What you need to know

YoIf the pictures and labs say you have thyroid disease, you have thyroid disease. But in the world of emotional and mental health diagnosis, where medical tests are largely useless, answers don’t come so easily. For example, ADHD and autism spectrum disorder.

My eight-year-old grandson struggles with ADHD and autism spectrum disorder. And if he’s having a tough time, you know other family members are too.

When it comes to the well-being of my grandson and his family, I have skin in the game. And if ADHD and autism spectrum disorder are part of your home or family, so are you.

Setting the table

The mission here is to review the facts. Now, there is a lot of information about ADHD and autism spectrum disorder; However, I have chosen to use only two sources: children and adults with attention deficit hyperactivity disorder (CHADD) and my grandson and his family.

It is important to know that autistic disorder, Asperger syndrome, and pervasive developmental disorder (not otherwise specified) have been combined into a single diagnosis: autism spectrum disorder (ASD).

Although you probably know it, ADHD stands for attention deficit hyperactivity disorder. For reference, here are the diagnostic criteria for ADHD and TORCH from the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5).

Ok, let’s connect some dots…

ADHD and autism spectrum disorder: Coexistence

Fact: More than 50% of people diagnosed with ASD also have signs of ADHD. And that makes it the most common co-occurring condition of ASD.

And how about this? Up to 25% of children with ADHD have low-level signs of ASD, which may include, for example, difficulty with social skills and sensitivity to clothing textures.

Why high coexistence?

Researchers have yet to determine exactly why ADHD and ASD co-occur so frequently. That being the case, let’s take a look at some relevant factors.

ADHD and ASD are neurodevelopmental disorders, which means that they affect the central nervous system, responsible for movement, language, memory, and social and concentration skills. The star player is executive functioning, where it involves decision making, impulse control, time management, concentration, and organizational skills. For many children, social skills are also affected.

By the way, ADHD and ASD are more common in children.

What about adults?

Yes, adults can have co-occurring ADHD and ASD; however, it is not as common as in children. You see, ASD is considered a lifelong condition, but long-term studies have shown that childhood ADHD symptoms continue into adulthood in one-third to two-thirds of cases.

What are the differences between ADHD and autism spectrum disorder?

This is how the differences between ADHD and ASD usually manifest themselves. My grandson’s experience has followed these models.

Many children are first diagnosed with ADHD when they start preschool or kindergarten because their behavior contrasts with that of their classmates.

Depending on the child, ADHD can lead to…

• Concern
• Impulsiveness
• Difficulty paying attention to an object or subject.
• Focus all your attention on one thing.
• Refuse to get involved beyond the object or subject of attention.

Interestingly, symptoms include both difficulty paying attention to an object or subject and refusal to engage beyond the immediate stimulus. Again, it depends on the child, right?

children with ASD

Signs of ASD are noticed in some children before the age of two. For others, they may not be obvious until they are school age and, like ADHD, display social behaviors that are clearly different from their classmates.

These behaviors include…

• Avoid eye contact
• Appearing disinterest in playing or interacting with others.
• The ability to speak develops slowly or does not develop at all.
• Concerned about uniformity in food textures or making repetitive movements, especially with hands and fingers.

Now some details…

Behaviors specific to ADHD and ASD

Children with ADHD often have difficulty focusing on an activity or task. Which, of course, makes it a challenge to complete that task before moving on to another. And being physically unable to sit still doesn’t help.

Another factor to consider is that some children with ADHD may be so interested in a topic or activity that they fixate on it. hyperfocus.

Children with ASD, on the other hand, are more likely to be overly focused, which inhibits their ability to divert their attention to the next task. And their low tolerance for change makes them inflexible when it comes to their routines.

Many children with ASD are very sensitive or insensitive to, or have a strong interest in, light, noise, touch, pain, smell, or taste. They may also have established food preferences based on color or texture. It is also common for them to make gestures, such as repeatedly flapping their hands.

Finally, concentrating too much can lead to the ability to remember detailed facts over a long period of time. And it may be one of the reasons why some people with ASD are particularly good at math, science, art and music.

How are ADHD and autism spectrum disorders treated?

Treatment for ADHD and ASD begins with finding a medical provider. A doctor with experience in both is recommended. My grandson sees a psychiatrist.

ADHD treatment traditionally includes medication. Because medication options for the treatment of ASD are limited, children may respond better to non-medication alternatives. We will review them shortly.

For a child with ASD, paying attention to diet is essential, because sensory-based food restriction can lead to nutritional deficiencies. For someone with ADHD, stimulant medications can cause loss of appetite.

Medicine

Again, medication is often part of the treatment plan for children with ADHD. And that’s because it helps reduce some of the main symptoms, such as hyperactivity and impulsivity.

These are the most frequently prescribed medications: generic name first, brand name in parentheses…

• methylphenidate (Ritalin, Concerta, Metadate, Quillivant)
• amphetamine (Adderall, Dexedrine, Vyvanse, Dyanavel)
• atomoxetine (Strattera)
• guanfacine (Intuniv, Tenex)

Of note, when those medications are used to treat ADHD and ASD, the stimulants (methylphenidate and amphetamine) appear to be less effective and cause more side effects than when used for ADHD alone. Those side effects include social withdrawal, depression and irritability.

Once again, medication is not as important a factor in the treatment of ASD. However, ASD symptoms that often overlap with ADHD (hyperactivity, impulsivity, inattention) may respond, if not as well, to medications used to treat ADHD.

Severe episodes of irritability, aggression, and self-harm related to ASD generally respond well to antipsychotic medications, for example, aripiprazole (Abilify), risperidone (Risperdal). Having to resort to them is a difficult reality to accept.

Without medication

I have always believed that if someone is using medications for a psychiatric condition, non-medication treatment needs to be included.

There are all kinds of non-medical interventions for ADHD and ASD. In fact, there are so many that including them here would be unrealistic. So I searched and found an informative article for ADHD, ADHD in adultsand TORCH.

For me it is personal

Damn, I broke a sweat writing this one. But because ADHD and autism spectrum disorder are difficult to separate, diagnose, and treat, I had to be thorough.

We are dealing with a couple of disorders that can affect the lives of children, adults and their families. We cannot relax in learning and application.

For me it is personal. You too?

I encourage you to spend some time with Chad. Lots of important and useful information.

And those Chipur information and inspiration articles – read the titles carefully.

Bill White is not a doctor and provides this information for educational purposes only. Always contact your doctor if he has questions, advice or recommendations.

After a decades-long battle with panic and generalized anxiety disorders, anxiety-related depression and alcoholism; I left the forest. I was lucky to have found my life’s passion and work along the way. So, at age 49 I entered graduate school and earned my counseling credentials. I produce an award-winning blog for those suffering from depression, anxiety and bipolar at chipur.com.