I sat down few weeks ago to talk about the differences between FASD, ADHD, and ASD or Autism Spectrum Disorder, when this handy dandy chart came into my world. I’m not intent on re-inventing the wheel so I thought I’d share the link here and talk briefly about why these disorders can be so confusing to professionals who are not trained in distinguishing them.
FASD can look a lot like ADHD (Attention Deficit Hyperactivity Disorder) at times. In both cases, kids have trouble paying attention, they can’t sit still, and they’re kind of all over the place. They drive teachers crazy. In my personal opinion and from observations of my former professional practice, ADHD is way over-diagnosed. It’s the go to diagnosis when you can’t get a handle with what’s really going on. Here’s the kicker about that…ADHD like symptoms mask a lot of other disorders and emotional issues. Like FASD, attachment issues, or trauma.
Autism Spectrum Disorder is also a neurological disorder and a pervasive developmental disorder, just like FASD. I think the biggest difference in the two disorders are in the way children interact with others. Children and adults with ASD have a lot more difficulty with social situations and often avoid interactions with others unlike most children with FASD, many of whom have never met a stranger. Most kids with FASD love everyone and are kind of indiscriminate in their affection. Liam, my oldest, at 4 has had to have lots of reinforcement about not hugging everyone he meets (over and over), and not chatting up every single person he comes across.
Here’s a great example from the line up at McDonalds (every time we go!).
Liam: “Open my window, Mom. I want to say “hi” to the lady.”
Me: “She’s working and taking orders right now, she can’t hear you.”
Liam: “No, I want to say ‘hi'”.
I give in and open the window….Sometimes, I give the cashier a heads up since some of them can’t hear and Liam takes that personally.
Liam: “Hi, my name’s Liam! What’s your name?”
Cashier: “Hi, Liam. I’m Tina. Are you getting some supper?”
Liam: “That’s my brother, Aiden. We’re going to go to Thailand. We have a Daisy dog at home!”
If we had gone in, he’d probably try to hug her.
ASD is characterized by patterns of withdrawal from others and difficulties in social settings. I’ve seen lots of situations where children with FASD have been misdiagnosed with “high functioning” ASD or Asperger Syndrome, particularly at a very young age. My youngest son, Aiden, was highly avoidant of people as an infant and toddler. He had difficulty making eye contact, and shied away from new situations and, when he was younger, ASD was tossed around by some of the professionals. (I think maybe they forgot for awhile that he tested positive for alcohol at birth). What he has is sensory processing issues (overstimulated all the time) and FASD, not Autism or Asbergers.
That chart up there nicely outlines the way the traits and symptoms of FASD, ADHD, and ASD can overlap. What’s even better is that the chart also shares traits from several other mental health disorders that people with FASD are often misdiagnosed with. Sometimes older kids and adults with FASD may have concurrent disorders where symptoms overlap as well.
FASD is hard….misdiagnoses make things a lot harder.