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MathGirl
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04 Nov 2010, 12:14 am

I still don't understand how someone can have both Asperger's and ADHD. I've met one person with hyperactive ADHD who has also been diagnosed with Asperger's, and he himself denies that he has it. I've met another person with both diagnoses, where I clearly see that he has Asperger's, but then I ask him how his ADHD manifests itself and he says that he cannot concentrate on things. However, I then clearly saw him focus on a book that was of intense interest to him. To me, that is a pure Asperger's trait. I've worked with ADHD kids before, who, even with medication, had difficulty concentrating on anything.

The central reason for my asking is because I've always seen Asperger's to stem from a very monotrack mind, having difficulty paying attention to more than one thing at once. ADHD, on the other hand, is usually portrayed as having an extremely multitrack mind, when there are so many channels in your mind that you have difficulty singling out an individual one.

So how can the two co-exist? How does this combination manifest itself in the thought process of the affected individual?


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04 Nov 2010, 1:15 am

I am wondering if your friend who can hyperfocus on things which interest him has the inattentive or mixed type of ADHD. I don't have Aspergers, but I have been diagnosed with the mixed type of ADHD, which includes traits of the both the hyperactive and inattentive forms.

It's quite possible for me to focus really intently on something I am very interested in; actually reading about one of my favorite subjects is like brain candy. But doing something like filling out a form (ARRGHHHH) can take me forever and there will be a million mistakes. :?

Link describing hyperfocus in ADHDers.


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Callista
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04 Nov 2010, 4:36 am

MathGirl wrote:
I still don't understand how someone can have both Asperger's and ADHD. I've met one person with hyperactive ADHD who has also been diagnosed with Asperger's, and he himself denies that he has it. I've met another person with both diagnoses, where I clearly see that he has Asperger's, but then I ask him how his ADHD manifests itself and he says that he cannot concentrate on things. However, I then clearly saw him focus on a book that was of intense interest to him. To me, that is a pure Asperger's trait. I've worked with ADHD kids before, who, even with medication, had difficulty concentrating on anything.

The central reason for my asking is because I've always seen Asperger's to stem from a very monotrack mind, having difficulty paying attention to more than one thing at once. ADHD, on the other hand, is usually portrayed as having an extremely multitrack mind, when there are so many channels in your mind that you have difficulty singling out an individual one.

So how can the two co-exist? How does this combination manifest itself in the thought process of the affected individual?
Actually, it is very common that ADHD kids are able to focus on something that is very interesting to them--more common than not. How many have you seen who can't sit still for a history lesson, but can sit for an hour playing a video game?

I have both AS and ADHD-I.

Asperger's and ADHD both have a common feature: Executive dysfunction. Both groups have trouble planning; people with AS often compensate by pre-planning everything so they won't have to do it quickly, and have extreme difficulty changing plans, while people with only ADHD often just don't plan at all. Attention problems manifest for people with AS in terms of not being able to block out unwanted sensory input and being unable to ignore "irrelevant" details; we notice everything and can't block anything out. Task-switching is a problem for both groups; Asperger's tends to create difficulty switching from one task to another, and ADHD tends to create difficulty sticking to one task without switching. Both groups can go into "hyperfocus"--a state where everything but the object of focus is totally ignored--and have problems multitasking--that is, rapidly switching between multiple stimuli in order to integrate them.

It's very likely that your young friend has both AS and ADHD, and is fascinated with whatever he was reading about. He probably hyperfocused on the book, but has extreme problems focusing on something he isn't naturally drawn to--he can't "force" himself to pay attention. I have this problem to an extreme degree; I try to force myself to pay attention, but if I'm not fascinated with it, my mind wanders no matter how long I sit in front of what I'm supposed to be doing. (Most of the day, sometimes, without getting much done.) The main attention problem faced by those of us with the AS/ADHD combination isn't actually lack of ability to pay attention; it's inability to control where the attention is focused. I don't know whether I'll be fascinated with my homework or unable to do any more than stare at it and repeatedly reel my brain in from the far corners of the multiverse. I have only very limited control over whether I pay attention to the test, or whether I pay attention to the swaying of tree branches outside the window. I can't ignore my neighbor's stereo, but if I'm hyperfocused I may let an alarm go off for half an hour because I can't switch away from what I'm doing.

There's a lot to do with the way our frontal lobes work (i.e., the brain's control center--the part of the brain that inhibits or doesn't inhibit other parts of the brain, and plays a big role in decision-making, emotion control, and self-regulation.) In fact, there's lots of speculation on whether autism and ADHD are connected somehow--whether maybe they have common traits because they have common genes or common features in the brain.


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06 Nov 2010, 11:05 pm

I have both. I have the inattentive form of ADHD (i.e. I am quiet, not loud, and, instead of being hyper, I typically have the energy of a stoned wombat).

And there's a characteristic of ADHD called hyperfocus, which can be a lot like an Aspie focusing on an obsessive interest. I even read a story once about a woman with ADHD whose house burned down around her, and she didn't even notice because she was so hyperfocused on something!

As for me: I know that I have ADHD, because, until I went on medication, I could not focus on homework for more than ten minutes at a time, and I could not focus in class or on conversations for more than about 30 seconds at a time. Yet, I know that I have AS and the hyperfocusing trait of ADHD, because I can research something I'm really interested in for hours, and talk about it like an encyclopedia (I do have a wider variety and shorter duration of obsessive interests than someone with just plain AS). I know that I have AS because I actually had to teach myself how to speak more informally and more like my peers - when I was in elementary school, my speech was so stilted and formal, I sounded like someone in a period piece from colonial times (minus the British accent). I know that I have AS, because I NEED to have a routine that I follow every day - but ADHD makes it incredibly hard to stick to a routine, or, at least, makes my routines take all day.

AS and ADHD do actually have quite a bit in common - like a previous poster said, there is executive dysfunction. People with both disorders also have sensory issues, although they are usually more severe in people with AS than they are in people with just ADHD. And, even though it is supposed to be diagnostically impossible for someone to be diagnosed with both, something like 70% of people with AS have enough inattentive and/or hyperactivity symptoms to warrant an additional diagnosis of ADHD!



MathGirl
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07 Nov 2010, 12:57 am

Hmm. I've always thought that you can denote the inattentive form by "ADD" and the hyperactive form by "ADHD"., so I did mean the hyperactive form in my post. It makes sense how the inattentive ADHD can manifest itself with AS. The only problem I have with it is that its symptoms are so similar to AS, as the poster above me (Azolet) noted. I wonder how the psychiatrist can possibly separate the ADHD-PI symptoms from the AS symptoms. It seems to me to be very easily misdiagnosable.

To other people, thanks for your feedback. I still see way too many similarities between the two, if AS and inattentive ADHD are co-existent. I have AS and have been told that I don't have ADHD in any form, but it's still difficult for me to control my focus sometimes. If, say, I'm doing my homework and there is something that reminds me of one of my interests, I will focus on that instead and then think about my interest. Or I'll rather keep thinking about something that is stuck in my head instead of listening to the professor.


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Last edited by MathGirl on 07 Nov 2010, 1:01 am, edited 1 time in total.

Dnuos
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07 Nov 2010, 1:00 am

I have Asperger's and ADHD. Not officially diagnosed, but: Asperger's was unofficially diagnosed by multiple professionals, and was treated for ADHD as a kid, and recognized to still show symptoms of it. It's complicated, but I have both, in some form.

They seem to contradict, as you described them. That's exactly me - a walking contradiction. The way I see it, the AS and the ADHD are basically like two different forces. Sometimes one manifests itself more, sometimes the other does. Sometimes I'm hyperactive, inattentive, etc... sometimes I'm hyper-focused onto my "Special Interest" and maintain social awkward-ness. Overall as a result there are symptoms from both, but with both I don't have all of the symptoms. (I'm pretty tolerant and patient considering ADHD, and... there are a few AS things missing)

There are symptoms that overlap, as said, and I find those overlapping ones apply to me.

I don't know if I'm the best representative either, because I also have depression and with those three (as well as possible anxiety issues and obsessive-compulse issues), it's all a complicated mess, lol.



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07 Nov 2010, 2:17 am

I have both Asperger's and ADD. It runs in the family, because my half-brother has ADHD, and I'm pretty sure my little sister has it too.



billybud21
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07 Nov 2010, 2:30 am

I know aspies that perseverate. (To repeat something insistently or redundantly). That may in some instances be confused with ADHD because they both deal with attention. However, anything is possible. A person could be an aspie and have ADHD.


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07 Nov 2010, 8:23 am

MathGirl posted: I still don't understand how someone can have both Asperger's and ADHD. I've met one person with hyperactive ADHD who has also been diagnosed with Asperger's, and he himself denies that he has it. I've met another person with both diagnoses, where I clearly see that he has Asperger's, but then I ask him how his ADHD manifests itself and he says that he cannot concentrate on things. However, I then clearly saw him focus on a book that was of intense interest to him. To me, that is a pure Asperger's trait. I've worked with ADHD kids before, who, even with medication, had difficulty concentrating on anything. The central reason for my asking is because I've always seen Asperger's to stem from a very monotrack mind, having difficulty paying attention to more than one thing at once. ADHD, on the other hand, is usually portrayed as having an extremely multitrack mind, when there are so many channels in your mind that you have difficulty singling out an individual one. So how can the two co-exist? How does this combination manifest itself in the thought process of the affected individual?
---
In the year 2010, there are 4 ADHDs (four types of ADHD, not just one type of ADHD - 2010). Then there is Asperger (2010) and Autism (2010). Asperger is scheduled to be renamed Autism in the year 2013. You might take a look at the term Venn diagram (pies - overlapping pies) which is often used to show overlapping items. Bottomline (my view), ADHD can be quite different than Asperger's since there are a few cases where the right medicine for ADHD (historically a central nervous system stimulant - alerting agent - like caffeine, Ritalin, Dexedrine, Adderall and so on) can temporarily reduce ADHD symptoms a little (not a cure) and temporarily increase the ability to pay attention including attention span a little (not a cure). This is quite different than Asperger/Autism where there really are no medicines which work (simplified answer). By the way, the term ADHD is interesting in how it has changed over the decades: Attention Deficit Hyperactivity Disorder (ADHD). ADHD is the current term for the lifelong neurological challenge which previously has been known as ADD (Attention Deficit Disorder), Hyperactivity, Hyperkinesis, Organic Brain Syndrome, Minimal Brain Dysfunction, and Minimal Brain Damage. (Source: ADHD BB)



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07 Nov 2010, 9:01 am

^^This thing about the medications interests me because I am at the maximum dose of meds for ADHD ( I am diagnosed with Inattentive type) and while it helps some my core problems still exist. It does not help me with my distractibility or my lack of will or my tendency to overload when given too much to prioritize. It just seems to take the edge off a bit.

I was reading recently about how ADHD can lead to problems reading social cues as well, so I'm beginning to wonder where one ends and the other begins. Anyway you look at it, I don't function well. I work hard just to achieve the basics it takes to get by and it exhausts me.



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07 Nov 2010, 9:33 am

Aimless wrote:
I was reading recently about how ADHD can lead to problems reading social cues as well, so I'm beginning to wonder where one ends and the other begins. Anyway you look at it, I don't function well. I work hard just to achieve the basics it takes to get by and it exhausts me.


There's a book about ADHD and figuring out social cues - I think it's something like "what does everyone else know that I don't know". I could have written the part in bold, too. It's exactly how I feel, too. ADHD seems to have so much in common with ASDs, that it's confusing at times, especially if it's combined with OCD.

And yes, MathGirl, that's hyperfocus that you're describing. There's a theory that people with ADHD are usually so scattered because it takes so much energy to go into hyperfocus. So it's like ADDers have the same amount of base energy but it gets distributed differently. I think Attention Deficit is a misnomer to a certain extent.



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07 Nov 2010, 11:34 am

MathGirl wrote:
Hmm. I've always thought that you can denote the inattentive form by "ADD" and the hyperactive form by "ADHD"., so I did mean the hyperactive form in my post. It makes sense how the inattentive ADHD can manifest itself with AS.


However, I note that the symptoms of ADHD that have to do with the difficulty to concentrate in one thing are in the innatentive part, not in the hyperactive part:

Quote:
Attention-Deficit/Hyperactivity Disorder

A. Either (1) or (2):

(1) six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Inattention

(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

(b) often has difficulty sustaining attention in tasks or play activities

(c) often does not seem to listen when spoken to directly

(d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)

(e) often has difficulty organizing tasks and activities

(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)

(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)

(h) is often easily distracted by extraneous stimuli

(i) is often forgetful in daily activities

(2) six (or more) of the following symptoms of hyperactivity/impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity

(a) often fidgets with hands or feet or squirms in seat

(b) often leaves seat in classroom or in other situations in which remaining seated is expected

(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

(d) often has difficulty playing or engaging in leisure activities quietly

(e) is often “on the go” or often acts as if “driven by a motor”

(f) often talks excessively

Impulsivity

(g) often blurts out answers before questions have been completed

(h) often has difficulty awaiting turn

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

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Code based on type:

314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for the past 6 months

314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criterion A1 is met but Criterion A2 is not met for the past 6 months

314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criterion A2 is met but Criterion A1 is not met for the past 6 months