Expert: James Michael Roan - 7/26/2006

Question
Is it possible to be diagnosed with ADHD, Tourrets Syndrom, Autism Spectrum Disorder or Aspergers Disease at the same time.

Thank You  

Answer
Hi Jeremy;

This is always confusing to parents and other professionals. Historically, and in some cases currently, psychiatrists, clinical psychologists, or other health care professionals who work from the "medical model," describe behavior using the Diagnostic and Statistical Manual-Fourth Edition (DSM-IV). Diagnoses are based on the presence of a cluster of behaviors. If the behaviors match the criteria for a particular category, then a label is placed on the individual. I'll get back to this subject in a bit.

I have worked with thousands of children who have the clinical labels you described. Looking at these labels and not knowing anything else about the individual you are describing, I suspect they really just have Asperger's Syndrome (AS), which IS on the high functioning end of the autism spectrum. Children/adults with AS also show motor and facial tics that are common in Tourette's. They also show inappropriate social behaviors that resemble inhibitory deficits seen in Tourette's. Children/adults with AS actually have attention problems or executive dysfunctions which looks very much like ADHD, but are not.

My guess, based on my experience, is that this individual's "true" diagnosis is most likely AS. Children/adults with AS can also have extreme behavioral and emotional reactions to variability and change beginning around 6-7 years of age and then get mislabelled with Bi-polar Disorder.

The point I am trying to make is that although an individual with an autism spectrum disorder demonstrates many features historically identified under other diagnostic categories, their "true" diagnosis is really autism or AS.

Please let me know if you need more clarification. This is a difficult task!

Regards,
James