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Does Your Child Have Asperger Syndrome, ADHD, or Both?

"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
  • Tantrums
  • 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.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book


==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

12 comments:

Anonymous said...

Dear Mark,
I appreciate the updated information. I presently teach a child who seems to have many symptoms of aspergers.
I continually read and self educate to help my students continue to learn and grow.
Thank you!
Have a Merry Christmas and Happy & Healthy New Year!

Anonymous said...

Dear Mark,
Thank you for your last item about the difference between ADHD and Aspergers.
I have a daughter that is A.S.but my nephew is ADHD,but they are very similar when they were young it isnt till now when they are both in their teens that the difference is more obvious. We know that the conditions are hereditry and we can now see traits in other members of our family.
thank you for this website.

Merry christmas and happy new year

Gretchen Jones Robinson said...

Thank-you, my daughter has both ADHD and Asbergers...with ADHD being the more dominant trait. Many people refuse to believe that you can have both, thank you for the article.

Anonymous said...

Thank you...great information. My son now 12 was diagnosed and has been treated for ADHD and ODD (Oppostional Defiance)since age 6. We are not seeing much improvement with his treatment and many of the Aspergers symptoms fit him to a tee. But so do many ADHD symptoms. Uncertain how to convince specialists to look at both syndromes to ensure the correct approaches are being taken. My son is now pre-teen and has explosive, over exaggerated bouts of violence and emotions toward other children. So certainly I am concerned as he gets older. 1 child retorted back to his name calling with a similar taunt and my son chased him home and took a spade shovel to his front door damaging it with holes beyond repair. This is extreme and his only answer is that the child made him mad and he just did it. Please help...I live in small town with limitted resources so any advice is appreciated. His compulsive tendencies for things (personal items, etc) to be "just so" bike parked "just right", bed made "certain way" and particular "cereal bowl" don't seem to fit in either spectrum. Should I be considering a different diagnosis all together?

Anonymous said...

why is aspergers and adhd so closley related? and how can i tell if it is just aspergers or adhd or both that affects my wonderful son?

Anonymous said...

i went to a adhd support group and by the time i left i had to ask myself, does my son have adhd/aspergers or is it just adhd....i am so confused...and should i trust that the diagnosis of aspergers came from the school phsycoligist? when another supposedly well respected doctor said that the problems he is/was having in school was due to adhd and NOT aspergers?

Anonymous said...

I have a son who was diagnosed with ADHD when he was 8 years old. He is now 11 years old.

Since being on concerta for over 18 months life became pretty much normal. However in January of this year my son started to say he was experiencing chest pain/heart pain. His doctor advised me to stop his medication straight away. Within a week I had a violent and very dangerous aggressive child at home and at school. He was put back on concerta for 2 weeks on half his original dose but seemed to become worse or continue his aggressive behaviour. Because of this it was decided to take him off medication altogether for a further period of 3 weeks. The school kept a daily diary of his behaviour so did his out of school club helpers and so did I. When putting all 3 diaries together the doctor decided things were so bad to try him on 20mg of Ritalin for the morning and another type of ADHD tablet for night time with 2 sleepings tablets since he has never slepted much as a child to this very day.

It's now 5 months since he has come off the concerta and I struggle to understand how I had 18months of an almost normal lifestyle with my son. Now because in December January time he complained of chest pain for 5months our lives have been in dispair! We seem to be getting nowhere.

Since last week it was decided to stop his Ritalin but to continue with his evening ADHD medication and 2 sleeping pills. He continues to wake up fully through out the evenings last night he work up at 4.15am and is still not asleep. Today I have tried getting an appointment with the ADHD doctor without success. Yet doctors say they are there to support us and to call them immediately if we are having difficulties then as a parent we are just ignored. I find this confussing when my son has been diagnosised as having severe ADHA

Unknown said...

I have an 11yr old son. He has problems copying from the board.retaining simple school work. Playing with children. The personal space of others. He can stay long hours playing one particular game on his tablet. He can play drumsvguitar
Without formal training. Sing songs seconds after hearing them. Has a marvellous voice. Recently he was seen by a senior paedritrician who says he exihibit autism features and ADHD. What should I do

Lyon Milligan said...

I feel the symptoms present as the illness but they are in fact learning strategies. I know I make rigid black and white assumptions of the world because the world is so chaotic and nebulous to me. I am bombarded by masses of information simultaneously so I need to structure it or I drown. If I was socially allowed I would be ADHD but it doesnt so I have learnt to be reserved. I am an actress. I mimic. Slow, unavailable sultry and sexy. When you get to know me I am like a butterfly with thoughts and concepts and incoming flying all over the place. It takes ages for me to come out of my Aspergers shell. The 'behaved me' is also exhausting so I can only do social contact for 2 hours and then I have to rest for three days. They say Im too far away to concentrate. Damn that ! I AM concentrating ! On something far more interesting than what they have to say. Focus ! when I focus I am searching through masses of information in a frenzied fashion from widely ranging topics trying to find pattern. Most people have trouble finding enough words for an assignment, I have too many words. 100 times the words and have to condense it to find its essence. Mindmaps are my best friend. You should see me when I run out of material to process. I can fall into the deepest of depressions. When i used to take drugs in my wild youth I would become extremely animated but only within a certain circle of crazy friends. I would say my Aspergers label equates to the qualities of ADHD stuffed into a Jack in the Box.
Thats only part of the picture. Why are aspergers attracted to ADHD? I have a theory it is because they need to know how to express that inner thunder. And vice versa. I actually swapped places with my adhd husband. He became inward and i exploded outwards. We taught each other. I think its two different strategies for the same thing. Ive seen his two boys adopt the two different strategies as they grew up. Family constellation? And what about my manic depression? two sides of the same coin? So what about a cure? Art music theatre. use of the other side of the brain. Juggling dance paino any skill that makes both sides of the brain work in harmony. Have a look at the Free Festival Scene in the U.K. you'll find 100's of expressive autistic folk. Interesting huh !

Unknown said...

Thank you, Lynn. I would like to use your story as I teach others. Hope that is ok.
I was a teacher and discovered what you are saying and how to work with these kids. All on the spectrum are differently oriented, more to the right brain than the left, for the right brain is open like a satellite dish for all those amazing words to congregate, insights and inspirations to arise, and beyond. Left brain stuff by itself is hard to deal with because spectrum individuals do not have a left brain filter, with which to sequence what comes at them, or to focus in that way for amount of time that is expected of them to deal with purely left brain linear information. You mention the great solutions...use both sides of the brain, and particularly these individuals, and actually all students, should be encouraged to follow their passions. Can I state my website here? I have a paper there, and will be putting others there in the next two weeks.

Lyon Milligan said...

Peggy, of course! I would be delighted. Im glad someone else has noticed this phenomenon also. I would love to have a look at your website. Do you know of a festival called Hedge-U-Cation ? Similar to what we're saying. I also know of an excellent story about left right brain balancing and a travelling circus if you'ld like me to give you the link?
Regards
Lynn

Anonymous said...

Where to start?!
All last year I was was certain my 2yr old son has aspergers. My brother was diagnosed as an adult. My son had a speech regression around the year mark. Although he rarely spoke he was never done pointing and wanting to know what everything was, especially when out. I knew he was retaining everything. He was obsessed with road traffic signs, had them memorised, knew all his colours and numbers to 10 by 15m. Counting to 20 and reciting/ able to identify the alphabet by 2. He entered nursery at 2. Within 2 weeks he was bitu g his nail terribly and when a child appeared on the TV he'd go up and whack it. This aggressive behaviour has escalated to actually hitting in person, other kids and me. Fast forward a year a day it's only gotten worse. I think initially he wanted to socialise and play but realised quickly he was different and it was difficult for him. He then chose to not want to interact and has a real a aversion to his peers. He loathes to share, even with me and becomes upset and violent when asked to do so. Not always but mostly. I'm convinced he has adhd, is experiencing avoidance of his peers because it causes him stress and anxiety. It's difficult to k ow what to do to unlock this cycle he's in. He is full throttle, on the go at all times, never sticks with an activity but his memory and recall are amazing. I just really worry about his self esteem and mental health. He seems angry a lot but can be so loving. He has major meltdowns, absolutely nothing is ever simple. He's very impulsive , defiant and oppositional at the tender age of 3!! I worry for the future if I can't find a strategy to help him cope and integrate more socially.

My child has been rejected by his peers, ridiculed and bullied !!!

Social rejection has devastating effects in many areas of functioning. Because the ASD child tends to internalize how others treat him, rejection damages self-esteem and often causes anxiety and depression. As the child feels worse about himself and becomes more anxious and depressed – he performs worse, socially and intellectually.

Click here to read the full article…

How to Prevent Meltdowns in Children on the Spectrum

Meltdowns are not a pretty sight. They are somewhat like overblown temper tantrums, but unlike tantrums, meltdowns can last anywhere from ten minutes to over an hour. When it starts, the Asperger's or HFA child is totally out-of-control. When it ends, both you and your child are totally exhausted. But... don’t breathe a sigh of relief yet. At the least provocation, for the remainder of that day -- and sometimes into the next - the meltdown can return in full force.

Click here for the full article...

Parenting Defiant Teens on the Spectrum

Although Aspergers [high-functioning autism] is at the milder end of the autism spectrum, the challenges parents face when disciplining a teenager on the spectrum are more difficult than they would be with an average teen. Complicated by defiant behavior, the teen is at risk for even greater difficulties on multiple levels – unless the parents’ disciplinary techniques are tailored to their child's special needs.

Click here to read the full article…

Older Teens and Young Adult Children with ASD Still Living At Home

Your older teenager or young “adult child” isn’t sure what to do, and he is asking you for money every few days. How do you cut the purse strings and teach him to be independent? Parents of teens with ASD face many problems that other parents do not. Time is running out for teaching their adolescent how to become an independent adult. As one mother put it, "There's so little time, yet so much left to do."

Click here to read the full article…

Parenting Children and Teens with High-Functioning Autism

Two traits often found in kids with High-Functioning Autism are “mind-blindness” (i.e., the inability to predict the beliefs and intentions of others) and “alexithymia” (i.e., the inability to identify and interpret emotional signals in others). These two traits reduce the youngster’s ability to empathize with peers. As a result, he or she may be perceived by adults and other children as selfish, insensitive and uncaring.

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to read the full article...

Highly Effective Research-Based Parenting Strategies for Children with Asperger's and HFA

Become an expert in helping your child cope with his or her “out-of-control” emotions, inability to make and keep friends, stress, anger, thinking errors, and resistance to change.

Click here for the full article...