ADHD in children with autism

[TheCosmicOwl]

Does anyone have any experience with a child with both ASD and ADHD?
How do you know whether it's ASD, sensory processing differences or ADHD that's causing a particular difficulty?

For background I have a 4 year old with an autism diagnosis, but I'm increasingly concerned about his inability to sit still, even to eat a meal. I can't take him somewhere like a shop as he runs around, touching everything. His behaviour is becoming increasingly difficult. He is a MASSIVE sensory seeker, which I've been told is part of his autism. I know the stereotype for ASD is a child who is overwhelmed and distressed in places like shops, and having meltdowns. This isn't my DS! He is the child running round destroying everything, with a manic smile on his face. He only has meltdowns when thwarted in his plans to cause as much havoc as possible!

Yes. DS was diagnosed with autism aged 4/5, but ADHD this year (he's 9).

I too had put it down to sensory seeking behaviour, but there is so much more to it than that.

The 'manic' look is very familiar - I've been trying to explain that face on DS for years.

He's really unable to concentrate on anything for long, both at home and school. He scored v high in the Conor's questionnaire.
He can 'hyperfocus' if he's interested, but if he's not interested it's almost impossible for him to pay any attention.

I need to admit I think my idea of ADHD was very cliched - DS is impulsive, but more in the way his brain doesn't give him a chance to think anything through before he acts, rather than running around.
He's so disorganised and majorly forgetful too.

We trialled medication but it didn't make any difference - however we have a review soon so we might try a different one.

For starters I would look at the Conor's questionnaire, and see if school will fill one out too.

I wish I had the answer...

DS1 (now almost 9) was diagnised with ASD 18 months ago. When we started the referral process a year before the assessment, I was convinced it was inattentive ADHD that would be the diagnosis, based on how he was/is at school. Classic appearance of day dreaming, inability to focus, needing to be "brought back" (three separate teachers told me this was their experience of DS), absence of any organisational skill, hyperfocus to the max on his own stuff but impossible to get interested in anything else, appalling short-term memory (but excellent long term). His teacher's completion of the Conors form said it all (I was astounded, she really got him to a tee).

But the psychologist who diagnosed said ASD - and I don't question that based on what came out in the assessment, stuff about his babyhood/toddler years and development, which I'd always known was "off", and particularly after having DS2, who is NT - the differences were subtle but also screamingly obvious in retrospect. I thought I was a bad mum who didn't connect well...

I queried the ADHD symptoms (as DS has a first cousin who has both ASD and ADHD, much more severely than DS) and he said he considered it all part and parcel of his ASD but that the acid test would be if he responded to medication. I'm leaning heavily towards pursuing this now, a trial, in any case, as behaviourally things are getting challenging, to put it mildly. He's definitely very impulsive.

But I don't know how to get a rereferral, or if that's even necessary. The psych we saw was a diagnostic clinic only, no follow up and we were left with basically that, no follow up, guidance, ideas of where to go next.

GP is involved again because of violence issues, Camhs bats a referral right back at him, school is thankfully having the EP see him in Sept. I'm hoping something will come of that... at least it'll be documented how he cannot focus in the classroom UNLESS he is really really engaged off his own bat on whatever it is. If he is - bingo.

I was licky in the sense that's ds1 is adhd combined profile only. Ds2 has asd but his attention is pants. So we r seeking an adhd diagnosis too, he's 7. We started referal when he was 6 as that's the youngest they will do it here. We went to gp and asked

Thanks for your replies. I did wonder if he's too young for an ADHD assessment as I've heard the age 6 or 7 thing before. I guess time, and starting school, will make things clearer.

DS2 (now 16) has ADHD, ASD & sensory issues.
The ADHD had masked the ASD, so the ASD wasn't picked up until after he had started treatment for the ADHD.