On the spectrum...or not?

[Anonymous]

It seems so subjective for some kids. And I am talking about a doctor's diagnosis. For some of these kids that are not obvious, what makes a doctor lean towards ASD vs ADHD or the opposite? My child seems like he could go either way. We have testing next month and I am juyst wondering what makes a doctor lean in the different directions? I know a diagnosis doesnt really matter, but it seems like it should be more clear,. Thank you for your help.

[Anonymous]

They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

[Anonymous]

Anonymous wrote:They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

Not entirely different - recent research is showing that these disorders may be more closely related than we previously thought.

OP, they way our dr. made the diagnosis was by measuring expressive/receptive language, and testing for non verbal social communication-- I'm sure he did other tests and observations as well.

As the pp mentioned, repetitive behaviors and restricted interests may distinguish autism-- kids with ADHD may also have some short term fixations that verge on obsessive and may also have tics, so as you point out, it can get tricky. We learned that my son does have deficits in social communication but it doesn't rise to the level of an autism diagnosis. He has ADHD with deficits in executive functions and social pragmatics. He has a friend with an HFA diagnosis and there are times when his dad and I smile at each other because sometimes these boys sound almost exactly alike.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

Not entirely different - recent research is showing that these disorders may be more closely related than we previously thought.

OP, they way our dr. made the diagnosis was by measuring expressive/receptive language, and testing for non verbal social communication-- I'm sure he did other tests and observations as well.

As the pp mentioned, repetitive behaviors and restricted interests may distinguish autism-- kids with ADHD may also have some short term fixations that verge on obsessive and may also have tics, so as you point out, it can get tricky. We learned that my son does have deficits in social communication but it doesn't rise to the level of an autism diagnosis. He has ADHD with deficits in executive functions and social pragmatics. He has a friend with an HFA diagnosis and there are times when his dad and I smile at each other because sometimes these boys sound almost exactly alike.

I agree that they are very close. My son with ADHD has SO many ASD like traits. I think it is one of the gauges they use to determine how severe the ADHD is. We have tics which could also be stims and perservation about words - but that might be because my son has a language disorder. My son also has major sensory seeking issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

Not entirely different - recent research is showing that these disorders may be more closely related than we previously thought.

OP, they way our dr. made the diagnosis was by measuring expressive/receptive language, and testing for non verbal social communication-- I'm sure he did other tests and observations as well.

As the pp mentioned, repetitive behaviors and restricted interests may distinguish autism-- kids with ADHD may also have some short term fixations that verge on obsessive and may also have tics, so as you point out, it can get tricky. We learned that my son does have deficits in social communication but it doesn't rise to the level of an autism diagnosis. He has ADHD with deficits in executive functions and social pragmatics. He has a friend with an HFA diagnosis and there are times when his dad and I smile at each other because sometimes these boys sound almost exactly alike.

Citation please? I had read differently.

[Anonymous]

Our DS with ADHD looks very different from his friends with ASD but could it be because he has the hyperactive type?
He's outgoing and has great social communication skills, is flexible, is not fixated on any topics, has great joint attention. But he can't stop moving. Even when he's "still" he's wiggling.

[Anonymous]

Anonymous wrote:They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

This is not true. ASD can be comorbid with ADHD and is it can be hard to tell if the attention deficits are driving the social communication behaviors or vice versa.. And lots of ADHD kids have stereotypies (aka repetitive tics) and kids with stereotypies without autism often present with ADHD or OCD. aJohns Hopkins has a whole research team working on non autistic stereotypies. So for some kids it's not a clear cut case. As my kid'a doctor says, it's a subjective behaviorial diagnostic, not a strep test.

[Anonymous]

13:12. Who is your child's doctor? I agree with the subjectiveness of the diagnosis.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

Not entirely different - recent research is showing that these disorders may be more closely related than we previously thought.

OP, they way our dr. made the diagnosis was by measuring expressive/receptive language, and testing for non verbal social communication-- I'm sure he did other tests and observations as well.

As the pp mentioned, repetitive behaviors and restricted interests may distinguish autism-- kids with ADHD may also have some short term fixations that verge on obsessive and may also have tics, so as you point out, it can get tricky. We learned that my son does have deficits in social communication but it doesn't rise to the level of an autism diagnosis. He has ADHD with deficits in executive functions and social pragmatics. He has a friend with an HFA diagnosis and there are times when his dad and I smile at each other because sometimes these boys sound almost exactly alike.

Citation please? I had read differently.

pp here- I'm on an iPad and having difficulty pasting links. Look up "white matter, ADHD, autism, OCD." There is some recent research showing similar areas/brain markers for the three conditions.

A direct quote from CAMH (Centre for Addiction and Mental Health) "Autism, ADHD, and OCD have common symptoms and are linked by some the same genes. Yet historically they have been studied as separate disorders." The study was done in Toronto in 2016 and published in the American Journal of Psychology I Juky 2016. Sample size is small but results are compelling-- especially for those of us with kids who have ADHD and autism traits.

[Anonymous]

Most kids with ASD also have ADHD so there is no clear line other than going to an experienced neuropsych who can administer ADOS in addition to a full workup.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:They're two entirely different disorders. ASD is a disorder of social communication and repetitive behaviors. A good clinician will be able to administer the ADOS in such a way that elicits the difference between a child who CAN engage in expected social communication, but might appear inattentive or unable to focus on communication due to ADHD. and one who cannot (due to ASD). They are really two different things, and if your doctor is saying he/she can't tell the difference, then you need a better doctor. If you truly believe your child is borderline or has both, then select two respected teaching hospitals with expert clinics (say CHOP and KKI) and get two sets of testing done.

Not entirely different - recent research is showing that these disorders may be more closely related than we previously thought.

OP, they way our dr. made the diagnosis was by measuring expressive/receptive language, and testing for non verbal social communication-- I'm sure he did other tests and observations as well.

As the pp mentioned, repetitive behaviors and restricted interests may distinguish autism-- kids with ADHD may also have some short term fixations that verge on obsessive and may also have tics, so as you point out, it can get tricky. We learned that my son does have deficits in social communication but it doesn't rise to the level of an autism diagnosis. He has ADHD with deficits in executive functions and social pragmatics. He has a friend with an HFA diagnosis and there are times when his dad and I smile at each other because sometimes these boys sound almost exactly alike.

Citation please? I had read differently.

pp here- I'm on an iPad and having difficulty pasting links. Look up "white matter, ADHD, autism, OCD." There is some recent research showing similar areas/brain markers for the three conditions.

A direct quote from CAMH (Centre for Addiction and Mental Health) "Autism, ADHD, and OCD have common symptoms and are linked by some the same genes. Yet historically they have been studied as separate disorders." The study was done in Toronto in 2016 and published in the American Journal of Psychology I Juky 2016. Sample size is small but results are compelling-- especially for those of us with kids who have ADHD and autism traits.

Sorry for the typos but the study makes for some fascinating reading.

[Anonymous]

Anonymous wrote:Most kids with ASD also have ADHD so there is no clear line other than going to an experienced neuropsych who can administer ADOS in addition to a full workup.

And ADHD does not necessarily mean that the kid is less impacted than a kid with Mild ASD. For kids at the higher end of the spectrum like mine, ADHD causes more issues than the ASD. We know this because ADHD can be medicated and then most of the problematic behaviors disappeared.

[Anonymous]

Anonymous wrote:Most kids with ASD also have ADHD so there is no clear line other than going to an experienced neuropsych who can administer ADOS in addition to a full workup.

It's about 50%.

[Anonymous]

I see a lot of numbers and facts being randomly thrown around here.

I would want to know with specificity if my child had ADHD (a disorder with medical and behavioral treatments for which there is strong evidence that a large proportion of children can grow out of) and ASD (a disorder with very different treatments that is lifelong generally). I would also want to know with specificity why the doctor did not consider any of the assessments deemed reliable (like ADOS) were not conclusive. If the diagnosis was dual I would expect to know how he found that, with specificity, not just "these kids look the same."

[Anonymous]

Yes, both ADHD and ASD can be very subjective diagnoses because they are based on outward behaviors and it's hard to tease out what is driving those behaviors.

A child who has trouble with social interactions may have this issue because he's a. impulsive and can't keep his hands to himself even though he knows this is annoying (ADHD), b. can't understand social norms and has no idea this is annoying (ASD), c. gets really nervous around social situations and tends to want to hide away (anxiety), or d. doesn't have the language to engage properly (speech delays). It could also be some combination of all of the above or something completely different.

ADOS can tease out some of the behaviors as being due to ASD-related deficits but remember that it's one test given by one clinician on one day and the test itself is scored in a very subjective way.

The criteria for ASD include challenges with flexibility, intense or repetitive interests or behaviors, challenges with reciprocity that cause SIGNIFICANT interference with functioning in one or more contexts.