ADHD vs. ASD--Follow up! Interesting way to distinguish

[jolie-fleur]

I've posted here a handful of times and I come here to read more often. I have to tell you that forever, I've worried about DS1! He has always been challenging, I've always felt something was off and I just finally did something about it.

I decided to have him evaluated because even though I read every book in creation, I still couldn't tell if he was more Aspergers or ADHD. He was definitely hyperactive but had some social dysfunction as well.

He saw three professionals, a psychologist, a psychiatrist and a developmental pediatrician that specializes in Autism. The first professional was also confused--he clearly had inappropriate responses at times!

The psychiatrist felt he clearly had ADHD and did not feel that he had any trace of Autism. That said, because he is homeschooled and is very pleasant to be around and we have a great family dynamic, she didn't feel that he needed medication! I felt lucky to find a psychiatrist that wasn't begging to give him meds! She felt that some of his social dysfunctions were related to his inability to focus or concentrate rather than on a fundamental inability to relate. I still wanted to see the Autism specialist, however!

The developmental ped spent 2 hours with us in intensive interviewing asking open ended and also more "quantitative" questions and it was determined that DS did not qualify for Aspergers. The developmental ped. said that he could qualify for a VERY mild diagnosis of PDD-NOS but felt that the ADHD could more than answer the few abnormalities in social appropriateness that he observed.

Then he shared this with me--this is for those mamas who, like me, are trying to determine which diagnosis is a fit--ADHD or ASD. In order to attain a diagnosis of ASD, the child needs both social dysfunction and also behavioral dysfunction. DS fit the social dysfunction bill in the following ways. During the interview occasionally he would not respond to his name, he had trouble maintaining eye contact and he get in others personal space.

However, he had none of the behavioral dysfunctions. He didn't have rituals, or difficulty transitioning, or stimming, or unusual interest in parts of toys, or fixations on a particular item. For that reason, he didn't fit the diagnosis.

Also, at the end of the interview, DS got some water bottles from the fridge (the developmental ped. invited him to do so as he was thirsty) and he got out three bottles--one for himself, one for the doctor and one for me! This kind of empathy is not common to an ASD diagnosis.

I hope this helps someone. I have to say that it was very enlightening to spend time with these professionals. All told, I spend over 7 hours with these various individuals throughout the course of our diagnosis. I now have a better picture of DS and what I can do to help him.

Thank you,

[2boyzmama]

Good, I'm glad that it was helpful!!! The Dev Ped we have for our middle son is also wonderful, and although I have never brought up the issues my older son has (sensory seeking and extreme behaviors if we have a break in diet) I've considered doing it. I think that, like you, we have a pretty good family dynamic and he's a pleasant child to be around a majority of the time, it's just that the effort it takes to create an atmosphere that allows him to be so pleasant is exhausting sometimes. Dietary changes have helped him tremendously (gluten is a biggie, but any processed and/or sugary food is also a trigger if he gets too much).

[ollineeba]

Originally Posted by jolie-fleur

Also, at the end of the interview, DS got some water bottles from the fridge (the developmental ped. invited him to do so as he was thirsty) and he got out three bottles--one for himself, one for the doctor and one for me! This kind of empathy is not common to an ASD diagnosis.

Thank you,

This thread is fascinating to me.
My ds has a dx of autism from our ped.
But...he is the most empathetic child you will ever meet (more so than my other two neurotypical children). He would do the same thing with the water bottles- he does that stuff all the time.

And when he was working with a therapist (and probably didn't want to be!), he said to her "You look like you need a break- do you want to take one?" Which, I thought, was not only considerate, but fairly clever on his part.

He would do anything to cheer someone up, even giving them the shirt off his back, and is very vulnerable in that way. He's also very affectionate.. always telling me how much he loves me (the whole family, not just me) and telling me I'm beautiful and hugging/kissing.



However, he had none of the behavioral dysfunctions. He didn't have rituals, or difficulty transitioning, or stimming, or unusual interest in parts of toys, or fixations on a particular item. For that reason, he didn't fit the diagnosis.

My son, with ASD, also does not have rituals, difficulty transitioning, unusual interest in parts of toys, or fixations on a particular item. About stimming- he will pull his arms in close to his chest sometimes when he is excited (not flapping, just still against his body).. so maybe that is what stimming is. I've never been sure exactly what stimming looks like.

During the interview occasionally he would not respond to his name, he had trouble maintaining eye contact and he get in others personal space.

My son does this, too.. sometimes I have to call his name a few times before he will look over, other times it's right away. Depends on what he's doing. He also will make eye contact, but not keep it for very long. Sometimes he does get in other people's personal space.. not often, but occasionally. I was told this is characteristic of autism?

I know that this might not be "typical" autistic behavior, but surely there are other kids who have ASD who are like this? I've always been told it's such a broad spectrum and there is no "typical."

We haven't pursued further diagnosis because we homeschool and I'm honestly not sure what I would do with the information, anyway.. although I am curious, because our sons sound very similar, but we do have the ASD diagnosis.

[savannah smiles]

What a great thread to stumble across. DD1, who's 8, was dx'd with ADHD/ODD when she was 5 years old but I've always wondered if she didn't have ASD. I know it presents differently in girls than in boys. To that end, I have an appointment next week w/ a psychologist to have her looked at again.