By Julie Le Franc, Psychoanalytic Psychotherapist and Psychologist
Autism is a disorder of neural development (1) and genetic research have provided evidence for an overlap between ADHD and autism suggesting some genes can be seen in the aetiology of both conditions (5).
Signs of autism can be detected from approximately 18 months through to adulthood, depending on their circumstances (2). Developmental disorders may include avoid cuddling or physical contact or eye contact, an avoidance in forming attachments, difficulties with non-verbal and verbal communications and social understanding, and a repetition in words, phrases and behaviours.
Diagnostic terms and characteristics:
(A) Autism (or Autistic Disorder): Impairments in the social and communication areas. People can often suffer from anxiety, poor attention and motivation and behave differently to other people, perform ritualistic behaviours and lack self-caring and hygiene skills.
(B) Asperger Syndrome (or Asperger Disorder): Individuals with autistic behaviour with well-developed language skills can be afflicted by a few odd behaviours such as being aloof, becoming egocentric, having a pre-occupation with certain interests and displaying difficulties in motor-co-ordination and empathy in understanding another’s feelings.
(C) High Functioning Autism (HFA): Both Asperger and High Functioning Autism are likely to be of average or above average intelligence.
(D) Pervasive Developmental Disorder (Not Otherwise Specified (PDD-NOS)): Individuals with characteristics of either autism or Asperger Syndrome but not severe enough for a diagnosis of either of these conditions (4).
Autism (ASD) and ADHD
Symptoms of attention deficit, hyperactivity and impulsiveness are common amongst people diagnosed with ASD and ADHD. ADHD presents with distractibility, fidgetiness, inattention and hyperactivity and people with HFA may be hyperactive, impulsive and have a short attention span and share in similar executive function deficits as people with ADHD (5).
Daniel Amen, MD., has suggested that children, teens and adults with autism spectrum disorders have unique brain patterns. He reported that when the cingulated system is abnormal, people can get stuck and locked into things, rethink the same thought over and over and may become worriers and continually obsess on the same thought (7). He reported that the brain SPECT imaging findings that are common in ASD are:
· Decreased posterior hemisphere, especially parietal and temporal lobes
· Smaller cerebellums
· Increased anterior cingulated and lateral PFC
· Ring of Fire as seen in bipolar ADHD
· Toxicity, scalloped pattern
Patient history: Seth was 16 years of age when his mother brought him in for violent outbursts, rigid and inflexible behaviour, incessant worrying and poor social skills. His scan revealed a toxic appearance (lack of oxygen at birth) and increased anterior cingulated activity (causing his inflexible, rigid behaviour). His treatment including hyperbaric oxygen therapy, fish oil, and two medications to balance his brain: Lamictal to help with his temper and Lexapro to calm his anterior cingulated to help him shift his attention and worry less (7).
Treatment: The main goals of treatment are to lessen associated deficits and family distress and to increase quality of life and functional independence. Long-term therapies involve; special education programs, behaviour therapy, developmental models, structuring teaching, speech and language therapy, social skills therapy and occupational therapy. Dietary therapies have been found to be most effective in improvement in behaviour.
References
(1) Cogen, Donald J., and Fred R. Volkmar. Handbook of Autism and Pervasive Developmental Disorders. John Wiley & Sons, 1997.
(2) Autism Victoria Diagnosis and Definitions (http://www.utismvictoria.org.au/diagnosis/)
(3) Crowley, D. (2009). Autism spectrum disorders (ASD) diagnosis, therapies and their perceived effectiveness – extract from a report of a parent survey. ACNEM Journal, 28(3), 11-16
(4) Fitzgerald, F., and Corvin A. (2001). Diagnosis and differential diagnosis of Asperger syndrome: Advances in Psychiatric Treatment. (2001); 7: 310-318
(5) Connor, M. (2008). Autism (ASD) and ADHD: Overlap and comorbidity. (http://www.mugsyorg/connor112/htm).
(6) Amen, Daniel, G. Autism and autism spectrum disorders: How brain SPECT imaging can help with autism spectrum disorders. (http://www.amenclinics.com/clinics/information/ways-we-can-help/autism/)
(7) Amen, Daniel, G. (1998). Change your brain, change your life: The breakthrough program for conquering anxiety, depression, obsessiveness, anger, and impulsiveness. New York: Three Rivers Press