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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Autism, Asperger’s & ADHD
Simon Bignell – Module Leader
Lecture 10
Spring 2010 (6PS048 & 6PS052)
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Outline.
• Summary Lecture of the module content.– Draw your own conclusions based on evidence.– Most importantly, to have an opinion you can
defend.• Recap the lecture content with recommended reading.• Draw out themes.• Try to reach some conclusions about the relations
between ASD and ADHD.• More time for questions.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Learning Outcomes Of This Lecture.On completion of the lecture and with independent study
you should be able to: 1. Give an overview of the key issues covered in the
module. 2. Express an opinion on the multiple relations
between Autism, Asperger’s and ADHD .
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lectures.Lecture 1 – Module Introduction.Lecture 2 – ADHD and Hyperkinetic Disorder.Lecture 3 – Autistic Disorder (Classic Autism).Lecture 4 – Asperger's Disorder.Lecture 5 – Classification, Assessment & Diagnosis.Lecture 6 – Aetiology.Lecture 7 – Comorbidity.Lecture 8 – Treatment For ADHD.Lecture 9 – Treatment For Autism.Lecture 10 – Autism, Asperger's and ADHD.Lecture 11 – Revision & Exam Tips.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 2 – ADHD and Hyperkinetic Disorder.Content:• Symptoms of ADHD.
– Inattention.– Hyperactivity/Impulsivity.
• Prevalence.• Comorbidity.• Developmental course of ADHD.• Consequences of ADHD.• Lifespan.• Controversy.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 2 – ADHD and Hyperkinetic Disorder.Key Points from Lecture:• First described around 100 years ago.• Problems with Attention, Hyperactivity & Impulsivity.• Affects 2-5% of school age children in UK.• Exists on a degree of severity.• Boys are six times more likely to be referred for help than girls.• Almost always occurs with other disorders/problems.
Reading• Barkley, R.A. et. al. (2002). International Consensus Statement
(January 2002). Clinical Child and Family Psychology Review, 5(2). p.89-111.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 3 – Autistic Disorder (Classic Autism).Content:• What is Autism?• Symptoms of Autism.• Prevalence of Autism.• How Autism was first recognised.• Assessment.• Diagnosis.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 3 – Autistic Disorder (Classic Autism).Key Points from Lecture:• First described around 65 years ago.• Exists as a spectrum, a continuum, a syndrome with various
degrees of impairment • Affects communication, social interactions, and strange behaviour
that impair education performance.• Generally evident before age 3.• A life-long pervasive developmental disorder with genetic
susceptibility.
Reading• Frith, U. & Happe, F. (1994) Autism: Beyond Theory of Mind.
Cognition, 50, pp.115-132.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 4 – Asperger's Disorder.
Content:• What is Asperger’s Disorder?• Symptoms of Asperger’s.• How Asperger’s was first recognised.• Characteristics of Asperger’s Disorder.• How is Asperger’s different from Classic
Autism.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 4 – Asperger's Disorder.Key Points from Lecture:• A higher-functioning form of Autism characterised by
impairments in the social domain, some impairment in the behaviour/interests domain.
• No significant delays in cognitive or language skills.• Motor clumsiness, especially in younger children.• Asperger’s tend to desire to interact with others, but don’t know
how to in an appropriate way.• May live very successful independent lives in appropriate job
settings. • Not so easy to spot Asperger’s Disorder.Reading• Baron-Cohen, S. (1999). The Extreme-Male-Brain Theory of
Autism. In Tager-Flusberg, H, (ed) Neurodevelopmental Disorders. MIT Press (1999).
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 5 – Classification, Assessment & Diagnosis.Content:• What is Classification?• DSM-IV-TR / ICD-10.• How does assessment happen in the UK?• How is a diagnosis of Autism, Asperger’s or
ADHD made?
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 5 – Classification, Assessment & Diagnosis.Key Points from Lecture:• Diagnosis has to be made on a behavioural basis.• Variations in symptoms and severity of impairments.• DSM-IV (APA, 1994) & ICD-10 (WHO, 1994).
• ‘Pervasive Developmental Disorder’.• ‘Attention-Deficit and Disruptive Behavioural Disorders’.• Missed diagnosis and misdiagnosis.
– Multiple referral routes.– Pressures on LEA resources.– Multiple assessment protocols and diagnostic tools.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 6 – Aetiology of ADHD & Autism.Content:• What is ADHD?• Theories of ADHD.
– Response Inhibition Theory.– Diet.
• Scepticism towards ADHD.• What is Autism?• Theories of Autism.
– Theory of Mind deficit.– Executive Function (Dysfunction) deficit.– Weak Central Coherence.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 6 – Aetiology of ADHD & Autism.Key Points from Lecture:• The causes of ADHD are not fully known.
– Likely to have multiple causes and complex interactions.– Good evidence for genetic component.– Evidence of structural and functional brain abnormality.
• Barkley’s Theory of Response Inhibition in ADHD.• Theory of Mind deficit. Executive Dysfunction. Weak Central
Coherence.Reading• Barkley, R.A. et. al. (2002). International Consensus Statement (January 2002).
Clinical Child and Family Psychology Review, 5(2). p.89-111. • Rajendran, G. & Mitchell, P. (in press). Cognitive Theories of Autism.
Developmental Review.• Frith, U. & Hill, E. (2004) Understanding Autism: Insights From Mind and Brain
In Autism: Mind and Brain, ed. Frith, U. & Hill, E. Oxford, Oxford University Press, pp.1-19.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 7 – Comorbidity in ADHD and Autism.Content:• A refresher: DBDs & PDDs.• Why is comorbidity important?• Are ADHD And Autism Really That
Different?• Comorbid conditions.• What might this overlap of symptoms
suggest?
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 7 – Comorbidity in ADHD and Autism.Key Points from Lecture:• A large number of medical conditions are very often
associated with ADHD and/or Autism.• High overlap between ADHD and ASD symptoms.• ADHD and Autism are generally described as
separate disorders with separate genetic aetiologies.
• Most genetic studies exclude cases of Autism from studies on ADHD and vice versa.
Reading• Gillberg, C., & Billstedt, E. (2000). Autism and Asperger syndrome:
Coexistence with other clinical disorders. Acta Psychiatrica Scandinavica, 102, 321–330.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 8 – Treatment For ADHD.
Content:• Clinical Symptoms.• Intervention Development.• Considerations for interventions in ADHD.• Non-pharmacologic Treatments.• MTA.• Medication
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 8 – Treatment For ADHD.
Key Points from Lecture:• Conduct problems and symptoms of ADHD may hinder treatment
and/or assessment.• All strategies do not fit all children.• Medication is the ‘treatment of choice’ for ADHD following MTA.• The MTA studies suggest that there’s very little benefit from any
psychotherapeutic treatment on core symptoms.• Stimulant treatment is easily available in the community and
behavioural treatment is not. But opinion remains divided.Reading• The MTA Cooperative Group. (1999). A14 Month Randomized Clinical
Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Archives of General Psychiatry, 56. p.1073-1086.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 9 – Treatment For Autism.
Content:• Autistic Disorder.• Treatment for Autism Spectrum Disorder.
– Medication.– Behavioural Interventions.– Other Treatments.
• Problems of treatment.• Parent advocacy groups.• Prognosis.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Lecture 9 – Treatment For Autism.
Key Points from Lecture:• Many different types of behavioural interventions for ASD.• Early intervention is most beneficial.• Treatment depends on the individual.• Most effective treatment for the disorder is highly structured and
intensive ‘Applied Behavioural Analysis’ (ABA).• Problems treating people with Autism, communication, non-
compliance, comorbidity, intellectual/emotional immaturity.Reading• Lovaas, O. I. (1987) Behavioral treatment and normal
educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Themes.• Misdiagnosis vs. Missed diagnosis.• Behavioural/Cognitive vs. Pharmacological treatment.• Normal vs. Pathological behaviour.• Continuum vs. Categorical classification.• Academia & Parental viewpoints.• Aetiological vs. Symptomatological. • Evidence-based vs. Anecdotal-based methods.• Acceptance vs. Rejection of Disorder.• Mild vs. Severe degrees of impairment.• Increasing incidence vs. Better awareness.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Relation between ASD & ADHD.
ADHD
• Usually spotted in school.
• Normal IQ.• Often pragmatic
language problems.• High comorbidity
with other problems.
• Often mistaken for bad behaviour.
Classic Autism
• Early onset• IQ tends to be lower• Often fail to develop
spoken language• Problems with non-
verbal communication
• Tend to be adept at basic motor skills
Asperger’s
• Later onset• Higher range of IQ• No language
deficit• Non-verbal
communication problems less severe
• Clumsiness in basic motor skills
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
Conclusions.
• Autism and ADHD : No single cause; no single cure. Hence: A spectrum, a continuum, a syndrome. (…debatable?)
• It’s easier to ‘spot’ Autism at the low-functioning end of the spectrum.
• ADHD is often diagnosed because of ODD/CD.• Although poor parenting does not cause ADHD (or
Autism) it can make things worse.• ADHD is a ‘preferable’ diagnosis to Autism.• Behavioural (ASD) and Pharmacological (ADHD)
treatments can be effective but may not address cause.
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Autism, Asperger’s & ADHD (6PS048)ADHD, Autism & Asperger’s (6PS052)
Simon BignellPsychology, School of Science
"We are not born to suffer. We are born to thrive. If you live in a dry area and your garden receives
little water, you plant plants which like dry soil. But when you are given a plant that likes wet soil, you
don't kill it, you water it, you spend one of your 1440 minutes each day watering that plant.
Because you know, that given the right care, that little bit of effort can produce spectacular blooms.
And so it should be with children like us." Joshua Muggleton, age 17
Accessed at http://mugsy.org/josh/
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