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ADHD versus Asperger’s Syndrome in Children

ADHD and Asperger’s Syndrome are two common disorders that are usually first diagnosed during childhood. They can appear very similar in their symptoms but have different causes and different treatments.

Symptoms of ADHD

While many children are diagnosed with ADHD in childhood, quite often Aspergers Syndrome is mistaken for ADHD at first. The APA in their latest revision of the DSM 5, did away with Asperger’s syndrome as a separate diagnostic category and included it with Autism. So, basically it is now considered high functioning Autism.

ADHD usually presents with symptoms of inattention, distractedness, forgetfulness, disorganization, and sometimes hyperactive or impulsive. In ADHD, symptoms are due to an inability to stay focused, and with feelings of restlessness, and boredom.

Symptoms of Asperger’s Syndrome

The traits of Asperger’s syndrome often look like ADHD as these children also seem distracted, disorganized, and off topic. However, the causes of the behaviors are different for ADHD and Aspergers Syndrome. Children with Asperger’s syndrome have trouble reading social situations so they are often unsure what the important things to pay attention to and focus on are within the classroom. They are often unaware of social rules so may not be aware, for example, that they shouldn’t get up and do something else while the teacher is teaching.

Students with Aspergers Syndrome also have difficulty with social reciprocity and something called Theory of Mind. This means they have difficulty considering a situation from another persons viewpoint, and as a result, may talk too much about their own interests, cut people off, and interrupt without being aware this is rude. It appears impulsive or as if they are not paying attention so looks like an ADHD trait, but it’s different.

Understanding Social Rules

Children with Asperger’s Syndrome are often not aware of “unwritten rules” the rest of us learn intuitively. Consequently, they say and do socially awkward things. Again, they appear impulsive or as if they are not paying attention to their surroundings.

It’s important when having a professional do an ADHD evaluation for a child, to have them rule out the possibility of Asperger’s Syndrome during the process. Quite often, the forms we have teachers fill out for ADHD will show significance for ADHD traits even in someone who has Asperger’s Syndrome, which means you can get what is called a false positive for ADHD. In my counseling practice, I often have children, teenagers, and adults come in for counseling who have previously been diagnosed with ADHD and treated with ADHD medication such as Ritalin or Adderall, to find out their symptoms are more consistent with Asperger’s syndrome. This usually explains why the medications were not making much difference.

Some of the things to look for in Asperger’s syndrome are whether the child has rigid thinking or behavior, such as needing to follow the same routine and getting overly upset when the routine is changed. Another thing to look for is whether the child seems to have trouble “reading” social situations wherein they may unknowingly say or do something offensive or awkward. This can result in them having trouble getting along with kids their own age. Sometimes they prefer the company of adults or of younger children.

Sensory Issues

A child whose emotions are hard to read because they don’t seem to show much expression on their face when happy, sad, or upset (unless they are really happy or really upset) can be another tell tale sign. While children with ADHD often have some sensory issues, they are most often things such as not liking the feeling of tags in their shirts or complaining of clothing being too restrictive.

Children with Aspergers Syndrome generally have more severe sensory issues than kids with ADHD. They will complain about noises being too loud, smells being too strong, places being too loud and crowded. They may experience a great deal of pain for a minor injury or hardly complain at all over serious injuries. Generally speaking, children with Asperger’s syndrome often have a distinct way of speaking. They often have a very good vocabulary for their age and speak with very precise speech. These children often choose not to use slang or more abstract terms. They often talk like “little professors” or they just talk in a more mature way than children their age.

More Symptoms of Asperger’s Syndrome

Children with Asperger’s syndrome often have trouble understanding sarcasm or language that contains too much abstract language. If your child has trouble understanding when you’re joking, it could be a sign of Asperger’s syndrome. Most children understand when an adult is kidding with them and will smile at their jokes just to be polite. When joking around with Asperger’s children, I often get no response, leaving me feeling I’m not very funny. Then I realize this may be an Asperger trait. These children sometimes don’t react with the reciprocity of smiling at jokes the way other people will.

Determing whether your child has Asperger’s syndrome requires an evaluation by a psychologist or the special education team at school. However, it can be useful to get a screening by a counselor first to get support for doing an evaluation.

Gary Watson is a Solution Focused Therapist in Grand Rapids Michigan.  He provides counseling for couples, counseling for teenagers, and adults.  He provides counseling for anxiety, depression, stress, college and work stress, and relationship problems.  For more information, please visit the website at www.turnaboutcounseling.com.