I don't understand the confusion between AS and ADD

Post Reply New Topic

I don't understand why people seem to have a difficult time distinguishing whether someone has AS or ADD. They seem as different to me as apples and lettuce, so I was hoping someone could explain ways in which they think they manifest in a similar manner.

I cannot understand it either. I think what people are really misunderstanding are those people who really do have BOTH--Aspies, with comorbid ADHD. People might have trouble figuring out which symptoms belong to AS and which belong to ADHD. The two are SO different though. I have moderate classic autism. My niece--who lives with me--has severe ADHD. I have no comorbid ADHD. She is nowhere on the spectrum. We are absolutely NOTHING alike, and NO ONE mistakes us for having the same disorder. No one!

http://www.primarypsychiatry.com/aspx/a ... cleid=1952

because in small children they can have alot of the same symptoms, or what outwardly looks like adhd symptoms but are actually not. that doesn't mean all cases look the same, not everyone has the same symptoms.

http://www.mugsy.org/connor112.htm

I would still say most of those probably have both. Doctors never thought I had ADHD (and I have been to more than 20 as a child and ADHD runs in my immediate family). My niece never had any ASD symptoms either as a child. I believe the ones who have similar symptoms are ones who truly have both together.

Often kids are diagnosed with ADHD first b/c poor attention and hyperactivity stand out like a sore thumb. Later the parents see additional symptoms not explained by the ADHD lable. Then the child is diagnosed with AS and the parents are confused.

Tracker's book has a fantastic illustration of the nest of details that an aspie holds in his brain on any given subject. He has to sift through the details to get what his needs. I don't think this is ADD. I think this is a brain that has to work harder to retrieve or process info. My son's therapist was going to call him AS and ADD. I stopped her, saying the inattention was simply a slow processing speed when he does math.

Both aspies and ADHDers stim but with ADHD it's called fidgeting. Sensory issues can be mistaken as ADHD. A child with autism may have a hard time paying attention in class and staying focused because of all the sensory issues going on from the noise. So that can be mistaken as a short attention span. Also an aspie rocking back and forth, that can be mistaken as being hyper and fidgeting. Same as pacing and foot tapping and fiddling with objects and staring at objects. Staring at objects can be mistaken as daydreaming.

Also they are both impulsive and may say things without thinking. But an aspie may not be aware of what they say is inappropriate while an ADHD person does know but they can't control their impulse. Plus they both have a hard time with organization.


So that is why most aspies get misdiagnosed with ADHD. Some of them do truly have it but it's still not the correct diagnoses because it doesn't explain everything.

I was suspected as having ADHD but I got diagnosed with ADD instead. Mom knew that wasn't the correct diagnoses because it still didn't explain everything and the treatment I was getting for it wasn't working.

Last edited by League_Girl on 11 Sep 2011, 1:48 am, edited 1 time in total.

Yes, this is true, but I think ADHD fidgeting and ASD stimming is a bit different though. My niece cannot sit still, but it is not a repetitive movement over and over again. Also her's are not so much to block out input as they are to simply create output because she is unable to sit still.

Edit: Of course, I realize I keep using my niece as an example, but this is because she is the most severe person I know with it. The other ADHDers in my family do this as well.

My understanding is that the majority of Aspies could also meet the criteria for ADHD, at least the Inattentive type, if not the Impulsive/Hyperactive type. I can see a lot of myself in ADHD-Inattentive and I am diagnosed with AS.

This webpage, for instance, is one view of the issue: http://www.yourlittleprofessor.com/adhd.html

In any case, both Aspies and ADDers appear to have problems with executive functions: working memory, task-switching, starting complex tasks, etc. I know I have problems in these areas, and questions about executive functions show up in the AQ Test for screening Aspies, but also feature prominently in lectures on ADHD by one of the leading experts, Russell Barkley. Barkley maintains that ADHD is more an executive function and motivation problem than an "attention" problem. Everybody gets distracted by irrelevant events, but the person with poor working memory (eg the person with ADHD or maybe AS) does not go back to their original task before the interruption occurred ... they have lost their working memory of the task, they have lost the "thread" of what they were doing beforehand. Both people with ADHD and people with AS can be fixated on a task for hours if it is intrinsically rewarding (e.g special interests in AS, video games in ADHD) - they can attend when they are motivated, but they are not motivated by distant rewards. The reward has to be immediate (e.g. a calming activity or an exciting game are self-rewarding; but homework is often not immediately rewarding unless it relates to a special interest). Of course, not all Aspies have these problems, but many appear to.

One issue is: until DSM-IV is replaced, you are not supposed to diagnose a person with ADHD if they meet the criteria for AS - they are mutually exclusive and AS takes precedence. However, in DSM-5 this restriction will be removed and it will be possible to have ASD with co-morbid ADHD. In practice, psychiatrists and psychologists have already been diagnosing some people with both conditions, despite it being against the "rules" of DSM-IV.

@one-A-N - nice answer

This post is very interesting to me. My older son was assumed to have ADD and I was positive that is not the case or at lest not the only thing going on with him. Then there is the case of my neighbors son. He is much like my two boys in some ways but very different in many others. Both my sons have aspergers but both are uniquely different in what causes glitches in their days. My neighbors son was being checked for aspergers and his mother wasted no time in asking what I thought since I have her son at my house more then the teachers at his school see him. I told her if he does it is not like in any others I have ever seen. She decided to have it checked out and sure enough the doctors (after loads of test and evaluations) came back saying that he had ADD not Aspergers.

Since we worked out some issues (like the schools insistence that he needed special ed because he could not read and after I intervened by suggesting an eye exam did they learn he needed glasses and could read fine) he no longer needs summer school and before and after school tutoring to be at level. I am so happy my neighbor did not just go with what she was being told by the school because her son is excelling now. Second opinions can be great.

Yeah I know but stimming can be mistaken for fidgeting so they think the person has ADHD than ASD.

To be honest, I can't tell the difference, not yet anyway. My daughter is on the waiting list for autism assessment (probably Aspergers). She's also hyperactive and inattentive, but to a lesser degree, I expect, than someone who'd get an ADHD diagnosis. In fact, this time last year, I thought she had a mild form of ADHD, but then the AS started to become apparent. When she's hyperactive, that's all you can see and it clouds everything else. I'm very similar to my daughter, with the exception that I always did as I was told, she never does. The hyperactivity disappeared when I was about 7yrs.

With regards to working memory, my daughter is now at an age that she can describe what's going on a bit better. She takes ages to copy sentences from the board into her jotter. I've been trying to figure out what's going on as she's a smart little cookie and can do it. It has become apparent that she's copying one letter at a time, She can't seem to hold a few letters in her working memory, only one. However, she does this even if she knows the word and how to spell it. I even saw her copying her own name like this, when I'd written on a piece of paper what she'd to write on a birthday card.

I think a child with ASD with an "active but odd" social approach and suffering sensory overload could be mistaken for a child with ADHD. Like if the child got up and wandered randomly around the room (due to overstimulation) while everyone was supposed to be doing some activity. Or talked in a way that constantly interrupted others. Or had difficulty following directions in class due to auditory/speech processing problems. As for working memory, there is no more working memory when the brain BSoDs due to sensory overload. The outwards behavior may look similar, but the child with ASD will feel totally different on the inside from the child with ADHD.

This is what is happening with my son. His periods of hand flapping when excited (by me sewing, by waves crashing on the shore, anything he finds interesting) and pacing while waving his arms in circles and bobbing his head making explosion noises (for upwards of 30 minutes at a time) has been interpreted as ADHD. It does not matter that we understand it to be the way he is choosing to self regulate. It does not matter that when he didn't have the opportunity to "jump it out" for a period of time, that he resorted to self harm in the form of banging his head on the floor, hitting himself with his fist, and biting his arms. It does not matter that his mentor can sit down and have him focus on a new board game for 45 minutes to an hour. It does not matter that if I provide him with a breakdown of the tasks that are expected, he gets right to work and completes them (including homework!). It does not matter that he is quite content to sit down with a book and read for close to an hour at a time.

(For reference, these are not the only things we experience with my son that makes me suspect Aspergers, there are plenty more characteristics/behaviors that fit the profile.)

However, the great psychiatrist has proclaimed he has ADHD, therefore it must be so!

At least I have a team of professionals who believe in me, and are willing to support me as we continue to work towards figuring out what is really going on....

I was just saying this the other day. My sons were originally dxed with both AS & ADHD. I have never thought the ADHD dx was a particularly good fit for them, but that their sometimes inattention & impulsivity can be explained by the AS and is symptomatic of sensory issues.

They have a friend with ADHD, and he is so very different from them. He is really engaged and responsive, and extremely social. He bounces from one activity to the next even if it is something he is really interested in, whereas my sons can focus for hours & hours one one thing when it is their main interest. He is chatty, and it isn't a monologue, he is looking for responses and indications that you are listening even if he can't help but interrupt those responses, and making direct eye contact. Very different from my experiences with my sons.