The differences between Aspergers (or HFA) and ADHD are subtle yet distinct. Knowing how to differentiate between the two is important for moms and dads and therapists.
ADHD and Aspergers, also called High-Functioning Autism (HFA), have many similarities on the surface. Both can involve inattentiveness and problem behaviors. In fact, kids on the autism spectrum are often diagnosed with ADHD prior to an autism diagnosis. However, the two disorders are not the same. It is important for therapists to be able to make a thorough differential diagnosis between ADHD and Aspergers/HFA. It is also important for moms and dads to be able to tell the difference in their own kids who have both diagnoses.
By definition, Aspergers/HFA does not include any significant delay in language (as opposed to autism). However, people on the autism spectrun do tend to have distinct differences in how they use language and tend to have language weaknesses that are not typically found in kids with average intelligence who have ADHD alone.
People with Aspergers and HFA tend to have weaknesses in their understanding of non-literal language, such as slang or implied meanings. They also tend to be more verbose and to have more one-sided conversations that are driven by their own topics of interest. They have a harder time taking turns in conversations or talking about a topic of interest to someone else. People with Aspergers and HFA also sometimes display less inflection in their voice.
In contrast, people with ADHD may have interests that they love to talk about and they may love to talk, but their conversations are more reciprocal. They can take conversational turns and they can switch topics to accommodate others' interests more easily. People with ADHD also do not tend to have specific weaknesses in their understanding of and use of non-literal language and speak with normal tone of voice and inflection.
People with Aspergers and HFA tend to have difficulty interpreting non-verbal communication and the more subtle nuances of social situations. For example, they may not easily distinguish between behaviors that may be appropriate in one setting and not in another or they may have difficulty interpreting facial expressions or posturing of others. In contrast, people with ADHD may be distracted and not pay as much attention to those things, but they do understand and interpret them appropriately.
While people with ADHD may be more impulsive and less observant of others' needs, resulting in more misbehaviors, they can easily consider others' perspectives and they easily participate in more reciprocal, or two-sided, social interactions. In contrast, people with Aspergers and HFA tend to be more eccentric and one-sided in their approach to others. It is not that they are indifferent to others but that they really have a harder time considering the perspective of others.
Language and social difficulties for kids on the autism spectrum tend to result in avoidance of many social situations. They have a lot of problems and often do not understand why. Many social situations become way too stressful, especially with peers, and they may prefer adults. Specifically, teaching social skills to these young people is often necessary. Kids with ADHD may have peer conflicts because of behavioral difficulties; however, they are more socially driven.
All individuals tend to have preferred topics of interests or activities. However, for people with Aspergers and HFA, those things can often be all encompassing and get in the way of more functional routines. Their preferred topics or activities also tend to have a sensory seeking quality to them (often visual or tactile) and include repetition. They may also be overly sensitive to things like sound and they may tend to get easily overloaded with sensory input.
Kids with ADHD often respond better to experiences that are highly stimulating. That is why they can sit for hours playing a video game, while attending to schoolwork may be very difficult. However, they tend to process sensory input in a typical manner. People with ADHD do not necessarily seek out sensory experiences in a repetitive or eccentric manner.
Aspergers/HFA versus ADHD—
Aspergers and HFA include many social, communication, and sensory difficulties that are distinct from ADHD. While the two disorders can result in behavioral and social difficulties, it is important for parents and essential for therapists to look beneath the surface and distinguish between them. Evaluations that appropriately differentiate between Aspergers/HFA and ADHD can lead to the most appropriate interventions for kids.
My Aspergers Child: Preventing Meltdowns
• Anonymous said... For some it can be. For others, its like they medication acts differently with there systems. We have one of each. For my daughter, it was cinstant irritability and 3-4x a day meltdowns.
• Anonymous said... I have 2 diagnosed with aspergers and ADHD. I do wonder sometimes if my son has both diagnosis because of his aspergers. He is inattentive but yet her know everything that is going on around him and even if he appears to not be paying attention he still hears everything that you say. I think that they lack of eye contact and the slow response time makes it appear that he is not paying attention. My daughter on the other hand has most if not all classic ADHD symptoms along with several communication issues.
• Anonymous said... Interesting... We have HFA, Asperger and possibly ADHD. The speech delay was pronounced, and now the physical attributes of speech making difficulties are present. Nevertheless, the IQ of 120 and very superior level of comprehension and other parts of language arts. Soooo... How all this is possible then?
• Anonymous said... Just want to point out this. I know they have changed the dignosis, as in Aspergers no longer exists, but one reason I dislike this is because aspergers and HFA are not exactly the same. The difference is, when young, those with HFA have had a language delay, as my 9 year old did. (has HFA diagnosis), And aspies didn't, my eldest son, (diagnosis of aspergers), was saying a handful of words at 6 months, was making small sentances by 9 months, and by 12 months you could have a back and forth conversation. I never knew till he was diagnosed just over 2 years ago, that early and advanced speech can also be a sign of aspergers. By definition, Aspergers does not include any significant delay in language (as opposed to autism). However, people with Aspergers do tend to have distinct differences in how they use language and tend to have language weaknesses that are not typically found in kids with average intelligence who have ADHD alone.. Anyone reading and not knowing very much, (just learning about this), may think their child probably doesn't have HFA, if they have a language delay, because it being said that Aspergers is often called HFA, not realising there are differences between the two, when children are very young. Just wanting to point this out, because I know when the younger of my sons was a toddler, I did think possibley autism, but so much of what I read was confusing...had I known then what I know now, he could have been diagnosed by 12 months, rather than 4 years.
• Anonymous said... Many kids have Aspergers and ADHD like my daughter. The symptoms can present the same in many cases. You treat the symptoms not the disorder.
• Anonymous said... One of each in our boys, both very mild, luckily. But it's interesting how it's easier to distinguish when they're right next to each other. More difficult if there's just one around to gauge.
• Anonymous said... We have found that there is some relief from the ADHD type symptoms in our ASD son with medication, I don't know if it's that way for everyone though.
• Amie Putnam said...I have two sons with both ASD and ADHD and a son not on the spectrum with ADHD and anxiety. The latter carried a mistaken ASD diagnosis for nearly 5 years because his symptoms really did look like autism sometimes...but we would notice he never missed social cues, could easily interpret meaning in facial expression, tone of voice, body language...in fact he frequently would "translate" for his brothers when they just didn't get it at all. That was my first big clue that he had been misdiagnosed. We took him to a psychologist last summer who clarified his diagnosis and he does not have ASD. As the article explained, sometimes his behaviors do look the same but the root cause is different. For example, he often does not do well with back and forth conversations, but he knows how and gets that he should, he is just distracted or anxious he will say something dumb. With my aspies, they will talk all day and never stop to think if the person they are talking to is even interested! One last thing, for those of us whose kids have both, I think it is still helpful to figure out which is causing which. Now that my oldest is 19 and he has learned mostly how to read social cues (he has both ASD/ADHD) I have noticed that most of his behavior problems seem to stem from the ADHD side...impulse control, etc and not from the other which is good because there are really good treatment options for ADHD.
• Anonymous said... ADHD symptoms and Anxiety are symptoms of Asperger's. The degrees may vary but it's important for people to understand that the root cause is neurological, not psychological
• Anonymous said... My daughter has both along with anxiety disorder
• Anonymous said... Oh, how I wish I could hand this article to everyone who thinks my child is "bad" and, by extension, thinks I'm a "bad" parent. I just want to tell them sometimes: "Welcome to my world. Don't judge my child or our family until you've lived our lives."
• Anonymous said...I had to share something along the same lines ADHD/Aspergers with the school my son was attending, and I felt their eyes glaze over, like they were saying "speak to the hand". Some times I feel the schools are so closed minded because they are familiar with ADHD and Aspergers is so "new" and they have their hands so full that they wont take the time to learn about Aspergers/autism.
• Anonymous said...It is especially painful when your own partner do not see what you know about your ADHD child and it makes especially difficult when he takes the sides of close minded teacher and blame the kid for being rude and undiscipline and blaming MOM for spoiling the kid. This whole thing is so painful!!!
• Anonymous said...my son is dxed Aspie, ADD/ADHD, and OCD. However, he is highly functional and verbal. He LOVES his friends, but struggles to reciprocate. He would rather be with kids his own age, but he wants them to do what HE wants to do and doesn't understand why he can't always play HIS games.
• Anonymous said...Oh, how I wish I could hand this article to everyone who thinks my child is "bad" and, by extension, thinks I'm a "bad" parent. I just want to tell them sometimes: "Welcome to my world. Don't judge my child or our family until you've lived our lives." You nailed it---thats EXACTLY how I feel :(
• Christina Steltz said....What treatment options worked for your son...mines 8 and he had a brain injury at 5 months...also he kept getting pink eye...over and over...found out it was coming from the sand box. I would really like to know the cause of my son's pro less before I go putting the meds in his brain. But then again I want to help my son asap. This is so hard...I feel for everyone who has to go through this.
• So true I'm going through same thing with my daughter
• Tiffany Smith said...We are in same situation they are trying to figure out what all going on its ADHD and aspegers at the moment not sure on the other autism just yet just waiting on more test and stuff.
• Unknown said...I live overseas I have a son who dud not want to breastfeed , he would cry like crazy. Later he did not crowl and when he walked he walked on tip toes. He never investigated his world through his mouth like mist babies. Feeding was tough especialky passing from mashed foods to whole. Still is does not like specific tectures. Interactions with other kids was hard I had always to introduce him myself. Has anxiety , some fears and starting to be hostile to me ( mother) was diagnosed with ADHD with depression and low self asteem. I also have ADHD that makes it hard. I am wondering if he has Aspergers. My peditrician did not refuse the option....I am confused. Are sensory and social problems a reason? Also he still at 8 now does not want to wipe himself and is slow in personal care. Has sense of humor and good in athletics but not in team sports.
• Unknown said...my son is dxed Aspie, ADD/ADHD, and OCD.However, he is highly functional and verbal. He LOVES his friends, but struggles to reciprocate. He would rather be with kids his own age, but he wants them to do what HE wants to do and doesn't understand why he can't always play HIS games.My son is at the beginning of the diagnosing process (for ADHD and AS) and he is the same which makes some of the people we see try and tell me that he is normal and just naughty, that he needs to think about others and that he can't have it all his way all of the time, needs to share, etc. If anything goes wrong, he is the first to be blamed .
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