The ADHD and Aspergers Connection

Hi there I’ve had a busy Tuesday so far looking for a nursery for my 18 month old daughter (Honey). The first one I saw had a kitchen knife lying on the side (at toddler’s height!), some old takeaway food on plates and a filthy carpet … not exactly what I’m hoping for! The next one seemed way too happy to let me in the building without really checking my credentials – another red flag I’m afraid! So the search continues as I am less than impressed with what I’ve seen so far. Like all parents I know I’ll have to compromise some of my very high standards that I expect – but I still want something pretty good none the less. Anyway let me move swiftly on to this week’s Aspergers blog post which looks at ADHD and Aspergers:

Question

Are there any connections between ADHD children and those with Asperger’s Syndrome?  My child is diagnosed with ADHD, but he seems to cross over a bit with weak social skills and emotional behaviour.  How do you determine what is ADHD and what is Asperger’s?

Answer

The symptoms of Attention Deficit Hyperactivity Disorder (ADHD) and Asperger’s Syndrome do mimic one another, and there are some connections between ADHD and Asperger’s.  In fact, there are dual diagnoses of ADHD and Asperger’s Syndrome in many cases.  Both of these diagnoses are developmental disorders; they share many of the same behavioural features and both affect children in the areas of behaviour, communication, and social interaction.  As a result, there is often some confusion as to which disorder(s) is present.  Medical, mental health, and educational professionals need to be trained to differentiate between the disorders and diagnose the correct one.

Here is a list of the behaviors seen in Autism/Asperger’s Syndrome and Attention-Deficit Hyperactivity Disorder:

Autism / Asperger’s Syndrome

Difficulty interacting with peers
Fearlessness; feelings of invincibility
Temper tantrums without provocation
Inappropriate laughter
Resistant to intimacy
Physical over-activity or lack of physical activity
Minimal eye contact
Impulsive work effort that results in mistakes
Inconsistent fine motor skills

Attention-Deficit Hyperactivity Disorder

Disruptive with others; cannot talk or play quietly
Impatient; does not want to wait
Risk taker; willingly becomes involved in potentially dangerous activities
Exhibits severe temper tantrums
Interrupts others; talks and/or acts inappropriately
Resistant to intimacy during younger years
Constantly active
Inattentive; has difficulty listening or conversing
Avoids attending to details; makes mistakes in work activities.

Both ADHD and Asperger’s Syndrome

Problems with gross/fine motor skills
Behaviour driven by impulses
Difficulty with appropriate emotional responses.

As you may already know I’ve written a resource guide for parents of child with ADHD which is still available at www.parentingadhd.com So this knowledge of the diagnostic differences, along with the information provided in The Parenting ADHD Resource Guide, will help you differentiate between symptoms of ADHD and Asperger’s Syndrome.

That’s all for the week and have a great day,

Dave Angel

PS – Just to let you know that the new Aspergers website is progressing along well and I’ve been putting together loads more information on topics such as college aged children, the effectiveness of therapies, helping your child to choose the “right” type of friends and how to support your child to cope with varied social situations. Keep watching this space for more details…!

32 comments »

1. good artical !

   Comment by Patty — October 21, 2008 @ 8:49 am

2. My 17 year old son was diagnosed at 4 with ADHD & Dyspraxia, it wasn’t until he was 11 that he was diagnosed with Aspergers and 15 when he was told he was mildly dyslexic. Not surprising, for a high functioning autistic he has not done so well at school due to lack of ‘correct’ support. Sometimes having a diagnosis does not change anything, in fact sometimes it makes matters worse.

   Comment by Paula — October 21, 2008 @ 9:02 am

3. I have a 11 year old son that has ADHD/Asperger Syndrome. We knew by the age of 4 years old that he had ADHD however it was more difficult to detect Asperger. By age 7 years old when the inappropriate behavior wasn’t so cute as it was at age 5 years,we had him tested. Being my first child I wasn’t aware that every developmental stage was delayed and after a while the delays started bringing up red flags. It is very hard to detect Asperger Syndrome until around age 7 or 8 years old if the child has ADHD. Look for no eye contact and difficulty with emotional responses as a key factor.

   Comment by Shirleyanne Marelly — October 21, 2008 @ 9:05 am

4. My son was diagnosed with ADHD by the time he started school and Asperger’s by 2nd grade. We knew something was wrong just never knew what until his teacher pointed out that his symptoms related to this disorder. Now having real problems in the 5th grade with getting him to do his school work! I pray for the strength!!

   Comment by Sandy Pierce — October 21, 2008 @ 9:25 am

5. Fantastic article Dave…As you know from my writings, my child is still undiagnosed (officially) at 10 years old. The UK definitely seem alot more advanced than the colonies!!! However, I digress. The reason for writing on this particular article is that in my search to find some form of treatment for my son, and help for me, I was often led to ADHD websites by the features my son was displaying. The diagnosis of ADHD is a far wider and more common occurrence, but be aware that if your child IS diagnosed with ADHD, especially where I live, it may be all they are labelled with, and as we all know, some treatments and recommendations for ADHD only exacerbate Asperger behaviour..so be aware, they may have either, or both…as for me, I think I might know more than any of the 20 or so people I have talked to here lately about it(please excuse my cynicism)…are there any professionals in Australia that you know of that I can contact?

   Comment by Bianca — October 21, 2008 @ 10:06 am

6. What a wonderful article. My son was dxd with ADHD at 7, but it took us 5 more years and lots of pain and suffering to figure out that many of his issues were caused by Asperger’s. Finding out about Asperger’s saved our life. We thought he was just being difficult. REalizing that there were actual issues causing his behavior made life for both of us much easier.

   Comment by Teri — October 21, 2008 @ 10:36 am

7. my daughter was diagnosed with ADHD at 4, put on ritalin, still on meds for ADHD. Diagnosed with Aspergers Syndrome last year, she is in 6th grade, 12 years old. Even more, she has a rare genetic condition called Galactosemia and there may be a connection with that. Galactosemia and Austism both deal with chromisome 9. Galactosemia is too rare to ever get medical research done to find a cure but back to the connection to ADHD and Aspergers, just letting you all out there know there is a girl in TX, USA that fits this profile too!

   Good article by the way.

   Comment by bonnie — October 21, 2008 @ 10:59 am

8. I have a 12 year old son with ADHD, which was diagnosed when he was 7. My daughter aged 13 has just been diagnosed with Aspergers, but we have had her tested at various developmental stages for gross motor problems, social skills problems, ADHD and ODD, but none of them were quite right. Understanding that she has AS has been a huge relief for all concerned and we can now work with her to help. So with this direct comparison between ADHD and AS, I would say that there are significant differences, particularly relating to the social skills problems, emotional responses and hyper-sensitivities in AS which are quite absent in my ADHD son. Living in South Africa, we find that while ADHD is fairly well understood in the private schools, AS is almost unheard of and I can only marvel at all your comments about school support in the UK for Aspies - I wish!

   Comment by Bryony Evans — October 21, 2008 @ 11:15 am

9. This is a great blog. My son was diagnosed with ADHD at age 4. He just turned 9 and is exhibiting some characteristics of high-functioning Asperger’s, in the areas of difficulty with eye contact and inablility in tying his shoes, which is a problem with motor skills. He had a speech delay which was overcome with 3 years of private speech therapy, along with one year at school, which helped him immensely. He also has impulsive bahavior. Thank you so much for the insight. His dr. just last month told me we should have him evaluated for Asperger’s.

   Comment by Denise Odier — October 21, 2008 @ 11:49 am

10. Great read that gave me a clearer picture of how the two go together. My son has both. they are still very much who they are but with added strategies we can help them get more from life.

    Comment by Rae — October 21, 2008 @ 12:19 pm

11. I’m not a parent of a child with Aspergers. nut I am a child with Aspergers. Actually, a teen. So anyways, they thought I had ADHD for a while and gave me Ritalin, which DID NOT work out. My mom says never to recommend Ritalin. (I think medications are overused anyways.)

    Comment by Aimee — October 21, 2008 @ 12:58 pm

12. Reading all your articles, I was sure that my son has AS as he has most of the simptoms listed in your book and in your articles. We’ve done official assessment through private psychologist, and she’d surprized me that she does not see him Aspi and she does not want to label him as a lots of kids this age (my son is 8), especially boys, having social skills difficulties. From one side I’m glad - my son does not have “label”, from other side - the problem still there.

    Comment by Inna L — October 21, 2008 @ 1:11 pm

13. ADHD is so over diagonosed. When I took my son in for testing that is the first thing the doctor diagnosed, even though I told him my son could read 2 or 3 hours without moving even to go to the bathroom. Took son to a nero. he said no way to ADHD. Yes to Asperger’s. Thank goodness I refused to throw my son on meds. Always get several views and trust you gut. And don’t use meds. except as a last chance.

    Comment by K. Koke — October 21, 2008 @ 3:01 pm

14. I would recommend a different psychologist to assess your son. My son went through the same sort of situation for many years, ended up being diagnosed Aspi at age 13. We missed many years of potentially beneficial therapies, had many misunderstandings concerning our son’s behaviors, and lacked adequate school support due to lack of a firm diagnosis. Since being diagnosed, my son is doing better in school, at home, and has a better understanding of why he is unlike his peers.

    Comment by Cindy — October 21, 2008 @ 3:53 pm

15. my son is nearly 17 and is only just going through a lengthy process to see if he does have aspergers. From the age of 2 I knew there was something not quite right. He had speech therapy and had help with motor skills and I was told he more than likely had dyspraxia. I was never convinced that this was the only problem. He never had extra help all through school. He is now at college working on A levels and doing very well, although obviously social skills as well as clumsiness and OCD (although with my help as a strong willed mum who has always helped as best as I can) there are more good days than difficult ones.

    Comment by lynn shalliker — October 21, 2008 @ 4:22 pm

16. My 11 year old daughter was diagnosed with Asperger’s at age 2.5 - but it was the undiagnosed ADHD that caused her to suffer for many years in school. All the “experts” missed the ADHD - they were too focused on the autism. It wasn’t until I read “Asperger’s Plus’ that I thought she might have ADHD as well. From the moment she first took the ADHD med, she was a different kid. It has been a miracle. Now she is mainstream in school, has friends, sleepovers, great grades. She is still an Aspie - I still have to coach her about modulating her behavior to that of the other 6th grade girls (like before the first 6th grade dance!). She still needs accomodations at school - extra time for handwritten stuff, no “theory of mind” writing topics, etc. But now that the ADHD is under control, her life is happy and her challenges are manageable. Amazing how the experts - including Yale - all missed the ADHD, which is the most commonly diagnosed disorder of kids in the USA.

    Comment by Lili — October 21, 2008 @ 4:58 pm

17. i can not see the article because of the advertising pasted on TOP of the article…cant read all of the comments for the same reason. what a waste

    Comment by Jeanene evitt — October 21, 2008 @ 5:40 pm

18. To Inna L: My son’s pediatrician did an evaluation and said he did see some AS “traits” but did not see enough signs/ symptoms to diagnose him at 6 years old. He also said a psychologist is not qualified to make a diagnosis (as his private school wanted to do some “gifted” testing and for Autism Spectrum Disorders). You should see his medical physician and/ or psychiatrist.

    Comment by Debbie B. — October 21, 2008 @ 7:01 pm

19. My son is 3 1/2 and just diagnosed as Asperger. Problem is, Malaysia lack of information or guideline. I’m standing in the crossroad here. Don’t know how to start and what is the next solution.

    Comment by Maggie — October 21, 2008 @ 8:01 pm

20. My nephew whom my husband and I have guardianship is 13 years old. He has ADHD and AS
    The hardest thing for me to deal with is distinguishing what is ADHD and what is AS. What he can control and what he can’t control. I feel helpless at times because I have to practically think for him. He get’s really good grades, however, he is very forgetful. I’m frustrated because I don’t want to always be constantly reminding him of doing this or doing that. Any comments or thoughts would be appreciated.
    Thanks

    Comment by Holly Urquizu — October 21, 2008 @ 8:22 pm

21. I just wish people would stop saying you can’t have Autism if your child makes eye contact. I think that is outdated and proved a myth. Kids with Autism do make eye contact, and can be very physical, ie likes hugs etc. I know a lot of people who’s kids are probable on spectrum, and resist getting a diagnosis because they were told oh they make “eye contact” therefore they don’t have Autism. Thats just one of many erroneous statements.I wish they would stop saying that. Autism in general is a lack of social understanding and social skills, not just lack of eye contact.

    Comment by Brenda — October 21, 2008 @ 10:56 pm

22. it is very hard to diagnose AS my child was diagnosed with anything and everything at the age of 7 with ADD and ADHD I think it was more to console the parents because we knew something was different with this child,so it was like to get us off their back lets give this one a label. We’ll say he is this and that will be that,then comes the prescription pad and the “MEDS.” Well when the meds hurt more than it helps and we are now wondering what did I do? This dont work and Im failing my child I felt as though he was a guiene pig,I caused all this by asking what’s wrong with my child….AND UNTIL that one person BY CHANCE you are told of does the testing and questioning required you are still in the dark. Its another label… but when you read the diagnoses and your child appears within the reading somewhere, the more you read the clearer the picture becomes, then you are on the RIGHT TRACK . And I thank the LORD for the knowledge of that one person that finally made sense…….

    Comment by Suzi — October 22, 2008 @ 7:12 am

23. And yes my son now at the ripe ole age of (15) is Asperger Syndrome. The word sounds worse than the diagnosis but its not he is just UNIQUE, and genuine mess!!!!! Sorry I forgot to say this in the first post above….

    Comment by Suzi — October 22, 2008 @ 7:18 am

24. My son is 10. Diagnosed at 4 with ADHD, and at 9 with ADHD/Asperger’s. I have hated the “label” as well. However, if they are not “labeled the schools will not help. These kids need as much help with social ques, and interaction as possible during the young years. They are learning how to co-exist with others. My doctor did not want to share the asperger’s diagnosis with my son’s school. However, with his high functioning, and good grades, they feel there is nothing more they can do for him. If he meets the Autism criteria, he will receive services such as, social skills, preparations for middle school, high school, and college transitions. Occupational Therapy can be offered, and the list goes on with testing accommodations, and so forth. Who cares what label is on your child if it helps him(er)?

    Comment by paige — October 22, 2008 @ 9:24 am

25. WOW!!
    This was so great to here. I was looking for just this type of thing.I want to copy this artical and have all my friends and family read this!Again, WONDERFUL INFORMATION!! thank you so much!!

    Comment by karen — October 22, 2008 @ 12:06 pm

26. Thanks for all the e mails they r a great help. Donna.

    Comment by Donna — October 22, 2008 @ 3:00 pm

27. In response to the boy age 8 who had a private psychologist asses her son. I have my 6 year old nephew living with me since the age of 22 months and we knew something was not right as we have 2 older children. We have had to fight for 3 years to have him assessed and have come across psychologists who do not want to label but I must say now he has been diognosed with AS and ADHD IT IS MUCH EASIER BECAUSE YOU KNOW WHAT YOUR UP AGAINST AND CAN DEAL WITH SITUATIONS APPROPRIATALLY, PLUS HIS MEDICATION HAS HELPED AND HE HAS NOW SETTLED IN SCHOOL, ENJOYS GOING, SO THERE IS NOT A BATTLE EVERY MORNING FOR AN HOUR……. Its not a label its a diognosis and can help the whole family deal with the child. I think if the psycholocists lived with a child with AS or ADHD they may not be so flippant.

    Comment by Sharon — October 22, 2008 @ 3:29 pm

28. My going on 13 grandson has been diagnosed with A.S.by C.A.R.D. The court psychologist says he has ADHD and wants to prescribe Ritalin but I have never been happy with that as I read Tony Attwoods book and could see my grandson on every page. My grandson read a couple of pages and felt that was him and he felt better that other children had the same problem i.e. when he tells a joke no one finds it funny because they find it hard to be friends with him and yet some one else could tell exactly the same joke and (he says he tells it better than the other guy) and they all laugh with the other person. A lot of his problem is interaction with his peers and in team sports he doesn’t run in softball (as he is big because he eats more carbs and needs more protein to balance out the carbs) and he will sit down on the ground if he is bored fielding out far (to the extent that other team members say “I would rather be dead, wouldn’t you”). He does not sit with them or talk with them or vise versa and is more happy sitting by his family. We love him heaps but others can only look at some of the gross things he does i.e.picking his nose, doing inappropriate things i.e. bunny ears behind a boy urinating and not realising the consequences of his behaviour. He seems to lack empathy for the feelings of others. If he had been at a lower decile school he would probably have been pummelled to the ground.

    Comment by Lillian Carde — October 22, 2008 @ 5:33 pm

29. i am reading the mails of parents narrating the condition and pronlems of children with AS and ADHD. it would be helpful if they give the methodologies of treatment and traing given to them.

    Comment by singeetam — October 23, 2008 @ 9:24 am

30. my 17yr old daughter was diagnosed with ADD and aspergers at 10..no direction was given to us except speech therapy. at 11 she scored as a 2 yr old with her pragmatic skills. I have loved and supported her and gone to what proffesional help i could find now at 17 I struggle to connect with my beautiful girl who is quiet and lovely but hardly talks and in order to get a cuddle i have to go to her but she wont let me hold on for long..her 3 younger siblings adore her. Im having trouble teaching her the basics. washing dishes, personal hygiene, and basic cooking.. I am terrified if something happens to us how will she survive. she cant seem to grasp the connection between germs hygeine and illness.

    Im soooo tired

    Comment by Diana — October 26, 2008 @ 6:12 pm

31. I would like to thank everyone who responded to my posting (see Comment 12) concerning misdiagnosis or absence of the diagnosis. No matter with diagnosis or without – the problems are still there and we have to cope with it. I think that would be great idea, if all parents can share their experience and thoughts regarding the suggestions made by the professionals. Regarding my experience I can say the following: before the official diagnosis I took my son to the Occupational Therapist (OT). She had made her assessment and had suggested set of excercises to straighten his upper body. According to her – most of the AS/autistic kids having low muscle tone, which makes them to move constantly and not to stay still. We’re trying to excercise every evening. Then we took 3 months classes of one-on-one social trainer, which was useless, in my opinion. Psychologist suggested some classes called “Behavior matter”, which involves group of children ages 6-10, where they are learning how to deal with bulling at school, how to make friends, how to share etc. They using different strategies, how to control themselves. I still do not know the outcome of these classes as we’re still in process, but the idea is pretty good and structured well. If someone living in Toronto is interested, I can share the phone numbers and names. That all we’re trying right now. I would really appreciate, if you can share your experience, how to deal with all those issues on daily basis and what type of help we may request from school (if any). Unfortunately, psychologist wasn’t able to help in that matter.

    Comment by Inna L — October 28, 2008 @ 9:11 am

32. I have a 7 year old boy with Asperger’s, ADHD, and CAPD and a 17 year old girl who has just been diagnosed with AS, has ADD, anxiety and depression. It has been a struggle getting any help for him through the school system. They just don’t see a problem because his grades are high. Now, they send home a paper to be filled out that makes him sound like a bad kid. What kind of help is out there for a family struggling get get their children help in these situations. They aren’t bad children. They can’t help getting overwhelmed and scared. It is rediculous. Now, we are trying to figure out how to send our daughter to college. She also doesn’t understand the hygiene thing or what being an adult is all about. She acts like she is still about 13 or 14. I worry about what is going to happen to her.

    Comment by Ramona H. — November 2, 2008 @ 9:23 pm

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