ASD or ADHD or AUDHD?

[biglipslittlehips]

As many characteristics are shared between ASD and ADHD, how do you (or assessors) determine whether someone has ADHD or ASD or both. I'm talking about when it's not obvious. Things like anxiety, need for routine and difficulty with time demands. These could be either.

I've always held the view that if there are no apparent issues in reading social cues then it can't be ASD even if there are many characteristics of ASD that are shared with ADHD. But how do they really know? Or if someone has been diagnosed as ASD and presents as being overwhelmed with too much stimulation, how do they know it's not that the person has ADHD as well as ASD?

yes, I have similar observations
I was just mentioning it for context really, because those two are so strongly intertwined in so many occurrences. I was a little puzzled when I realized that only 11 years ago, physicians had to decide between the two to diagnose as the manual would not allow dual diagnosis then.

There’s quite an overlap in symptoms.

I thought my DS was a straight up case of ADHD, but it transpires he is also autistic.

I think it’s very difficult for a non-trained person to diagnose. I’d leave it to the professionals. Of course, you can have suspicions and push for an assessment for both. But most specialists would test for both as it is very common to have both.

This is fascinating. I agree that the overlap is huge.

also wish there was more discussion about this among SEND teachers. The one at DS’s school pulled a face when I said he’d also been referred for ASD assessment. She agreed he had ADHD but said there was no way he was autistic. Yet he was!

thats no criticism of her- I completely agreed with her

For my child with AuDHD the clinic said they had never seen such good feedback from school before. He holds it together at school and follow the rules so teachers love him. That one is a very good masker. It's why I am so confident that my other child doesn't have autism - there is just no way he can mask better.

That was a really interesting video so thank you for sharing. I learnt a lot (and recommend it for people with kids with ADHD in particular).

He doesn't say so, but I can believe that Dr Berkley may think (and may have definitively said more recently) that emotional dysregulation should be a required criteria for an ADHD diagnosis [Using my layman's example this would get him saying that it you don't have pain in your foot, it's not a blister even if there's a lump]. He certainly believes it's fundamental to the condition and that the lack of recognition of it leads to misdiagnosis if other conditions (particularly ADHD emotional dysregulation being mistaken for mood disorders) and that it is key to treatment options for both ADHD and some comorbid conditions (particularly ways to prevent ODD developing into a social disorder).

But what he doesn't say is any of these two points you've made:

However, it is well document that these criteria are not complete, for example, (emotion) dysregulation which is at the core of ADHD was
purposefully taken out of the criteria in one of the last revisions as an attempt to make diagnosis easier for certain professionals

And

The requirements to meet for the threshold have been waterdown to make diagnosis (ensuing support accessible to those who needed it) that’s why it’s brought up. The criteria are to not thrrr to facilitate the assessments as it is a fact that that not all assessors are equal in the expertise, knowledge or training. But those criteria do not reflect entirely what it is to live with either or and it is misleading for people to try and understand it

Even putting aside the fact that, whilst he's not a young man, I doubt he thinks that a 1968 revision is a recent revision, he literally says nothing about watering down if diagnostic criteria to make things easier for clinicians. In fact he doesn't reference the way ADHD is diagnosed at all.

I don't think it's worth doing much further on this one. Whilst it's possible(albeit pretty unlikely) that the reason that when the DSM was introduced in 1968 it didn't mention emotional dysregulation to make it easier for clinicians to diagnose, it's not really relevant to any discussion now, and given the extensive revisions to the DSM since then I find it really hard to believe that would be the main reason it's not in there now and people wouldn't be shouting about it (plus more it's not really in psychiatrists interests to make diagnosis easier for clinicians with limited training - puts them out of a job!). And it's certainly not relevant to this thread which is about how clinicians can tell ADHD and autism apart.

But on the autism/ADHD point, could it be that if you're autistic you generally meet the current diagnostic criteria for ADHD but don't necessarily have the emotional dysregulation?

Wondering what people who have worked with a lot of kids with autism think. One of the problems is that autism often comes with Alexithymia and it does for me. I'm not sure whether I am emotionally dysregulated or not!

I'm not going to watch a channel 5 news video on what its like to have AuDHD. It would probably lead to me throwing my phone across the room!

Completely agree with this. We had the exact same experience with DD. I was convinced was ADHD as in the family and all her traits pointed to this but she has been diagnosed with ASD and they would not diagnose ADHD because the traits were covered by ASD.

Your Facebook profile has been shared in that link so you may want to consider getting it deleted.

Also the clip doesn’t confirm that diagnostic criteria have been watered down etc so really not sure where that has come from.

For me noone has ever brought up ADHD in my life and ASD was often got brought up before diagnosis and I had clear symptoms for ASD strongly from early childhood.
Yes I had some symptoms for ADHD but not enough for a diagnosis and many people do. It didn't affect my life and not diagnosis level.

Look at the checklist yourself a good one and really ask yourself did I have this or do this.

I wouldn't look to go through testing so rigorous unless you feel you have to.

For me yes I can have strong interests in what I am passionate about and hold that hyperfocus. I have read that many people can struggle with longterm projects. I don't know if this is true though as do they survive with their work?
I can struggle with repetition and communication as well.

I read there are sensory differences between ADHD and ASD again.

I am just moderate level ASD in some areas.

I don't know if this is true though as do they survive with their work?

Many don't. Others don't do jobs where they need to do long term projects. I work in an environment where there are long term projects but there's also a major amount of short term fire fighting / need to suddenly dig into something that gives me the dopamine hits. I struggle with the long term projects a lot.

Oddly I am very good with change when it's change within parameters I would expect, but change outside the parameters I would expect can just throw me into meltdown, and because I am no conscious about what those parameters are it makes my reaction to a change very unpredictable (and can be a complete shock for those around me because I will melt down suddenly at something that would seem small to anyone else). For example, absolutely no issue getting a random call during the day with a new issue to deal with, or where someone disagrees with my position/approach (well within reason :) ). However, if I've been working on certain parameters for something believing that they're completely established and that my boss is aligned, to discover there's been a misunderstanding/miscommunication and my boss doesn't want to take that direction can (and has) made me meltdown, even when I'm not being criticised in the slightest!

majesticallyopposite thank you for sharing your experiences of ADHD. So it is clear about the variability levels. It did seem to indicate that when I looked at PIP support level groups and saw those with severe ADHD could be treated as in greater need of support than someone who didn't suffer so significantly with the disorder. I did wonder by how some would manage the forms, We don't hear much at all about the severity levels of ADHD.

In the media the representation we often get those with ADHD often seem be able to focus to a high level with the condition. Think of Simone Bayles and Jamie Oliver. These people have been able to focus on their career so it is good hearing other voices more accurately.

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