1. Your worries are unfounded. Focus on symptoms, OP. A lot of them overlap between ADHD and ASD anyway!

2. My son needed social exposure and practice, but the social skills groups we tried never worked out quite well because he wasn't a good fit with the other kids. That is VERY COMMON, and most definitely not proof that your son is not autistic. It's very difficult to create groups where kids match.

3. I always suspected my severely ADHD son was on the spectrum; it was red flagged for us at his first neuropsych at 10, and the only reason they did not diagnose ASD was that they needed to conduct extra tests which we were not willing to pay for at the time; but then ASD was confirmed at his second neuropsych at 17. At 17, I WANTED the ASD diagnosis to get him a single room with private bath in college! So don't dismiss the labels, they might come in very useful one day...

I wouldn’t focus on the diagnosis. Autism in particular has such a wide wide spectrum that the term is meaningless anyway. I will say, though, that having an autism diagnosis can help a lot with getting the necessary school services and support that your child needs. Just focus on your kid and not the label that someone puts on them. They are still the same kid at the end of the day.

Anonymous wrote:ASD is getting over diagnosed. It’s a catch all for quirks. It’s not helpful.

Couldn't agree more, it's OVERUSED AND RIDICULOUS - how is it acceptable now that everything falls under a spectrum, no one kid with ASD looks the same, it's very frustrating as parent, because the label is overused and not well understood, even from present day educators who think kids fall under the same pot. We're in the same boat, with a kid that has some ASD traits but is leaning towards more ADHD, but because he can pay attention and isn't overly hyper, somehow he's more leaning towards ASD. Isn't there something else in between - there is so much gray zone with the spectrum discourse, can't they come up with some better (more accurate) labels?!

ASD is getting over diagnosed. It’s a catch all for quirks. It’s not helpful.

I think you should trust your gut. This would really frustrate me as a parent, too. I do think providers, while well-intentioned, are human and can pathologize some behavior or traits into a diagnosis that they shouldn’t. Example, I have a textbook ADHD kid. Dr asks if he’s having any worries or issues. He says, no not really, everything is pretty good. Dr says, nothing? He says, well I did have a nightmare last week and I’m sometimes scared of the dark. All of a sudden I see anxiety on the chart and bill. This is an 8 year old who self-reports he generally is worry-free and was pushed to come up with some answer to satisfy the dr. I have no problem if my kid has anxiety but I do have a problem if we are adjusting treatment and focusing on fears because one benign comment got misinterpreted or overblown. So I empathize with you.

Anonymous wrote:Specifically on the social skills groups: I have a very social ASD kid and our psychiatrist told us to forget about the groups, they are designed for kids who don’t interact much. My kid does a ton of peer interacting including on two sports teams, and psychiatrist said that’s frankly even better. So yeah you can get more familiar with ASD, see what fits, and reject what doesn’t. You don’t have to accept it fully or reject if fully. Maybe just be… curious. And be comfortable with that for now.

Not op, but in a similar boat.

This resonates.

Anonymous wrote:Specifically on the social skills groups: I have a very social ASD kid and our psychiatrist told us to forget about the groups, they are designed for kids who don’t interact much. My kid does a ton of peer interacting including on two sports teams, and psychiatrist said that’s frankly even better. So yeah you can get more familiar with ASD, see what fits, and reject what doesn’t. You don’t have to accept it fully or reject if fully. Maybe just be… curious. And be comfortable with that for now.

could not agree more! I have a very similar kid.

op I’m curious to know what led you to do the evaluation?

A huge number of adhd - up to 83% in some studies - also have autistic traits. And vice versa

https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-020-02703-z

We have to start normalizing ‘traits’ language because we now know that there is no ‘line’.
I would use the label that is most helpful to the child and to others in as much as it’s helpful. If autism is a red herring and leading people down the wrong path - then it’s not the thing to lead with. I think in ten years time we’ll have much more nuanced diagnoses and we’ll see less definitive language and much better supports as a result

Your concern is real and you need to respect your instincts. Sounds like it’s time to pull back and circle the wagons.
Boys mature in their own time and on their own schedule and that tends to be later than the “norm”.
Middle school is such an awkward time. I would let IT ALL go, hire tutors when needed, and give him down time.
It sounds like the universe may be overthinking this.
Best of luck.

Anonymous wrote:Follow your gut. Full stop. Treat the symptoms that are a challenge for him. Who cares if they are ASD vs ADHD in nature.

This. My kid was diagnosed as a teen. First, ADHD and then ADHD. Practitioners recognize that there is a big overlap between the conditions. Don’t worry about labels. Just treat the symptoms.

(Oh and PS: the person who did the neuropsych told us to do a bunch of things… the provider who has known my kid longer has a much more nuanced view. Wait and take advice from the providers who really develop and ongoing relationship more than the neuropsych.)

Specifically on the social skills groups: I have a very social ASD kid and our psychiatrist told us to forget about the groups, they are designed for kids who don’t interact much. My kid does a ton of peer interacting including on two sports teams, and psychiatrist said that’s frankly even better. So yeah you can get more familiar with ASD, see what fits, and reject what doesn’t. You don’t have to accept it fully or reject if fully. Maybe just be… curious. And be comfortable with that for now.

There's a lot of overlap. We rely on the psych report's recommendations rather than the actual diag.

Follow your gut. Full stop. Treat the symptoms that are a challenge for him. Who cares if they are ASD vs ADHD in nature.

Please be kind.
We re-tested our (textbook) ADHD-c middle schooler and during the intake expressed his therapists' concerns that he may be on the spectrum. I now feel that putting it out there was a mistake because every little behavior was interpreted as a sign of autism by the evaluator (e.g., fidgeting was seen as stimming). I don't want to question the AuDHD, but at the same time have a hard time seeing it. DC has rejection sensitivity and anxiety but I am afraid his ASD diagnosis will bias the providers towards recommending suboptimal supports designed for ASD and not ADHD and anxiety. E.g., we were being encouraged to attend social skills groups, but the one he tried had kids with much more pronounced ASD issues and it was unclear how the group would benefit him. I am also afraid to mess up by following my gut and not getting him the services he needs. The absence of a clear ASD presentation is driving me crazy and makes me question the diagnosis.