“After the meeting with Mrs. K., my mother and father talked to me about what she had said and I did whatever I could to try harder even though I didn’t really know what they meant…The irony was that it wasn’t hard for me to give my attention, I just gave it to everything and was unable to focus on any one thing.”[1] When parents are faced with a situation like this, along with developmental delays and low grades, they want to know. Is it ADHD or Autism?
Although David Flink’s book does not address Autism, it gives voice to what often occurs with many who have ADHD. Yes, it could be ADHD. Yes, it could be Autism. But it could also be both.
There is a high probability that sometimes there is more than one condition being exhibited. “Roughly two-thirds of kids with ADHD have a least one co-existing condition, and Autism Spectrum Disorders-ASD- are among the conditions that commonly occur with ADHD. Some studies suggest that up to half of kids with ASD also have ADHD.”[2] This helps to explain why even when your child is taking the medication and/or going to the therapy, the situation isn’t changing for the better.
Another factor that often occurs with many who have ADHD, is the fact that ADHD and Autism have many overlapping symptoms. They both share communication and focusing problems. This makes it more difficult to diagnose because of the close relationship between them. We need to remember that they are two distinct conditions even with the similarities.
As more is being learned about ADHD and Autism it has been recognized that these two conditions can occur together in the same person. Before a study in 2013[3], doctors couldn’t make this dual diagnosis because of the existing diagnostic guidelines. The study showed reports that had been emerging that stated ADHD was comorbid with Autism Spectrum Disorder (ASD). The current version of the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM5) which lays out the guidelines for diagnosing psychiatric disorders now allows doctors to issue a joint diagnosis of Autism and ADHD.
What Is Autism?
Autism or Autism Spectrum Disorder is a mental condition involving an impairment in communication and social interaction. It is usually seen as a spectrum disorder because doctors believe that it is made up of a variety of conditions that have a range of characteristics from repetitive behaviors and limited speech to varying degrees of social skills.[4]
Here it is pertinent to also explain Asperger’s Syndrome. This is a specific neurodevelopmental condition that is part of the group of Autism Spectrum Disorders. AS may also prevent children from clearly communicating and socializing. It is seen as a milder form of Autism that can often occur with ADHD. [5] However, it is important to note that according to an article on Focus for Health, Asperger’s Syndrome was removed from the DSM5 (Diagnostic and Statistical Manuel of Mental Disorders V) in 2013. More severe cases were added to the Autism Spectrum and less severe cases were not given a diagnosis related to Autism at all.[6]
Later in this article you will find similarities and differences between Autism and ADHD. But specifically of note here are three stand out symptoms that I haven’t listed elsewhere. The first makes Asperger’s more like ADHD. That is their episodes of nonstop talking. This is because with Asperger’s Syndrome there is usually a more normal verbal language development schedule than that of some of the other Autism Spectrum Disorders. The second stand out symptom also involves verbal language. That is the prosody of their voice.[7] Their voice is a monotone pitch or a lack of rhythm in speaking. The last symptom is the lack of progress in motor skill development. They have trouble catching and/or bouncing a ball, for example.[8]
What Is ADHD?
ADHD is a neurodevelopmental condition whose symptoms are typically the inability to focus, hyperactivity and impulsivity. Symptoms might also include problems associated with social interactions, processing information and/or emotions and following directions.[9]
Similarities Between ADHD and Autism
Autism and ADHD have some commonalities, but ADHD is not on the Autism spectrum.[10] Most Autistic children though share some of the symptoms of ADHD such as:[11]
- Difficulty settling down-They may both be fidgety and always seem to be “on the go.”
- Social awkwardness-They may both have trouble making friends because they don’t know how to relate to others either as a result of inattention (ADHD) or lack of social understanding (ASD). A Child with ADHD may struggle with social interaction, but a child with ASD will totally disengage from the situation.
- Ability to focus only on their interests-Children and teens with ADHD have trouble keeping their focus on only one thing; while ASD children and teens have trouble getting their focus off of one thing.
- Impulsive-They may both act without clearly understanding the danger or the results.
- Communication Problems- The communication skills of children with ASD are less developed than with ADHD children. Some children with Autism never talk at all. The communication issues in ADHD are not as severe as in ASD.
Differences Between ADHD and Autism
Let’s look now at some of the differences between ADHD and Autism that can be present.[12]
| Autism | ADHD |
| May struggle to communicate | May monopolize a conversation |
| May Have a hard time putting thoughts into words | Talks nonstop |
| Loves order and repetition | Doesn’t like doing the same thing over and over |
| Craves sameness | Craves novelty |
| May have delayed speech | May have trouble following directions |
| May struggle with nonverbal cues | May Struggle with organization and task completion |
| May have trouble with safety and danger issues | May act without thinking of the consequences |
| Early onset can be as early as 18 months18 months | Later onset at around 7-9 years of age or older |
| Range of severity | Range of symptoms |
Alarming Rise in the Number of Cases of Autism and ADHD
According to an article in The New York Times, “Nearly 1 in 5 high school age boys in the US and 11% of school age children have received a medical diagnosis of ADHD. This was the new data from the federal Centers for Disease Control and Prevention. (CDC) Estimated figures show 6.4 million children have ADHD. This is a 16% rise since 2007 and a 41% increase in the past decade.” It goes on to state that the number could go higher because the American Psychiatric Association (APA) plan to broaden the definition of ADHD so more people can receive a diagnosis and treatment.[13]
The number of cases of Autism in the US have also risen alarmingly in 2014 according to an article in The Washington Post. The CDC report stated that they went up about 80% from 2011-2013 to 2014. Instead of 1 in 80 children, it now is estimated to be 1 in 45 children that have Autism.[14]
Both articles mentioned that the possible increase was caused by toxins in the environment. They also expressed concern that doctors were perhaps over-diagnosing the condition. No matter what the cause, it is an alarming trend.
Notes:
[1]David Flink, Thinking Differently, Harper Collins, 2014 p.4 and p.7
[2]Kay Marner, Is It ADHD or Autism? Or Both?, ADDitude Inside the ADHD Mind
[3]Rebecca J. Landa, Patricia A. Rao, Association Between severity of Behavioral Phenotype and Comorbid Attention Deficit-type Disorder Symptoms in Children with Autism Spectrum Disorder, Sage Journals, June 5, 2013 http://journals.sagepub.com/doi/abs/10.1177/1362361312470494
[4]FastBraiin [sic] Staff, FastBraiin, August 4, 2017
[5]Darla Burke, Asperger’s Syndrome, review by Timothy J. Legge Healthline October 14, 2016
[6]Robyn Charron, Autism Rates Across the Developed World, Focus for Health August 28, 2017
[7]Prosody is a linguistic function such as tone, intonation, stress and rhythm.
[8]Kimberly Holland, Asperger’s or ADHD? Symptoms, Diagnosis and Treatments, Review Timothy J. Legge, Healthline June 25, 2018
[9]FastBraiin Staff, FastBraiin August 4, 2017
[10]Eileen Costello, Is My Child with ADHD on the Autism Spectrum?, ADDitude Inside the ADHD Mind
[11]Eileen Costello, ADHD and the Autism Spectrum, ADDitude Inside the ADHD Mind
[12]ADHD or Autism?, WebMD
[13] Alan Schwarz and Sarah Cohen, ADHD Seen in 11% of US Children as Diagnoses Rise, The New York Times March 31, 2013
[14]Ariana Eunjung Cha, Autism Cases in US Jump to 1 in 45: Who Gets the Diagnosis, in 8 Simple Charts, The Washington Post November 13, 2015