ADHD or Asperger's - how to tell? (long)

iVillage Member
Registered: 06-28-2005
ADHD or Asperger's - how to tell? (long)
13
Fri, 03-30-2007 - 1:04am

Hi, I hope you don't mind my visiting here. I'm hoping you can help me gather some info that might help my oldest son. Three different people in recent months (one a parent of an Aspie, two special ed teachers) indicated that they thought my son had Asperger's. I would correct them and say, no, it's ADHD, but I can't help but wonder... I'm trying to compile a list of specific questions for his doctor.

A little background: DS is 11, very small for his age (in the 10th percentile), acts very 'young' for his age. He was evaluated at age 3 b/c of a speech impairment. "Delay" isn't quite the correct word. He was speaking words at age 2, simple phrases at age 3 but they were his own words and his articulation was poor. His hearing is fine. He's still in speech therapy at school.

At age 4 and a half, we had him re-evaluated. At that time, it was noted that on certain test that he had a "lower than average" chance of ADHD. However, at age 6, he was indeed diagnosed with ADHD. He's very hyperactive and distractible but he can focus with laser like precision on certain tasks.

He was re-evaluated a couple of years later by a different pediatric psychiatrist specializing in ADHD, who confirmed the initial Dx. He does well in school academically, and is pretty organized about his school work (that's pretty uncommon among kids with ADHD) but at this age it's becoming painfully aware that he marches to the beat of a different drummer. He takes Adderall to help manage his ADHD symptoms.

He has few friends and generally seems to prefer the company of books (or video games, which I limit). I often send him outside on a beautiful day to play with his brothers and minutes later, just find him doing his own thing. His social interactions are often awkward. Because of his speech issues, his intonation and inflection are somewhat odd. Frankly, often when he speaks he sounds rather sassy, altho' it's unintended. At this age, he still very literal. An example, he was the last one to wake one morning and his dad said, "time to get up, there's a fresh baked cinnamon roll out here with your name on it!" DS was disappointed that his name was not literally written in icing on his roll. He doesn't seem to realize that adults are not his peers and should not be spoken to as such (unless invited). His end of the conversation usually comprises of 1) teaching someone what he knows, or 2) correctly someone. Diplomacy? Forget it! True, two sided conversations are a rarity and very difficult to sustain. Eye contact is minimal. I wouldn't say that he's displays an intense interest in only a few topics. Rather he has developed a near-encyclopedic knowledge of dinosaurs, geography, the Lord of the Rings trilogy (not only the story, geography, timeline and genealogy), medieval weaponry... He's in the 6th grade, but writes at a 4th grade level, yet reads beyond a 12th grade level. He only occasionally has trouble with transitions.

I realize that these traits can be attributed to ADHD, but I also know that there are some mis-diagnoses. Part of me thinks that since two docs said it's ADHD, then that's probably what it is. I asked his ADHD doc about it once and he was rather dismissive. He didn't come right out and say it couldn't be Aspergers, but I got the sense that ADHD seems to be an educational issue whereas Asperger's is a social issue and what good is another label? Believe me, my son has enough labels, but I want to be sure he's getting all the help he needs. I've visited OASIS's website and a couple of others. I'd like to learn more, compile a list of specific questions, and approach his doc again before seeking another opinion elsewhere.

Sorry for the length and thanks in advance.

~ Lisa

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iVillage Member
Registered: 06-28-2005
Sat, 03-31-2007 - 10:52pm

Thanks, Lainie. I'm learning a lot from the different perspectives. My son is what they sometimes call "socially immature" - not intellectually immature, mind you. His reading comprehension and memory recall are very high - as long as it's 'black and white,' that's great. But when it comes to dealing with people who can be unpredictable, inconsistent, emotional, he has trouble.

Under his current IEP, he receives certain accommodations for ADHD (preferential seating to minimize distractions, extended test time altho' he rarely needs it). He is also in speech therapy at school to work on his significant articulation issues.

I think my first step might be to contact the IEP coordinator at my son's school to see what other services might be available to him given his current Dx of ADHD. I wonder whether there are any services in place that might help him improve his social skills.

I will also ask his pediatrician and his ADHD doctor (a ped psychiatrist) more about Asperger's. He's not due to be evaluated by the school system until next year, I believe, so I may look into having him re-evaluated on my own.

It's tough b/c his ADHD doc says kids with ADHD tend to mature slower than their non-ADHD peers, but that seems into imply that he's a late bloomer and will someday catch up. My fear is that it's not as simple as that and I'd rather explore this now (he'll be 12 in June), than when he's 18 and wants to head off to college.

I appreciate your input.

~ Lisa

iVillage Member
Registered: 06-28-2005
Sat, 03-31-2007 - 11:05pm

Thanks, Paula. Actually, it was very helpful (as were the other folks who responded). In this early stage of my research, I did learn that multiple diagnoses aren't uncommon at all (i.e. that it doesn't have to be ADHD *OR* Asperger's). His ped. psychiatrist specializes in ADHD and didn't seem too interested in really discussing the Asperger's.

I realize that both share many of the same symptoms, but with his ADHD diagnosis, he's currently receiving no help with his social skills. At this point, I'm more concerned about that than I am his poor articulation (his progress with speech therapy seems to have leveled off after 7.5 years).

I mentioned in my reply to Lainie that I think my next step will be to contact the school and/or the school board to see if he's eligible for services to improve his social skills under his current ADHD diagnosis. If not, I'm going to the ADHD doc to discuss the issue further. I will also start checking with my insurance company for a provider (I wasn't familiar with the term neuro-psychologist) who can re-evaluate my son. Fortunately the insurance company is pretty good about these things.

His doctor said that ADHD kids often mature later than their non-ADHD peers, but I don't want to sit around and wait for him to 'outgrow it' because I really do believe his needs some time of intervention to help him develop the skills to navigate the social waters, so to speak.

Thanks again, Paula.

~ Lisa

iVillage Member
Registered: 03-25-2003
Tue, 04-03-2007 - 4:07pm

I'm totally a lurker here, because ADHD's the diagnosis my son has right now, but socially, we see not-quite aspergers type things, so it's helpful to have this perspective. Sound vaguely familiar? Our school system sounds more helpful than yours. My kid had speech pragmatics (that's from the speech therapist, means how to use speech in the real world), and a "social skills" group--called "lunch buddies", basically playing games, supervised, at lunchtime once a week. My take on his social skills is very much that, be it the ADHD or something else, he does NOT pick up on them on his own, but does generally understand if it's explained (eventually!). Except often he's too black-and-white about it. Anyhow, I think you're right about talking to the school, and thought I'd just give you the terms our school uses to help another kid in a similar situation (though, he's only in 4th grade). I think our school's theory is it's better to solve these issues BEFORE you get a kid who can't socially handle school/the world. It's not just academic progress, but social progress as well...

Good luck!!

Megan

Megan

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