ADHD or Aspergers?

Post Reply New Topic

I posted this question over on the General board to see what info I might get but here is the situation.

Both my boys have been previously dx'd with Aspergers by more than one doc. But for School we had to get a new eval with a new doc and due to the Doc's "observations" it's only ADHD and a LD.

I know it's Aspergers, but it got me thinking. When is it ADHD and when is it Aspergers? I know they look so much alike sometimes but I am confused. Altho they will qualify for an IEP now (didn't before) my dh and I worry they will not get the exact services they really need unless there exact needs are identified. Even tho by law they have to fit the individual needs of my children, we all know SD's who don't work that way. (It's a very difficult SD to work with here)

So what are the things/traits that make it more than just ADHD?

Thanks

My sons are dxed with both. The things that go beyond ADHD are the social deficits, such as difficulty with eye contact, and difficulty understanding jokes and figures of speech etc. ADHD is inattention and/or hyperactivity, not necessarily difficulties with pragmatic language, repetitive body movements, "special interests", rigidity etc.

Looking at the DSM-IV definitions may help in clarifying the differences.

Could be both. I am digonosed with ADHD and having a Non Vebal Learning disorder/disibility.

I am under the impression that many kids are mistakenly labeled ADD when it really is AS, although it certainly is possible to have both. If I understand it correctly, the difference is what causes the inability to focus. In ADD, the disraction is internal; it wouldn't matter what situation you put the child in, they will always have trouble staying on a single focused task (althougth there can still be exceptions). My sister is ADD (undiagnosed) and she is always a buzz of activity, can't stay organized without some significant tools, but she is also a social wiz making her career in PR. I have concerns about ADD with my daughter, as well, but she does so well in school that no one has much interest in considering a diagnosis. With my son, there was a lot of worry about ADD, but once you mitigated all the sensory problems, he would focus just fine. The distractions for him are external, not internal. In a controlled environment, he is naturally single minded. My daughter, however, will still buzz onto something else, or have a new thought she just "has" to follow, and so on.

It is important because it affects treatment. When AS is mistaken as ADD you can end up medicating a child that doesn't benefit. Meds are too easy an answer, IMHO. Always look more carefully.

My son was dx'd through the school with AS. We then went to a neuro who agreed with the dx and then further evaluated him and dx'd him with ADD in a ddition to the AS. He's had a horrible time trying to focus, although he can hyperfocus very well, and even did this in class and totally missed the whole class getting up to get breakfast! I have heard a lot of people being dx'd with both AS and ADHD/ADD. He does have social awkwardness and is very easily led.

My son was dx with dyspraxia at 8yrs ,Aspergers at 11yrs, hyper mobility disorder at 14yrs by Great Ormond Street Hospital. He was a very floppy baby & a late walker & talker & always falling over ,so when he was dx with Dyspraxia the hyper mobility disorder it made sense, but the Asperger i still question, he suffers a great deal of anxiety, social phobia which can manifest itself Only recently i found out that anxiety, panic attacks agoraphobia are strongly linked to hyper mobility disorder that it is genetic. Just for the record hyper mobility Disorder means a person is very bendy, flexible, double jointed , may have bad posture , tie very easy, may find sports hard.

I agree that it can easily be both. We went to see a well known Neuropsych a few years ago and she said that it's quite common to see "one if not all of the big three" in these kids, which was ADHD, AS, Tourettes. My son has all three. We suspected ADHD first but he got AS as his first dx, then ADHD, then Tourettes.

There's no reason why it has to be one or the other. In my son's treatment we had to treat the issues he had in order of what was most severe. Tied for first place was anxiety and hyperactivity, both of which directly impacted his social skills. He definitely carries strong traits in all three of his dx's

I was incorrectly diagnosed as ADHD (inattentive type), later on "no evidence of impulsivity was found". I think it is because I have serious attention problem caused by an underling cognitive dysfunction. Most attention problems are associated with "impulsivity" nowadays as is the fashion, and the not impulsive cases don't get the attention;) they deserve. However when I was considered ADHD, I was also diagnosed as ASD. I think it is poor show for school skinks to be so sure of themselves and also schools that think they know best. I agree the PTA/parent groups, or individual pushy parents can be a bane too, what you really need is a common sense balance.

Hyperactivity and stimming are a response to different parts of the brain needing stimulation.

This can be tough thing to distinguish because a lot of the end behaviors are the same with AD and ADHD. I've been forced to research this a lot because we have a couple of family members that are struggling with the idea of the AD diagnosis and insist my daughter is just ADHD and isn't on the spectrum. Here is what I've come up with:

The difference is mainly in the reasons behind the behavior:

-both ADHD and AD children have social difficulties. For the ADHD child, it's because they lack control. They may talk over others because they can't wait to tell their ideas. They are impulsive and may ignore others in pursuit of what they want at the moment. For the AD child, it's because they can't understand that other people have thoughts, feelings, motivations, and desires different than their own. They can't tell when when other people are uncomfortable or irritated. ADHD kids make appropriate eye contact and understand body language. Aspie kids do not.
-A child with ADHD knows what to do but forgets to do it, or gets distracted. An AD child doesn't understand the rules or why a rule exists. AD kids are very rule bound and once they understand and agree to a rule, they will rarely or never break that rule again. ADHD kids will repeat the same behavior due to a lack of self control.
-Kids with ADHD tend to be disorganized and have difficulty following a routine. AD kids need absolute organization and follow a strict routine, and have significant problems when the routine is not followed.
-Both types of kids have problems focusing: for ADHD kids they are easily distracted and not detail oriented, they tend to see things as in a "big picture" perspective. Aspies get stuck on very small details and cannot focus on the rest of the task until the small detail is resolved. They have no "filter" so to them the teacher's earrings are as important as what the teacher wrote on the board.
-ADHD meds can help children with both disorders...BUT for an ADHD child the problem is largely resolved by the meds, while for AD kids some symptoms are decreased. For example, when you give an ADHD kid medication, many of their social problems are solved because it helps their self control. For the AD child, the social problems continue because they are caused by not being able to read other people, not impulsivitity.
-Another big difference is the sensory integration problems: these extreme sensitivities to sensory input is unique to kids on the spectrum. An ADHD child may have trouble focusing if a lot is going on, but for the Aspie kids sensory overload is downright painful. My daughter will hear the vacuum cleaner and run outside crying and covering her ears because the noise is hurting her, and will sometimes vomit if she tries to eat something that turns out to have a objectionable texture (for example, she loves brownies, but if she puts a brownie in her mouth and bites into a walnut she spits it out and feels sick afterward)...ADHD kids wouldn't do this.

A secondary thing I want to mention (ok this is a picky detail...lets just say my kid got this from somewhere!): per the DSM IV one child cannot be correctly diagnosed as ADHD and Asperger's, although it seems a lot of clinicians are doing this. ADHD can only be diagnosed when related behaviors are not attributable to another disorder. Since AD kids have many behaviors that are similar but are attributed to the Asperger's, the correct diagnosis for a kid that seems to have "both" would be Asperger's syndrome with associated attention deficits"

Oh boy I wouldn't putt too much weight on what either the DSM or clinicians say. Psychiatry is pseudoscience. One of the main reasons for being pseudoscientific is its completely arbitrary nature. There are arbitrary reasons for inclusion or ruling something out, being mutually exclusive or not. They can’t justify their reasons because there simply isn’t the evidence for the most part.

The fact is it is just guess work, but not done in a very methodical way, and poor data collection practices. It is actually amazing how little raw data they have collected considering how long the discipline has been around.

The DSM itself lacks authority because it takes them ages to update it, so only do after decades of talking about it, therefore it is already years out of date by the time it get published, and continue to promote this arbitrary checklist/mnemonic culture.

Consider this: Psychiatry on the whole acknowledges the spectral nature of things, but very little of what they do actually reflects this. If you allow different traits to be free moving through analysis, then that allows for the possibility that things may or may not be bolted together. If you assume traits are not free moving but bolted together, then you are unlikely to establish anything other than your fixed belief.

My understanding is consistent with eeyore's, that technically a person cannot have a diagnosis of both ADHD and AS, its supposed to be one or the other.

Also, one possible way to tell the difference is that medications like Aderal are effective with ADHD but ineffective with AS. Unfortunately, for reasons that were beyond my control, we learned this the hard way.