How Can You Tell Asd From Add/adhd In A Young Child
It is entirely possible for children to have both ASD and ADHD. In fact, it is actually quite common for the two disorders to co-occur. A National Institutes of Health study published in 2014 showed that 18 percent of children diagnosed with ADHD actually showed symptoms of ASD.
If youve found yourself here, reading this page, youre asking yourself:
Which if any- of these disorders does my child have and how can I tell?
Early diagnosis and intervention of behavioral and neurological disorders is imperative. Proper treatment can actually reduce the severity of the symptoms, no matter what the diagnosis might be.
If youre concerned your child may have one or both of these disorders, the earlier you voice these concerns to a doctor, the better. The young brain is an adaptable brain and early treatment options may help reduce the severity of symptoms as your child ages. In some cases, the faulty neural connections in the brain can actually be rerouted.
Though the final diagnosis should come from a healthcare professional, the first steps in unraveling the mystery often come from a parents own detective work. Parents play a crucial role in identifying the symptoms because as a parent, you know your child better than anyone.
Parents should not lose hope in the case of a dual diagnosis. This just means that treatment and therapy will need to be more individualized and in many cases, more intensive.
Why Parents Miss Signs Of Aspergers Syndrome
Parents may be slow to pick up the signs of autism enumerated above. A child with distinct special interests, like dinosaurs or cloud formations, may seem delightful to an adult, but odd to another 7-year-old. When a child goes to preschool, social difficulties become more evident. Typically, kids with behaviors associated with AS find it difficult to make friends. They have a hard time reading other people or understanding humor.
Most children with autism want to make friends, but frequently dont know how. Their poor conversation skills and difficulty reading social cues can lead to loneliness or a mood disorder as they go through middle school.
Summary And Future Directions
Research specifically focusing on co-occurring ADHD and ASD has only recently evolved, being previously limited by the DSM-IV exclusion criteria. What we have so far learned is that both disorders frequently co-occur, and when they do, they cause greater morbidity, and create a more complicated clinical challenge. The new DSM-V, allowing for a dual diagnosis, will hopefully facilitate research, by eliminating the exclusion of many patients and allowing the study of broader phenotypes. Most recent research focuses on etiology and clinical presentations, with less direct work on treatment and early intervention protocols. Very few studies have looked at pre-school children presenting with both conditions, on the impact of early intervention in this age group and its effect on developmental trajectory. Furthermore, many of the above quoted studies have used parent and/or teacher rating scales to assess clinical profiles, rather than direct clinical diagnoses of the two co-existing disorders. In the future, as a dual diagnosis is officially possible, studies using direct clinical assessment of both comorbid diagnoses are essential.
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Causes And Risk Factors
While scientists dont know the exact causes of ASD, research suggests that genes can act together with influences from the environment to affect development in ways that lead to ASD. Although scientists are still trying to understand why some people develop ASD and others dont, some risk factors include:
- Having a sibling with ASD
- Having older parents
- Having certain genetic conditionspeople with conditions such as Down syndrome, fragile X syndrome, and Rett syndrome are more likely than others to have ASD
- Very low birth weight
Is Adhd A Form Of Autism
Although attention deficit hyperactivity disorder is not a form of autism spectrum disorder , the two conditions are related in several ways. Many symptoms of ASD and ADHD overlap, making correct diagnosis challenging at times. They are linked in various ways, but it is important to understand that ADHD is not ASD.
Having one of the illnesses may increase your risk of getting the other. Both ASD and ADHD tend to run in families and are specified by the Diagnostic and Statistical Manual of Mental Disorders , a handbook used by healthcare professionals in the United States for the diagnosis of mental disorders. A comparison of ADHD and ASD is given below.
Definition as per DSM
Autism Spectrum Disorder :
- A neurodevelopmental disorder that causes social communication difficulties, repetitive behaviors, and restricted interests. Consistent symptoms must appear before three years of age.
- A neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity.
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Asd Symptoms In Children With Adhd
This profile of social difficulties differs, however, from that observed in ASD, in which impairment in the basic understanding of social realm is central, such as a lack of emotional reciprocity and engagement with others, and the low interest or enjoyment in social interaction. Cantwell described a type of social difficulty in ADHD by a lack of savoir faire, and estimated that this social naivety may affect some 20% of ADHD children and adolescents. Recent research suggests that many individuals with ADHD may experience social impairments that are more consistent with those observed in ASD. In children with a primary diagnosis of ADHD, the level of autistic symptomatology corresponded to the severity of ADHD subtype children with the combined type of ADHD-demonstrated the most autistic symptoms . In a study recently published by Kotte et al. , a positive autistic traits profile operationalized from the CBCL, was significantly overrepresented among ADHD children vs. controls .
What Role Do Genes Play
Twin and family studies strongly suggest that some people have a genetic predisposition to autism. Identical twin studies show that if one twin is affected, then the other will be affected between 36 to 95 percent of the time. There are a number of studies in progress to determine the specific genetic factors associated with the development of ASD. In families with one child with ASD, the risk of having a second child with the disorder also increases. Many of the genes found to be associated with autism are involved in the function of the chemical connections between brain neurons . Researchers are looking for clues about which genes contribute to increased susceptibility. In some cases, parents and other relatives of a child with ASD show mild impairments in social communication skills or engage in repetitive behaviors. Evidence also suggests that emotional disorders such as bipolar disorder and schizophrenia occur more frequently than average in the families of people with ASD.
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How Are Adhd And Autism Diagnosed
To obtain an accurate, complete diagnosis, Bertin suggests working with a profession- al who is familiar with both conditions. A thorough evaluation aims to define a childs strengths and weaknesses, he says. Various test measures try to document ADHD symptoms, executive function, social and communication delays, anxiety, mood disorders, and a host of other symptoms.
But tests alone are not enough. Evaluating both ADHD and autism remains a clinical skill based on getting to know a child and seeking a comprehensive picture of their life in the real world, a global sense of a childs social and conversational abilities, as well as their play and daily living skills.
Diagnosis can be a fluid, ongoing process. It was for Clark, now 17, according to his mother, Pamela Fagan Hutchins, the author of the book The Clark Kent Chronicles: A Mothers Tale Of Life With Her ADHD And Aspergers Son. Although Hutchins earliest concerns about Clark were about autism-like symptoms, ADHD, not ASD, was Clarks first diagnosis.
We first noticed autism-like symptoms when Clark was two, like running to the left in circles while waggling his left hand, Hutchins says. It was when he started school that we noticed ADHD symptoms. He had a lot of trouble staying on task. Clark received anADHD diagnosis in fourth grade, and Aspergers syndrome about a year and a half later.
Autism And Your Environment
Sometimes, when a situation is too much to cope with due to sensory input , or being asked to do things that cause stress or distress, an autistic person can become overwhelmed.
Meltdowns and shutdowns
When an autistic person becomes overwhelmed and isnt able to use or benefit from their coping strategies, they might have meltdowns or shutdowns.
Its important, for parents of autistic children in particular, to be aware that a meltdown isnt a tantrum. A tantrum is something that a child can control, and tantrums often happen because a child wants something. A meltdown or shutdown isnt something an autistic person can control, and its caused by being overwhelmed.
During a meltdown, an autistic person might try to make themselves feel less overwhelmed. This can include doing things like:
- trying to get away from people for example by running away or hiding
- trying to get people away from them for example by shouting, screaming, hitting, or acting aggressively
During a shutdown, an autistic person might try to block everything out for example by not responding to anything or anyone around them.
Challenging behaviour
Like everyone else, autistic people can display challenging behaviour if theyre in the wrong environment. While it can be challenging for the people around them, this behaviour is often a result of distress or frustration, particularly if an autistic person has difficulty with communicating.
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Diagnosis Of Tourette Syndrome
According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders , Tourettes Disorder may be diagnosed when a person exhibits both multiple motor and one or more vocal tics over the period of a year, with no more than three consecutive tic-free months. Previous editions of the DSM included a requirement for marked distress or significant impairment in social, occupational or other important areas of functioning, but this requirement was removed in the most recent update of the manual, in recognition that clinicians see patients who meet all the other criterion for Tourettes, but do not have distress or impairment.
Getting The Proper Support
The first step in helping your child get the proper support 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 support 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 support is so vital.
Behavioral therapy can be helpful for ADHD, and is recommended as the first line of support 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:
- methylphenidate
- mixed amphetamine salts
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Asperger Therapies And Services
Find the following services near you using the Autism Speaks Resource Guide.
Cognitive behavioral therapy can help address anxiety and other personal challenges.
Social skills training classes can help with conversational skills and understanding social cues.
Speech therapy can help with voice control.
Physical and occupational therapy can improve coordination.
Psychoactive medicines can help manage associated anxiety, depression and attention deficit and hyperactivity disorder .
Adhd In Children With Asd
A significant percentage of children with ASD seeking services at clinical centers present with comorbid symptoms of ADHD, with rates ranging between 37% and 85% across studies conducted in the United States and Europe . ADHD was the third most common disorder identified in a community sample of 517years old children , with 31% of the sample meeting full ADHD criteria and another 24% with subsyndromal ADHD symptoms. This is lower than reported rates of ASD and ADHD in clinic samples . Very few studies have looked at the epidemiology of co-existing disorders in pre-school age children diagnosed with ASD. Two year-old twins from the Boston University Twin project were studied by Ronald et al. for autistic-like traits and ADHD behaviors using Child Behavior Checklist answered by their parents. Controlling for cognitive abilities and socioeconomic status, autistic like traits correlated positively with ADHD behaviors , a lower correlation than described for older children. In a recent survey by Carlsson et al. , 198 pre-school Swedish children with ASD who treated in a habilitation center, were assessed for such disorders. They found language problems in 78%, intellectual disability in 49%, below average motor function in 37%, and severe hyperactivity in 33%.
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Functional Medicine And Naturopathic Therapies May Offer Some Relief For Asd And Adhd Sufferers And Their Families
Functional Medicine
The science of developing a partnership between a patient, their families and the doctor, is to identify the root causes of many of the physical and psychological effects of these disorders and is a positive first step to better health. In addition to the psychological affects, there are often physical issues that contribute to these psychological issues. Sleep disorders, digestive disorders and leaky gut syndrome, allergies, metal toxicity, sensitivities to light, dairy, yeast, soy, wheat and other foods. Fabrics and chemicals including mold. Respiratory issues. Functional Medicine doctors look to invest in the patient and their complete health reviewing diet, exercise, lifestyle and environment. This is performed though testing such as blood work, food sensitivity testing, metal toxicity testing, adrenal stress profiles, advanced cardiometabolic testing, comprehensive stool analysis, genetic testing and in-depth discussion and observation by a trained and certified Functional Medicine physician. Upon completed testing, changes in diet and lifestyle, supplementation and therapies can be initiated to combat the negative effects of these disorders. All therapies and treatments are non-invasive and drug free.
Autistic Traits And Diagnosis
Autistic traits meaning things that autistic people often do, think, and feel are often shared by people who dont have autism too. This doesnt mean that everyone is a little bit autistic, or that autistic people dont need support.
To be diagnosed with autism, a person has to have a lot of autistic traits from birth, and those traits need to have a big effect on their life. In order to be diagnosed with autism, those traits must cause what a healthcare professional would call clinically significant difficulties in their day-to-day life. This means that they have difficulties with day-to-day life due to their autistic traits and need to use their own ways of overcoming those difficulties, or the people in their life need to help them to overcome them, or both.
Being in a supportive environment makes a big difference to an autistic persons wellbeing and quality of life.
Psychological therapies like cognitive behavioural therapy are often used to treat depression, anxiety, and sleep problems, both in people who have autism and people who dont.
Psychological therapies can help to manage conditions linked with autism, like anxiety, but psychological therapies arent a treatment for autism itself. Therapy techniques might need to be adapted to work for an autistic person.
Challenges in daily living
Possible therapies include:
Finding the right therapies
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Is Adhd On The Autism Spectrum
Characteristics of autism spectrum disorders and ADHD sometimes overlap. More than half of children on the autism spectrum have symptoms of ADD, according to CHADD difficulty settling down, social awkwardness, the ability to focus only on things that interest them, and impulsivity. ADHD itself, however, is not part of the autism spectrum.
A mother I previously met summed up her confusion and eventual enlightenment: John is smart and quick to learn something new if he is interested, she says. But he has a terrible time focusing on things he doesnt find interesting. When this happens, he starts rocking or pacing around the room. For years, we thought it was ADHD, but, at his last evaluation, his teachers suggested that he might have a form of autism. After seeing a pediatrician, he received a diagnosis of Aspergers. Knowing he has it and working to manage the symptoms is a relief.
Manifestation In Males Vs Females
Males are more likely to have ADHD with impulsive features or more obvious signs of ASD than females. ADHD and ASD can present differently in males than in females, but also more research has been conducted on cases in males.
Females are more likely to have ADHD that presents itself as inattentiveness rather than impulsiveness. They may also mask ASD symptoms by trying to match others social interactions. Younger girls who have ADHD or ASD have a better chance of being diagnosed and receiving the help they need to navigate through childhood into adulthood more successfully.
People become better at coping with ADHD and ASD as they get older. Adults with ADHD can feel disorganized and inattentive, requiring them to work harder than others at managing tasks in home and work life. Adults with ASD can feel disconnected from others.
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How Has Our Understanding Of Asperger Syndrome Evolved
1944: Austrian pediatrician Hans Asperger described four strikingly similar young patients. They had normal to high intelligence. But they lacked social skills and had extremely narrow interests. The children also shared a tendency to be clumsy.
1981: British psychiatrist Lorna Wing published a series of similar case studies. In it, she coined the term Asperger syndrome.
1994: Asperger syndrome listed in the Diagnostic and Statistical Manual of Mental Disorders .
2013: Asperger syndrome and other previously separate types of autism folded into one umbrella diagnosis of autism spectrum disorder in DSM-5.