ASD with Comorbid ADHD as a Predictor of Bullying Behaviors Morgan Jolliffe, B.A.; Ruth Ellingsen, Ph.D.; Elina Veytsman, B.A.; Elizabeth A. Laugeson, Psy.D. UCLA Semel Institute for Neuroscience and Human Behavior UCLA Tarjan Center UCEDD BACKGROUND PROCEDURES DISCUSSION Prior research suggests that children with Attention-Deficit/Hyperactivity Disorder (ADHD) are more likely to be perpetrators of bullying behaviors than children without ADHD (Bacchini et al. 2008). While youth with Autism Spectrum Disorder (ASD) are no more likely to bully others than typically developing adolescents (van Roekel et al. 2010), the presence of ADHD in ASD might be a contributing factor to the bullying dynamic. Little research has been conducted on bullying behaviors in adolescents with ASD and comorbid ADHD. Bullying has been shown to predict later self-esteem problems and loneliness (Tritt & Duncan, 1997), and therefore it is important to understand the potential impact of these comorbid diagnoses on bullying behaviors. Understanding the different social challenges adolescents presenting with both ADHD and ASD face may inform social skills interventions. In order to assess for ASD, parents completed the SRS-2 All participants had clinically elevated ASD symptoms, as determined by a total score ≥ 60 M = 74.62; SD = 13.61 Similarly, in order to assess ADHD symptoms, parents completed the SNAP-IV Inattention Subscale clinical cut-off = 1.8 and the Hyperactive/Inattentive Subscale clinical cut-off = 2.4. Bullying behaviors were measured using the SSIS parent-report Measure of social skills, problem behaviors, and academic competence. All assessments were conducted at baseline prior to treatment. These results suggest that adolescents with ASD and clinically elevated ADHD hyperactive/impulsive symptoms engage in more bullying behaviors that those without hyperactivity/impulsivity. This study highlights the importance of understanding the risks of hyperactivity and impulsivity with regard to the perpetration of bullying behaviors, particularly those with comorbid ASD. Prior research suggests that youth with ADHD not only bully more, but also experience more victimization (Wiener & Mar, 2009; Blake et al., 2016). Understanding the different social challenges adolescents with ASD face when comorbid hyperactive/impulsive symptoms are present may inform the development of more targeted social skills interventions. RESULTS Across the total sample, 74 adolescents met the clinical cutoff for ADHD on the SNAP-IV, with the majority demonstrating clinically elevated inattention (n=60) and the minority exhibiting hyperactive/impulsive and inattentive combined symptoms (n=14). The remainder of the sample had ASD alone, with no ADHD symptoms (n=89). An ANOVA was used to assess group differences in the perpetration of bullying behavior. Findings suggest that participants with ASD and clinically elevated hyperactive/impulsive and inattentive combined symptoms demonstrated more bullying behaviors than the group with ASD only (p=.05). Results further reveal that adolescents with ASD and clinically elevated inattentive symptoms did not differ from the group with ASD only. REFERENCES OBJECTIVE & HYPOTHESIS Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., & Swanson, J. M. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms psychometric properties and normative ratings from a school district sample. Assessment, 15(3), 317-328. Bacchini, D., Affuso, G., & Trotta, T. (2008). Temperament, ADHD and peer relations among schoolchildren: The mediating role of school bullying. Aggressive Behavior, 34(5), 447-459. doi:10.1002/ab.20271. Blake, J. J., Kim, E. S., Lund, E. M., Zhou, Q., Kwok, O., & Benz, M. R. (2016). Predictors of bully victimization in students with disabilities. Journal of Disability Policy Studies, 26(4), 199-208. doi:10.1177/1044207314539012. Constantino, J. N., & Gruber, C. P. (2012). Social Responsiveness Scale-Second Edition. Los Angeles: Western Psychological Services. Gresham, F. M., & Elliott, S. N. (2008). SSIS rating scales. Minneapolis, MN: NCS Pearson. Tritt, C., & Duncan, R. D. (1997). The relationship between childhood bullying and young adult self-esteem and loneliness. Journal of Humanistic Education & Development, 36(1), 35. Van Roekel, E., Scholte, R. H. J., & Didden, R. (2010). Bullying Among Adolescents With Autism Spectrum Disorders: Prevalence and Perception. Journal of Autism and Developmental Disorders, 40(1), 63–73. http://doi.org/10.1007/s10803-009-0832-2 Wiener, J., & Mak, M. (2009). Peer victimization in children with Attention-Deficit/Hyperactivity Disorder. Psychology in the Schools, 46(2), 116-131. The purpose of this study was to examine whether adolescents with ASD exhibit different levels of bullying behaviors when comorbid subtypes of ADHD are present (ADHD-combined type, ADHD-inattentive type, & ADHD-hyperactive/impulsive type). We hypothesized that adolescents with ASD and comorbid ADHD-combined type or hyperactive/impulsive type would exhibit higher levels of bullying behaviors than adolescents with ASD only. METHODS PARTICIPANTS N = 163 adolescents in middle or high school presenting for social skills treatment the through the UCLA Program for the Education and Enrichment of Relational Skills (PEERS®; Laugeson & Frankel, 2010), an evidence-based, parent-assisted social skills program for adolescents with ASD and other social challenges. Gender: Males=76%; Females=24% Age: 11-18 years (M=13.68, SD=1.79) Ethnicity: 62% Caucasian (n=101), 17.8% Asian American (n=29), 10.4% Latino (n=17), 7.4% African American (n=12), and 2.5% Other (n=4). MEASURES Social Responsiveness Scale-Second Edition (SRS-2; Constantino & Gruber, 2012) Swanson, Nolan, and Pelham Questionnaire, 4th edition (SNAP-IV; Bussing et. al., 2008) Social Skills Improvement System (SSIS; Gresham & Elliot, 2008) ACKNOWLEDGEMENTS The authors would like to thank the dedicated program staff, research coordinators, and families who participated in this study. CONTACT INFORMATION For additional information please contact: Morgan Jolliffe at mjolliffe@ucla.edu or (310) 26-PEERS Or visit the PEERS website at www.semel.ucla.edu/peers