do you suffer from attention deficit disorder?
Yes, especially so because in some countries (or most countries or all, frankly, I don't know about situation as it is worldwide), medication for ADHD can and/or will only be prescribed to someone with a diagnosis of ADHD but not to someone with a diagnosis of ASD who definitely has symptoms of ADHD that require treatment but who does not have a diagnosis of ADHD.
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Autism + ADHD
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I am daydreaming all the time and i find it hard to concentrate even if i found something interesting to read. It is strange because my daydreaming usually involves imagination but i've read that aspies have trouble with it. Or it is not a rule?
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It is necessary to remove the exclusion from ADHD regarding autism for the DSM-5 - many people do deal with both, and the assumption that they do not is itself not particularly scientific in nature. It is actually somewhat accepted in common practice these days that someone can be diagnosed with both, and screening for ADHD is a typical part of many clinics' autism screening.
Actually, per the CDC "because of the evolution of the case definition and differences in how the case definition is operationalized, there is disagreement as to ADHD prevalence and precise characteristics of children with the disorder."
A very large population study is planned with consistent standards to determine actual prevalance and co-morbidity with other conditions. Part of the reason current studies are all over the place in prevalence and co-morbidity of ADHD in clinical trials is that case definitions are not consistent between research in small clinical trial samples that have been done.
Clinical trials can be accurate at what they measure per specific case definitions within clinical environments that measure limited demographics, but they are evidenced as not providing accurate evidence of either prevalence or co-morbidity in the general population, because of the differences in case definitions and demographics limited to each specific clinical environment.
Overview
Attention-Deficit/Hyperactivity Disorder (ADHD) is a serious public health problem because of the large estimated prevalence1 of the disorder, significant impairment in the areas of school performance and socialization, the chronic nature of the disorder, the limited effectiveness of current interventions to attend to all the impairments associated with ADHD, and the inability to demonstrate that intervention provides substantial benefits for long-term outcomes.
However, because of the evolution of the case definition and differences in how the case definition is operationalized, there is disagreement as to prevalence and precise characteristics of children with the disorder.
Due to the lack of a single, consistent, and standard research protocol for case identification, variable and disparate findings have been noted in the literature. Consequently, relatively little is known about the etiology of ADHD, although genetic factors are believed to be important contributors.
Current Research
Project to Learn About ADHD in Youth (PLAY)
Because of increasing concern and awareness among health professionals and the public alike, CDC’s National Center on Birth Defects and Developmental Disabilities (NCBDDD) is funding a joint collaboration research project with the University of South Carolina and the University of Oklahoma Health Sciences Center to conduct population-based research on ADHD among school-aged children.
Recognizing that many uncertainties remain concerning prevalence, etiology and treatment patterns of ADHD, this research will shed light on:
•Short and long-term outcomes of children with ADHD
•The prevalence and treated prevalence of ADHD in children
•The existence of comorbid and secondary conditions in children with ADHD
•The types and rates of health risk behaviors in children with ADHD
•Current and previous treatment patterns of children with ADHD
The result of this collaboration will be one of the largest community-based, epidemiologic studies of ADHD in the United States.
These data will also provide information critical to understanding the magnitude of the disorder, the expression of ADHD in diverse population groups, the receipt and quality of community care, and factors associated with differential outcomes in children with the disorder.
The DSM has always acknowledged that individuals with ASD's commonly experience co-morbid symptoms associated with ADHD, however to this point they have precluded dual diagnoses in that the symptoms were better accounted for by ASD's. That issue has been a controversial one, but one based on scientific research.
The decision to preclude dual diagnosis was based on previous research into the issue, and the decision to allow dual diagnosis will be provided based on recent research into the issue. At this point recent research provides evidence that out of a group of 2000 children studied whom are actually diagnosed with ASD's close to half were evidenced with symptoms of ADHD, a third would likely meet criteria for a diagnosis of both ASD and ADHD, but only 1 out of 10 of the group of 2000 were being treated for symptoms of ADHD.
This is the type of research that could be a decision changer for the DSMV working group, in the importance of encouraging dual diagnoses to ensure appropriate treatment options are provided for symptoms of ADHD. Per the last revision the decision was to preclude dual diagnoses, but that decision may be changed per the final revision of the DSM5.
http://www.sciencedaily.com/releases/2011/09/110919093851.htm
Children with ASD frequently have other symptoms that may compound difficulties with communication, socialization and restricted interests. More than one in three children evaluated had symptoms suggesting that they might have ADHD. Approximately one in ten of the children studied were receiving stimulant medications typically used to treat ADHD. This suggests that most of these children and adolescents with ASD and ADHD symptoms are not being treated with medications for these inattentive and hyperactive symptoms.
Last edited by aghogday on 06 May 2012, 12:27 am, edited 1 time in total.
Verdandi
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You have far more faith in the system than I do, then. I couldn't find anything that seriously validated this assumption, any more than I could find research that really validated the assumption that the majority of people diagnosed with autism also had intellectual disability - but I could easily find research that refuted both assumptions. I simply do not see how they could conclude that the symptoms were better accounted for by ASDs to the point that being diagnosed with an ASD precludes an ADHD diagnosis without carrying assumptions into the research itself.
As I pointed out, in practical terms, people are being diagnosed with both. In typical autism screenings, are often being screened for both due to the high rate of co-morbidity that has been empirically established.
You have far more faith in the system than I do, then. I couldn't find anything that seriously validated this assumption, any more than I could find research that really validated the assumption that the majority of people diagnosed with autism also had intellectual disability - but I could easily find research that refuted both assumptions. I simply do not see how they could conclude that the symptoms were better accounted for by ASDs to the point that being diagnosed with an ASD precludes an ADHD diagnosis without carrying assumptions into the research itself.
As I pointed out, in practical terms, people are being diagnosed with both. In typical autism screenings, are often being screened for both due to the high rate of co-morbidity that has been empirically established.
It appears that you read that statement as I intended it, however I accidentally put a "not" in there that literally made the opposite point. I edited it so it would provide the statement that I intended. The difference can be seen in the post that you quoted.
The DSM organization bases it's decisions, in part, on this issue, per independent research as evidenced below. Up until recently symptoms of ADHD seen in Autism Spectrum Disorders have been considered inclusive of Autism Spectrum Disorders, both by the ICD10 and the DSM IV.
The ICD10 came to the same conclusion, per the two disorders being mixed, as quoted below.
However there is the potential that this will change in the ICD11, if that decision has not already been made, per allowing dual diagnoses.
As it turns out, two days ago the DSM5 has made the decision, per link and most recent revision in the quote below to allow dual diagnosis, based in part on evidence per recent research providing similiar conclusions to the research I provided in the last post.
Regarding your comment on Intellectual disability and Autism, as I remember there was older limited research that suggested that intellectual disability occurs in autism disorder alone, at rates of up to 70%, however intellectual disabilities in ASD's are measured by the most recent government supported research by the CDC, at 38% on average, per the same study that provided the recent 1 in 88 statistic.
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6103a1.htm?s_cid=ss6103a1_w
Data on intellectual ability are reported for the seven sites having information available for at least 70% of children who met the ASD case definition (Figure 2). [b]When data from these seven sites were combined, 38% of children with ASDs were classified in the range of intellectual disability (i.e., IQ ≤70 or an examiner's statement of intellectual disability), 24% in the borderline range (IQ 71–85), and 38% had IQ scores >85 or an examiner's statement of average or above-average intellectual ability. The proportion of children classified in the range of intellectual disability ranged from 13% in Utah to 54% in South Carolina. The two sites with the highest proportions of children classified above the range of intellectual disability (IQ >70) were Utah (87%) and New Jersey (73%). In all seven sites reporting data on intellectual ability, a higher proportion of females with ASDs had intellectual disability compared with males, although the proportions differed significantly (52% for females and 35% for males; p<0.01) in only one site (North Carolina). When data from these seven sites were combined, 150 (46%) of 328 females with ASDs had IQ scores or examiners' statements indicating intellectual disability compared with 608 (37%) of 1,653 males.
http://www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=383#
a. Magnitude of change. Minor change
b. Reason for change. There is a growing literature suggesting that ADHD and Autism Spectrum Disorder might co-exist. There is no exclusion of an ADHD diagnosis in the presence of any other developmental disorder or intellectual developmental disorder in DSM-IV. This change is also to bring the ADHD criteria into harmony with the revised criteria for Autism spectrum disorders being proposed by the developmental disorders workgroup.
c. Evidence for change. Previous literature in recent years has suggested that: 1) ADHD symptoms occur frequently in Autism Spectrum Disorder (ASD). In some data sets, ADHD is the second most frequent comorbid diagnosis in patients with ASD. There is some evidence for overlapping genetic influences on autistic and ADHD behaviors in community samples. The presence of ADHD symptoms in patients with ASD might confer different neurobiological and clinical correlates from those found in patients with ASD w/o ADHD; 4) Stimulants and other ADHD medication are efficacious in treating ADHD symptoms in patients with ASD (data available includes RCTs). Thus, it is important to note that the exclusion of ADHD in the presence of ASD defined in the DSM-IV exclude patients with ASD and impairing ADHD symptoms of receiving adequate treatment in countries were reimbursement is based on DSM system. This literature was fully reviewed in a systematic review conducted by the Workgroup in 2010 leading to support for this change.
d. Negative consequences considered. Prevalence of ADHD will increase slightly because it is common among children with ASD. ADHD in ASD may be a different disorder than ADHD without PDD. The workgroup did not have the data and resources to adequately evaluate this possibility. However, considerable evidence supports the clinical benefits of allowing co-diagnosis of ASD and ADHD (see above), and the confusing for clinicians that would result from having a conflicting rule out guide in the ASD/PDD versus ADHD criteria was seen as unacceptable. These points outweighed the potential problem of creating an undetected but distinct subgroup of children with ADHD.
Current criteria for a DSMIV diagnosis ADHD:
http://www.ldawe.ca/DSM_IV.html
Current Criteria regarding differential diagnosis from the ICD10:
http://counsellingresource.com/lib/distress/adhd/hyperkinesis/
Mixed disorders are common, and pervasive developmental disorders take precedence when they are present. The major problems in diagnosis lie in differentiation from conduct disorder: when its criteria are met, hyperkinetic disorder is diagnosed with priority over conduct disorder. However, milder degrees of overactivity and inattention are common in conduct disorder. When features of both hyperactivity and conduct disorder are present, and the hyperactivity is pervasive and severe, “hyperkinetic conduct disorder” (F90.1) should be the diagnosis.
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The statistics about intellectual disability in autism mean nothing to me. The receptive and eggspressive communication impairments of autism prevent the accurate measurement of intelligence in autistic children, eggspecially those with classic autism and lack of or limited speech, auditory processing problems, and lack of understanding of communication, such as wtf is asking and answering questions for IQ tests. Also, autistic children think and perceive differently, so they will often give answers not matching the eggspected answers on IQ tests and therefore score poorly on IQ tests. Also, autistic children often suffer from sensory overload and brain shutdown in the presence of unfamiliar people like the IQ testgiver or in unfamiliar places like the IQ testing place, so that drop in cognitive functioning will also bring down the scores.
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This was the kind of point I was trying to make the last time that came up.
Proper assessment of the children's abilities in these classes for the developmentally disabled, where these statistics came from, is vital as to whether or not they are going to eventually be able to gain the ability to express and/or communicate their potential intelligence, through proper therapy and accommodations. IQ tests are acknowledged as limited in testing overall intelligence, and are a small piece of the pie of assessment for the abilities of an autistic child.
IQ tests provide a limited measure of intelligence; some individuals with Aspergers that test very high on IQ tests, that are not even identified by the government in these classes for the developmentally disabled, are limited in brain function, in areas that IQ tests don't touch.
All the impairments that you list above that can limit one in taking an IQ test, are clinical features of autism that are influenced by limits in brain function; unfortunately this impacts the ability for some in taking tests that attempt to measure certain identified areas of intellect, but some tests also do not measure any of those limits in brain function that result in the clinical features of autism similar to the ones you list.
Some of which are impairments in non verbal/ verbal communication, sensory integration problems, auditory processing problems, attention problems, focus problems, executive functioning problems, short term working memory; the list goes on. These are inherent issues of deficits in cognitive function, measured in some autistic individuals through other means than IQ tests, related to the abilities associated with the expression of intelligence.
Standard IQ tests measure deficiencies in verbal intelligence, however non-verbal tests of intelligence like raven matrices tests measure little to none of the rest of these variables associated with limited brain function as it pertains to the real life expression and/or communication of intelligence evident in Autism Spectrum Disorders.
Some children that are not able to take standard tests of intelligence, whom lack verbal abilities, are already provided alternative non-verbal testing such as the raven matrices test of intelligence.
Standard IQ tests are evidenced to underestimate fluid intelligence in some children with autism, particularly those that measure low in verbal intelligence, however neither Standard IQ tests or non-verbal measures of intelligence fully measure other limits in brain function of autistic individuals that can make the difference in how well one can function in life, associated with social/communicative, physical, and emotional intelligence, resulting in impairments observed in behaviors.
It's all part of the entire pie of intelligence, that many of these children in these classes for the developmentally disabled experience as disabling factors per limits of brain functioning as it relates to functioning in real life. And for some whom may graduate at the top of their class and never enter the doors of a class for the developmentally disabled, who might also score higher than 130 on an standard IQ test or equivalent on a non-verbal test for fluid intelligence.
Limits in brain functioning are core to diagnosed cases of autism spectrum disorders, whether measured through IQ tests or observable behaviors, both for those that score 70 on an IQ test and potentially for those that score 130. A part of why some people don't get the assistance they need in life; cultural bias on what intelligence even means, as it relates to every day life functioning.
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I don't think that IQ testing is critical to measuring anything in autistic children. I think that the best way to figure out if an autistic child is intelligent and capable of learning is to teach them the three R's in ways that work well for autistic cognition, e.g. visual > verbal, concrete > abstract, clarity > ambiguity, and work within the limits of autistic impairments, e.g. matching > pointing, reading > listening, typing > handwriting.
Standard IQ testing is a small part of the assessment of learning difficulties in determining what areas of strengths and weaknesses occur and how they should be properly addressed in a child with autism. However, Standard IQ testing is a scientifically acknowledged important measurement in determining whether or not some individuals on the spectrum have the condition described as non-verbal learning disorder.
It also can be a pre-determining factor as to whether or not a child should have an MRI to determine if there are brain lesions in the right hemisphere of the brain, associated with this condition.
There is no standard for autistic cognition; some children do very well in verbal communication, some do poorly, some are seriously deficient in non-verbal communication, while others do not even meet that currently non-mandatory criteria of problems with social interaction. As well as many other variations in cognition.
For those that are able to take Standard IQ testing, general differences in certain areas of cognition among individuals on the Autism Spectrum can be detected. Differences in verbal intelligence as well as other measures of intelligence such as performance IQ vary greatly within the spectrum, as evidenced by Standard IQ testing
http://www.wisconsinmedicalsociety.org/savant_syndrome/savant_articles/nvld
No, that's not ADHD.
ADHD is more about be unable to choose what to focus on. Sometimes people with ADHD can hyperfocus but it's not always in our control.
Like even now, on my meds, I'm finding it very hard to focus on what I need to.
Like AS there's a whole criteria to fit in ADHD and if the above our your only issues than I'd say you wouldn't fit it.
As for me I have combined ADHD; both Inattentive and hyperactive symptoms. My symptoms actually feel completely separate from my autism. It's like when I'm bothered by them I'm less bothered by autistic symptoms and vice versa. Same goes for hyperactivity and the inattentive symptoms. It's like when I'm experiencing one I don't experience another. It's probably because one is more serious at that moment, and other people can usually experience all at once.
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