"Is ADHD a result/symptom of Aspergers, or do the two disorders tend to coincide with one another?"
People often wonder if these two disorders are opposite, independent, or correlated. At first blush, ADHD seems to be short attention span and inability to focus, and Aspergers (high functioning autism) the opposite problem. But then, descriptions of ADHD also mention ‘hyper-focus’. If they do turn out to be correlated or similar, then what are the differences between the two?
Aspergers and ADHD share some similarities that can make diagnosis challenging. However, a close examination of their definitions reveals that the attention problems in Asperger are quite different from ADHD symptoms. The fact that a child can have both Aspergers and ADHD further adds to the confusion. Roughly 60-70 % of children with Aspergers have symptoms which are compatible with an ADHD diagnosis.
Here are some of the similarities between ADHD and Aspergers:
- Attention problems
- Irrationally energetic activity
- Learning problems
- Often appears to not be listening to someone during a conversation
- Problems following directions
- Says inappropriate things and has problems figuring out the appropriate response to some situations
- Talking at someone or talking nonstop
- When younger, difficulty accepting soothing or holding
Both Aspergers children and ADHD children have serious sensory integration problems, can be uncoordinated and impulsive, and they both very much respond positively to structure and routine. Whenever there is a deficit in executive functions, it manifests itself in inattentiveness, distractability and impulsivity – three areas recognized on both the Aspergers and ADHD checklist of behaviors.
Here are some of the differences between ADHD and Aspergers:
1. Aspergers focuses more on attention problems related to (a) a need for strict routines, (b) language difficulties, (c) obsessive rituals, and (d) self-stimulating behaviors. Conversely, ADHD focuses more on attention problems related to (a) impulsivity and (b) hyperactivity.
2. A child with Aspergers has the ability to focus on an activity of interest. A child with ADHD does not.
3. An Aspergers child tends to focus on only one activity with a level of intensity that excludes everything else in his environment (e.g., he may spin an object for hours and refuse to engage in any other activity). On the other hand, an ADHD child tends to be interested in multiple activities, but is easily distracted by the environment and jumps from one activity to the next.
4. A child with Aspergers may get angry if his routine or favorite activity is interrupted, but he does not generally show a wide range of emotions in public. A child with ADHD may be prone to express emotions directly and clearly.
5. An Aspergers child can stick with one activity for long periods of time. The child with ADHD may not be able to focus on any activity or subject for more than a few minutes.
6. Children with Aspergers and children with ADHD usually want to have friends. Both groups have poor “rite-of-entry” skills and both groups play badly. Yet both groups usually fail socially for different reasons. With Aspergers, the behavior is so unusual and idiosyncratic that the child is viewed as a “nerd” or a “weirdo”. With ADHD, the behavior is so loud and chaotic that the child is viewed as annoying or disruptive.
7. Children with Aspergers like rules, but break the ones they don’t understand. Children with ADHD frequently break rules they understand, but defy and dislike.
8. Children with Aspergers are often oppositional in the service of avoiding something that makes them anxious. Children with ADHD are often oppositional in the service of seeking attention.
9. Children with Aspergers crave order, hate discrepancy, and explode (or withdraw) in the face of violation of expectations. Thus, they are very brittle and fragile. Children with Aspergers are much more tyrannized by details – they accumulate them, but cannot prioritize them. Children with ADHD also have poor organizational skills, but can be much more fluid in their thinking, more inferential in their comprehension, and less rigid in their treatment of facts that they are able to organize.
10. An Aspergers child can talk or play quietly. An ADHD child finds talking or playing quietly very difficult.
11. An Aspergers child has difficulty waiting for his turn in games or activities due to a lack of social intelligence. An ADHD child has difficulty waiting for his turn due to impulsivity.
12. Both groups seem not to listen when spoken to directly, but for different reasons. It appears that the Aspergers child is not paying attention because he avoids direct eye-contact. It appears that the ADHD child is not listening because he is focused on other things at the time.
The main differences between Aspergers and ADHD deal with focused attention ability as well as whether or not obsessive behaviors and sensory issues are present.
It is possible for a child to have a cormorbidity of ADHD and Aspergers (i.e., both conditions are present). A child with both conditions will have more ADHD symptoms (e.g., impulsivity and hyperactivity) than common in Aspergers.
The problem with the Aspergers - ADHD overlap is that, at the more severe margins of the ADHD spectrum and the less extreme margins of the Aspergers spectrum, clinicians can legitimately argue for one over the other diagnosis. It is common for a child with Aspergers to first be diagnosed with ADHD due to attention and behavioral issues. As further tests are done and more specialists get involved, a more specific diagnosis of Aspergers is often made.
Most of the processes to get these labels placed are not an exact science, and the frustrating process for parents, teachers, and medical professionals is finding the right label to make sure that the right approaches are taken to help the child progress in the best manner possible.
The Aspergers Comprehensive Handbook