Confusing ADHD and autism

Post Reply New Topic

My friend has a son and she has long thought that he has ADHD, according to her he fits the bill, and from my limited knowledge I'd agree. But after the first meeting the psychologist says she thinks it's autism. I realize it might be both, but I'd still like to know if any of you autism that manifests in such a way that it could be mistaken for ADHD. I'd like to think the psychologist knows what she's doing.

I also suspect that maybe he'll get diagnosed with autism as a means of getting resources because kids weith ADHD don't get nearly as much support here. If that's the case I suppose he'll get a dual diagnosis.

So, does anyone here with an autism diagnosis manifest in a way that could be mistaken for ADHD, without actually having ADHD? And how?

me me me....

I was a member of ADD/HD forums for stinking years...pretty much ever since I discovered a name for it on my own as a teenager...Then eventually somebody suggested that I investigate the autistic spectrum, and it happened to more accurately cover the issues that have affected me since i was a child...such as face blindness, auditory processing difficulties, and so on....

I really do have a modicum of AS and ADD features...and they all mesh together in a great big non-beneficial way...and in some ways my ADD features do cancel some of my AS features out...though there is no denying that the AS features exist.

My AS features include...obsessions...that I find it very hard to escape from...growing up, I was plagued with sensory issues...but those have toned down over the last few years thankfully....ummm.....my motor issues seem to be more AS-related than ADD related..

Now I am being summoned to bed so I can't explain further...Many of the ADDers that I have encountered over the years on ADD forums would find lots to relate to on WP.
I def. think that (true) ADD and AS are related...I also think that a lot of kids are pegged for ADD who are really just normal kids who are just a bit more precocious..and are really more on the creative/NT side...unless I just have it all wrong..
I cringe at the idea of my partner's niece going on ADD meds...just because she is a tad unruly...
At the same time..ADD meds help me immensely with my horrible executive dysfunction issues...she does not have executive dysfuntion..she is just a curious little girl....

I had a friend, call her "K", who was mistaken for having ADD or ADHD, than was rediagnosed with Aspergers at some point in elementary school. Now I recently met another girl recently at college who told me she has the duel diagnosis of ADHD and Aspergers. She seems somewhat shy to me, (but not nearly as much as I am) and more hyper (not difficult, I don't get excited easily). Though, she is less hyper than a girl I knew, "A" who just has ADHD (but she's the type who is constantly hyper, hugs you randomly, etc.) My knowledge of the two conditions being combined is fairly limited b/c its based on what I've seen in others (not much).

Am I misspelling stuff b/c the post thing keeps telling me "Aspergers" and "rediagnosed" are misspelled?

This is just about the ultimate question around here right now.

One thing, though, before I get going... She should get a second opinion before committing to a course of action. Standard medical stuff, that. Goes the same for psychology.

My two older kids both have executive dysfunction issues as do I. I, however, am the only one with screaming social issues, face intolerance (far as I know) and more stims than you can fit in an hour-long documentary. I was called hyperactive as a child because they didn't know jack about anything. I wasn't that hyper in school, y'see, I stayed in my seat, but I doodled and fidgeted. My mom, like most parents, seemed to think that her only recourse was to work with the school and make do with what help they had to offer, and to take me to a psychologist. All of which was just so much elephant poo.

We are having worse troubles with our kids. The oldest is the sitting, fidgeting, daydreaming doodler and is getting very little attention for her problems because she did so well before the work got harder (the schools seem to think they're dishing it out appropriate to age level) and because her little brother learns everything they teach him in spite of never actually sitting in his chair and in between running away from class and attempting to hit and kick the school staff. I secretly laugh my butt off about this, mind you... something about the phrase, "He kicked the school psychologist," just brings me out in gales of naughty laughter. Probably some unresolved rage of my own.

Anyway, he's been "diagnosed" (by a school team) with Asperger's and ADHD. Well, this is because he does not seem to
"get it" socially and because he couldn't tie his shoes or repeat his address and phone number, along with everything else. Also, I think it was a ploy on their part to get extra time with him to address these things. Fact is, he probably has those problems because he has an antisocial possibly Aspie mom who didn't get around to teaching him his address and phone number, and because he has velcro shoes all the time. Anyway, he is decidedly a special needs student and fits the definition of ADHD well. They want to re-evaluate him since the kicking incident (snort... giggle) and I can only imagine what they'll call him this year. We're going to be more aggressive this year, though, because we've been seeing a psychologist who actually knows what he's doing and who thinks Asperger's is being overdiagnosed as most things like it are when newly discovered. This is fine since I, like your friend, hadn't felt my son had it anyway, but that he had ADHD.

From what I've seen, the two have so many common traits, and so little in the way of solid scientific means to diagnose either, that odds are they are different stages of the same thing! It's that hard to call.

The rest is about my son's particular case which may or may not be beneficial to you. I got carried away. I'll leave it in but just so you know that's all that's after this.

The psychologist is helping us look at his personality and see how he sees things, and help train him in situations he hasn't learned to handle because none of us knew what we were doing is dealing with a kid like him. We were making steady progress... being careful not to say thing's like can't, won't, must, have to, or anything else that he could perceive as a calling him out (it's like throwing down a gauntlet, seriously, you say "can't" and it's on)... separating him from his sisters when he gets too wild... giving him specific choices to choose from so that he can see how to modify his own behavior and learn self-control... offer incentives for good behavior and praise him for individual successes, and always point out that if we have to leave a place because if his behavior that it was his choice not to behave but that we will try again later thus giving him the chance to correct himself at that time... All with the long-term plan of fixing years of mis-management and getting him to stop himself before he runs... then school started again, and now it's back to:

"Stop that. We don't do that in here. You can't do that. Get back here right now or you're going to the office. You have to go to the office." (and later) "Mrs. Mom, I was going to send home a note saying how well he did today... And then he ran away from the lunch ladies."

So apparently, because of one incident whose cause they never look into, everything else he did right is rubbish. Why should he try at all with the attitude facing him?

Plus they chase him, thus challenging him to stay out of reach, and at the same time proving that he can make them chase him, that they are not in control...

Now he's run away from his teachers almost every single day, and been sent home 3 times. Since the 8th of September. I do actually sympathize... the teacher has 32 students and is not exactly an Olympic champion runner, and he is to say the least unruly. But you'd also think they'd figure out that what they're doing isn't working.

I've been formally DXd Aspie, have a female cousin DXd Aspie, and a niece who's been Dxd ADHD, whom I believe more likely fits the ASD profile. Admittedly I'm not around the girl an awful lot, but I do not and have never seen evidence of hyperactivity in her at all. She's just a bit of an odd bird and I recognize that all too well. What concerns me is that if you're diagnosed on the autism spectrum you're far less likely to be pumped full of pharmaceuticals than if you're labeled hyperactive, and I hate to see anyone unnecessarily medicated. I'm very wary of the Frankenstein cocktails they cobble together out of molecules that have absolutely no organic elements whatsoever. The body and brain were never evolved to interact with those poisons.

Rant, rant, rant...

I suppose it would depend on how it manifested itself. My son, for instance (the little guy in my post from today), has a lot of behaviors that would be assumed by many to be ADHD, simply because people do not understand the behaviors.

He barks at people occasionally if he doesn't know what to say, then giggles nervously. He jumps and spins in circles, throws himself about in his desk on some days, makes a lot of sound effects noises, etc. But they never tie the actual behavior to a reason. I have taken the time to do so, of course, and most of it happens when he is overwhelmed or cannot think of a thing to say in a social situation, even if I ask him questions, I get these responses at times.

A lot of other people still think it's ADHD and he needs medication. But we refuse. It really doesn't take him a long time to calm down, and we don't just tell him to stop behaviors... we'll tell him to hum quietly and things like that, and when he barks we ask him what he is wanting to say to us and all, and usually he will stop and tell us something-if it is something pretty inappropriate (he had this thing with thinking butts are hilarious for a long time and would smack them occasionally), we try to redirect it and give him something else to do with that energy. He gets a grip on himself quite quickly when things are handled properly. I also participate with him in calming exercises and such too, so he's not working on these things all alone.

Sometimes there are days when he just can NOT calm down, but we almost always find out later (whether it be a week or a month) that something happened and was causing it.

Judging by what I've read here, it seems that people suspected of ADHD often are on the autistic spectrum, and that gets discovered later. Does it ever go the other way around? That is to say, do they ever suspect Asperger's and then decide that, no, it's "just" ADHD?

What is a typical (stereotypical?) profile of someone with ADHD but not an ASD?

Well, I think same thing-here is the criteria list.

-------------------------------
Inattentive Symptoms

· often fails to give close attention to details or makes careless mistakes in schoolwork,
work, or other activities;

· often has difficulty sustaining attention in tasks or play activities;

· often does not seem to listen when spoken to directly;

· often does not follow through on instructions and fails to finish school work, chores, or
duties in the work place (this failure is not due deliberately refusing to do it or not
understanding instructions);

· often has difficulty organizing tasks or activities;

· often avoids or is reluctant to engage in tasks that require sustained mental effort;

· often loses things necessary for tasks or activities;

· is often easily distracted by extraneous stimuli;

· is often forgetful in daily activities;



Hyperactive/Impulsive Symptoms

· often fidgets with hands or squirms in seat;

· often leaves seat in classroom or in other situations in which remaining seated is expected;

· often runs about or climbs excessively in which it is inappropriate (in adolescents and adults, may be limited to subjective feelings of restlessness;

· often has difficulty playing or engaging in leisure activities quietly;

· is often "on the go" or often acts as if "driven by a motor"

· often talks excessively;

· often blurts out answers before questions have been completed;

· often has difficulty awaiting turn;

· often interrupts or intrudes on others (e.g. butts into conversations or games)

To avoid diagnosing individuals who show only isolated difficulties, at least 6 inattentive symptoms and/or 6 hyperactive/impulsive symptoms must be present to possibly qualify for an ADHD/ADD diagnosis. In addition, these symptoms must have been present for at least 6 months to a degree that is considered inappropriate for the individual's age.

I don't remember where I read that I guess was in one of Christopher Gillberg's books, he says that in cases where people with Asperger Syndrome are misdiagnosed the most comon misdiagnosis is ADHD. Gillberg goes on further and says that a person can't be diagnosed with ADHD and Asperger cause if he/she has Asperger Syndrome all characteristics of ADHD can be explained because he/she has AS. So I guess the two conditions are more or less related. From my personal experience I guess the two conditions are somehow related cause I have AS and my father has ADHD and we have many problems deficiencys in common, except that he is impulsive and can't focus.

The person who assessed me as having AS told me the same thing..that I can't have AS and ADD..that my ADD symptoms are really just part of the AS...I understand that the general consensus on the board is that they CAN be co-morbid.
There are some with AS who don't have ADD and also ADDers who don't have AS...

Well, at first I was thought to be AS but I wasnt diagnosed or anything. And then I was thought to be more ADD or ADHD. And then I was thought to be an eccentric, creative, unruly NT. And now they say I am just a mystery
I think its swaying towards the middle one again though, ADD or ADHD.
who knows whats next? XD
I guess I actually dont mind to much, I like mysteries.

So, yes, I think it can go from as to adhd but I would guess that adhd to as is more probable. I am not a very good example though, to (ohhh whats that word...errrr...not normal? sorry, inglesh isnt a first language ...unpredictable? I hope someone knows what I mean)

I have wanted to jump into a discussion about this since I first learned of both ADHD and AS. I decided to go ahead and bold the traits that are obviously traits of both... I wanted to highlight more, but stopped myself. So much of the hyperactivity/impulsivity has to do with understanding particular situations and with behaviors we might call "stimming". As for the inattention, I think for both sides it's a problem figuring out what to attend to.

I think we call a lot of these things "executive functioning". There is no doubt in my mind that ADHD and autism are so linked together it may sometimes be difficult to pull apart which is actually which. I sort of think of AS as ADHD+, at least as it applies to me. I have been formally diagnosed with ADHD, along with enough other things that they led me to seek a simpler diagnosis. Ever hear of Occam's Razor? Pretty much the idea that the simplest explanation is usually the best one. For some, ADHD fits that. For others, and I see myself as one of the "others", there is a better explanation.

To digress: Where I see the difference in myself (and I can only speak for myself) is that I do not have a short attention span. What I have is problems understanding what is going on sometimes, and I make up for that by hiding inside myself, stimming (some might see it as "hyperactivity") or getting the heck out. When I do not know how to sequence activities (a problem seen with both ADHD and AS) or something changes a sequence of activities I have figured out (I think we call that "routine"), I respond by melting down. I do not know how to explain the distress that sequencing things or having my established sequences altered does to me. I do not think that is an ADHD trait.

Perhaps another issue dividing the two would be the ever-present social side of life. Many people with ADHD experience difficulty with impulse control. One of my teachers called it "foot-in-mouth-syndrome" and I think that is an apt descriptor. These people are not unaware of what it takes to achieve well-executed social reciprocity, they are unable to hit the "pause" button long enough to make it happen. People with AS are unaware of many of the rules that govern social behavior, at least in an application context. It usually ends up looking the same to people on the outside, but it's the neurology of it that draws a line between the two. Maybe.

Is it possible to be both? Well, I don't think it's possible to carry a dual diagnosis. There's something in the ADHD diagnostic criteria that states something like: ADHD should only be diagnosed if the behaviors seen are not better explained by a pervasive developmental disorder or psychotic disorder. Or something like that. But I think a person with AS can have all the symptoms of ADHD and I think a person who is ADHD can have some of the symptoms of AS, and not just because of the obvious diagnostic criteria overlap. It's a matter of why. And the problem is that many of the people getting diagnosed with both of these "disorders" often do not have the ability to explain why, so a shrink throws on whatever label seems to fit and completely overlooks the truth of the matter.

I was diagnosed with ADHD eight-and-a-half years ago, probably because I told a shrink I had trouble not moving some part of my body at all times, couldn't organize a thing, and had difficulty following conversations. Yeah, all traits that could go either way. What he didn't bother to notice (and I am being critical, but it was his job to notice) was that I didn't look him in the eye the entire time he talked to me. I read the titles of all the books on his bookshelf, stared at a potted tree with vines on it, and looked out the window. He just wrote me a script for Ritalin and was done with it.

I think doctors really do go by that saying "when you hear hoofbeats, think horses- not zebras". A doctor explained what that meant to me once, and I told him I was a zebra. He laughed. It wasn't a joke. Professionals are people, too, and they only see what they want to see. It's just too bad that so many zebras are getting told they are horses, one way or another.

My understanding is that the core mental processes with dysfunction that cause ADHD are Executive Function and Working Memory. Dysfunction in those processes are also part of AS. AS has additional dysfunctional mental processes that cause things like sensory issues, repetitive behavior, and social issues that go beyond ADHD plus poor self image.

So, if someone has AS, they have a bit of ADD or ADHD too. If someone has ADHD, they don’t have dysfunction in the areas outside of Executive Function and Working Memory that would be explained by AS.

Replace “dysfunction” with “difference” if my post offends you.

When I was 6 I was diagnosed with ADHD; this was in 1992 so Asperger's Syndrome wasn't even a diagnosis yet in the US and people, even most psych people, were ignorant of "higher functioning" Autism. I only got diagnosed with AS in 2001, when I was 15, simply because I was lucky to have had my doctor switched to a pediatrician knowledgeable about developmental disorders, and who instantly saw that I had AS. Not only was it a revelation to me, it was for my mom and my paternal grandmother, too; because I have an aunt who is a LFA and my mom and grandmother suspect that my maternal grandfather had AS.

AS is often misdiagnosed as ADHD because of the Executive System Dysfunction aspect and because sensory issues and stimming can be misinterpreted as hyperactivity.

You said in another thread that what I said was just about right (or something like that). Now I say the same about you... at least in concept. I'm still searching for a doctor who has at least three working brain cells to go and talk to. That can be hard when living in Nowhere, USA. But you hit the nail on the head about misdiagnosis and did it much more concisely than I ever could. Kudos.

I was originally dxed ADHD.