ADHD and ASD

Up to 20-25% of children with ADHD fall on the autism spectrum (ASD) and as many as 50-60% or more of children with ASD have ADHD. This lecture focuses on the nature of these two disorders, how they differ, and how their comorbidity affects treatment of ADHD in the context of ASD. This lecture is 1 hour in length. For more information, see Dr. Barkley's books, Taking Charge of ADHD: The Complete Authoritative Guide for Parents, and How to Treat ADHD in Children and Adolescents.

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[cayladodd]

I have been living with severe ADHD symptoms my entire life and had no idea that I had a disability. Listening to you explain symptoms at various ages was like listening to a stranger describe my life story back to me. Very surreal. I look back at all the obvious signs now and wonder how it was that no one noticed or helped me. I was VERY CLEARLY struggling lol I feel like the adults in my childhood utterly failed me and consistently wrote me off as a lazy, unintelligent, problem child.

[jimmyb]

Dr. I am glad u have finally clarified this. I was told my high IQ was attributed to my ADHD. I believe that ADHD has robbed whatever achievement my IQ should have given me

[kathiebradley]

Kid of the 80s, never diagnosed with adhd our autism although I have now learned I have both. The symptoms were clear as a child but I was treated as a behavioral problem because of my inability to connect and crying all the time cause "everyone was so mean". I wonder what the real numbers of prevalency are as more and more of us become aware of our issues we have learned to adapt to or hide? My mother's and grandmothers autism was much more noticeable, leading me to believe I had no issue, as my symptoms were more subtle in comparison, even though I questioned it numerous times as a child, usually when I had an issue with math retention (dyscalculia). 2 college degrees and a registered nurse, so I've done well, but life continues to be stressful in distressing ways regarding relationships and how many demands I can handle at once.

[annak]

13:25 ASD - panick reactions, meltdowns, limbic storms characterized by anxiety, panic, aggression
14:08 emotions seen in ASD are extreme, easily provoked, irrational, longer duration, more difficult to recover from

[jimmyb]

I want to add, some of us are still Hyper I don't stop moving ever! Thank you for advocating for ADHD and making me more self aware. I wish I could talk to you more!!

[blt]

The more I learn, the more I think my grandfather may have been on the spectrum and I may be as well. I went to be tested for ADHD and was diagnosed with EFD. There was mention of quirks in my assessment but at that time it wasn't of any concern to me. I'm at the point in life where I'd like to understand myself more and think I'll go back for more insight. I appreciate all of the information you've shared!

[ginnyjanisse]

This is a really great video about these two conditions and how they differ. What I would love to hear more about is the symptom complexities when they co-occur. Thanks again!

[wendelsantana]

Sr. Barkley, thank you for this video. I'm an brazilian ADHD. I had my psychological report in December 2022, accompanied by a psychologist, psychiatrist and neuropsychologist.

I'm loving your videos and your book _"Taking Charge of Adult ADHD"._ I would like to know more about difference between perseveration and hyperfocus. Thank you so much.

[harlakshsingh]

Would love to have you on the podcast

Specifically talking about:
- ADHD, ASD in Entrepreneurs
- Late diagnosis
- Overlaps w/ other conditions
- Emerging protocols as possible solutions beyond the current solutions
- AI's benefits/problems for people w/ ADHD, ASD

I know you're busy and I'll understand if you're not able to do this

But nonetheless, thank you from all of us working through some of this stuff with your help

Your continued work in the space has been immense :)

[TheKillaCake]

Nice to have real informative videis so available online. Isn't it incredible how easy it is to pay attention to someone saying something of value?
I swear our attention spans arent decreasing from short form content, but rather from the lowering quality of information available in that content.

[Heathen-Sun]

Regarding SCT. I definitely like your naming rather than “sluggish”. Anyway. I am watching your lectures and content because I feel like you understand more about us (AuDHD) than anyone I have ever heard talk about us and worse, the way we get treated.

I think you are spot on about SCT yet to me it feels like the bridge because I experience both and it’s bad in the sense of no matter how hard I try I cannot for the life of my stay engaged. My brain will find ANYTHING else to engage with regardless of whether or not I am highly interested. This has been an ongoing issue with me in relationships and academics.

Regarding social relationships this is very hurtful not just to me but also my kids and husband and “friends” because I DO wonder off in my head and people see this and no matter how hard to I try to backtrack it comes across as “she’s not interested” or worse “she doesn’t care.” Imagine when your own child who you love and are most interested in says this to you and you cannot explain in any meaningful way that it’s not them. You’re not boring but also you are to my brain.

This had created so many problems both inward and outward because it is absolutely true to me that I I will start analyzing things being said and go off into different areas in my head and miss what was truly important to those around me as well as checking in and out in class and often telling myself “please pay attention” and it’s a loop that I really cannot help.

I often feel like my attention is splayed across so many different things and my attention comes in and out if focus so rapidly that I have to go back over and over again to pick up what I missed because I know I did when things aren’t making sense. This is excruciatingly frustrating NOT to mention that I HAVE to move.

To me it feels like the battle to stay awake like you see in kids who kick about when told to go to bed and become agitated.

It’s how I operate 80% of my days..thank the maker of Audiobooks because it’s easier for me to stay engaged when I can move about while doing so.

At any rate. I feel compelled to offer my input to someone who really seems to understand because psychologists/psychologists and people have made me feel like a detriment to society for never being able to succeed in all the places society has great expectations for.

Nearly everything you say I relate to. There are just a few aspects that I don’t quite understand that you didn’t speak of here and that one being Objective Theory because I see others or NT being deficient when it comes to the way they use people as a means to attain something and how I interpret that yet I also don’t understand what is being asked about when it comes to the nature of bonding when trying to bond with others has been a primary issue where I feel like I am but that is usually not reciprocated so I feel a lot of rejection.

Anyway. I am rambling. I know you said this was in 2021 and don’t know how well received your understanding is for those in your profession but I do hope they are listening because above all else. I just want people to understand me when I say I cannot help it.

[priyabriggs]

Thank you Dr Barkley for another brilliant lecture. Truly grateful for the knowledge you share.

[JonBrase]

I have diagnosed ADHD and a strong suspicion of autism. I think "sluggish cognitive tempo" is more accurate than it might appear. It's not that I lack intellectual capacity: I'm usually the smartest one in the room. But I tend, in some sense, to think in paragraphs rather than sentences, so while *throughput* is higher than others around me, *tempo* is indeed slower, it takes time to collect my thoughts, and if a group conversation goes back and forth too rapidly, I tend not to be able to get a word in edgewise.

I have a suspicion that a factor in autism may be that information is processed in larger batches with fewer batches per unit time. This could explain sensory issues; if thoughts are larger and take longer, and every sensation that crosses a certain threshold interrupts a thought, then with a given threshold a greater percentage of thoughts will be interrupted and more total mental capacity will be lost to interruptions. An individual with a low threshold will hardly be able to think despite ample capacity, and an individual with a high threshold will be able to think just fine, but will hardly notice anything in the outside world.

This could also explain comorbid motor issues: if information takes longer to process, then motor planning is likely to lag sensory input by more than it would in a neurotypical.

[lalir]

Thank you Dr. Barkley you are the best !

[CatalogK]

I’m surprised the sensory issues with both disorders, most particularly with autism, weren’t mentioned. I must admit, I’m disappointed that autism was spoken of in terms of “functioning, ” which is largely rejected by autistic people and modern researchers in favor of “support needs” language, as the “spiky profiles” of skills and symptoms (as with ADHD) tend to cause inconsistent levels of “functioning”, which are largely moderated to observers by the ability to “mask” these difficulties (or to communicate effectively in regards to them). Many autistic people are more empathetic and have better social and communication skills than neurotypicals, but due to the Double Empathy Problem, often encounter social difficulties from the neurotypicals’ end, as autists are often able to adapt to a neurotypical communication style, while neurotypicals are far less often able to adapt to the neurodivergent communication style, thus placing autistic communicators at a higher than average communication level, with social difficulties arising on the neurotypicals’ end (a recently published study demonstrated this lopsided communication deficit quite starkly). I must say I am also quite disappointed that no mentioned was made in regards to ABA “therapy” being coercive, abusive, and not remotely evidence-based or effective, and recently rejected by the APA (iirc; it may have been another prominent psychology org) on these and other bases. Most effective and evidence-based accommodations for autism are focused on supporting sensory and communication needs, and with children especially, include support for social skills (as the “unwritten rules” of society are not generally intuitive, but can be learned). The vast majority of “challenging behaviors” seen in autistic people stem from sensory and communication struggles, and so addressing the core difficulties is helpful, whereas ABA’s approach to coerce children into ignoring their discomfort and pain for the purposes of enforced obedience for its own sake is damaging and unhelpful.

[nyoreachoja]

Thanks for the lecture and your immense contribution to this field. I'd like to ask, Which of ADHD or ASD has a greater effect on one's ability to express one's self or reach their emotions, draw from knowledge you should have and use it effectively in the appropriate situations?

[lostsanityreturned]

I was diagnosed with ADHD in the 90's back when if you were diagnosed with one you were automatically precluded from the other and I believe I was very likely misdiagnosed at the time.

I have very little to no overlap with the symptomology of ADHD, but Autism with a fairly high level of impact/impairment fits both my past and current experiences far more accurately.

It is nice to see that there have been advances in symptomology identification and distinction over the years. SCT naming withstanding is interesting to see mentioned and outlined.

[philippeansaloni]

Guanfacine really helps with my autism emotional and behavioral issues! Suggested to it to my doctor after seeing it mentioned in your videos, thank you Dr Barkley!!

[j.b.]

I have these. At times, they work off of each other, but generally…my life is very difficult.

[cyberbemon]

First time hearing about SCT. I was diagnosed with ADHD when I was 29 (almost 4 years ago), my therapist is a firm believer I am most likely on the spectrum as well, since I struggle a lot with things like eye contact, social situations, sensory overload when it comes to certain sounds/textures etc But at the same time I also struggle with day dreaming and zoning out, to a point numerous people have pointed out and asked me if I am zoned out. I am now more confused as to what I am lol