Symptoms confusion - AS/ADHD

[KarenThirl]

Since getting J's diagnosis of AS on Monday, I've been reading everything I can get my hands on on the subject, but I'm finding that I'm more confused than ever with regard to symptoms. J seems to have far more of what I regard as ADHD indicators and there are glaring gaps in what appears to be regular in AS. I'm reading Luke Jackson's 'Freaks, Geeks...' and finding more empathy with his ADHD brother than with him personally.

It seems to me that the crossover symptoms that occur in both conditions must present differently to determine which category they fit into. Is this right? J certainly has concentration and distraction problems (though they appeared not to be so much in evidence on the day the psych visited in school) - is this usual with AS?

What would help is if all you AS mums could let me know what YOU think of as symptoms you would definitely associate with the condition, that a child needs to have for an accurate diagnosis. It would be equally helpful to know what mums with dual diagnosis think.

I hope that makes sense. My brain's a big puggled this morning.

Does ANYBODY have any thoughts on this?

Cant help but thought I`d bump.

Hi Karen , this is what we've been told regarding our son.
He displays all the symptoms of adhd but after a recent (3 months ago) revised assessment called a D.I.S.C.O (DIAGNOSTIC INTERVIEW FOR SOCIAL AND COMMUNICATION DISORDERS) the pyschiatrist has stated our son doesn't quantify for a seperate dx of adhd the signs of it he is showing is just inline with his autism all part and parcel. My son is on the lower functioning end of the spectrum and he told me in his professional capacity that lower functioning cannot have adhd its very unusual its normally found in higher functioning and in aspergers (not always).He did say some children display more symptoms of just adhd than AS or autism and this confuses the parents (certainly has with us) but there are further tests that will clarify adhd such as the one ive mentioned above and also the connors test , usually the connors is done when assessing for an asd but the D.I.S.C.O one is relatively new (in our area anyway). I cant give you anymore advice as we've been told our son does not have adhd were still unconvinced especially as he was back flipping and moonwalking across the kitchen on his hands at 5.30am .

Thanks Mommalis, that's very helpful. I think I ought to pursue this - the psych hasn't done the Connors test (which I was expecting) and I'm concerned that she's based her provisional diagnosis on two and a half hours of observation, during which James appeared to concentrate well. I've read one ADHD expert who claims that the only sure-fire way to accurately diagnose is if you actually go and live with the child for a few weeks, as sometimes they DO have periods of intense concentration.

I've made a note of the tests you've mentioned and will raise that with the psych when I see her next - God, this list is getting long!

Thanks!

My ds has been diagnosed with HFA, and the older he's getting the more likely he has AS, although are they the same anyway!!
I know exactly what you mean with regard to the different diagnosis and how they overlap. My ds has not been diagnosed with adhd, but he also has distraction and concentration problems, he can never maintain concentration for a long period of time, becomes easily bored, unless he is on his playstation, and then that's an entirely different matter.
He can never walk anywhere, he's always darting around, won't hold my hand if out and about.
He has trouble with sleeping at night, needs very few hours of sleep.
Only last week a neigbour asked if he had adhd, I've always put this type of behaviour down to his asd.

My son has a dual diagnosis of aspergers and adhd. I think he's more ADHD than AS but certainly some of his social behaviour fits squarely into AS.

For what its worth, I personally think they are probably the same thing, but not yet recognised as such. Its described as a spectrum for a reason and where you come on it depends what dominant characteristics yoou exhibit and therefore what diagnosis you get (not just my view but also that of our Ed Psych.)

I think you're probably right there 3mum about ADHD and AS being 'same but different'. Some sources say that ADHD is on the spectrum but others don't - my guess is that nobody is entirely sure. For the time being I'm just happy that J has a diagnosis of any kind and that he's no longer regarded as 'just a naughty boy' - he's on the school's SN register now and the SENCO is meeting with the Ed Psych on Tuesday to start the statementing process, and that's enough for me to be going along with. Any additional diagnosis will follow if it's there.

Hi
Have read this with interest. Ds1 was diagnosed with AS about a month ago aged 7. We had however suspected this for some time. Adhd was suggested a couple of years ago but we didn't feel this quite fitted as he was and is relaxed and calm except when something triggers AS symptoms this can be too much noise, or other stimuli, the wrong tone of voice, a very literal understanding of whats been said.
I think the confusion with ADHD comes with the reaction to stresses which trigger the symptoms when these stresses aren't present then there is no evidence of ADHD. I understand that kids with ADHD had continual symptoms (please tell me if I'm wrong as I am no expert).
Certainly with AS there are lots of strategies for managing behaviour where as with ADHD stuff like Ritalin is often prescribed - this wouldn't work for a child with AS. I have heard of parents being told by schools to get their kids onto Ritalin (or whatever its called) and not being prepared to do much else to help when the was a diagnosis of AS.

Would love to discuss this further and find out how others have got on with statementing etc and any strategies you find have helped.

Looking for help and advise as I think my daughter, aged 10 may have AS. She has had ongoing problems since she was a baby put trying to get a dagnosis is proving very difficult. She walked tip toed and wore splints on both legs for a few years still attends physio. She attend speech therapy every week as she has language problems, have discussed dyspraxia. She has learning support at school as she has problems reading writting, maths etc.
She shows signs of depression, always sad reverts into her own world blocking out everyone around her.Has no close friend as she finds other children difficult to be around. Suffers stress and anxiety, doesnt like large crowds,parties,disco. Unable to understand simple things, pantomines, films, computer games. I am looking for nay help or advice anyone can offer.

Devkaren, there are many SN mums on here that can give much better advice than I can to help you.
So I'm just bumping this because I know how worrying it is when you feel there might be a problem with your ds. Good luck

Jellybrain, you said: "I think the confusion with ADHD comes with the reaction to stresses which trigger the symptoms when these stresses aren't present then there is no evidence of ADHD. I understand that kids with ADHD had continual symptoms".

That's partly my point. Up till recently J has appeared to have no AS-type 'trigger' to set him off, he's always been difficult, impulsive, argumentative, physical etc etc and many other predominantly ADHD characteristics. More recently (and especially since he's been in Yr 1) we've noticed more of what could be recognised as AS behaviour - temper tantrums (which he's never had before) and increasing difficulty with peer relationships. Again, I'm not sure about the continual symptoms because of the ability to focus intently on subjects of strong interest, although symptoms do have to be present in all settings to qualify as ADHD.

That said, since posting this I've been reading another book (YET another!) which much more clearly defines ADHD type behaviour as part of the AS spectrum - "Aspergers Syndrome And Difficult Moments" - it could have been written for J, whereas other books I've read so far describe children who are nothing like him. He seems to lack many of the 'typical' AS symptoms and it's got me baffled.

Devkaren
It might be worth starting a new thread so more people are likely to see your question.

Diagnosis can be hard to get especially as the autistic spectrum is so broad and there is no blood test or physical attributes that can be refered to.
Your best weapon (because this is a battle)is knowledge and lots of it both of AS so read as much as you can try the National Autistic Society website also the Semantic Pragamtic Disorder Website. Then start a diary noting any behaviours or reactions how do these compare to AS behaviours you've read about. Ask the class teacher to keep a diary.

Even if you haven't got a diagnosis yet its well worth trying strategies for dealing with AS and perhaps discussing the possibility with her. We told Ds about ASpergers and how it made him see and feel things in a special way for example when he hears a sound he doesn't like it hurts or certain sights and smells actually make him feel sick though other people might hardly notice them and that he likes things to be done in order. At school he has his own workstation in a quiet part of the classroom which is able to go to when he becomes overwhelmed by the classroom environment knowing he can 'escape' has really helped with anxiety levels. He has also found social stories helpful and has a box of index cards with instructions for different tasks he finds difficult for example getting changed for P.E or moving to a new task. He finds it very difficult to retain multiple verbal instructions ie if he was asked to go and get a particular book or items from his drawer and complete a task he might get as far as the drawer and then forget why he was there.
i am sorry this post is getting really long if you want to email me through CAT i'd be happy to chat with you about this and the experiences we have had.

Karenthirl Have just read your post and can really relate to what you said. DS ceratinly appeared continually 'hperactive' when he first started school but seems less so now.
What sort of things trigger you son's tantrums have you found and strategies for dealing with them?

Jellybrain - I actually think ds is MORE hyperactive now since starting school! He's certainly harder to control, I find. Triggers seem to be transition times, being interrupted when he's focussed on something, involvement with other children etc, though those things don't necessarily trigger tantrums, just an increase in his uncontrollability and 'off-the-wall-ness'. Coming out of school is a nightmare - he runs away from me, back into school to disrupt the after-school club, throws his lunchbag and water bottle around etc. Even the teacher can't control him at hometime. Off the school grounds he picks up litter, sticks etc and throws them around (sometimes at other people), shouts rude words all the way home (sigh). His behaviour can change instantly when another child appears on the scene, eg when I took him out in the street on his bike last weekend, he was fine when it was just him and me but when a boy that he knew passed he started picking the bike up and throwing it around. So you see, it's not really tantrums but worsening of general behaviour problems.

As for strategies ... they change with the weather, tbh. What works one day might not work the next and vice versa. Generally I have a combination of star chart for positive behaviour and each point represents 10p towards the week's pocket money, and a token jar from which he's fined for anything inappropriate. The token jar is great because there are so many stages to it, eg I ask him to do something, he refuses, I ask again, he refuses, I TELL him to do it, threaten to count to three, START to count to three (with the understanding of what happens when I reach three), then I take away a token without repeating the reason why. There's no need, he already knows. If he gets upset at losing a token I remind him that he can earn it back if he wants to. I think the type of tokens you use matters a lot - the pasta jar wouldn't work with J because he hates pasta! - so we're using shells and coloured glass shapes.

If he gets into a real paddy I find the best thing is for me to stay calm, acknowledge that he's angry and explain that we can talk it through when he's calm. I've taught him to try counting to ten and breathing deeply, but he's not too happy with this because he expects everything to be right again by the time he reaches ten, but of course it isn't so it upsets him all over again. I also remind him of what the 'reward' will be for calming down and complying with my request, and he'll always get a point on his chart for coming out of a tantrum.

I also use forthcoming events as a carrot - tonight we're taking him to a basketball match (with tickets he won for full school attendance) and I've been dangling that one all week.

It's all based on positive reinforcement really, but sometimes it works and sometimes it doesn't. For that reason I never threaten or promise something I don't want to follow through, because consistency is incredibly important.

Can I jump on the bandwagon here and ask what ages are your DS's - mine is 5 and I would love to use the pasta jar thing but I cannot think how to explain it to him he doesn't really understand things like that ?? It is very hard to get him to stand and concentrate to explain something to him. We have requested an assesment but will be at least another 6 months before this gets done.

My ds has been diagnoised with O.D.D. which is an oppositional disorder. The symptoms are like ADHD and tbh I can also relate to AS, doesn't like social groups, parties and poor eye contact and never says hello or goodbye.
I do feel that they may have not got to the bottom of my ds and feel that the phsy is missing something. The phsy has said he hasn't got AS as ds has a good sense of humour, yes to a degree but ds has not got any good social skills at all. He finds it too difficult to socially interact in a group- PE is a no go situation.
Therefore I understand how confusing this is and after reading the thread there appears to be similar connections with all the children. larsxx

Cosmo, J is 6. Perhaps your ds would be more able to understand the concept if you used tokens based on something he's particularly interested in (which is why we've used shells). Perhaps mini-cars, or something like that. I've heard other people using smarties too, as it's more instant and most kids understand chocolate!

Karenthirl - not much age difference between our two then - I definatley could not use smarties - he cannot have sweets - they send him even more hyper - or so we were told, so we avoid them now only as a very special treat. Is your DS the same with sweets?

My DS sounds very like yours - I do not really know if DS has social problems - he likes things his way and is very moody if he doesn't want to talk he won't - for instance if his grandparents ask him what he done at school he always says nothing but if I ask him while he is in the bath/shower he will tell me all - Is this social problems? Oh I cannot wait to get him dx - at least that way it will be easier to control him, while I am finding all this info. invaluable and find him much easier to cope with as I know the more calmer I am the calmer he is but hubby and grandparents are another story - I constantly print out info. for them and tell them how to deal with them but they do not take any heed!! Ah well enough moaning for Friday afternoon.

Cosmo - I have a very rare child, one who doesnt like sweets! He loves chocolate but even then he self-regulates and doesn't have too much. I avoid additives in food generally so I don't really know whether they make him hyper.

Try to be patient with your dh and relatives. I've had to work through J's problems on my own for four years (I've known they were there since he was two) with everyone around me except my mum telling me he was 'normal'. It's been incredibly hard work, in addition to coping with the problems themselves. Once you get a diagnosis they will come round, as mine did. DH eventually came onside when I was near breaking point last Oct and said I didn't care what he thought, I was calling in the HV again tomorrow and starting the assessment process again. Told him I felt I was failing J as a mother if I didn't get him diagnosed and he could take it or leave it. He's backed me up all the way ever since. Grandparents couldn't be better now either, reading books and keen to do anything they can to help. Seriously, the diagnosis does make a big difference. At the moment yours are reacting to what they see as your opinions, but once a medical professional has had their say, they're likely to think differently.

Why six months till the assessment? Is that because of waiting list or something?

Lars - Just saw your post. Ds recently dx with AS and he definitely has a sense of humour though he doesn't always get jokes. If your son fits the triad of impairments associated with AS the fact that he has 'a sense of humour' should be irrelevant i would have thought.
Have you read the bookFreaks, Geeks and Asperger Syndrome by Luke Jackson - he has AS and is very funny!.

KarenThirl - Sorry only getting back to this now - I do not know what they say it will take 6 months - GP referral will take at least a year and going through the school takes 6 months for assessment - we did enquire about going private but they do not do private appointments in our area ( Northern Ireland) - I have tried to explain to both sets of grandparents - as I seen another thread on dyspraxia and can definately see that DS has most of these symptons too but also others - but both grandparents keep saying 'He will grow out of it' I tried to explain that he probably will always need help at school but they think I am overreacting - DH and I are going through a rough time at the minute as he doesn't have as much patients with DS and keeps saying how much is due to what he has and how much is bad behaviour but either way shouting at DS is not going to help - dosn't help the fact that I am 5 months pregnant and cannot stand the bickering so I tend to just go off with DS and do everything ourselves which DH says then that I am excluding him!!! Oh the joys of family life and I am about to have another - Sorry this has turned into a moan. Think I will phone the docs and school and see if I can hurry on the appointments.