Expert: James Michael Roan - 6/29/2006

Question
My son was dx Bi-polar, but know we are questioning autism-pdd. I need to know how to seperate the two since they look alot alike in sympotoms. Could he have both?

Answer
Hi Brandy;

This diagnostic label business always gets messy when we are dealing with PDD-NOS/high functioning autism (HFA)/Asperger's Syndrome, which are really the same thing.

If your son has Asperger's Syndrome (AS), then the Bi-polar diagnosis has, in my opinion, actually been a misdiagnosis. Bi-polar disorder and the tantrums/ anger outbursts in AS look behaviorally the same but are quite different in many respects. The behavior problems in AS are due to a concrete thinking style, and when his expectations do not meet up with outcomes he will become instantly and extremely distressed and angry. Additionally, children with AS have social anxiety because they lack the skills to be socially competent among their peers. They can't keep up with the social-communicative pace and they know it. The result is they become anxious and eventually do not want to go to school, but go to school they must. The result of the anxiety and that stress is often obsessive-compulsive behaviors that develop as a means of ameliorating the anxiety. The next thing you know a physician is labeling them with obsessive-compulsive disorder (OCD). Does that mean they have Asperger's Syndrome, Bi-polar Disorder, and OCD? Simply put: No!

If you can, visit Tony Attwood's web site and consider purchasing his DVD on cognitive behavioral therapy (CBT) for children with Asperger's who have trouble with anger. It's very inexpensive and it's the best source of information and intervention out there. Dr. Attwood does not know me and I receive nothing from him when I promote his products. He's just the best in my opinion.

Kind Regards,
James