Autism and ADHD Co-Occurrence: A Case report and literature review

This case report describes the clinical profile of a four-year-old male presenting with multiple developmental delays, including cognitive impairment, speech delay, and hyperactivity, following an episode of neonatal hypocalcemia. Born full-term via cesarean section after an uneventful pregnancy, the child exhibited delayed initiation of crying, requiring NICU observation. Early feeding difficulties and a diagnosis of hypocalcemia were noted. By the age of two and a half, parental concerns escalated regarding poor attention span, speech unintelligibility, and delayed social communication. Although gross motor milestones were achieved on time, the child showed significant deficits in language processing, attention regulation, and adaptive skills, including feeding and toilet training. Symptoms aligned with Attention-Deficit/Hyperactivity Disorder (ADHD) were evident, and minimal progress was seen despite therapeutic intervention. The clinical presentation suggests the possibility of an underlying neurogenetic syndrome, such as 22q11.2 deletion syndrome. This case emphasizes the importance of considering metabolic and genetic etiologies in the differential diagnosis of developmental delay. Early identification and multidisciplinary management are critical for improving long-term functional outcomes in children with complex neurodevelopmental disorders.