What's the difference between Aspergers and ADHD

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fleeced
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18 Jul 2010, 3:05 pm

Are there any symptoms common in one and not the other?



Willard
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18 Jul 2010, 3:35 pm

An inability to focus for extended periods is not the same as impaired processing of nonverbal social signals. They may be comorbid,in that one individual may have both, but they are two completely separate ailments.



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18 Jul 2010, 3:39 pm

Quote:
A. Either 1 or 2
1) Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Inattention
a) Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
b) Often has difficulty sustaining attention in tasks or play activities
c) Often does not seem to listen when spoken to directly
d) Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
e) Often has difficulty organizing tasks and activities
f) Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
g) Often loses things necessary for tasks or activities (eg, toys, school assignments, pencils, books, or tools)
h) Is often easily distracted by extraneous stimuli
i) Is often forgetful in daily activities
2) Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity
a) Often fidgets with hands or feet or squirms in seat
b) Often leaves seat in classroom or in other situations in which remaining seated is expected
c) Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
d) Often has difficulty playing or engaging in leisure activities quietly
e) Is often "on the go" or often acts as if "driven by a motor"
f) Often talks excessively
Impulsivity
g) Often blurts out answers before questions have been completed
h) Often has difficulty awaiting turn
i) Often interrupts or intrudes on others (eg, butts into conversations or games)
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before 7 years of age.
C. Some impairment from the symptoms is present in 2 or more settings (eg, at school [or work] or at home).
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder and are not better accounted for by another mental disorder (eg, mood disorder, anxiety disorder, dissociative disorder, or personality disorder).
Code based on type:
314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: if both criteria A1 and A2 are met for the past 6 months
314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if criterion A1 is met but criterion A2 is not met for the past 6 months
314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive, Impulsive Type: if criterion A2 is met but criterion A1 is not met for the past 6 months
314.9 Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified


Quote:
(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects


(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."



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18 Jul 2010, 4:21 pm

SOME of the traits overlap to a pretty huge degree in some cases, IMO, once you get the basic differences out of the way. This is how I first learned about AS, researching my ADHD dx and trying to fugre out why I felt like I didn't quite fit in with the rest of the ADHDers. I knew I was sort of like them and that was something was definitely up, just never knew what.

I've found varying information, some of it conflicting. Much of the information that I've come across says that the MAIN difference is repetitive/ritualistic behaviors and the propensity for factual knowledge, along with social difficulties. This isn't common with many ADHDers. I am obsessive and a worrier, very detail oriented, love watching the same videos repeatedly or listening to the same music to gather every single detail...always loved to do ritualistic things to get inside of my own world, I guess, and have always been described as having a computer brain.

An ADHDer can have those traits as well so it really depends on how severe they are and how much they affect that person's life.



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18 Jul 2010, 4:48 pm

fleeced wrote:
Are there any symptoms common in one and not the other?


I don't recall anything about specific symptoms, but, my impression from what I've read is that sometimes, there is no difference. Keeping in mind that, in both cases, these are labels based on symptoms. It's not like with AIDS where they can look for HIV. There's no equivalent to HIV... it's outward symptoms. So, keeping that in mind, it's like, I think, sometimes, it's two labels for the same thing, depending on which traits are being looked at, and/or what one is familiar with. One doctor sees ADHD, another see Autism or Asperger's. But, at the same time, I think it's quite possible for some people to have both, as two separate things.


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eon
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18 Jul 2010, 6:07 pm

Yes, it's possible for someone to have both. The ADHD is essentially only going to refer to executive function impairment. For the spectrum disorders, executive function impairment of some kind can be a feature, and has been found that it is not an essential feature through clinical experience.

So it is likely most accurate to say that not all spectrum individuals have ADHD, but some do. And ADHD exists outside the spectrum as well. I can see some influence though in the ways that one is supposed to learn social intuitions in early years, that learning process could be very impaired because of ADHD symptoms, contributing to the overall developmental delays that define some of the essential spectrum components.

That's my opinion based on some of the writings of Tony Attwood.


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pgd
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18 Jul 2010, 8:30 pm

Tend to feel that a person with ADHD has a much greater likelihood of responding to a central nervous system stimulant - alerting agent - (such as coffee, caffeine compounds, Ritalin, Dexedrine, Adderall and so on)(not a cure) than a person with Asperger's. Also tend to feel that a person with ADHD may recognize some sort of mild gross or fine motor control/ hyperactivity present in one or both sides of their body vs a person with Asperger's. Tend to feel that person with ADHD may have a broader range of interests than some of those with Asperger's.



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19 Jul 2010, 12:57 am

I have both...the ADHD responds to stimulants, the AS doesn't. Someone already posted the criteria so no need to repeat.

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19 Jul 2010, 3:38 am

i probably have nothing really informative to add to this conversation (and am speaking from personal experience rather than any actual research or clinical criteria), but i'll go anyway.

my mother has ADD (probably primary inattentive type), not in any way mild. her executive function problems are pretty severe, and she has some spectrum-like traits (lot of time spent alone, tiring after social functions, socially naive, stims at times, obsessive about special interest which has persisted her entire life ..) but there would be no mistaking her for someone with Asperger's. first, she is very "warm" and likes a lot of direct face to face contact, likes to "comfort" people by petting them and sitting in their personal space; she's very interactive with others and 100% emotionally driven, liking to avoid issues that cause her grief instead of working through them systematically, and i could go on. but neither would she be mistaken for a neurotypical (as i wouldn't consider someone with her degree of ADD neurotypical, but maybe that is a matter of opinion). she is visiting me and i arrived home half an hour ago to find her asleep and her keys in the door. she leaves a trail of forgotten items, post-it notes, etc everywhere. it's plain difficult for her to get anything at all (besides reading fiction or holocaust literature - her special interests) done, no matter the level of importance. she doesn't remember anything you've asked her to do, she will let things go undone for many years because she can't begin the process (no exaggeration here: i have been asking her to find an item of mine she has stored for fifteen years with no luck). she can't find anything, she gets lost all the time, she can't remember anything, she can't start anything, she is pretty much stuck sitting in one place reading a book most of the time. but: no social problems. no communication problems. no sensory integration problems. no problems reading emotion / non verbal communication (except mine, since we're nothing alike). no anger or frustration issues. no meltdowns. no particular routines, except repetition of things she enjoys. no particular difference in expression of symptoms when under stress.

she almost needs a caretaker, yet there is no feeling of detachment from or alienation from other people, nor any difficulty interacting with other people or her world, nor any anxiety about it; she simply cannot get anything done.

.. ..

my nephew: both ADHD (considered severe by his diagnostician) and AS. (although i have heard some will not diagnose both, so i don't know whether to consider the ADHD as its own condition in this case or a part of his AS). He can't get anything done either, but also cannot be reached for communication at times when there is a lot of activity around him; totally spaced, can't hear anything. very bright kid but severe deficits in both attention and communication / social interaction.
sample phone call: me - awkward question. him - one word answer. silence. me - hemming and hawing until i can come up with another question, hoping it's one that interests him. him - one word answer. me - "ok, let me talk to your dad again." :?
him in person, on trip to natural history museum when he was 4 or 5: "what it says on the card is wrong; this dinosaur actually didn't exist yet in the paleozoic era ... "

i have a friend also who has ADD (by itself) and is on Ritalin: socially unimpaired. when she misses a dose, she says she cannot read.


i think that ADD symptoms could be part of AS. but by themselves, they aren't going to resemble it much. (my opinion, however, admittedly based on a small sample of people.)


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Daftwrist
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19 Jul 2010, 5:16 am

I have AD/HD. You do not have to be visibly hyper to have AD/HD. Very often the hyperactivity is internal, - a constant feeling that your head is buzzing and won't switch off.

I think the main difference is that on the whole, problems with social interactions, stimming, rigid obsessions, and routines feature far less in AD/HD, the latter two almost never occur in AD/HD.

AD/HD is a problem of self-control and motivation for applying attention. We can't stay focused on something if it's anything short of riveting because the intrinsic motivation isn't there. My attention can stray 30 seconds into a 2 minute video on you tube cos I got bored, I can spend an entire weekend reading a chapter which takes most people one evening....it can get relentless the lack of control and direction your attention has. It makes simple things hard - reading, listening, learning, because your mind always strays.

I do however believe there is a huge overlap between AS and AD/HD a lot of people are comorbid. I also read these conditions share a lot of the same genetics, which is why you tend to see clusters of AS and AD/HD people in the same family.



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19 Jul 2010, 6:23 am

In the ADHD's DSM-IV:

"E. The symptoms do not occur exclusively during the course of a pervasive developmental disorder"

With that, one that has both Autism Spectrum Disorder (which is classified under Pervasive Developmental Disorder) and ADHD diagnosed is not possible to have both of them to be co-morbid diagnosis together with that criteria.

I was diagnosed with ADHD when I was younger. My current diagnosis excludes ADHD and includes AS.



fleeced
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19 Jul 2010, 7:07 pm

Daftwrist wrote:
AD/HD is a problem of self-control and motivation for applying attention. We can't stay focused on something if it's anything short of riveting because the intrinsic motivation isn't there. My attention can stray 30 seconds into a 2 minute video on you tube cos I got bored, I can spend an entire weekend reading a chapter which takes most people one evening....it can get relentless the lack of control and direction your attention has. It makes simple things hard - reading, listening, learning, because your mind always strays.


I experience something similar, especially the reading issue. I also feel like I want something to end I don't like to be in the process of doing something. I was on a fairground ride with my daughter and all I could think was when is this over - I couldn't enjoy the moment. I want it finished and a line drawn under it. Maybe that's just peculiar to me.


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