2017.11.22 Thoughts on Autism vs ADHD

There is a reluctance of certain professionals in the mental health field to carefully consider the diagnosis of ASD as it applies to the individual under their care. With the diagnosis of ADHD or ADD, Attention Deficit Hyperactive Disorder or Attention Deficit Disorder, there are drugs that can be prescribed that rule in or rule out the disorder. As prescribers note, if the medication works, then the child or adult has ADD/ADHD. With a diagnosis of ASD, Autism Spectrum Disorder, there is no clear medication regimen for the alleviation of ASD specifically. In other words, the sequelae of ASD are treated, such the accompanying anxiety or depression, or even, ADHD/ADD, but the autism itself is not affected by pharmaceuticals.

The benefit of a diagnosis is improved outcome of the client's clinical condition, using evidence based practices. In addition to the practical tools that apply to ADD/ADHD, the medications, there are financial incentives for all involved - from the drug purveyors to the prescriber of the child; the child's performance improves and everyone benefits.

In the case of ASD, the parsimony of giving the diagnosis means that the diagnostician is acting like a gatekeeper of the public resource. With an ASD diagnosis the only beneficiary is the child and the child's social environment. Regarding ASD, the pressure is to not give the diagnosis for, in actuality, there is no financial gain for any of the actors involved.

If the essential element of autism is an inability to learn emotional self regulation from the conduct of another person, then the diagnosis is essential if the condition is chronic. Intellectual capacity and social rehearsal may make it appear that the child has better abilities in social interactions than is the case. Because the condition is masked by rote learning, the provider can be mislead into ignoring the condition and short change the client by denying access to the behavioral interventions that have merit. The child or adult with untreated autism needs specific supports to function well in society, especially if intellectual capacity, so vital in all aspects of society, is not at the savant level.