HELP FOR PARENTS OF CHILDREN WITH ASPERGER'S & HIGH-FUNCTIONING AUTISM

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Is it High-Functioning Autism, ADHD -- or Both?

“My high functioning autistic son has difficulty paying attention in school (3rd grade). He is also somewhat hyper most of the time. My husband and I are beginning to wonder if he has ADHD instead of – or in addition to – high functioning autism. Are these two disorders similar? And do some high functioning autistics also get the ADHD diagnosis?”

Hyperactivity and inattention are common in kids with High-Functioning Autism (HFA), particularly in early childhood. Differential diagnostic considerations are paramount, particularly in the context of HFA. Hyperactivity and inattention are seen in a variety of other disorders (e.g., developmental receptive language disorders, anxiety, and depression). Therefore, the appearance of inattention or hyperactivity does not point exclusively to ADHD. The compatibility of the child and his school curriculum is particularly important when evaluating symptoms of hyperactivity and inattention. There is a risk that a school program that is poorly matched to the child’s needs (by overestimating or underestimating his abilities) may be frustrating, boring, or unrewarding. If the verbal or social demands exceed what he can manage, they may produce anxiety or other problems that mimic inattention or induce hyperactivity.

Some experts believe that HFA and ADHD are themselves both spectrum disorders, with bleary margins wrapped around core characteristics that can’t be quantified. There is a large overlap in symptomology between the two. Approximately 65 % of kids with HFA have symptoms which are compatible with an ADHD diagnosis.

The problem with the ADHD and HFA overlap is that at the more severe margins of the ADHD spectrum and the less extreme margins of the autism spectrum, professionals can legitimately argue for one over the other diagnosis. Many kids with severe ADHD can be obsessed with Nintendo, can be bullied and teased, have meltdowns at the drop of a hat, have no friends, have severe sensory integration problems, lack perspective-taking skills, can be socially aberrant, and talk constantly and too loudly (just like HFA children).

Young people with ADHD can have as bad - or worse - executive functioning skills as HFA kids. Kids with ADHD often have verbal IQ which are much better than their performance IQs (just like HFA kids). The child with ADHD shares a great many neurocognitive features with the HFA child, and that is one reason why neuropsychological testing by itself is not the best way to make a diagnosis of HFA.

In general, HFA kids “have more” than most kids with ADHD (i.e., more neuro-integrative problems, more perseveration, more splinter skills, more stereotypies, and more trouble telling a coherent story). If you suspect that your HFA child may also be experiencing the symptoms of ADHD, consult a child and adolescent psychiatrist for an evaluation (preferably one who specializes in autism spectrum disorders).


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COMMENTS:

•    Anonymous said... My boy has both as well. Once we got his ADD under control, we had an easier time with the other.
•    Anonymous said... My daughter was borderline ADHD w/ Anxiety first before the Aspergers diagnosis. I definitely see some crossover symptoms between the two.
•    Anonymous said... My son has also been diagnosed with both.
•    Anonymous said... My son has both
•    Anonymous said... My son was diagnosed with ADHD first and then Aspergers about 2 years later.
•    Anonymous said... These two are co-morbid! There is some cross over but definitely worth looking into
•    Anonymous said... Very common with ADD or ADHD together with aspergers. My daugther has ADHD+aspergers, and my son got ADD+Aspergers. She needs to address these issues with the child's doctor to get the added diagnosis, there are good medications that might help, my son had much help from it, my daughter was too little when we first tried, it didn't fair to well, so I wanted to wait til she got older (which would be now) and try again at age 10.

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