Autism Spectrum and Attention Deficit Hyperactivity Disorder (ADHD) in children
ADHD is a condition that makes a person inattentive, impulsive and hyperactive. An increasing number of children are diagnosed as having both ADHD and autism spectrum, and many parents are understandably confused about the links between the two. Can a child have both conditions and if they do, how can you best support them?
There are many reasons for the two conditions being confused in young children. Many children with autism spectrum display signs of hyperactivity and inattention when they start school. However, experts are very clear that as the child becomes older the apparent similarities between the two conditions will separate out. The child with autism may become more withdrawn and given the right environment their hyperactivity should wane and their difficulties with social skills will emerge. Children with ADHD on the other hand are unlikely to become calmer with age unless they receive medication or high-quality therapeutic interventions. They still develop social and communication skills and are unlikely to have the anxiety levels of a child with autism.
ADHD is a common behavioural disorder that affects about 10% of school-age children. Boys are about three times more likely than girls to be diagnosed with it, though it's not yet understood why.
Kids with ADHD act without thinking, are hyperactive, and have trouble focusing. They may understand what's expected of them but have trouble following through because they can't sit still, pay attention, or focus on details.
Of course, all kids (especially younger ones) act this way at times, particularly when they're anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and happen in different settings. They hurt a child's ability to function socially, academically, and at home.
Common symptoms of ADHD include:
- A short attention span or being easily distracted
- Restlessness, constant fidgeting or over activity
- Being impulsive
ADHD can occur in people of any intellectual ability, although it is more common in people with learning difficulties. People with ADHD may also have additional problems, such as sleep and anxiety disorders.
Symptoms of ADHD tend to be first noticed at an early age, and may become more noticeable when a child's circumstances change, such as when they start school. Most cases are diagnosed in children between the ages of 6 and 12.
The symptoms of ADHD usually improve with age, but many adults who are diagnosed with the condition at a young age will continue to experience problems.
Autism Spectrum Condition and ADHD
Both disorders share many common symptoms. This is why it is not unusual for one condition to be mistaken for the other in the earliest stages.
Symptoms of ADHD include:
- being easily distracted
- frequently switching attention from one thing or task to another
- difficulty focusing
- difficulty concentrating and narrowing attention to one task
- growing bored quickly with tasks
- talking nonstop
- dashing around a room, jumping from object to object
- having trouble sitting still
- blurting out
- interrupting conversations or activities
- not showing concern for other people’s emotions or feelings
Symptoms of autism spectrum disorder include:
- unresponsive to common stimuli
- impaired social interaction
- intense focus and concentration in a singular item
- withdrawn behaviors
- avoiding eye contact
- an inability to react to others’ emotions or feelings
- repetitive movement, such as rocking or twisting
- delayed developmental benchmarks
Autism and ADHD - which diagnosis is right?
Many doctors were hesitant to diagnose one child with both ADHD and autism spectrum for many years. For that reason, very few medical studies have looked at the impact of the combination of conditions on children and adults.
For many years, the American Psychiatric Association (APA) stated that the two conditions could not be diagnosed in the same person. However, in 2013, the Association changed its stance. In the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5), the APA states that the two conditions can co-occur. The APA notes that doctors should also consider the possibility of a separate disorder that might account for all of the behaviors.
In the UK, using the WHO | International Classification of Diseases doctors are still reluctant to diagnose both conditions, however with the focus shifting from labels to actual support the actual diagnosis that your child has received is irrelevant here. Some children with autism will also display hyperactive behaviours and some children with ADHD will demonstrate autism spectrum traits. As a result they will need behavioural and other interventions that recognise this combination of needs.
Support at home or at school should be appropriate and provided for their actual needs regardless of what condition they have. This is why at The Practice | MK we encourage clients to consider Personal Centered Plans (PCP). Person-centered planning is a unique, individually-focused approach to planning for persons who are in need of services and support. It is an important tool for empowering individuals to have a voice in the planning process and to actively shape their futures. It is a structured way of organising planning that focuses on the unique values, strengths, preferences, capacities, needs, and desired outcomes or goals of the individual.
We recommend talking to your schools's SENCO to ensure that any support requested for your child is addressing their need and to be cautious of trying to implement ADHD or ASD solely focussed interventions.
At The Practice MK we specialise in the assessment and diagnosis of autism in children and adults and can help formulate interventions and support plans to help you and your family through our network of counsellors, coaches, therapists and psychologists. Please feel free to contact us to discuss the options available to you. We will happily talk all day about autism spectrum so no question is too much for us to help answer.