for total CBCL scoring). Moreover, they demonstrate higher levels of oppositional defiant problems (p = 0.034) and conduct problems (p = 0.012) according to DSM-oriented scales.
• Comparison of CBCL scoring across different socioeconomic statuses reveals significant differences in various behavioral and emotional. Patients with low SES demonstrate lower scores in school-related behavior (p = 0.000) and overall total CBCL scoring (p = 0.018), indicating potential challenges in academic and overall functioning. Additionally, patients with low SES exhibit higher levels of aggressive behavior (p = 0.002), externalizing problems (p = 0.007), and total DSM-oriented problems (p = 0.002), suggesting increased behavioral difficulties. Patients with low SES had lower levels of affective problems, anxiety problems, and attention deficit/hyperactivity problems according to DSM-oriented scales.
• Patients with a positive family history had significantly higher scores in school-related behavior (p = 0.004), somatic complaints (p = 0.026), rule-breaking behavior (p = 0.004), externalizing problems (p = 0.006), and total DSM-oriented problems (p = 0.037). Patients with a positive family history had significantly lower levels in withdrawn-depressed behavior (p = 0.004) and other problems (p = 0.040).
• Anxious Depressed, Withdrawn-Depressed, and Internalizing behaviours positively correlated with age of patient. While Aggressive Behavior and Externalizing negatively correlated with age of patient. Thought problems positively correlated with age of father. Withdrawn-Depressed behavior, internalizing behavior, Thought problems and Somatic problems positively correlated with age of mother. Withdrawn-Depressed behavior, internalizing behavior, and Affective problems positively correlated with parity.
• Positive correlations exist between these domains and the age of onset. Additionally, positive correlations are observed between thought problems and the number of siblings. There were significant negative correlations between CBCL scores and VABS IQ.