Asperger’s Syndrome and/or ADHD

My eldest son was diagnosed ADHD in 4th grade (he is now in 10th), and he certainly has the “classic” signs, but the more I learn about Asperger’s, the more I recognize my kid. It isn’t impossible that he has both (very funny, Universe), but it makes me wonder. I would love to hear from the experts out there, because I am definitely not one. My son’s own psychiatrist is always too rushed for any kind of speculative conversation, and while we have a very good relationship, he tends to get a little impatient with my more novel theories. Not to say that this concept is particularly novel. I was able to find a lot of articles on the subject. There seems to be a lot of overlap in symptoms, but with different motivations behind the behaviors. Daniel Rosenn, M.D. writes:

Children with Asperger’s Disorder and children with ADHD usually want to have friends…both groups usually fail socially for different reasons. …What often turns on a child with Asperger’s Syndrome is behavior so unusual and idiosyncratic that it can be unfathomable even to another child with Asperger’s. Children with ADHD frequently break rules they understand, but defy and dislike. Children with Asperger’s Syndrome like rules, and break the ones they don’t understand…Children with ADHD are often oppositional in the service of seeking attention. Children with Asperger’s disorder are oppositional in the service of avoiding something that makes them anxious… Children with Asperger’s are much more tyrannized by details; they accumulate them, and cannot prioritize them. Children with ADHD also have poor organizational skills, but can be much more fluid in their thinking, more inferential in their comprehension, and less rigid in their treatment of facts that they are able to organize.

Other differences I have found:

1. Lack of eye contact which is very common in AS, but not an issue with ADHD

• teachers are always telling my son to “look at me in the eye!” and he prefers to sit next to me instead of across from me at the table at dinner.

1. Odd motor mannerisms (i.e., hand flapping, awkward body movements, etc) – very prevalent in AS yet not necessarily a problem with ADHD individuals

• my son has strange thrashing tics and repetitive movements, considered part of the “restlessness” of ADHD

1. Poor motor skills – AS have trouble both with fine and gross motor skills while it is not a symptom of ADHD

• he is super-clumsy, but is it beyond “normal” teen awkwardness? I’m not sure.

1. Difficulty figuring out what to say or do – AS individuals have difficulty within the social arena and with pragmatic speech while persons with ADHD may have difficulty in this area due primarily to their impulsiveness.

• I really see this in my son. He has more than just a lack of social awareness, more of a total lack of understanding of the way people typically relate to each other. He is constantly asking me what he or she “meant by that.” He has trouble reading facial expressions. His own facial expressions are often inappropriate.

The rest of my family is using their “let’s humor Raven, she’s been playing doctor on the internets again” voices that they always use when I recognize a possible medical issue. Never mind that my son really is lactose intolerant, and my mother really did need to adjust her Lithium when she quit smoking. I’m not trying to diagnose anything. I am just a total medical geek, and so I come across a ton of info, and I just want to help. So there.

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