Autistic Spectrum Disorders. and Attention Deficit/Hyperactivity Disorder (AD/HD): A Comparison

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1 Autistic Spectrum (ASD) and Attention Deficit/Hyperactivity (AD/HD): A Comparison Sally Bloch-Rosen, Ph.D. Licensed Clinical Psychologist Educational Director William Beaumont Hospital Center for Human Development 1695 West Twelve Mile Road, Suite 120 Berkley, MI Difficulty Adjusting to Changes & Making Transitions Autistic Spectrum s Prefer sameness due to cognitive deficits which limit abilities to adapt spontaneously to change. Prefer novelty, but have difficulty realigning behavior in changing circumstances. Subjectively more apt to be described as anxiety-provoking. Subjectively, more apt to be described as exciting. Inattention & Distractibility Autistic Spectrum s Distracted by objects and movement of objects. Attend to atypical stimuli and, therefore, appear quite inattentive. Prone to tune out due primarily to difficulties in mentally imposing organization on their environment. More apt to be distracted by the activities of other people. Attend to stuff that most kids would find compelling. Tune out because of mental fatigue, have missed too many bits and pieces of information to make sense of the input, etc.

2 Autistic Spectrum s Repetitive/Annoying Behaviors Often represent a self-stimulatory behavior and more often has an odd quality. Often represents a discharge of energy to permit greater mental focus. Resistant to incentives and rewards. More success using reinforcers. Examples: head banging, hair pulling, Examples: foot tapping, pencil gnawing Responsiveness to Reinforcement Autistic Spectrum s More difficult to find out exactly WHAT they find reinforcing (may be somewhat unusual). Often prefer to stick with the same reinforcer, and then after many trials, may suddenly find it no longer rewarding. More typically respond to reinforcers that make sense and are consistent with rewards that most other children desire. Need to change reinforcers frequently. Response to Rules Autistic Spectrum s LOVE rules. Rules help them to bring order to what they perceive as a chaotic environment. Often the little policemen of the school, may be unnecessarily rigid or persnickity as to the details of a rule. Not quite so fond of rules, may have difficulty conforming to rules due to impulsivity. May stretch the rules as much as possible. 2

3 Language and Communication Autistic Spectrum s Usually reflects preoccupation with area of special interest and is wanting in terms of meaning. Nonverbals like facial expression, often do not match inner feeling states. Pervasive probelms in pragmatics using language to accomplish a practical goal. Speech usually marked by unusual prosody and inflection. May go from one topic to another, but intent to communicate is clear and within normal limits. Usually inner feeling states are apparent may have trouble modulating or suppressing expression of emotion. Typically do not show a significant problem in pragmatics, may be skilled at wearing down adults using language. Unusal speech patterns not associated with core diagnostic features. Social Skills Deficits/ Difficulties In Establishing and/or Maintaining Peer Relationships Autistic Spectrum s Social relatedness problems arise from difficulties dealing with novelty AND using nonverbals to regulate social interactions. Social relations dirupted by problems with impulsivity, turn-taking, etc. which can disrupt the flow of social relationships. Do not get it. Have a more solid grasp of nonverbal communication but may have difficulties with response inhibition which prevent competent execution of their knowledge. 3

4 Cognitive Markers Autistic Spectrum s Poor grades in math due to difficulty grasping mathematics concepts, especially as concepts become more abstract. Poor grades most commonly arise out of careless errors in computation. No consistently observed difficulty in conceptual math for AD/HD. Sloppy handwriting, motor planning deficits, never liked to color, fine motor deficits. Not much improvement with medication. Difficulties with gross motor skills (sometiems with islands of competence) but often seen as clumsy or accident prone (due primarily to cognitive impairments.) May or may not have motor planning/fine motor deficits. Handwriting sloppy often due to a tendency to rush through. Often more of a significant improvement with psychostimulant treatment. May be accident prone because they assume a fast pace of activity, act without fully thinking through possible consequences. Gross motor immaturities may or may not be present. Difficulties in sports because they are often viewed as meaningless activities. Difficulties participating in sports may emerge due to problems sustaining atention (as in baseball) or due to response inhibition which reduces the capacity to work as a team. 4

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