do you think that the autistic spectrum should include ADHD

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natesmom
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18 Apr 2009, 10:32 pm

2ukenkerl wrote:
I was diagnosed as ADHD, but AS fits better. 30% of people diagnosed ADHD are Autistic! Knowing what I know now, a lot of ADHD symptoms ARE autistic!



Zuk - you are definitely AS!!



Last edited by natesmom on 19 Apr 2009, 5:06 pm, edited 2 times in total.

natesmom
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19 Apr 2009, 2:03 am

That is wonderful news.

To everyone: see good news can happen!! :)



ster
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19 Apr 2009, 3:16 am

natesmom & sinsboldly- will check out the links you've sent, thanks.
dw a mom- i totally believe that there are people with a ADD/ADHD dx that don't belong on the spectrum.....i do believe, however, that some people with that dx ( with more severe symptoms) belong within the spectrum. my daughter, unlike your sister, does NOT get along socially well- she has 2 friends. she does not get invited to birthday parties. she does not get invited for playdates. she is socially around the age of 5-and she's chronologically age 10. my question, in part, is really whether or not the symptoms my daughter has are really ADHD or some other unclassified dx between ADHD & AS- her symptoms, IMO, are too severe to be ADHD & too "light" to be AS.she seems to fall somewhere in the middle of the 2 dxes.



GreatCeleryStalk
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19 Apr 2009, 3:42 am

Diagnostically, ADD/HD as it is currently conceived isn't a part of the autism spectrum. There are other disorders which impair social behavior that are not classified as autism spectrum. Is it possible your daughter may have one of these in addition to ADHD?

Is it possible that your daughter may be an example of an ASD and ADD/HD co-morbidity? The diagnostic criteria in the DSM and ICD are simply our best guess based on current knowledge and research, and I think there's a tendency to treat them like gospel among parents. Pardon me, but I'm in educational psychology and I see this behavior often in people. I find it frustrating.

How does your daughter fit with what we currently understand as autism? Nonverbal behavior? Eye contact? Repetitive behavior? Coordination? Obsessive interests? The autism spectrum is more than a lack of social skills and more than even marked difficulty in social interaction; there are also many causes for chest pain which are not heart attacks.

If an ASD and ADD/HD are able to co-exist diagnostically it still does not mean that ADD/HD is on the autism spectrum. NVLD isn't really on the autism spectrum either; it's caused by right hemisphere brain damage, but there's a high incidence of AS/atypical autism co-morbidity and many clinicians view a diagnosis of AS as more beneficial than an NVLD diagnosis. IIRC one researcher estimated that 90% of those with NVLD also have AS, but that doesn't change the diagnostic criteria for either.

Maybe your daughter also has an ASD... maybe your daughter is socially impaired for other reasons. However, I don't think calling ADD an ASD is really beneficial. We don't have enough information about your daughter's behavior to really speculate in any diagnostically beneficial manner, either.



jenny8675309
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19 Apr 2009, 9:03 am

OK, so if NVLD isn't on the spectrum (our doc says it has an autistic "flavor") and a kid doesn't fit ADHD criteria, AS criteria, and is too mild for PDD-NOS criteria, then what is it? Drives. Me. Bonkers.



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19 Apr 2009, 1:58 pm

jenny8675309 wrote:
OK, so if NVLD isn't on the spectrum (our doc says it has an autistic "flavor") and a kid doesn't fit ADHD criteria, AS criteria, and is too mild for PDD-NOS criteria, then what is it? Drives. Me. Bonkers.


I've never heard a competent clinician exclude ADD/HD because a parent thinks that their child is "too severe" to be ADD/HD. The diagnostic criteria are similar, but different. The OP wasn't questioning the diagnosis of ADD (I don't think) but was wondering whether it's on the autism spectrum. Sinsboldly posted a study that shows that they might be genetically related, but that doesn't mean they're on the same spectrum.

I don't think it would be good for those of us with Kanner's, Asperger's, PDD-NOS, or atypical autism if ADD/HD were included on the spectrum. The same kinds of treatment don't work for ASDs, for one thing.



jenny8675309
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19 Apr 2009, 2:18 pm

Now I'm confused. LOL I wrote that he doesn't fit the criteria for ADHD, not that *I* think he's too severe for ADHD. So ADHD is excluded because the kid can focus and isn't hyper. :) But he is impulsive...

It's just that he doesn't truly fit in any category. He's a mixed bag. But that's not exactly a clear diagnosis. :wink:



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19 Apr 2009, 3:57 pm

jenny8675309 wrote:
Now I'm confused. LOL I wrote that he doesn't fit the criteria for ADHD, not that *I* think he's too severe for ADHD. So ADHD is excluded because the kid can focus and isn't hyper. :) But he is impulsive...

It's just that he doesn't truly fit in any category. He's a mixed bag. But that's not exactly a clear diagnosis. :wink:


I thought we were talking about ster's child. Psychology is a difficult art to master and diagnosis isn't exactly a science; have you had your child diagnosed or are you reading the criteria yourself and making inferences based on observed behaviour?

If that's the case, all I can say is that there's a good reason that psychologists and other MH professionals go through quite a lot of training before they're qualified to diagnose.

You would have to explain exactly how social and emotional impairment manifest themselves in your son; NVLD would probably be excluded if he hasn't suffered right hemisphere brain damage or doesn't have other structural abnormalities related to the corpus callosum or white matter.

The diagnostic criteria for PDD/ASD require particular kinds of impairment in social and emotional cognition. I'm not particularly familiar with them in a clinical setting other than the fact that I exhibit them.



annie2
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19 Apr 2009, 4:34 pm

Personally I think it would be more benefitial to have a broader category of NEUROLOGICAL SPECTRUM, along with the various traits within that spectrum eg. AS, autism, ADHD, dyslexia, dyxpraxia, giftedness. There are lots of co-morbids within those "labels", and it may be more helpful to look at where individuals fit within a wider range of things, rather than being pre-occupied as to which box they fit into. The main thing is to work out what your kid's issues are, and do the best you can to help. Medical people love labels and, while I know they are helpful to an extent, I think they have their own limits as well.



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19 Apr 2009, 5:54 pm

Well... we have a category similar to the neurological spectrum already, at least for impairments. There are impairments with a recognized neurological cause. I'm not sure how giftedness belongs on a spectrum which deals with impairment, however.

What do many of these things have in common that would qualify them as part of the same spectrum? A spectrum that is too broad is rather less than useful. Autism spectrum disorders have enough commonalities that most diagnosticians feel they are related and that it's useful to look at these disorders in the form of a spectrum with blurring between boundaries.



ster
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20 Apr 2009, 6:06 am

thanks so much for your replies.........i've posted here at great length before about daughter's difficulties......can't quite figure out how to link to the posts.....oh well
some of daughter's social impairments are: inability to maintain friendships, steers conversations to her own topic of choice ( usually Webkinz or Sims).... in addition to having social impairments, daughter has behavioral idiosyncracies such as: flapping her hands, pacing, grooming herself like a cat, biting her toes...she is a very literal thinker, very naive, has gross & fine motor skill impairments, reads voraciously-but can't tell you the main idea of what she's read or infer what might happen next .has visual-spatial awareness deficits- can't tell you North, South, East, West- confuses Left and Right. sensory deficits include: oversensitivity to crowds and loud noises, won't wear clothes that are "too tight", won't wear pants that button, won't eat foods that are "spicy"-like peppermint candies........there are plenty more impairments-this is just a small list
son & hubby both have dxes of AS....we've taken daughter for a total of 2 evals. the first one was when she was 7- that's when she got the dx of ADHD & anxiety disorder NOS....this second one we just received at the age of 10- this doc says that the anxiety disorder doesn't exist, and that she's just ADHD. the doc we got this eval from is not her regular psych. both her regular psych & therapist believe that daughter is on the spectrum & that she suffers from anxiety( she takes meds for her anxiety)- daughter is far less anxious on the meds than without them....her current psych, however, sent us to a new psych to get an eval because current psych is older & by his own account-not skilled enough to dx a girl with AS.
why does this all matter ??? we just want what's best for daughter. we want to make sure that she gets the services she needs. really skeptical that she'll get much of anything with just a ADHD dx......her school is actually doing an eval of her now...it will be interesting to see what they come up with............i think it's also really frustrating to belive that daughter is AS & have the new psych say that daughter doesn't exhibit enough of the symptoms-she's not AS...new psych says she's an enigma..



jenny8675309
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20 Apr 2009, 6:46 am

Sorry, I saw NVLD mentioned, and since I mentioned that too, I thought that was for me. And you quoted one of my posts...

Anyway... No, I'm not diagnosing my child myself. I was responding to the topic of confusing labels. He's been seen by 2 psychologists and a neuropsych but no one can pinpoint a diagnosis, just that he's sort of "atypical". NVLD doesn't fit him, and he doesn't have damage. PDD-NOS is probably as close as it's going to get, but nobody wants to label him that because he's a mild case. He sounds similar to ster's daughter, actually.



GreatCeleryStalk
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20 Apr 2009, 2:31 pm

Ster's daughter definitely sounds at least PDD-NOS/atypical autism.



Dee_
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20 Apr 2009, 2:41 pm

I am both ASD and ADHD

I have a daughter who is ASD
I have 2 sons who are ADD (actually one is ADD, other is ADHD).

Both of my boys exhibit ADD traits but function as NT's otherwise, outside the ADD behavior set... similar to me when I am having an ADHD moment which is dominate over me ASD things... Outside ADD things, they do not exhibit any ASD behaviors...

My daughter exhibits ASD behavior which is consistent.... very similar to me when I am in ASD moments which are dominate over ADHD things...

I noticed with me, in some cases, the ADHD behaviors are magnified or increased by ASD, in other cases the ASD and ADHD balances each other out (not quite but minimizes when 2 polar opposite behaviors are playing out and balancing two extremes into a middle ground somewhere)...


I do not think ADHD should be in the spectrum..

It is like saying color blindness should be linked only with being left handed

right handed (NT), left handed (ASD)
color blind (ADD/ADHD), not color blind (non ADD/ADHD)...

like,
I am left handed and color blind
my daughter is left hadned but not color blind...
my sons are right hadned but color blind...

some similar tihngs between ASD and ADD/ADHD but I believe ther eis too much differences between the two because they are derived from different sources...

ASD -> genetic - how the mind is wired
ADD/ADHD -> brain chemistry

how the mind is wired can have similar results as how the brain chemistry creates results that can be seen...

maybe other similar things can be an extention or result from autism and non-autism genes or other things.... there is a lot that is still not understood about the brain...

Doctors know a lot of things but you yourself know your own self more than anyone else.... Properly quipped with your own diagnostic tools, you can learn about yourself more than anyone else can learn about you...


My two cents worth...

also how the brain is wired will have differnt things than ADD/ADHD...



ster
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20 Apr 2009, 4:30 pm

jenny- at least i feel like there's someone else out there who's an " enigma". it's so frustrating being told she doesn't have quite enough of anything to be anything.......will keep you posted as to the results of the school eval.



2ukenkerl
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20 Apr 2009, 5:22 pm

jenny8675309 wrote:
OK, so if NVLD isn't on the spectrum (our doc says it has an autistic "flavor") and a kid doesn't fit ADHD criteria, AS criteria, and is too mild for PDD-NOS criteria, then what is it? Drives. Me. Bonkers.


PDD-NOS

is

PDD NOT OTHERWISE SPECIFIED!