This blog has gone over much of what has made autism, autism. But Attention deficit hyperactivity disorder (ADHD) is something else altogether, even though it can be comorbid with autism. Attention Deficit Hyperactivity Disorder, or ADHD, was the headlining diagnosis du jour in the early nineties. Parents were running out to have their three year olds checked out because they were very energetic only to discover their children were perfectly normal. All the same, many kids of that decade ended up on ADHD meds, some who needed it, and several thousands more who didn’t.
Pediatricians and child psychologists are more careful now about diagnosing kids with ADHD and prescribing the medication because of the long term effects of Ritalin (methylphenidate) on that group of children from that decade. Ticks, twitches, Tourettes-like behavior, and lack of ability to think with any clarity are the result of long term use of moderate to high doses of Ritalin. However, if you feel that your child has ADHD and/or autism, tests can confirm or deny its presence.
How to diagnose child with ADD/ADHD?
One note of interest here; since it is 2013, the newest DSM V manual on the diagnostic criteria for both autism and ADHD has changed. A shift in thinking is eliminating Asperger’s altogether, and relabeling it as “high functioning autism”. ADHD is now one label, even if hyperactivity isn’t present, creating four subcategories of the disorder instead. If you take your child in to be tested, don’t be surprised to hear new terminology tossed around to express the results of the testing and of the diagnoses.
Ergo, even if your child doesn’t exhibit hyperactivity or you’re not concerned about the level of energy they have, they may still be diagnosed with the disorder but have one of the subcategories of it. This may be very confusing to those who have been around long enough to remember the original ADHD definition and find you’re redefining it for them.
The new diagnostic criteria isn’t available for public viewing just yet, but many therapists and trained professionals have been updated on the criteria. With the new criteria, the therapists are going back over their ADHD cases to reassess if the diagnosis still stands. In most cases it does, but when a child with autism seemed to be just on the border between “has it” and “doesn’t have it”, the new criteria could actually tip the scales one way or the other.
Children with autism quite often have ADHD-like behaviors, but it’s never completely certain if its part of the autism or a separate issue/disorder all its own. Children who are high functioning enough to understand the test questions and answer them on their own can be more accurately diagnosed than those who are not. The newer DSM criteria will also be able to eliminate the vague borderlinetendencies and provide a more definite answer on the matter.
Where ADHD medications have been prescribed to children with autism because there was no definitive answer, and the medications really seem to help them gain control and focus overall, it clears up the question quite well. However, this isn’t a catch all for all children with autism because the medications don’t always work the same way for these children as they do with children with “average” brains or children who actually do have ADHD. It’s a difficult path to tread, and it’s very hard for parents in this position to know just what to do.
The old criteria for ADHD can help somewhat, for the parent looking for answers. Generally they have to answer yes or no to the following list of questions:
1. Does your child fidget a lot?
2. Is he/she constantly moving or their speech so rapid it’s hard to understand him/her?
3. Does your child have a hard time focusing in school?
4. Does he/she daydream a lot or seem to be somewhere else all the time?
5. Does your child have a very hard time falling asleep at night because he/she is moving around in bed/constantly rolling or tossing?
6. Does it seem like they have so much energy and it NEVER runs out?
7. Do they remember anything about what they were learning in school during the day?
8. Do they need frequent breaks in order to focus for shorter time periods?
9. Are they easily frustrated by uninteresting tasks?
10. Do they seem slower intellectually than their peers or just incapable of absorbing information?
11. Are there things that interest them that can hold their attention for a very long time?
As you can see from this partial list, it would be very hard to separate the things that define an autistic child from an autistic child with ADHD. In both diagnoses, traits are extremely similar, and really the only thing that makes a difference is how the child answers the questions, if they are able to verbalize the answers at all. Still, it’s a good starting point for parents who aren’t sure. Consulting with a pediatrician and a child psychologist are very important at this point, and will help make things a little clearer.