What you need to know

If imaging and labs say you have thyroid disease, you have thyroid disease. But in the world of emotional and mental health diagnosing, where medical testing is largely irrelevant, answers don’t come as easily. For example, ADHD and autism spectrum disorder.

My eight-year-old grandson is struggling with ADHD and autistic spectrum disorder. And if he’s having a rough time, you know the other members of the household are as well.

When I created Chipur, the targeted audience was folks enduring mood and anxiety disorders. It’s time to expand our reach, so you’ll be seeing content focusing upon a variety of emotional and mental health disorders and topics.

Regarding this piece, when it comes to my grandson and his family’s well-being, I have skin in the game  And if ADHD and autism spectrum disorder are part of your household, so do you.

Setting the table

The mission here is reviewing facts. Now, there’s tons of information out there on ADHD and autistic spectrum disorder; however, I’ve chosen to go with two sources: Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) and my grandson and his family.

It’s important to know that autistic disorder, Asperger syndrome, and pervasive developmental disorder – not otherwise specified have been rolled into one diagnosis: autism spectrum disorder (ASD).

Though you’re likely aware, ADHD stands for attention-deficit/hyperactivity disorder. For reference, here are diagnostic criteria for ADHD and ASD from the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5).

Okay, let’s connect some dots…

ADHD and autistic spectrum disorder: Coexistence

Fact: In excess of 50% of individuals diagnosed with ASD also have signs of ADHD. And that makes it ASDs most common coexisting condition.

And how ‘bout this? Up to 25% of children with ADHD have low-level signs of ASD, which can include, for example, difficulty with social skills and being very sensitive to clothing textures,

Why the high coexistence?

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

ADHD and ASD are neurodevelopmental disorders, which means they affect the central nervous system – responsible for movement, language, memory, and social and focusing skills. The star player is executive functioning. It includes decision making, impulse control, time management, focus, and organization skills. For many children, social skills are also affected.

Incidentally, ADHD and ASD are more common in boys.

What about adults?

Yes, adults can have coexisting ADHD and ASD; however, it’s not as common as it is in children. See, ASD is considered to be a lifetime 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?

Here’s how the differences between ADHD and ASD typically play out. My grandson’s experience has followed these models.

Many children are first diagnosed with ADHD around the time they start preschool or kindergarten, based upon their behavior contrasting to that of their classmates.

Depending on the child, ADHD can generate…

• Restlessness
• Impulsivity
• Difficulty paying attention to one object or subject
• Focusing full attention on one thing
• Refusing to engage beyond the object or subject of attention

It’s interesting that symptoms include both difficulty paying attention and refusing to engage beyond the immediate stimulus. Again, depending on the child, right?

ASD children

The signs of ASD are noticeable in some children before their second birthday. For others, they may not be obvious until they’re school-aged and, just like ADHD, display social behaviors that are clearly different from their classmates.

These behaviors include…

• Avoiding eye contact
• Seeming disinterest in playing or engaging with others
• Ability to speak developing slowly or not at all
• Preoccupied with sameness in textures of food or in making repetitive movements, especially with their hands and fingers

Now for specifics…

ADHD and ASD-specific behaviors

Often, children with ADHD have difficulty focusing on one activity or task. Which, of course, makes it challenging to complete that task before jumping to another. And being physically unable to sit still sure doesn’t help. Another factor to consider is 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 most likely to be overfocused, which inhibits their ability to shift 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 highly sensitive or insensitive to light, noise, touch, pain, smell, or taste – or have a strong interest in them. They may also have set food preferences based on color or texture. It’s also common for them to make gestures, such as repeated hand flapping.

Finally, intense focus means people with ASD are often able to remember detailed facts for a long time and may be 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. The recommended choice is a medical doctor who has experience with both.

ADHD treatment traditionally includes medication. Because medication options for the treatment of ASD are limited, children may respond better to non-medication alternatives. We’ll review those in a short.

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

Medication

Again, medication is frequently part of the treatment plan for children with ADHD. And that’s because it helps reduce some of the major symptoms, including hyperactivity and impulsivity.

These are the most commonly 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 – seem to be less effective and cause more side effects than when used for ADHD alone. The side effects include social withdrawal, depression, and irritability.

Again, medication isn’t much of a factor with ASD treatment. However, ASD symptoms that often overlap with ADHD – hyperactivity, impulsiveness, inattention – may respond, if not as well, to the medications used to treat ADHD.

Medications to treat ASD are now being developed. In the meantime, ASD-related irritability, aggression, and self-injury usually respond to antipsychotic medications – e.g. aripiprazole (Abilify), risperidone (Risperdal).

Non-medication

I’ve always believed that if someone’s using meds for a psychiatric condition, non-medication treatment needs to be pursued.

There are tons of non-med interventions for ADHD and ASD. So many, in fact, that including them here would be unrealistic. So I browsed around and found an informative article for ADHD, Adult ADHD, and ASD.

To me, it’s personal

Dang, 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’re dealing with a couple of disorders that can run roughshod over the lives of children and adults, as well as their families. We could never give them enough attention.

To me, it’s personal. You too?

I’m encouraging you to spend some time with CHADD. So much important and helpful info.

And those Chipur info and inspiration articles: peruse the titles.

Bill White is not a physician and provides this information for educational purposes only. Always contact your physician with questions and for advice and recommendations.