Article

What is the difference between Asperger’s Disorder (AS) and Attention Deficit Disorder (ADD)?

By Rebecca Shafir,M.A.CCC

Children and adults with AS are often misdiagnosed as ADD and vice versa. Both diagnoses share some similarities, and it is possible for a person to have both diagnoses, but there are distinct differences between the two conditions.

ADD is primarily characterized by restlessness, impulsivity and distractibility. It is marked by hyperactivity and/or inattentiveness. Socially, ADDers typically talk too much, interrupt others but are usually very engaging and interactive.

The major distinction between AS and ADD is that in AS there is a marked impairment to initiate and sustain connection with others. They do not read or demonstrate nonverbal behaviors such as eye contact, facial expression, vocal inflection and gestures that help regulate social interaction. Vocabularies may be extraordinarily rich and some AS children sound like "little professors." However, persons with AS can be extremely literal and have difficulty using language in a social context. AS persons have difficulty with transitions or changes and prefer sameness. There is also a tendency to demonstrate an obsession with repetitive patterns of behavior, interests, and activities. Many persons with AS exhibit exceptional skill or talent in a specific area. It's important to remember that the person with AS perceives the world very differently. These persons may be perceived by others as being aloof, "in their own little world" and oblivious to the feelings of others. Many behaviors that seem odd or unusual are due to those neurological differences (believed to be a right hemisphere dysfunction) and not the result of intentional rudeness or bad behavior. Because of their eccentricities, ASers easily become victims of teasing and bullying.

The confusion between ADD and AS results from some overlapping features. Both disorders are characterized by reduced performance on tasks of executive function and information processing. Both ADDers and ASers may have difficulty making and keeping friends, but for different reasons. Intelligence scores are often in the superior to exceptionally high ranges. Because both groups have unique difficulties ADDers and ASers may be seen as anxious. And, like ADD, AS is most certainly not the result of "improper parenting."

A complete neuropsychological evaluation is recommended as a way of determining a differential diagnosis. Treatment may involve medication, but the most successful treatment approach is with social skills groups. ASers need to learn how to read and demonstrate subtle non-verbal messages, friendship skills, anti-bully tactics, stress reduction. A coach or therapist who specializes in executive function can be a helpful addition to the treatment team.