What is Autism?
1. Formal diagnosis: Autism Spectrum Disorder (ASD).
2. Affects: 1%; more boys than girls.
3.Diagnostic criteria: 1) problems with social communication/ interaction, and 2) restricted and repetitive behaviors.
4. Difficult to process and interact with the world: to communicate, form relationships, explore, play and learn.
5. Co-exists with: ADHD, Tourette's syndrome or other tic disorders, epilepsy, dyspraxia (developmental co-ordination disorder), and other.
6. Main treatment: Behavior and communication therapies.
7. Medication: Not available to treat main symptoms, but to manage sleep, high energy levels, inability to focus, depression, or seizures.
8. Diet: Weak scientific support, but can work for some children with gut symptoms or systemic inflammation.
9. Might help: B6 with magnesium, B12, antioxidants, omega-3 oils and anti-inflammatory diet.
10. Adults may lead functional lives, but less likely when autism is combined with an intellectual developmental disorder.
11. Autism is a developmental disorder and many milestones (cognitive, motor) can be developed but with a delay.
12. Potential & Strength: Eye for detail, exceptional memory, see pattern and structure, analytical, ”scientific” brain and talk, special interests, focused, persistent, create perfection, like repetitive work, honest, stands up for weak, speak one’s mind where others don’t dare.
What is ADHD?
1. Formal diagnosis: Attention Deficit Hyperactivity Disorder (ADHD).
2. Affects: 5-9%; more boys than girls.
3. Diagnostic criteria: 1) inattention, and 2) hyperactivity and impulsivity.
4. Difficult to keep track and focus: to pay close attention to details, organize tasks, keep quiet and still.
5. Co-exists with: a learning disability, dyslexia (reading disability), oppositional defiant disorder, conduct disorder, anxiety and depression, bipolar disorder, Tourette’s syndrome.
6. Main treatment approaches: Behavior therapy and medication.
7. Medication: Stimulants will help 70-80%; Non-stimulants have less side-effects.
8. Diet: Most science discard sugar as affecting the symptoms, however food additives may impact.
9. Might help: Omega-3 oils and anti-inflammatory diet.
10. Almost all adults can live independent lives.
11. ADHD is a developmental disorder and only continues into adulthood for some.
12. Potential & Strength: creative, imaginative, original, adventurous, innovative, sees the big picture, thinks outside the box, comfortable with change and chaos, energetic, outgoing, passionate.
ADHD vs. Autism
Some children get diagnosed with one of the disorders and then receive the other diagnosis at a later time. This is particularly true for girls. Aslo pay attention to a possible reading disablity (present in half of the children with ADHD), and make sure that problems with reading is not confused with low intelligence. Symptoms for both autism and ADHD include problems with organization, sensory issues, attention, and social skills. However, the delay in acquiring language that occurs with more severe autism isn’t consistent with ADHD. The causes of autism and ADHD are not exactly known, but both can be affected by genes and environmental factors, including smoking during pregnancy. Research is also looking into the role of inflammation.
A new diagnostic manual was released in May 2013 (the old version was from 1994). A lot of new research has been done since then and it was decided to replace the sub-diagnoses (Autistic Disorder, Asperger’s Syndrome, Pervasive Developmental Disorder Not Otherwise Specified, and Disintegrative Disorder). The diagnosis is now called Autism Spectrum Disorder (ASD).
For ADHD updates have been done to support diagnosing adults and to now allow a co-existing diagnosis with Autism Spectrum Disorder. Subtypes have also been mapped and replaced with presentation specifiers.
More on Diagnosing the Autism Spectrum Disorder
Earlier symptoms were divided into three areas. These have been rearranged into two: 1) social communication/interaction, and 2) restricted and repetitive behaviors.
- All of the following symptoms must be met:
- Problems reciprocating social or emotional interaction, including difficulty establishing or maintaining back-and-forth conversations and interactions, inability to initiate an interaction, and problems with shared attention or sharing of emotions and interests with others.
- Severe problems maintaining relationships — ranges from lack of interest in other people to difficulties in pretend play and engaging in age-appropriate social activities, and problems adjusting to different social expectations.
- Nonverbal communication problems such as abnormal eye contact, posture, facial expressions, tone of voice and gestures, as well as an inability to understand these.
Two of the four symptoms related to restricted and repetitive behavior need to be present:
- Stereotyped or repetitive speech, motor movements or use of objects.
- Excessive adherence to routines, ritualized patters of verbal or nonverbal behavior, or excessive resistance to change.
- Highly restricted interests that are abnormal in intensity or focus.
- Hyper or hypo reactivity to sensory input or unusual interest in sensory aspects of the environment.(Such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects).
More on Diagnosing Attention Deficit Hyperactivity Disorder
Inattention: At least six symptoms (present for 6 month) of inattention for children, or five for adolescents 17 years and older.
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
- Often has trouble holding attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
- Often has trouble organizing tasks and activities.
- Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
- Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Is often easily distracted
- Is often forgetful in daily activities.
Hyperactivity and Impulsivity: At least six symptoms of (disruptive) hyperactivity-impulsivity for children, five or more from 17 years up. Often fidgets with or taps hands or feet, or squirms in seat.
- Often leaves seat in situations when remaining seated is expected.
- Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
- Often unable to play or take part in leisure activities quietly.
- Is often "on the go" acting as if "driven by a motor".
- Often talks excessively.
- Often blurts out an answer before a question has been completed.
- Often has trouble waiting his/her turn.
- Often interrupts or intrudes on others (e.g., butts into conversations or games).
Current Sub-Groups ADHD = Presentation Specifiers
Used if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months.
Predominantly Inattentive Presentation
Used if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months.
Predominantly Hyperactive-Impulsive Presentation
Used if enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.
Because symptoms can change over time, the presentation may change over time as well.
The Previous Autism Diagnoses & Sub-Groups
In the diagnostic manual from 2013 there are no sub-groups for the Autism Spectrum Disorder. Below is a description of the previously existing groups.
The Autism Disorder used to have three criteria (that are now combined into two):
- Problems with social interaction – including other people's emotions and feelings and building friendships.
- Impaired language and communication skills – including delayed language difficulties to take part in conversations properly.
- Unusual patterns of thought and physical behavior – including a need of fixed routines, sensitivity to changes.
High-Functioning Autism Vs. Classic Autism
"High-Functioning" has been added to the Autism diagnosis as a specification for children who can talk and do not have an intellectual development disorder. If these two traits have not been present, terms like "Classic Autism" or "Severe Autism" can be seen. To confuse matters, some people use the term Autism with a reference to only "Classic/Severe" Autism, others also include "High-Functioning", and others include Asperger's in it as well. Different doctors could give a different diagnosis with this old division.
Asperger’s Syndrome is essentialy the same as High-Functioning Autism, but with spoken language developed before age of three.
PDD-NOS (Pervasive Developmental Disorder Not Otherwise Specified) was diagnosed in children who share some, but not all, of the traits of autistic disorder or Asperger’s syndrome.