Hello...I have recently been diagnosed with ADHD, and have been working with a great psychiatrist whom I implicitly trust. (It's been a long two year journey, but I think we've both learned a lot on the way...)

Anyways, back to my query...yesterday was my latest visit with my Doc to talk about my meds and explore more of my background/childhood in light my ADHD. (Exploring my childhood memories has always been an excruciatingly frustrating task for me, not that my childhood was traumatic or bad; but it has always been uncomfortable for me to recall or discuss; in a way, I guess I just decided to not want to acknowledge it.)

But, during the course of the visit my doctor began to have suspicions that I may have Asperger's Syndrome. He was able to give me a basic understanding of the condition, but I am trying to make sense of it on a personal level and am confused.

Can anyone share any knowledge or experiences with Asperger's Syndrome that is easier to comprehend and understand than the clinical DSM-IV definition? Am I correct in the assumption that while an individual can be diagnosed with ADHD and not have Asperger's, it is far more common for some who is diagnosed with Asperger's to have ADHD, because the criteria for ADHD easily fits within the span of Asperger's and not vice versa? Did I lose anyone there? I almost lost myself...

TIA,
ESM

ADHD, Asperger's, OCD, ODD all tend to have "overlapping" symptoms. Is someone fidgety because they are hyperactive, or is it because of sensory issues? Does someone blurt out inappropriate comments because they are impulsive, or is it because they don't understand social cues? Are they obsessive, or hyperfocusing? That's why most seem to start with a diagnosis of ADHD, and then after a time and failed management of symptoms they will get an additional diagnosis, or a different one.

One can have ADHD, Asperger's, or both. You don't have to be ADHD to have Aspergers. It seems to be more common to have a dual diagnosis, but it's possible to be "just" an Aspie.

Basically, Aspies have little no no understanding of non-verbal communication. Tone of voice, body language, etc. Since 90% of communication is nonverbal this tends to cause difficulties in understanding.

Speaking in general terms here, Aspies don't "get" sarcasm. they will say things that can be considered rude, if true like telling someone their dress is ugly. Not out of malice, but just not understanding that it's not polite. Many tend to have one subject that they hyperfocus on, and it can be odd things. I've heard of kids that have an encyclopedia's knowledge of deep fryers, air conditioners, mathematics, dates, presidents, etc. Their knowledge is vast, and told at great length to anyone who won't flat out walk away.

A lot of Aspies also tend to have sensory issues. Lights will seem brighter, sounds louder, or quieter, clothes, water, pressure on the skin, and sometimes this can come and go. I've also noticed (in the midst of all my reading) that oddly enough Aspies seem to be disproportionally skewed to the more intelligent side.

Does that help, or did I just overwhelm you? :)

1: Child Adolesc Psychiatry Ment Health. 2008 Jan 31;2(1):4 [Epub ahead of print]
Links
Inhibition, flexibility, working memory and planning in autism spectrum disorders with and without comorbid ADHD-symptoms.
Sinzig J, Morsch D, Bruning N, Schmidt MH, Lehmkuhl G.

ABSTRACT: BACKGROUND: Recent studies have not paid a great deal of attention to comorbid attention-deficit/hyperactivity disorder (ADHD) symptoms in autistic children even though it is well known that almost half of children with autism spectrum disorder (ASD) suffer from hyperactivity, inattention and impulsivity. The goal of this study was to evaluate and compare EF profiles in children with ADHD and in children with ASD with and without comorbid ADHD. METHODS: Children aged 6 to 18 years old with ADHD (n=20) or ASD (High-Functioning autism or Asperger-syndrome) with (n=20) and without (n=20) comorbid ADHD and a typically developing group (n=20) were compared on a battery of EF tasks comprising inhibition, flexibility, working memory and planning tasks. A MANOVA, effect sizes as well as correlations between ADHD/ASD-symptomatology and EF performance were calculated. Age- and IQ-corrected z scores were used. RESULTS: There was a significant effect for the factor group (F=1.55; df=42; p=.02). Post-hoc analysis revealed significant differences between the ADHD and the control group on the inhibition task for false alarms (p=.01) and between the ADHD group, the ASD+ group (p=.03), the ASD- group (p=.02) as the TD group (p=.01) for omissions. Effect sizes showed clear deficits of ADHD children in inhibition and working memory tasks. Participants with ASD were impaired in planning and flexibility abilities. The ASD+ group showed compared to the ASD- group more problems in inhibitory performance but not in the working memory task. CONCLUSIONS: Our findings replicated previous results reporting impairment of ADHD children in inhibition and working memory tasks and of ASD children in planning and flexibility abilities. The ASD + ADHD group only showed similarities to ADHD group with regard to inhibitory but not to working memory deficits. However the heterogeneity of these and previous results shows that EF assessment is not useful for differential diagnosis between ADHD and ASD, but it might be useful for evaluating strengths and weaknesses in individual children.

PMID: 18237439 [PubMed - as supplied by publisher]

Obviously as Lady Lark mentioned there are various social skills problems associated with aspergers that do not necessary apply to ADHD. But I will
try to explain some differences in ADHD and aspergers with ADHD.

(from the abstract above)
(condition) (problems)
ADHD alone : inhibition & working memory
ASD alone : planning and flexibility
ASD+ADHD: inhibition

I think working memory deficits is the key difference. Working memory for example has been linked to dopamine receptors and various polymorphisms in
dopamine genes has been linked to some cases of ADHD but not to ASD.
In some areas of learning ADHD does not improve with age as well as ASD
does (not clear how ASD+ADHD compares).

1: Psychiatry Clin Neurosci. 2006 Jun;60(3):312-8.
Links
Discrepancy of performance among working memory-related tasks in autism spectrum disorders was caused by task characteristics, apart from working memory, which could interfere with task execution.
Nakahachi T, Iwase M, Takahashi H, Honaga E, Sekiyama R, Ukai S, Ishii R, Ishigami W, Kajimoto O, Yama****a K, Hashimoto R, Tanii H, Shimizu A, Takeda M.

Department of Clinical Neuroscience, Osaka University Graduate School of Medicine, Osaka Second Police Hospital, Suita, Osaka, Japan. nakaha@psy.med.osaka-u.ac.jp

Working memory performance has been inconsistently reported in autism spectrum disorders (ASD). Several studies in ASD have found normal performance in digit span and poor performance in digit symbol task although these are closely related with working memory. It is assumed that poor performance in digit symbol could be explained by confirmatory behavior, which is induced due to the vague memory representation of number-symbol association. Therefore it was hypothesized that the performance of working memory task, in which vagueness did not cause confirmatory behavior, would be normal in ASD. For this purpose, the Advanced Trail Making Test (ATMT) was used. The performance of digit span, digit symbol and ATMT was compared between ASD and normal control. The digit span, digit symbol and ATMT was given to 16 ASD subjects and 28 IQ-, age- and sex-matched control subjects. The scores of these tasks were compared. A significantly lower score for ASD was found only in digit symbol compared with control subjects. There were no significant difference in digit span and working memory estimated by ATMT. Discrepancy of scores among working memory-related tasks was demonstrated in ASD. Poor digit symbol performance, normal digit span and normal working memory in ATMT implied that ASD subjects would be intact in working memory itself, and that superficial working memory dysfunction might be observed due to confirmatory behavior in digit symbol. Therefore, to evaluate working memory in ASD, tasks that could stimulate psychopathology specific to ASD should be avoided.

PMID: 16732747 [PubMed - indexed for MEDLINE]

That study showed that when tested correctly a person with ASD in most working memory areas does as well as the controls.

Personally I've had major exposure to lead which can damage working
memory so my working memory abilities are weak in various areas.

I have a stepsister has asperger's.http://www.addforums.com/forums/images/editor/separator.gif She is extremely intelligent but is so affected by asperger's and ocd that she is currently on disability. She is 21. The biggest thing I can say about asperger's (and autism) is the complete lack of ability to read non-verbal cues, and she takes absolutely nothing figuratively and sarcasm is completely lost on her. She also has a very hard time discerning what is appropriate in public, like say, picking at zits while waiting in line at subway...

sarcasm is completely lost on her.

Its important to note that it is a "spectrum" condition and things like not understanding sarcasm is not universal in aspergers. Its why I do not like to
try to diagnose people online presumably alot doctors with a lot more skill and knowledge about a patient get the aspergers diagnosis wrong often.

I do believe in the idea:

If it walks like a duck and quacks like a duck, I would call it a duck

So if a person scores high enough on some of the online tests for aspergers
that puts them on the spectrum in my book. Officially it does not because there
maybe a better diagnosis that fits a person situation. But there is a major over lap in some conditions. Like Schizotypal Personality Disorder(SPD) is very similar to aspergers. Another person and I made an online java-script grading version of a public domain SPD test .

http://www.themachine1.110mb.com/

This spectrum thing is very true, also in ADD and especially Bipolar. My sister also has OCD and was originally diagnosed as having Tourette's (?!) for the first 15 years of her life. There is a human element in every case which makes them all different.

I'd really recommend reading TEMPLE GRANDIN's books about Autism/Asperger's.

She is a Psychology Professor with high functioning Autism or Asperger's.



http://www.templegrandin.com/


http://www.templegrandin.com/templegrandinchapterone.html

The interesting part is that I'm officially diagnosed as Asperger's Syndrome on the spectrum but I take meds for ADD + Anti-Anxiety/Anti-Depressants due to my history growing up, etc. Yeah I'm extremely smart but I have problems with planning, time management, impulse control, etc. The interesting part is since I'm in college I work best at night in my own dorm as it's always been at night that I've been working, etc. I need musical stimulation to get me going and have a bit of OCD/Tourettes (episodes of fingernails/etc/etc/). :eek:

Asperger's is the toughest diagnosis for me because the sympyoms overlap with several other diagnoses.

The ADHD Handbook : Third Edition (2006) by Russ Barkley,Ph.D., does an excellent job of providing case studies in terms of how you can differentiate between the 2 (ADHD vs ASD).

The key to determining ASD in such cases is to look for Perseveration ( pathological , persistent repitition of a subject matter or activity ).

What happens in dealing with these children is that you might find a child who's watched a certain movie several hundred times in a row, or mentions a favorite topic throughout every part of their discussion with you; even though there's no connection .

There are obviously cases where they will be comorbid, however, it is still a tough (diagnostic) call for me.

Hope this helps.

tc
mctavish23
(Robert)

My father watched the "Rocky Horror Picture Show" in it's entirety every day for over 3 years. He would freak out if he couldn't watch it. He also had to collect all of the California Raisins figurines when they were popular. Additionally, he has read every single mystery book in print.

Funny thing (as if all of that is not bizarre enough), he is a genius, computer programmer, engineer, etc. He invents stuff all the time and is always holed up in the garage doing something. He just retired last year but is still writing software, etc. If you met him briefly, you would never guess about those obsessions.

I think my grandmother is Asperger's as well. She had a minor stroke about 7 years ago, so her personality changed a lot, but she made the same exact sewing quit, just with different fabrics, over and over. She made thousands. She has never understood social cues either, but she sure is funny and wonderful.

Her mother had the repetitive thing going on as well-- she crocheted thousands of the same doily. Weird.

I am crafty/artistic, but the same thing over and over? Never.