ADHD? Aspergers? or Both?

“Everyone has a kid with ADHD!” That’s what my neighbor said to me when I told her that my younger boy was recently diagnosed with ADHD. And she’s probably right.

So many boys get diagnosed with ADHD.

What Is ADHD?

Simply put, ADHD is either the inability to focus or the inability to sit still or both.

Is ADHD for Real?

Some say ADHD doesn’t exist.

The naysayers point out that schools require boys to sit too much and therefore ADHD is in the minds of the (female) teachers. I can see their point to a certain extent. Schools have shifted from being boy-focused to being girl-focused. However, I’ve compared my younger boys’ behavior to his classmates, and I can see the difference.

As an example argument that ADHD is over-diagnosed, read “Why so many kids can’t sit still in school today” published by the Washington Post.

Is It ADHD or Giftedness?

Now, THAT’S a great question! If you’ve got a kid whose advanced thinking and vocabulary make you pause, you may have a child with giftedness–no matter what his grades show. Not all gifted kids score A’s.

However, discussing giftedness is a post all its own, so stay tuned!

Is ADHD on the Autism Spectrum?

Some say ADHD belongs on the Autism Spectrum–at the very top end, higher on the Spectrum than Aspergers. (One such author is Dr. Kenneth Bock, who said as much in his book Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies.)

This one makes me pause. My boys are 4 years apart, and it took me a couple of years to see that the younger one does NOT have Aspergers. (Want to learn more about Aspergers? Read my first blog post.)

Why? Because to me, the diagnostic criteria for ADHD looks a whole lot like symptoms of Aspergers.

ADHD’s Inattention

Let’s take my older boy, who has Aspergers, (we call him Trio Man) as an example. Under the criterion of attention deficit (which the DSM 5 calls “inattention”), Trio Man shows all 9 symptoms (only 6 are required for diagnosis). Of those 9, I’d say that three are true if the tasks are not his preferred tasks. That is to say that he can focus on what he wants to do–his “restricted, repetitive interests” (an Autism criterion)–but he cannot focus on non-preferred tasks. Just ask his teachers.

The 9 symptoms include missing details, not able to pay attention, doesn’t seem to listen when spoken to, doesn’t follow through on instructions or schoolwork or chores, finds organizing tasks difficult, avoids anything that requires mental effort, loses things, easily distracted by what’s going on around him, forgetful. That describes both of my boys!

Kids with Aspergers can seem like they don’t listen because they are so entrenched in what they are doing and they cannot transition to listening.

Kids with Aspergers don’t follow through on instructions because they cannot handle orally stated multi-step procedures, which is often seen in Autism.

Kids with Aspergers often appear disorganized (unless they are also OCD).

Kids with Aspergers often avoid things that require mental effort, assuming that the “thing” is not his/her preferred interest. For example, Trio Man loves chemistry and will tell me all sorts of facts and trivia about the elements in the Periodic Table. However, he will avoid botany.

ADHD’s Hyperactivity and Impulsivity

Under hyperactivity, my boy with Aspergers shows 5 of the 9 symptoms (6 are required). The 9 symptoms include fidgeting, leaving his seat, runs or climbs when not appropriate, unable to be quiet during play, seems to be “driven by motor,” talks excessively, blurts out answers, can’t wait his turn, interrupts others all the time. Oh, yeah, that completely describes my younger boy (we call him Spider-Man).

Kids with Aspergers talk excessively about their preferred interest. Actually, they talk ad nauseam–until you are nauseous from listening to all those details!

Kids with Aspergers blurt out answers because they are not aware of the social conventions of waiting their turn.

Kids with Aspergers interrupt others, usually by changing the topic to their preferred interest, because they are not aware of the social conventions.

ADHD? Aspergers? or Both?

Trio Man, my boy with Aspergers, probably could be

diagnosed with ADHD (the psychologist would probably say “predominantly inattentive”)
co-diagnosed with ADHD and Aspergers
diagnosed with just Aspergers (or Autism Level 1 under the DSM 5–see previous blog).

In my experience talking with other moms, I have learned that many kids with Aspergers are first misdiagnosed with ADHD. Often, when those kids are correctly diagnosed with Aspergers, they maintain a co-diagnosis with ADHD.

Does it really matter?

Only in that the child gets the services (and meds, if you choose to medicate) that he needs covered by insurance and the services that he needs in school.


Aspergers? But the DSM 5 says Autism Level 1

Yes, I know that Aspergers doesn’t exist as a diagnosis in the USA any more, but I like the term “Aspergers” so much more than “Autism Level 1.”

What the DSM 5 Is

What am I talking about? If you’re already entrenched in the world of Autism, then you know that the American Psychiatric Association published a new version of their diagnostic manual about 1-1/2 years ago.

With the new version (edition 5), Autism Level 1 has replaced Aspergers as a diagnosis. That means that in the USA, people will not be newly diagnosed with Aspergers.

If you’ve never heard of this manual before, you can look it up on Amazon. It’s the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, or DSM-5, published by the American Psychiatric Association. It’s what doctors use to categorize mental disorders in order to prescribe medications and therapies.

The DSM 5 is a classification system that explains what is and what isn’t a particular disorder. In it, you’ll find about 700 pages of diagnostic criteria that include things like Neurodevelopmental Disorders (of which Autism and ADHD are categorized), Schizophrenia, Bipolar, Depression, Anxiety, and more.

The previous version of the manual, the DSM 4, included Aspergers as a diagnosis that’s separate from Autism. However, we as a society have understood for years that Autism and Aspergers are on the same spectrum of behaviors, but the severity of behaviors are different.

Schools, for example, when they do their special education evaluation, don’t use the term “Aspergers.” Instead, they use “Autism.” When my son (Trio Man) was first evaluated by the school district, one of the specialists said, “Everyone’s on the Spectrum.”

How Aspergers Compares to Autism

Well, that’s all fine and dandy, but for me, “Aspergers” is a better descriptor than “Autism.”

Because Aspergers looks different from Autism.

An Aspergers kid looks like a typical kid.
An Autism kid does not look engaged.
An Aspergers kid wants to hang out with other kids (but doesn’t know how to).
An Autism kid is indifferent to other kids.
An Aspergers kid says things that are impolite.
An Autism kid may not talk at all.

The differences between Aspergers and Autism became clear to me when I led groups of Aspergers and Autism kids through Vacation Bible School. The Aspergers kids could be described as quirky kids. The kids with Autism were more obviously special needs.

What Aspergers Looks Like

Other parents have said to me:

“He doesn’t look like he has Autism.”
“I couldn’t tell that he has Autism.”
“He has Autism?”

I could respond by saying, “Thanks! but that’s probably because he has Level 1.” I would probably get the response, “Level what?”

Kids with Aspergers or Autism Level 1 are like typical kids (neurotypical–or NT) who are “a little off.”

They look like typical kids, but

      they don’t make eye contact or

they say something awkward or

they seem rather uncoordinated.

An Aspergers kid often talks like an adult ad nauseam about their favorite topic (that is, until you’re nauseous!)
They have excellent memories.
They are very concerned about fairness and justice.
They have attention problems (unless the topic is their special interest).
They don’t think ahead and therefore don’t adapt well to change.
They may be sensitive to sounds or touch.
They have uneven development.
And like all kids with Autism, they get absorbed in their special interest, whatever that may be.

Yep, that’s my boy!