What's the difference between ASD and ADHD/ADD?

[StarlightMcKenzee]

Because I have looked down the list of ADD diagnostic criteria and can place ds against every single one.

However, I can also say that these symptoms are typical of his type of presentation of autism.

Inattention for example, I have always put down to rigidity of thought. When I am trying to teach him something, he is fixed on his own preferred thoughts iyswim.

With massive effort and motivational techniques I can get him to learn what I am teaching him, and usually he is happy and proud of himself for puting in the work, but the sheet EFFORT it takes both for me and for him makes me wonder if an ADD and trial on Ritalin might be worth exploring.

However, I'd get now outside support with this. DS is not just 'fine' in the usual outsiders version of 'fine' but compared to children they would know with ADD, he is NOTHING like them. He can manage, due to enormous practice, to keep still and focussed for an hour's activity, but the day is planned carefully, with loads of stimming/down-time/wriggling/movement before and after. What other people see is not what I know.

Does this sound like potential ADD, or just the way autism is?

Like I said I can tick off every symptom on the lists of diagnostic criteria I have seen, but assumed it was a symptom of autism.

I think there's a massive overlap. I wouldn't be surprised to find that adhd was part of the autistic spectrum.
My youngest has dual diagnosis and it's hard to tell what's the autism and what's the adhd.

My DS was diagnosed with ADHD and then ASD a few years later. I have always felt that the diagnosis of ASD suited him better as he never seemed to be to like other kids with ADHD. His difficulties with inattention always seem to be sensory related, ie inability to filter out backround noise or slow processing speed which seem to be more related to ASD than ADHD. Like your DS the way he gets engrossed in his own thoughts or visually sees things in pictures makes it difficult for him to focus sometimes. My DS is on medication which definitely works so that's when I think he must have ADHD also. However his paed agrees that DS does not have the full blown version(well he didn't say exactly that but something along those lines). It is def noticeable when he doesn't have his medication though.

It's a really hard one. I feel the same with my dd who is very similar. The biggest barrier to her learning is her lack of attention. How she has even managed to learn anything at school surprises me (she is average/slightly below in most subjects except art, pe, music in which she is well below average cannot even draw which also makes me think dyspraxia)! She has also been diagnosed with auditory processing disorder which I understand has similar symptoms to ADD. It's so complex I am totally confused by it all.

The overlap is enormous, which is why it took 3 years from initial diagnosis of ASD to get a dual diagnosis for DS1.

I think what makes the subtle distinction clear for us is that DS2 shows no signs of ADHD. His attention span is pretty much in line with his developmental age (which is way behind his chronological age). He's also not hyperactive and not overly impulsive. DS1, OTOH, has something of the Duracell bunny about him.

My ds also has dual diagnosis and we tried medication successfully last year. I'm not sure it's working as well as it should now but initially school said it was a huge difference. Tbh I wasn't sure where the asd stops or inattentive add starts so I was hoping the medication working (or not) would separate the diagnosis. It doesn't really though for us. School say medication works and they can tell when he is on it. For the summer holidays before ss starts in sept I'm trialling without as I think language is better off medication.
I was urged to try medication initially and that's why I pursued a diagnosis for add. But in reality I don't honestly believe our doctors could clearly say if add or the asd were causing the lack of attention.

Thank you everyone. That's all really helpful.

Also, it's a bit of a relief to see that it's all a little confusing to others. DS doesn't present as a 'stereotypical' child with ADHD, but I'm long enough in the tooth to know that has nowt to do with it. He doesn't present as a 'stereotypical' child with ASD either (who does?).

Ouryve That is interesting about development/chronological age thing. I'll have to keep an eye out for it if we go through the process.

Like most parents, the thought of medication really worries me, but I also want to make my ds' life easier if I can.

One problem we have is that he is very good at pretending to 'attend' when he is doing nothing of the sort, so his subsequent inability to do what has been asked is put down to processing or capability. I've realised through HE that it can take 4 or 5 attempts to work through his different convincing 'pretence' and avoidance acts (which can take a substantial amount of time - time no school has) to the attempt where he finally is paying attention. And when he is, he learns faster than you could ever dream.

But it's hard work. For me, though also rewarding because I know we'll get there, but my concern is how much work it is for him.

My 8yo has dxes of ASD-PDA and SPD. Like you Starlight, I can tick off every point on an ADHD questionnaire list. As far as I can see, it can all be explained by his sensory processing difficulties. (ADHD has been brought up, in a passing thought kind of way, by more than one of the various professionals we've seen, but never pursued as a possible dx.)

Hmm,

ds' language is okay. His understanding of it is fine when you take out the ASD-ness iyswim. So clear instructions should be paid attention to. But they aren't unless he is highly motivated. He prefers his own thoughts.

I suppose it is technically possible that though he 'can' understand it is still hard for him due to language and so his preference is his own thoughts.

One of the main reasons I can't drive is because it takes too much concentration and I'd much rather be thinking about something else than the road. I understand that can happen once I am experienced, but I'll never get experienced because I can't cope with an hour of my thoughts being owned by someone else.

Probably why I failed my A-levels. Preferred thinking about boys.

I have both. Sometimes it is hard to know the difference between the two. I think ASD is really about a different way of communication/interacting with people. ADD is really about being extremely easily distracted (saying that it is possible to have hyper focus with ADD). Sometimes the distraction comes from sensory issues and sometimes it is just from own thoughts. There is a great tendency with ADD to jump from thoughts to thoughts combine this with impulsivity (also an ADD trait) it means you can start a task, and jump to the next without completing the first and on to the next… (makes housework rather interesting!), this also mean that people with ADD can be very creative. As with ASD some people might have ADD traits without having a full diagnosis.

Ds2 who is also home educated atm shows a lot of inattentiveness too and wriggly behaviour when asked to listen or concentrate. Once he is interested in something he is very interested but otherwise PFUT...off with the fairies. I think it is a lot to do with the way the teaching material is presented. I'm not his perfect classroom setting by any means - I thinks he likes the pressure to be off and to be part of a manageable group. He often does better when asked to do something entirely by himself - I think he finds it distracting having another human interfering when he is in the middle of a task. Conversely on some occasions he craves some sort of feedback hence endless irrelevant questions on some mildly related topic. Perhaps he just likes talking himself...anyway he does learn but I'm not convinced he learns in a linear logical fashion. There's a good book called Hitchhiking through Asperger's by Liz Pyles about home educating an ASD child and it has a section on medication for or against.

I definitely don't think ds2 has ADHD it is more that he is fixated on things that interest him rather than things that interest me. I think he does like structure though, within that caveat, so as long as something is part of a plan he will accept it more willingly. I always tell him how long we will be doing something and how much longer we will be doing that task, he seems to need a lot of external reassurances. As an adult one doesn't think from that angle, it just feels like the task needs to be done in the best way rather than how long it takes, but it is something imposed by an adult to them, even if they respect your rules.

Dt1 DX with ADHD with autistic traits...
Dt2 DX with ASD with ADHD traits...

They are very very different. One us much busier into everything neither has an off switch unless Minecraft counts. One love spontaneous fun the other likes rigid structure .

It's an interesting one.

DS1 has Aspergers (DXed at 4.8) and ADD (DXed at 10.5).

For years we assumed his attention deficit issues were simply part of the ASD, we had various management strategies in place and he was doing well.

It was a Y5 teacher who felt that his difficulties were perhaps more pronounced than you might typically associate with DC on the spectrum and encouraged us to seek further advice / DX for ADD.

We did opt to try medication and after a shaky start (methylphenidate was a disaster) DS is now taking atomoxetine and doing really well.

There are a number of overlaps, and it seems that ASD and ADHD are very often co morbid, but there are distinct differences too. For example I know several boys with ADD/ADHD only who do not have DS's social awkwardness/difficulty. Equally I know several others who are very much on the spectrum and DXed with HFA or Aspergers but do not struggle anywhere near as much as DS does with attention deficit.

There are a few in my family with ASD/ADHD, including me, although I haven't been diagnosed with ADHD just asperger's. I think there is a difference. ADHD ones are novelty seekers, tend to have weight/alcohol problems (addictive personalities) , impulsive, rebellious, do every thing at 90 miles an hour, less inclined for routine, tend towards PDA, are more sociable, often class joker.Three generations in my family fit the ADHD/ASD profile, including my son who is diagnosed with both. He is medicated, but only to help him concentrate at school

My DS has ADHD and autism. Diagnosed with ASD first at 3.5 then ADHD at 6.5. I was told by the psychiatrist that the 2 conditions are very often co-morbid but sometimes once a child has one diagnosis other conditions are overlooked as it is easy to put behaviours down to the diagnosed condition. With DS I would say the primary issue is in many ways ADHD. He was very noisy and nothing was helping to reduce it. When he started Ritalin he improved massively to the extent he is now in a mainstream school with full time 1 to 1. He did fit ASD criteria and is probably on the middle of the spectrum. However, there were certain quirks such as he is quite sociable although struggles with conversation and quite outgoing compared to some ASD children. It was the noise and not being able to keep still that suggested ADHD to me. He is in the category of ADHD that cannot be managed without medication as he cannot concentrate enough to respond to behavioural therapy without medication. He also has general learning and speech and language delay but with the meds he can at least access learning which he was not doing before despite being in a special school

Dd3 has Aspergers, dd1 has ADHD

Dd3's main traits are social difficulties she isn't interested in talking to others and is hypOsensitive, she doesn't quickly respond to temperature changes or pain.
Dd1's traits are food/alcohol use and is hypERsensitive to temperature and pain and frustration but loves talking

My pead uses two pictures - one is a venn diagramme with scoial and communication difficulties, attention difficulties and co-ordination difficulties. Where that overlaps is autism - as far as she's concerned to have an ASD dx you have a bit of all three - communication, ADHD-type stuff and dspraxia type stuff.

Then she draws it as a graphic equaliser (showing both our ages here!) so within an ASD dx a child can have different levels of difficulty - my ds for example has a lot of planning and co-ordination and social problems and would tick every box for dyspraxia, not so much for ADHD.

Now I know what she's presenting doesn't exactly fit in with the dx 'rules' but I have to say it made masses of sense to me. And gave me a lot of insight into his planning difficulties, which we both believe contribute to his attention difficulties at school. I don't know if that's helpful to others?

Lonny, that is really interesting, it's how I see things. ASD has a little bit of everything and if you get a bit more inattention for example you would get ADD as well, a bit more motor coordination you get dyspraxia…

That does make lots of sense Lonny. Thank you.

I think I might use the diagram myself if I pursue an investigation because I would have the 3 circles overlapping widely, and place ds right in the corner of the ASD centring him in the Attention circle iyswim.

I'll ask other family members to do it too, like a kind of pin the tail on the donkey exercise. I might even get others who know him to do it. It is such an easy thing to cart around and takes 5 seconds for an opinion.

That will give me an idea as to whether I am right to be thinking as I am.

That's a good idea Star

Because DS initial diagnosis was social communication disorder, I'm very switched on to that. So the picture was a massively useful reminder of his difficulty with motor planning etc, which we'd kind of missed.

Thata interesting Lonny. I have seen diagrams where each circle was ASD, dyspraxia and add but never really thought about the overlap as described by you to be ASD and then the differing make ups of that overlap . Makes s lot of sense