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Column originally published Apr 26, 2022

Children With Autism Can Have ADHD, Medicine Can Be Very Helpful For Them

Question: Our younger son has Asperger Syndrome. He was diagnosed at two years of age, and had IBI which improved his interaction with others. He is very smart, but also hyperactive. In kindergarten, his teacher was concerned that he couldn’t pay attention. He is now in grade one, and he is getting worse. He cannot stay at his desk, and constantly interrupts the teacher. The school got an education assistant in the classroom to redirect him and help him focus. We had a meeting recently, the principal suggested that he should be assessed for ADHD. I am reluctant to have another label on him. He is so young, I don’t want him to have more roadblocks. His twelve-year-old sister was diagnosed with ADHD when she was in grade 3. She wasn’t hyperactive, she was a daydreamer. She had difficulty learning because she couldn’t pay attention. She is much better now, taking medicine every day. I am struggling to accept that our son has ADHD on top of autism. Is there any harm if we delay treatment for ADHD?

Answer:

I understand your concern about your son. It is a challenge for him, and for your family, to be diagnosed with Autism Spectrum Disorder (ASD). I am glad that he was recognized early, and received IBI (Intensive Behavioural Intervention). This helps him with communication and interaction with others. Still, there are many challenges that come with ASD. Children with Asperger Syndrome (AS), also called high-functioning autism, are very intelligent. However, they can have unique interests that make it difficult for them to pay attention to other less interesting things.

It has been known for some years that children with autism can have co-existing ADHD (Attention Deficit Hyperactivity Disorder). We don’t know how these two conditions connect, but some have both ASD and ADHD. When we ask family history of those with ADHD, it is not uncommon to find relatives with autism. Conversely, a child with autism often have relatives with ADHD, sometimes in siblings.

Your daughter was not hyperactive, but had difficulty paying attention that affected her learning. As you have said, ADHD medicine is very helpful for her. These are often long-acting medications that children take once a day in the morning. They can be effective throughout the day and into evening, helping them to learn in school and doing homework, as well as after-school activities. They can improve interaction with peers and family, and won’t change their character or creativity.

In my work, I have seen many children with both autism and ADHD. It is more challenging if they are hyperactive and disruptive in class. Having an education assistant (EA) can help to redirect him, keep him focused, and explain concepts in a way that is easier for him to understand. However, it is not a good long-term solution. He is smart, but he may not be able to achieve his academic potential. This can affect his self esteem, and lead to anxiety. As he gets older, he can be teased for needing an EA. It can stigmatize him, and affect his social development and relationship with his peers.

I know you are worried and reluctant to find out whether he may have ADHD or not. However, if he can be properly assessed, and if he does have ADHD, he can get the same help like his sister. Children with autism can respond very well to medicine. This can improve his ability to focus, and learn things that he is not interested in as yet. It can broaden his interest and knowledge, and give him more opportunities when he grows up. The diagnosis and treatment can open more doors for him instead of being barriers.

I encourage you to have him properly assessed by specialists that are knowledgeable in both conditions. Take a positive approach instead of worrying what ADHD might bring. Good luck.