ASD and ADHD Symptoms

[BGD2012]

I'm after some advice from the parents on here. My lovely son is yr 7 and was diagnosed with ASD when he was 9. He is not disruptive, confident socially (although some kids find him overbearing and rigid) and is happy to attend out of school activites. He is independent enough to navigate water parks, queue nicely and go on the big slides without supervision -he loves water slides, rollercoasters and noisy discos, basically anything that stimulates the senses - The over riding issue since a young child is a lack of focus, his mind is very quick and his mental arithmetic is fantastic, he can learn complex spellings in minutes. However anything that needs concentration beyond 10 minutes is a struggle, following observation his new school are arranging a prompt and rest breaks for future exams. They told me that they are using strategies that they would use for children with ADHD. He can't keep still, if we are in a shopping queue he has to dance or jump around, as soon as he comes home from school he has to go on his trampoline (or jump around the house), if we watch a film at home he is sliding on and off the sofa or leaving the room to have a jump around (though in the cinema he is fine). He speaks very quickly and although polite he interrupts a lot. Is it possible that he could also have ADHD or is the fidgeting etc an ASD symptom? He is a bright boy and I want to help him all I can. I've made an appointment with a paediatrician but I have to wait 2 months. I'd be really grateful for some thoughts. Thank you.

It's interesting, your description of him doesn't sound like ASD at all, if you had not mentioned he had ASD I would not have guessed it, in fact, some of the things you mention that he is good at I would have thought they would have been a struggle with a child with ASD. Was he evaluated using ADOS or CARS? diagnosis would have required a fair amount of observable deficits in social communication and some form of repetitive behaviour (part A and part B of the ADOS). Your description sounds more like ADHD than ASD - just thought it was interesting. Do you remember the reasons they gave for him being diagnosed?

Thanks for the response. It took sometime to get a diagnosis and the paediatrician was clear that there were a number of ASD traits that he didn't have. (good eye contact, sociable, doesn't mind noise or crowds etc). At the time he had a fixation on Disney movies and he can still be repetitive with his conversational subjects and is rule driven. So there are definitely some ASD traits. He has poor fine motor skills so he was also assessed for dyspraxia (which he doesn't have but he is hypermobile). He will work at things (when pushed)and from finding it difficult to ride a bike he will now go mountain biking for 10 miles. The main issue holding him back is the inability to concentrate and keep on task. It was his new school that raised ADHD but I have noticed how constantly fidgety he is. (He couldn't sit and read a book). I think maybe I have a son who has a sprinkling of this and that but the one constant is the difficulty to focus.

It is interesting and I agree with you - do you remember if he met communicative milestones when he was younger, for example, did he point to request (so for example pointing to food that he wanted), and to share (like a plane in the sky) by the time he was 18M old? or did it come much after that?

He was certainly meeting his milestones at that age and his record says that his speech was advanced at 2 years old (never crawled though and he started to walk at 17 months). He attended nursery from 12 months and nothing was raised by them or the health visitor. It was around the age of 4 that a teacher told me that he found it difficult to follow multiple instructions and a year later another teacher told me his concentration was the worst in the class. He also liked to take the same Disney toy in each Friday. He was well behaved, never disruptive and I think he was happy to have a fidget and look out the window all day. Quite sociable liked having friends around and going to their houses for a play. He had SENCO support but because he had lots of little issues (poor hand writing, rigid interests, lack of focus, uncoordinated) I feel I've been pushed around the system trying to get him help. I really had to push for a diagnosis to try and get the school to access some funding for him (which was then turned down). I have made an appointment to see a paediatrician in April. He is now having a crazy dance around his bedroom with Alexa on full blast!

I have a dual diagnosis, so it's possible he has both. It's also possible to be autistic and social, and some autistic people can also give eye contact (or fake it well). Issues with noise would be a sensory processing issue rather than autism, so I'd say that it's not possible for someone over the internet to dispute his diagnosis based on a couple of paragraphs (not saying that's explicitly what's happening, but just wanted to point it out). Just remember, like with non-autistic people, autistic people are individuals, and not just a list of traits (or worse still - seen as a list of deficits).

Autism is incredibly under diagnosed, and it's extremely rare to get a misdiagnosis of autism (you're more likely to get a misdiagnosis of something else when it actually is autism).

If I were you I'd get a copy of the ADHD questionnaire that is used on the NHS, and complete it for your son. You can find a copy on a website called 'Psychology Tools'. Take your completed form to your son's paediatrician, and see what they think.

Thank you very much for your response. Do you have any suggestions as to how I could help him improve his concentration? I was told to use a timer for tasks but he hates it. I'll take a look at the questionnaire this evening.

I am medicated, but I don't take it every day because I forget. Meds do help though.

Other than that I do task breakdowns with things I like to do inbetween. I also find doing things with my hands while doing a task which requires concentration and my attention helps.

I can find timers stressful, but reminders on my phone helpful.

Thanks for taking the time to respond. I have started to breakdown tasks with him.