Double Diagnosis: When Your Child Has Adhd And Autism
Nearly a third of children with autism have ADHD symptoms, yet until recently, medical guidelines didn’t allow for both to be diagnosed in the same child. Learn how one mom found the comprehensive treatment her son needed for both disorders.
Beau Baldassari, 8, part of a military family, showed his parents early on that he didn’t respond well to the frequent moves that are part of a military career. “One month before the move, he became angry all the time, defiant, just the definition of a behavior problem,” said Beau’s mother, Ally Baldassari. She didn’t know it at the time, but Beau was showing the first indications that he was suffering from both autism and Attention Deficit/Hyperactivity Disorder, or ADHD.
Medical guidelines regarding autism, ADHD, and attention deficit disorder have changed in recent years. Previously, psychiatrists were unable to diagnose a child as having autism or autism spectrum disorders , as well as ADHD or ADD. But a study published in the June 2013 edition of the journal Autism has found that nearly one in three children with autism also have some form of ADHD symptoms. Faced with this, the latest version of the Diagnostic and Statistical Manual of Mental Disorders , which lays out guidelines for diagnosing psychiatric disorders, now allows doctors to issue a joint diagnosis of autism and ADHD.
Inattentiveness Signs And Symptoms Of Adhd
It isnt that children with ADHD cant pay attention: when theyre doing things they enjoy or hearing about topics in which theyre interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out.
Staying on track is another common problem. Children with ADHD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. Kids with ADHD also have trouble concentrating if there are things going on around them they usually need a calm, quiet environment in order to stay focused.
How To Explain The Diagnosis To Your Child
The primary rule to remember when revealing your child’s autism diagnosis is to stay positive. There is absolutely no need for the news to come across as ominous, worrying, or disappointing, and to convey it as such may do irreparable damage to your child’s self-esteem. Remember that we are living in a society where the concept of neurodiversity is gaining considerable momentum, so introducing your child’s diagnosis as a natural variation in the human mind – one that is to be embraced and understood – is often the best way to go forward. You may wish to begin the conversation by highlighting your child’s positive traits, e.g., Have you ever noticed how much more analytical and organized you are than most of your classmates? Likewise, before you reveal your child’s diagnosis, it’s a good idea to establish the concept that differences between people are normal, acceptable, and beneficial for example, you may point out that while you are good at math and your spouse is not, he is much better at writing or working with people, and when you both work together, these different skill prove to be highly complementary.
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Speech And Language Difficulties May Present As Early Signs Of Autism
Children with ASD may have a hard time speaking and communicating at the expected level for their age.
Even during infancy, you might notice that your child does not babble or coo in response when you talk and attempt to interact. By their first birthday, most toddlers can speak a word or two, but autism symptoms in children often include delayed speech.
Sometimes, children with ASD babble and coo in the first few months of life, and then cease to communicate altogether. In these cases, all forms of verbal communication and normal language development and experimentation with speech abruptly stop. This can be disconcerting for parents and is often a sign of autism in young children and an indicator that its time to investigate further by seeking professional help.
Even in cases where autistic children do speak and demonstrate pretty typical signs of normal language development, they often repeat unrelated words and phrases over and over and, in essence, speaking without really communicating or conveying a feeling, thought or desire.
Early intervention is key to helping autistic children learn to communicate, whether it is through spoken language, or in more extreme cases, through sign language or even an alternative augmentative communication device.
Can A Child Have Signs Of Autism But Not Be Autistic
Those suffering from Asperger syndrome display symptoms that are milder compared to autistic disorder. These patients encounter social challenges along with unusual interests and behavior, but they do not display intellectual disability or difficulties with language. This type is often abbreviated as PDD-NOS.
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How To Help Any Autistic Behaviour That Occurs As A Child Becomes A Teenager:
- Take a calm, quiet approach when talking to the young person
- Give them their own space, while ensuring that they dont retreat from family life altogether
- Limit online activities to encourage face-to-face time with people
- Plan activities for weekends and holidays in advance and share those plans with the young person
- Keep to a routine
- When talking to your son or daughter, do so while engaging in a chosen activity, such as walking through the park or driving in the car with them as a front-seat passenger, rather than sitting looking at them
- Use lots of subtle and genuine praise, as children with autism generally have low self-esteem and need more genuine praise then neuro-typical children. But remember that many autistic children dislike being singled-out in front of others and praised
How Pediatricians Screen For Autism
Children are screened by pediatricians after they are born. Your childs pediatric primary health care provider will start screening your kid for any developmental or communication challenges.
This will happen at your childs first well-baby appointment.
Pediatricians observe the behavior of your child. They inspect the babys giggles, eye movements. They point or wave and call your babys name to assess their reactions.
In addition, they get family history, examine the health of the child as well as the input from the childs parents or caregivers.
With that, pediatric primary health care providers identify whether the child is at risk for autism spectrum disorder.
The American Academy of Pediatrics recommends that all children be screened for ASD at their 18 and 24 month well baby visits.
This is done in addition to the regular developmental observance and screening. This may identify children with significant developmental delays early.
Multiple tools can be used by the health care provider for ASD screening like Ages and Stages Questionnaires SE-2 , Pervasive Developmental Disorders Screening Test-II , Communication and Symbolic Behavior Scales , and Modified Checklist for Autism in Toddlers Revised with follow-up .
However, screening does not equal to diagnosis.
If pediatricians notice a delay or suspect ASD, they will refer your kid to a specialist in order to provide a certain diagnosis and plan on a treatment plan.
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Early Signs Of Autism In A 3 Year Old
As your kid grows older, certain signs become a little bit less clear compared to the first few months. You can get a better idea by checking the developmental milestones to see if your child is behind on some.
- Some autism red flags for 3 year olds are as follows:
- Prefers being alone,
- Doesnt like physical contact
- Has difficulty in understanding feeling
- Doesnt respond when their name is called
- Is not able to form sentences
- Speaks in flat tone
Find Inspiration From Your Own Experience With Death & Grief
From there, I did not cry on my own accord again. I was extremely close to my grandma . Even at such a young age, I felt no need to cry again. I had an understanding in my mind that I knew my grandma would not want me sad.
I remember the confusion this caused my cousins and my cousin Junior to get mad at me because I was not crying. Though I explained to him that grandma would not want us sad, he could not understand why I was not crying. Doing this resulted in him telling me that I didnt love grandma because I wasnt crying.
As you can imagine by the fact that this is engraved in my memory, this was very upsetting to me. I saw death as very concrete. I understood that her soul was no longer with us, and all that remained was a body. The only part that ever confused me was why others responded to her death the ways they did.
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Getting The Proper Treatment
The first step in helping your child get the proper treatment is getting a correct diagnosis. You may need to seek out a child behavior disorder specialist.
A lot of pediatricians and general practitioners dont have the specialized training to understand the combination of symptoms. Pediatricians and general practitioners may also miss another underlying condition that complicates treatment plans.
Managing the symptoms of ADHD can help your child manage the symptoms of ASD, too. The behavioral techniques your child will learn may help lessen the symptoms of ASD. Thats why getting the proper diagnosis and adequate treatment is so vital.
Behavioral therapy is a possible treatment for ADHD, and recommended as the first line of treatment for children under the age of 6. For children over the age of 6, behavioral therapy is recommended with medication.
Some medications commonly used to treat ADHD include:
Treatment Options For Adhd
Understood.org outlines the professional help that is available for patients who are ASD or ADHD. In the case of ADHD, clinical child psychologists can provide behavior therapy to teach kids to manage their actions and interactions. Cognitive behavioral therapy, often just called CBT, can help kids manage the emotional issues from the condition, it adds.
In addition, educational therapists and organizational coaches can help kids with their time management skills, it adds. Medication can be administered , and co-existing conditions such as anxiety can be identified .
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Communication: Early Signs Of Autism
In the first year of life, childrens social and communication development is an important area to watch for early signs of autism. Social and communication development includes things like learning to smile, make eye contact, and use gestures.
Social interaction and communicationIf young children are autistic, they might:
- not consistently use eye contact to get someones attention for example, they might not always look at you and then at a snack to show you they want it, or not look back towards you when they see something that excites them
- rarely point to or hold up objects to show you things for example, they might not point to a dog and look back at you to make sure youve seen it too, or they might drop a toy in your lap and walk away instead of holding it up and looking at you
- not consistently respond to their name being called
- not consistently use gestures on their own for example, they might not wave bye-bye or clap without being told to, or without copying someone else whos waving or clapping
- not consistently smile at you or other familiar people without you smiling at them first
- rarely copy other peoples actions, like combing their hair when you do it
- not sound like theyre having a conversation with you when they babble
- not understand simple, one-step instructions for example, Give me the block or Show me the dog.
Relationships and playIf young children are autistic, they might:
Who Is This Child Adhd Quiz For
This simple assessment is for parents of children who may have symptoms of attention deficit hyperactivity disorder . Below is a list of questions that relate to life experiences common among children who have been diagnosed with ADD/ADHD. Please read each question carefully, and indicate how often your child has experienced the same or similar challenges in the past six months.
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When To Seek Medical Advice
Early intervention is very important in children with autism spectrum disorder. Services such as speech therapy and behavioral and skills training are more effective if begun when a child is young.
For this reason, it is helpful to receive a diagnosis as early as possible. However, many children remain undiagnosed until they are in school. Some people are not diagnosed until they are adults.
If you suspect someone has autism, including yourself, contact a medical professional as soon as possible.
Introduce The Concept Of Time
Before you can teach an autistic child to read the time, it is important they understand the concept of the passage of time. Make sure they are familiar with terms like day, night, morning, noon, and evening.
You can also introduce the idea of months and years. However, it is best to stick with hours and minutes in the beginning. It is important to give the child time to process one thing at a time. Once a child can decipher hours and minutes and understand the idea of day and night, then you can eventually teach them about months and years.
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Failure To Recognize Facial Expressions And Not Making Eye Contact Can Be Early Signs Of Autism
From an early age, children learn to make eye contact with their parents, smile when they are being smiled at, and point or wave at things they find interesting, such as an animal at the zoo or a favorite toy.
Children on the autism spectrum have a harder time recognizing emotion in facial expressions and may show little to no emotion themselves. When something startling occurs , its actually normal for a child to look to their parent and in seconds process their facial expression to identify what emotion is being conveyed. This is done as a way to verify if they too need to be concerned with what just happened. With an autistic child, however, there is often no reaction at all, which for a parent, can be very puzzling and concerning.
Older children with ASD will often look at the ground or let their eyes wander when an adult is speaking to them making eye contact is often a key struggle for children with ASD.
Because children on the spectrum have trouble reading facial expressions, they may fail to react or even react inappropriately when a parent or sibling is expressing joy, anger, or sorrow.
Spotting Adhd At Different Ages
Because we expect very young children to be easily distractible and hyperactive, its the impulsive behaviorsthe dangerous climb, the blurted insultthat often stand out in preschoolers with ADHD. By age four or five, though, most children have learned how to pay attention to others, to sit quietly when instructed to, and not to say everything that pops into their heads. So by the time children reach school age, those with ADHD stand out in all three behaviors: inattentiveness, hyperactivity, and impulsivity.
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Signs Of Autism In Young Children
Symptoms of autism spectrum disorder are usually clear by two or three years old. The range of behaviors and skills covered here may become apparent between two years old and five years old.
Some signs that a child has autism spectrum disorder may include:
- Not expressing emotion or only a limited range of emotions
- Difficulty interpreting different emotions in others
- Not seeming attached to parents
- Lacking interest in playing social games or the company of other children
- Interest in playing with one particular toy or object
- Echolalia, repeating other peopleÃ¢â¬â¢s words or phrases
- Repeating own words over and over
- Using formal language and expressions, rather than the slang of their peers
- Not developing language skills at all
- Difficulty toilet training
- Challenging behaviour, such as banging head on wall or picking at skin
- Engages in behavior such as flapping hands, rocking or twirling
Children with autism spectrum disorder have difficulty interpreting what other people are thinking and feeling, and often miss social cues. A child with autism may not be able to tell the difference between an adult who says Ã¢â¬Åcome hereÃ¢â¬ï¿½ while happy and smiling, and an adult who says Ã¢â¬Åcome hereÃ¢â¬ï¿½ while angry and frowning. This can be confusing and creates the impression the child is not connecting with people.
How Are They Different
Keep an eye on how your child pays attention. Those with autism struggle to focus on things that they don’t like, such as reading a book or doing a puzzle. And they may fixate on things that they do like, such as playing with a particular toy. Kids with ADHD often dislike and avoid things they’ll have to concentrate on.
You should also study how your child is learning to communicate. Although kids with either condition may struggle to interact with others, those with autism can have less social awareness of others around them. They often have a hard time putting words to their thoughts and feelings, and they may not be able to point to an object to give meaning to their speech. They find it hard to make eye contact.
A child with ADHD, on the other hand, may talk nonstop. They’re more likely to interrupt when someone else is speaking or butt in and try to monopolize a conversation. Also, consider the subject. Some kids with autism can talk for hours about a topic that they’re interested in.
An autistic child usually loves order and repetition, but one with ADHD may not, even if it helps them. A child with autism might want the same type of food at a favorite restaurant, for instance, or become overly attached to one toy or shirt. They can become upset when routines change. A child with ADHD doesn’t like doing the same thing again or for long times.
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