Presentation Transcript

1. ADHD OR ASPERGER’S SYNDROME

   WHY DOES IT MATTER, WHAT DIFFERENCE DOES IT MAKE?
2. EDWARD B. AULL, M.D. 13450 North Meridian Street, suite 354 Carmel, Indiana 46032 Office: 317-582-7654 Fax: 317-582-7660
3. DSM-IV vs. DSM-V DSM-IV says that ADHD and Asperger’s syndrome exclude one another. DSM-V will allow a co-morbid diagnosis, but I do not feel it is a co-morbidity but an essential part of the Asperger’s diagnosis. DSM-V may eliminate Asperger’s and call it an autistic spectrum disorder
4. DEFINITION Asperger’s syndrome is a combination of ADHD, anxiety, and a language-based learning disability, in that they take language too literally and don’t read body language well, if at all, and even if they do read it correctly it may not affect their behavior
5. ASPERGER’S More likely to receive services earlier than ADHD, mostly related to delayed language. More likely to have First Steps or developmental preschool Very few children with just ADHD are going to require treatment prior to Kindergarten
6. KINDERGARTEN Boys should be older ADHD should exhibit mostly hyperactivity rather than inattention AS much more likely to exhibit aggression, refusals, and difficulty with transitions If AS is already diagnosed, start Kindergarten looking more at social maturity rather than academic capability, even if they can read
7. FIRST AND SECOND GRADES Very rote, scheduled, and consistent ADHD more likely to be a problem than AS
8. THIRD AND FOURTH Third, list of directions, complete independently, and in a certain amount of time Both ADHD and AS show up Fourth grade is the major shift from show and tell learning to lecture and reading Also a big shift to more abstract concepts and questions
9. MIDDLE SCHOOL Very social, lots of abstraction, bullies AS has much more social difficulty than ADHD Mild AS is much more likely bullied than very odd AS, whom the other kids generally leave alone Girls are much more aggressive to each other than boys, but more verbally and by cyberbullying
10. HIGH SCHOOL NO friends, much more typical of AS than ADHD Dating and sex difficult for both but much worse for AS because of difficulty with non verbal language and non written rules
11. COLLEGE Nearby or far away. Easy to go check on them Small or large college. Access to professors, courses taught by teaching assistants that may not have English as their primary language. Specialty degree. Easier to spot a student who isn’t going to class
12. WORKPLACE Trouble with managerial relationships, more likely with AS but some with ADHD Trouble with timeliness more likely with ADHD Trouble with coworkers more likely with AS, and they can set you up to lose your job without you seeing it coming Trouble with paper work more likely with ADHD
13. WORKPLACE Incomplete instructions on how to do the job properly much more of an issue for AS AS worker asks too many questions for reassurance When interrupted with a redirection, AS may get angry, ADHD may forget to return to first task Pace of work is often slow but careful in AS
14. MEDICATIONS ADHD, typically easier to medicate, more tolerant to side effects, AS more side effects AS will have at least two medications, one for ADHD and one for anxiety, most ADHD one medication Stimulant medications pressure anxiety due to dopamine, may aggravate social quietness, and aggravate lack of tolerance for imperfection in others
15. CARREERS ADHD good at sales poor at paperwork AS poor at personnel management, but may be excellent at resource management AS good at engineering, architecture, accounting, computer geek, lab researcher, college professor, airplane mechanic ADHD good as a physician, if can get through medical school
16. MEDICATIONS Anxiety, mostly SSRI’s, Prozac, Zoloft, and Lexapro are approved for use in children I stay away from benzo’s, if possible, Xanax, Valium, Klonopin, etc. Standard ADHD medications in AS, usually after anxiety under control, but typically at much lower doses
17. MEDICATIONS Atypical antipsychotics are used far more often in AS to assist SSRI in treating anxiety and depression. To alleviate outbursts and aggression and to even mood. Abilify and Risperdal are approved in children for autism spectrum disorders. May help with being an “A” hole
18. QUESTIONS?