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ADHD & ASD


Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder (ADHD) is most commonly characterized by series of developmentally inappropriate inattentiveness, hyperactivity and/or impulsivity that continue to persist throughout the course of time and has proven to negatively impact several areas of life (Antshel, Zhang-James, & Faraone, 2013). These areas of life which may become affected include school, social relationships, workplace, and at home (Flamez & Sheperis, 2015). It is a disorder that is common among children and can often persist into adulthood, which can cause significant daily life challenges as about 90% of adults with ADHD are undiagnosed (Flamez & Sheperis, 2015).

According to Flamez and Sheperis (2015), it had been concluded that ADHD was not an obvious or easy disorder to be diagnosed. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), it previously focused of diagnosing ADHD by primarily focusing on behavioral traits related to hyperkinesis. One of the first accounts of observing ADHD took place in 1845 when a German psychiatrist named Heinrich Hoffman described a young boy he referred to as “fidgety Phillip” as unable to sit still during dinner, rocking back and forth while sitting in his chair, resulting in him pulling the table cloth onto the floor along with the dinner. This later helped other psychiatrists discover more about the disorder. Since ADHD was primarily diagnosed as hyperkinesis, it was misidentified as a somatic/behavioral issue.

In 1902, a British physician named George Frederick Still published work in which he described symptoms of ADHD, but were classified as kinetic behavior, resulting in others continuing to do so for the remainder of the 20th century (Flamez & Sheperis, 2015). Many tried exploring the disorder through MRI tests, but the results were inconclusive, ruling out the possibility that it was a brain dysfunction (Flamez & Sheperis, 2015). Once the 1970’s came around, many started recognizing the reality of attention deficit, which led to the 1980’s publication of the DSM-III in which the inattentive and hyperactive types of the disorder were clearly differentiated (Flamez & Sheperis, 2015). In 1987, the DSM-III-R finally renamed it attention-deficit/hyperactivity disorder, which later editions of the DSM brought upon the acronym, ADHD (Flamez & Sheperis, 2015).

Autism Spectrum Disorder (ASD)

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impairs and restricts social communication and interaction among individuals. Additionally, individuals with ASD often demonstrate repetitive patterns in behavior, interests, and/or activities (Flamez & Sheperis, 2015). Since it is based off of behavioral observations, it is similar to other DSM-5 disorders such as ADHD which is based off observations of behavior. However, due to the complex nature of the disorder, decades of research still have not provided clear, exact answers as to how or why ASD develops and how it can be cured. It is estimated that about 2% of children has been diagnosed with ASD, and this rate continues to grow (Flamez & Sheperis, 2015). Additionally, ASD is 4-8 times more prevalent in males than females, which is thought to be attributed to heritability and the X chromosome (Flamez & Sheperis, 2015). The onset of ASD is very early in development, about 50% of parents whose children have been diagnosed with ASD expressed their concerns within the first year of their child’s life, and 90% of parents were able to identify associated difficulties by the time their children turn 2 (Flamez & Sheperis, 2015).

Historically, Leo Kanner was the first person to successfully explain autism in his detailed case notes of children he had observed and took notice of their shared characteristics, which later provided a starting point for diagnosing autism (Singh, 2015). Shortly after Kanner’s discovery, a pediatrician from Austria named Hans Asperger made a similar discovery by describing the first case of Asperger’s syndrome from children he had observed, but differing slightly from Kanner’s observations in language, motor, and learning abilities (Singh, 2015). Unfortunately, Asperger’s contribution was not recognized immediately and did not become recognized until his work reached countries where people spoke English (Singh, 2015). Similar to others, Kanner built his knowledge upon psychoanalytic thought, which identified autism as a kind of psychosis related to childhood schizophrenia which was thought to be attributed by mothers not being nurturing enough towards their children. This was later debated by Dr. Bernard Rimland in 1960 who was the first to argue the psychogenic theory of autism by offering the idea that it was a medical condition based on genetics, thus refuting the idea that autism was caused by cold, overly-anxious mothers and successfully shifted the blame away from parents (Singh, 2015).

Infantile autism was not included in the DSM until 1980 and the diagnostic criteria has since undergone many significant modifications over the past 30 years. Initially, the DSM separated the categories social interaction and social communication, however they have since grouped them into one category (Flamez & Sheperis, 2015). Today, it is clear that early intervention is critical for ensuring the positive developmental trajectory of an individual with ASD (Flamez & Sheperis, 2015).

 

References

Antshel, K. M., Zhang-James, Y., and Faraone, S. V. (2013). The comorbidity of ADHD and autism spectrum disorder. Expert Review of Neurotherapeutics, 13(10), 1117-28.

doi:http://dx.doi.org.proxy1.ncu.edu/10.1586/14737175.2013.840417

Flamez, B., and Sheperis, C. J. (2015). Diagnosing and treating children and adolescents: A guide for mental health professionals. ProQuest Ebook Central

https://ebookcentral.proquest.com

Singh, J. S. (2015). Multiple autisms: Spectrums of advocacy and genomic science. ProQuest Ebook Central https://ebookcentral.proquest.com




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