Howdy y'allz:faint:

Some experts say autism and ADHD may exist on some kind "spectrum." What do y'all think about this? Myself, I have been dx'd with Asperger's syndrome in 2002, at the tender age of 18. Before that I had received a bunch of dxes: neurologically-based specific learning disability impacting on written language (the problems used to dx it have now been resolved; my spelling, punctuation, and capitalization are now very good), overanxious disorder of childhood, undifferentiated attention-deficit disorder, and obsessive-compulsive disorder (y0wz3rz that's a lot!).

What is y'all's opinion? Are autism (like Asperger's) and dis whole hyperactivity funk related to each other in some unseemly genetic inheritence?

I would now like to quote the Beatles (because):
Each day just goes so fast
I turn arond it's past
You don't get time to hang a sign on meeee

Floating while you can
Go on, little man

A lifetime is so short
Anyone can be bought
But what you've got means so much to meeee

Wake up all day long
Think of singing songs

I'm not well versed here...but the big difference I see is that Dr. Russell Barkley keeps on pointing to disruptive behaviours as being a key component of ADHD. With the Autism spectrum, doesn't the behaviour come more out of anxiety, lack of control, and not being understood?

I'll give you two examples and then perhaps you can correct me if I am sterotyping the Aspergers kid.

For an example...if you put an 8 year old ADHD kid in an office with lots of stuff in it and leave him alone for any length of time, he will start playing with things that are not toys, play with the electrical stapler...take it apart and maybe even break some valuable stuff. He'll know that he shouldn't do this. What would the 8 year old Aspergers kid do? Sit there...amuse themselves with their own thoughts, or find something which they find stimulanting or interesting? If they did use something they would give some thought as to ownership and the possibility of something breaking. They may find some paper and a pencil.

With the Autism spectrum, doesn't the behaviour come more out of anxiety, lack of control, and not being understood?
Yes, sometimes. My own mother sometimes says I act like a "four year old" despite my intelligence. Major factors in so-called aberrant behaviors in many people on the autistic spectrum are sensory integration problems (they will become overwhelmed from certain sounds, for example). Anxiety plays a major role in the autistic psyche; familiarity is a comfort. Once a procedure has been learned, it can be repeated. Put an autistic person in a highly unfamiliar situation, and he or she might just panic or have a "melt down."

I'll give you two examples and then perhaps you can correct me if I am sterotyping the Aspergers kid.

For an example...if you put an 8 year old ADHD kid in an office with lots of stuff in it and leave him alone for any length of time, he will start playing with things that are not toys, play with the electrical stapler...take it apart and maybe even break some valuable stuff. He'll know that he shouldn't do this. What would the 8 year old Aspergers kid do? Sit there...amuse themselves with their own thoughts, or find something which they find stimulanting or interesting? If they did use something they would give some thought as to ownership and the possibility of something breaking. They may find some paper and a pencil.
I don't know if an ADHD kiddo would break stuff knowing it's wrong; they don't think about whether it's right or wrong before they act. Boy aspie is not necessarily an introverted child.

My social problems are the result of a mix of a snippet of impulsivity and a bit of not understanding the flow of social interactions quite as most people do. Sometimes I would break stuff, accidentally, being a little reckless with things I was playing with. At school I compensated by being extremely reserved and shy.

Scuro, that is a clever interpretation based on your observations, but it doesn't line up wholly with the science. PDDs like autism and asperger's are neurobiologically related to ADHD which is also considered a developmental disorder. Specifically, the vast majority of PDD patients meet the criteria for ADHD. Cognitive tests reveal subtle differences in executive functioning between the two. The behavioral profiles can be similar, but anyone who's witnessed both can disguish them easily.

These spectrum theories are intended to catch traits that show up in a wide range of disorders while other traits may be weaker or non-exsistant. The real relationship between the two involves executive structures, and some limbic/arousal structures as well. These findings reveal themselves well in both imaging and cognitive/behavioral studies.

The differences that Scuro is talking about are compulsions and stereotypies that arise from disregulation in very different regions. People with ADHD score significantly higher than average on tests measuring compulsive traits, but don't go anywhere near the PDDs in this regard. People with autistic spectrum disorders also have executive deficits that tend to be more widespread (affecting more cognitive functions ie. visual/verbal working memories, attention, set shifting, etc.).

While ADHD has classically been studied as a disorder involving primarily the catecholamines, Autism appears to involve more regions, especially the serotonin system, as well as the catecholemines. These finding mesh well with the stereotypies and compulsions involved which have been attributed commonly to the serotonin system. This also explains why SSRI, and especially Risperdal (which is the most serotonergic atypical antipsychotic), are so efficacious in PDDs.

Stimulants medications that work so well in ADHD patients are thought to exaccerbate compulsive behaviors and have been relatively contraindicated in the literature. In practice however, clinicians are finding that they can work very well for higher-functioning, and asperger's like patients when combined with other medications. Many aut-spectrum individuals are now functioning better because of these advances.

So basically, ADHD and autism-spectrum disorders are highly related, and this is a well-established connection. It's way too early to tell how the advanced cognitive deficits in autism, and thier treatment, will affect future approaches to treatment. Of note, researchers studying different executive functions have commonly used ODD, CD, ADHD, and Autistics as models, as each disorder carries its own unique set of executive deficits.

I've got some really cool research in this area. Maybe I'll post some links, if people want more in depth info.

Lata,
-Brian

I've got some really cool research in this area. Maybe I'll post some links, if people want more in depth info.
Lata,
-Brian
Yes, please. I hope all of you continue this very interesting discussion.

Here's some quick links. I have a ton of stuff, but I don't retain the hyperlinks , so I can't readily retrieve them for the purpose of sharing.

General

An excellent read on ADHD by the man himself: Russell Barkley (http://www.cognitivetherapynyc.com/pdf/mash3.pdf) *Warning* Document is about 60 pages long!
Another good read on ADHD (http://adt.lib.swin.edu.au/uploads/approved/adt-VSWT20050406.141958/public/02chapters1-4.pdf) *Warning* Document is 82 pages long!

Metacognition and executive functioning (http://www.bu.edu/anatneuro/dcn/researchers_and_students/publications/executive_dysfunction.pdf)
2001 executive functions overview (http://www.txasp.org/Executive%20Functions%20Overview.pdf)
More simplified EF summary (http://www.cambridge.org/resources/0521651174/2509_0521651174c50_p313-316.pdf)

Good review of Autism and PDDs (~35 pages)
A good paper on Autism theory and findings (http://adt.lib.swin.edu.au/uploads/approved/adt-VSWT20050406.141958/public/02chapters1-4.pdf) (~30 pages)
EF in three neurodevelopmental disorders (http://www.psychology.nottingham.ac.uk/staff/dmr/c8cldc/EF-Ozonoff%20&%20Jenson.pdf)
EF theory in Autism (http://www.icn.ucl.ac.uk/dev_group/documents/DevelopmentalReview.pdf)
EF Autism (http://www.icn.ucl.ac.uk/dev_group/documents/HillTICSJan04.pdf)
Autism and social cognitive impairments, joint attention, and EF (http://www.brown.edu/Departments/Clinical_Neurosciences/articles/ss15205.pdf)
2002 review of executive functioning, and its typical and atypical development (long) (http://www.brown.edu/Departments/Clinical_Neurosciences/articles/ss15205.pdf)
EF and language performance in Autism (http://www.bu.edu/anatneuro/dcn/researchers_and_students/publications/executive_dysfunction.pdf)
Autism and frontal cortical mirror neurons (http://cogprints.org/2613/01/mn.pdf)
Orbitofrontal and theory of the mind: Autism (http://chd.ucsd.edu/articles/Sabbagh.article.pdf)
Functional neuroimaging in Autism (http://chd.ucsd.edu/articles/Mueller.article.pdf)

Quick summary of EF in ADHD (http://www.psychiatrist.com/supplenet/v64s14/v64s1407.pdf)
The inhibition theory of EF deficits in ADHD (http://www.u.arizona.edu/%7Eascheres/EF.pdf)
2002 ADHD Overview (http://www.psychiatrist.com/pcc/pccpdf/v04s04/v63s1201.pdf)
ADHD and the search for endophenotypes (http://www.psychiatrist.com/pcc/pccpdf/v04s04/v63s1201.pdf)
ADHD and delay of re-inforcement (http://adt.lib.swin.edu.au/uploads/approved/adt-VSWT20050406.141958/public/02chapters1-4.pdf)
ADHD and Obsessive-Compulsive Behavior (http://www.cpa-apc.org/Publications/Archives/CJP/2005/January/cjp-jan05-ickowicz-jan-OR.pdf)
ADHD and ODD/CD EF study (http://www.cpa-apc.org/Publications/Archives/CJP/2005/January/cjp-jan05-ickowicz-jan-OR.pdf)
Dopamine appetite and cognitive deficits in ADHD (Good paper studying ADHD mind-theory) (http://folk.uio.no/jonathaw/WilliamsTaylor2004MFFT.pdf)
Interesting developmental theory of ADHD (http://www.bbsonline.org/documents/a/00/00/12/14/bbs00001214-00/bbs_Sagvolden.pdf) *Warning* Paper is about 75 pages!

This ought to keep some of you busy for awhile ;) There is so much more I wish I could share, but I don't have the time right now. I'll do some more searching for you all though.

*Edit: Fixed the Barkley link. Let me know if these work out.

Take care,
-Brian

Thanks for posting those links, Brian. I have some reading to do.

You know they may be on the same spectrum although I haven't heard that officially...but in the classroom they look very, very different.

Thanks for posting those links, Brian. I have some reading to do.

You know they may be on the same spectrum although I haven't heard that officially...but in the classroom they look very, very different.Any time :)

BTW, looks like I screwed up the "Good review of Autism and PDDs (http://info.med.yale.edu/chldstdy/neuroimg/publications/AutismReviewJCCPJan04.pdf)" link above. Hopefully this works :eyebrow:

-Brian

Gee. I was just going to say that, yeah, it does seem like autism and ADD are on some kind of spectrum, and I have thought that myself. Yet I speak intuitively, not scientifically.

Then I decided, nah. You guys have enough info to discuss.

(slinks away feeling dumb....but happy to leave the science to the scientists)

Thanks for posting those links, Brian. I have some reading to do.

You know they may be on the same spectrum although I haven't heard that officially...but in the classroom they look very, very different.
Ditto.

Brian;

Please post more!!! This is great stuff.

Me :D

Thanks for posting those links, Brian. I have some reading to do.

You know they may be on the same spectrum although I haven't heard that officially...but in the classroom they look very, very different. Scuro, do you find it very easy to connect with AS or Autistic kids?

Scuro - I'm not so sure if they look all that different unless you haven't met a high-functioning Aspie like my boy. You put my boy in that office (and we have), and his stress level over a new situation skyrockets. His MD was amazed that the only time he ever sat still was when reading and that was only maintained for a minute or two.

In our experience (My oldest boy has ADHD, my third child, also a boy, has ADHD and ASD), ASD is subtly different. It's the toe-walking, it's the black-and-white thinking, it's the lack of eye contact, it's the rigid adherence to rules, it's the total disorganization and inability to follow more than 3 instructions at a time, it's the outbursts, the one-way *conversations,* the hyperfocusing on one while unable to focus at all on other things - it's ADHD and then some. For several years, we were content with the ADHD dx, but there was always something more, something in the behavior that just wasn't addressed by the books, behavior (and punishment) modifications, just something more.

So much of his behavior, like the outbursts, the hyperactivity, the lack of focus, sort of hid his ASD under the ADHD. As he got older, the fact that there was more to this began to take hold until one day his therapist suggested Asperger's.

So, the Aspie kid would be so stressed by the new situation that s/he can not focus, can not settle down and as far as pencil and paper? Forget about it - with the motor skill problems, you couldn't MAKE my Aspie (and others) come near a pencil even with the most dire of threats - handwriting is nearly impossible for him now since his school refused to help him earlier. He will probably never write legibly, our goal now is to get him to the point where he might be able to read his own handwriting.

Just like with ADHD, there are different levels of severity with Autistic Spectrum Disorder. You may not see it in your classroom, but I know of at least two teachers that are struggling with this right now.

I think all of those disorders are related!

Selena:)

Howdy y'allz:faint:

Some experts say autism and ADHD may exist on some kind "spectrum." What do y'all think about this? Myself, I have been dx'd with Asperger's syndrome in 2002, at the tender age of 18. Before that I had received a bunch of dxes: neurologically-based specific learning disability impacting on written language (the problems used to dx it have now been resolved; my spelling, punctuation, and capitalization are now very good), overanxious disorder of childhood, undifferentiated attention-deficit disorder, and obsessive-compulsive disorder (y0wz3rz that's a lot!).

What is y'all's opinion? Are autism (like Asperger's) and dis whole hyperactivity funk related to each other in some unseemly genetic inheritence?

I would now like to quote the Beatles (because):




Each day just goes so fast


I turn arond it's past
You don't get time to hang a sign on meeee

Floating while you can
Go on, little man

A lifetime is so short
Anyone can be bought
But what you've got means so much to meeee

Wake up all day long
Think of singing songs