Dear Specialist: There is a child in my daughter’s class that seems to display some of the symptoms of ADHD but I have been told he has Asperger’s and not ADHD. What is the difference between these disorders?
-- Classroom Mom
Dear Classroom Mom: Thank you for writing. These two disorders often share some symptoms, such as appearing not to listen when spoken to, unable to maintain attention on a directed task, or difficulties with social skills. The root causes of these behaviors, though, are very different and the disorders need different forms of treatment to help the child.
Asperger’s Disorder (sometimes called Asperger’s Syndrome) is often considered to be on a spectrum of related conditions which have similar symptoms (sometimes referred to as the Autism Spectrum, though more properly known as Pervasive Developmental Disorders) and includes Autistic Disorder, among others. Unlike children with Autistic Disorder, children with Asperger’s disorder generally have good language skills. However, they also have difficulty with the subtleties of language, such as humor, irony, or metaphors. They have a trouble with the give-and-take of a conversation and trouble with turn-taking between friends or in a group. Like children affected by ADHD, they display attention difficulties but those are more related to a need for rules and routines to be followed than to a perceived overload of stimuli. By comparison, a child with ADHD has difficulties with attention due to impulsivity, novelty and, for some, hyperactivity.
A child affected by Asperger’s tends to focus all of her attention on one task or activity. A child affected by ADHD normally has her attention drawn away from a task or activity by trivial stimuli in her environment, such as another child coughing or a bird flying by the window. While the child with Asperger’s remains focused to the exclusion of other events, the child with ADHD is more likely to be distracted by her environment and may quickly jump among activities or behaviors.
Another difference between the expressions of the two disorders is a child affected by Asperger’s generally does not show a wide range of emotion, while the child affected by ADHD may have difficulty controlling his emotions and move very quickly among emotional states. Children affected by Asperger’s have difficulty making or maintaining eye contact. For this reason, they may appear to not be listening to adults when they actually are. A child affected by ADHD is not listening because he is focusing on other things, environmental stimuli or even his own thoughts. Another area of significant difference is the understanding that other people have separate thoughts, emotions, wants, and needs than the child does. This is called social reciprocity. A child with Asperger’s lacks this understanding of social reciprocity, while the child with ADHD in most instances grasps the understanding.
Both ADHD and Asperger’s Disorder are typically not diagnosed before middle-childhood (i.e. not before the age of six or seven, though possibly later). Parents who are concerned that their child shows any of these symptoms need to discuss these concerns with their child’s health care provider and seek a thorough evaluation. For both disorders early treatment is key to future success in life. The majority of children identified with either disorder and who receive proper treatment, grow up to be happy and successful adults.
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