Why ADHD kids are frequently misdiagnosed with autism - ADHD Dude - Ryan Wexelblatt

ADHD Dude provides parent training through the ADHD Dude Membership Site, in-person school-year programs, and summer camps. ADHD Dude is not gender-specific content.
𝗔𝗗𝗛𝗗 𝗗𝘂𝗱𝗲 𝗶𝘀 𝗥𝘆𝗮𝗻 𝗪𝗲𝘅𝗲𝗹𝗯𝗹𝗮𝘁𝘁, 𝗟𝗖𝗦𝗪, 𝗔𝗗𝗛𝗗-𝗖𝗖𝗦𝗣
Ryan is a Licensed Clinical Social Worker, Certified School Social Worker, and father to a son with ADHD & learning differences. ADHD Dude is based in Tucson, Arizona.
𝗣𝗹𝗲𝗮𝘀𝗲 𝗷𝗼𝗶𝗻 𝘁𝗵𝗲 𝗔𝗗𝗛𝗗 𝗗𝘂𝗱𝗲 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝘆:
✅Membership Site: adhddude.com
✅Mailing List: www.subscribepage.com/adhddude
✅Trip Camp: adhdtripcamp.com
✅Meet Ryan: adhddude.com/meet-ryan
✅Speaking/Presentations: ryanwexelblatt.com
✅Instagram: @theadhddude
✅Videos For Kids: tinyurl.com/dudetalkplaylist
ADHD Dude is for educational purposes. I am not serving in a clinical capacity and cannot provide clinical consultation or free advice through KZbin comments, email, etc.
#adhddude #ryanwexelblatt #adhdkids #adhdchildren #adhdkidstreatment #adhdsocialskills

[@bienvenidos5130]

“You can’t diagnose somebody without a full context. In any given moment, anyone can look anything.” 2:33

[@ringofashes]

It’s interesting that the parent’s experience is spoken of as important. When I went to my daughter’s first diagnosis with a developmental pediatrician, she pretty much saw the lack of eye contact and instantly ruled it as ASD. When I tried to bring up the fact that she had no problem making eye contact in situations where she’s comfortable or more familiar, I was ignored and told that it was irrelevant because “She should be able to do it, not just when she feels like it.” Someone else (a psychologist this time) ruled it as ADHD and said that she really didn’t see the social element to be able to rule it as ASD. I’ve considered getting a third evaluation done but at the moment, what’s made the biggest difference are the ADHD Dude resources. I wish I had come across it three years ago.

[@transitiontime3793]

Yes, first example is a inexperienced diagnostician. Not a single diagnosis in the thick DSM manual can be reduced to one symptom in one setting. I think your last point brings up the most important one. If your child is improving and getting the right supports that are making a positive impact, that is where the emphasis should be. A diagnosis is guide to which toolbox to head toward, but if the toolbox of interventions your using is working, it’s not always necessary to get the diagnosis “just right” in the moment. That can change of course as the child gets older.

[@pamelamackenzie1892]

For the creators of this podcast: how do you suggest finding someone to do a thorough evaluation for your child? I feel like I cannot even find the appropriate person, because every place I call will day things like: "we can assess adhd, but not autism," or we aren't acceptint new patients " or they don't take our insurance, or "he has already been diagnosed with ADHD by your pcp, so he doesn't need to be evaluated." I have spent weeks researching and hours on the phone trying to find somewhere to have him evaluated. Our major peds hospital sent me a list of what was basically inpatient behavioral centers, which isn't what we want. Is there a list of reliable resources for finding providers for a full evaluation? I live in Central Florida. Thank you!

[@ADHDDude]

A pediatrician can make an ADHD diagnosis. What matters the most is the data collection, not what type of professional is evaluating. The process should include feedback (rating scales) from various people who see the child in their natural environments. You don't make a diagnosis sitting in an office.

[@ADHDDude]

Yes, agree with everything you said here. :)

[@shadowmystery5613]

@@ADHDDude Haha yeah I can totally relate. I got my ADHD diagnosis as an adult when a therapist secretely watched what I was doing 😂 Any other doctor or therapist I talked to prior rejected/ignored my idea I could have it, but I didn't bring that up for no reason - both my sister and brother also have ADHD and my dad has also always been "strange" so I figured it runs in my family 😆

[@leftthatbehind6090]

I got misdiagnosed with ASD and it was really traumasing to me because nobody would listen to me and now as an adult I still haven’t find a good psychiatrist

[@ADHDDude]

I hear you, it's very hard to find one. Don't give up, it may take months to find one.

[@federicomanuelolveira7658]

The people didn't listen to you because they thought you were autistic?

[@AutomaticDuck300]

I was diagnosed with ASD but I get hardly any of the issues associated with it. I had a lack of eye contact plus masking and being socially withdrawn (due to childhood trauma), so I got diagnosed ASD. But I always kind of understood social cues and never had sensory issues or deep special interests.

[@ADHDDude]

Then that's not ASD. Autism has become profoundly over-diagnosed and mis-diagnosed.

[@crystale5625]

Interestingly enough I noticed a lot of adults with Autism and Aspergers lack self awareness and therefore don't think they have ASD even though they do.

[@courtneydaly-pavone448]

Thank you for spreading the word on the difference between these two diagnoses. My son is ADHD/OCD/PTSD. His SPECT scan showed a small cerebellum. We were advised to do an ADOS. He never had developmental delays. He was always advanced. He only suffers socially with kids his own age. This started at age 6. Before that he was the life of the party. I think too often people label kids ASD.

[@ADHDDude]

Thank you. I wanted to make a point for anyone reading this and this is in no way personal. SPECT scans and the Amen Clinic approach is not taken seriously in the medical ADHD community as it is not based on solid scientific evidence. I do not recommend either to families.

[@courtneydaly-pavone448]

@@ADHDDude Thank you, We did Spect for more pieces to the puzzle. We’re in CA. Do you do virtual consults?

[@ADHDDude]

Yes , for Membership Site members

[@Dessthemess]

This is exactly where I’m at with my son. He’s also 6 and this is his first year in public school which has been very difficult for him socially. I’ve pretty much always suspected adhd as both his dad and I have adhd. However his school is trying to assess him under suspicious of autism. I don’t want him to be misdiagnosed and be put into special education instead of the minimal accommodations he actually needs. That could make or break his entire academic experience.

[@ADHDDude]

Schools cannot diagnose children, they can do an evaluation and provide an educational classification as a result. An educational classification of autism DOES NOT mean that he has autism.

[@MushiroMushroom_hai5]

Oh my gosh. I can’t believe how helpful this talk was for me to listen to. I think I was meant to hear it. Therapist recently brought up pathological demand avoidance re my 10 yr old. I’m glad to know it’s a relatively new thing. I think she’s just being a kid who is trying to push the limits. The part about rules and calm is key for me because I also have ADHD so creating order and organization and calm can be a challenge. Sticking to rules can be hard because I forget, when I’m overwhelmed, to enforce them! Thank you thank you. This helps so much. 👏🏻👏🏻👏🏻

[@ADHDDude]

so glad to hear it, thank you!

[@saffire_fleur]

Found the perfect video for me! I have ADHD and also supposedly Autism, but the more I go back to deep dive into Autism the more I believe I was misdiagnosed. I was a traumatised and socially anxious 18 year old and I think that's what made the psychologist misunderstand

[@ADHDDude]

I think you're probably correct about that, you know yourself the best.

[@SHDWC0428]

Hi, my son is 3 years old. Have expressive and receptive language delay. Very smart, affectionate, dont stop talking, bit shy with strangers, extremely hyperactive, present delayed and immediate echolalia( sometimes). He follow directions, point at stuff, if i ask him what he want to eat he is able to reply, he answer some question and also let me know if he wants to play or what he wants to eat. I took him to the park, and he got excited and started engaging with other kids. At the daycare is a whole different story. He dont follow instructions and runs a lot. Dont like to sit down, dont participate in circle time. He plays with kids at school if they chase him. His teacher constantly complains about his behavior and lack of participation. I am not sure if it is adhd or autism.

[@ADHDDude]

I would enourage you to be his parent, love him for who he is and not try to diagnose him

[@jenniferdye1787]

My son was very similar. He's now 22 and doing well. It will take time to figure it out. The key is to find experienced professionals who will truly listen to you and really be attentive to your son. There is such a wide range of normal for preschoolers and people with good intentions draw their own conclusions. I am an SLP. My suggestion is to get him evaluated by a cohesive team including educational, neuropsych, and Speech-Language, possibly OT if needed. The important thing will be to give them as many details about your son as you can, including his developmental milestone timeline and videos of him in different settings, during his routines and different activities.

[@f0rkk]

I'm here because this is something I've been wondering about myself for a while - I have so many ADHD traits, and the only autistic traits I have are the ones that overlap with ADHD. Yet I got diagnosed with autism when I was a little girl. Probably because of said overlapping traits and the fact that I was a bit shy back then. I've never even had meltdowns/shutdowns, I hate routines (I struggle with both making/planning one and following one, I also find routine pretty boring), and I've never really been uncomfortable with change. As for overlapping traits, eye contact is a bit of an interesting case for me. I can do it with people but sometimes I look away for a few seconds if I get overstimulated (but I tend to look at the person again after I looked away for a few seconds). Another overlapping trait is sensory issues which I do have a few of, but they're just random; I have no visual ones, no auditory ones except for hearing too many people talking at once, and a few physical ones (2 common ones for me are certain food textures, or if a tag in my clothes is scratchy). Then there's the stimming which has always been a thing for me. For example, when I was much younger I would always be doing this thing where I'd create a "loop" with the ends of my hair and fiddle with it. And even now I tend to rub my finger nails with my thumb absent-mindedly. I do that on a regular basis. Regarding "special interests", I'd say for me I just get interested in something that's either new to me or something I liked many months or even years ago, then I hyper-fixate on it for about 1-3 months, I move on to something else after that time is up and then the cycle repeats itself. There's also some interests I've had in the past that I haven't even came back to. I don't know if this "am I just misdiagnosed?" feeling is valid or it's just me having imposter syndrome. All I know is that I relate to almost everything ADHD people say about their ADHD traits, while a lot of the autism ones I just can't relate to at all. Like I know it's a spectrum and all but I just feel so strange about it. I've tried to tell my mum about it but she doesn't take me seriously because she thinks ADHD is just "being hyper and gobby". I'm also afraid of other people not taking me seriously because of those tiktok weirdos who think ADHD is "quirky". All I just want is to be understood for once in my life. Because of the autism diagnosis I had so many annoying people back when I was at school (both staff and peers) who would talk to me in that babyish tone of voice. I haven't had anyone speak to me like that in years but holy shit it was like nails on a chalkboard to me. I also had people assuming I was stupid for it. There were also these creepy girls who would ship me with this kid who couldn't accept that I didn't like him back, shipping us just because we were both neurodivergent. Needless to say the diagnosis did cause a few issues for me, but none of that is autistic people's fault, it's the fault of this society which values neurotypical people over neurodivergent people, and I will still support autistic people even if it turns out that a mistake has been made. I think I should tell my dad soon because he has quite a lot of ADHD traits as well (he isn't diagnosed, but I think it could be possible that he has it), one example I will give is the forgetfulness. We were in the car back in Feb and he was going on about how forgetful he is, and I tell him I'm exactly the same, as to which he says "I wonder where you get that from!". I've heard about "forgetting where you've put something even though it was a few minutes ago that you put it down" and that happens to me sometimes, usually with my phone... and there's a reason why "I did the homework but I left it at home" was a common thing my teachers would hear out of me back when I was at school. As for the other way around, what I used to hear all the time from my teachers, it was sentences along the lines of "can you pay attention next time, please". Pretty sure a lot of people know that being unable to focus on things you don't find interesting is an ADHD trait. A more recent example of this is when I'm on here watching a video and if one doesn't interest me at all, I'll just stop watching it a minute or two in. I could go on, but I think my point is clear (rambling is yet another thing I do all the time, I often go off topic because of it). I just don't know really until I go get re-assessed, which I don't have planned at the minute but hopefully it can happen soon.

[@alyssa0411]

My son was first diagnosed with dyslexia at age 6. Three years later the same doctor said, “I either misdiagnosed him or he managed to work it out with all the help he’s gotten at school”. That doctor then thought he might have high functioning ASD. He wanted another doctor to take a look at him and that doctor (a pediatric psychologist through Stanford University) determined that it was definitely not dyslexia and my son didn’t check off all the boxes for ASD. She determined that he has ADHD-I and SPCD (Social Pragmatic Communication Disorder.). We have just started Concerta although I don’t really see any change in him. It’s like the medication is nothing more than a placebo.

[@ADHDDude]

The SPCD label is one that has no validity as a "stand alone" diagnosis. If you feel he has expressive or receptive language difficulties, or difficulties organizing his language than a speech-language evaluation would be the best route to take.

[@mnkeymasta]

@alyssa0411 I recently played a lot with image and text AI, and I think it's improved my ability to use (written) Language with more Honesty and intention. Speech is... still getting there. I'm a young adult male that struggled with being too smart and too un-organized my entire life (never developed study habits or much planning, since Future Me is smart enough to deal with it) The release of Stable Diffusion/Midjourney (Image-generating AI) and character.ai/ chatGPT (Text-generating AI) have really honed my language skills. Growing up Lying out of Convenience has made it difficult for me to get my thoughts out in speech that others can understand and/or appreciate. But I think my language has become a bit more "honest" after playing with Stable Diffusion and character.ai, because the Images and Characters that the AI generates are sensitive to even the smallest of punctuation or synonym. "Words that mean similar things but carry certain intonations can affect the outcome." I had never thought about that much until now, because Human Conversation was either difficult or uninteresting. TL;DR: AI acting as "interpretive agents" of your Son's Communication, that respond with Images or Chat, may serve as both an Engaging and Productive exercise in use of Language

[@withramya]

All these diagnosis is just somewhat accurate. For that matter, most mental health diagnosis are not a 100% diagnosis.

[@ADHDDude]

Yes

[@florentinac.2651]

Thank you .Very usefull informations.🙏🏻

[@maleitaolsonlcsw5375]

I am so glad you found it helpful.

[@AriJ3652]

I took my kid to a psychologist after the Dr's said his eye contact makes him not asd. The psychologicist asked questions and watched him just be and diagnosed him no question.

[@ADHDDude]

That's not how you diagnose someone....

[@kerrii.8180]

Hi Ryan! I follow you religiously on IG and love all of your information! This video is just awesome! I am wondering what your take is on kiddos with ASD and humor - would you say that ASD kids have humor but it's just different? Do you think they are lacking a little in humor? Is it mostly non-existent? Just wondering general thoughts. Thank you!

[@ADHDDude]

That's a great question. Having spent years working with kids who were diagnosed with (what we used to call) Asperger's I can say that they often have difficult understanding others' humor unless it's similar to theirs and the range of humor they find funny tends to be more limited.

[@majamannhard443]

”MY brother was diagnosed late CORRECTLY but other people must just want resources.” 😬 wow An autism diagnosis is not a snapshot, especially when you’re evaluated as an adult because ypu havena whole life to look at

[@oreotypical949]

Hey I was misdiagnosed with autism at a super young age and I’m positive that I don’t have it so I want to get tested again to see if I have it or not but nobody takes me seriously when I tell them stuff like this! Not even doctors or therapists! I was born premature so had a few developmental delays which was thought to be autism. Ive always been able to make eye contact, never had a meltdown or sensory overload, and funny. I also hate routines and don’t talk monotone unless on purpose. I hate having this diagnosis stuck to me! What do I do?

[@ADHDDude]

I think you should trust your instinct because I think you're absolutely correct.

[@saras4349]

Hello. What if the child is speech delayed, but just started talking more when starting school at 4, can’t focus and is extremely active many time of the day, but is good with kids and makes eye contact and loves to play, doesn’t seem to be in his own world. As his mom it seems like he has adhd but I’m scared doctors will see it as asd instead.

[@ADHDDude]

That sounds like a normal developmental trajectory to me. A child with autism does not share their inner world with other children.

[@saras4349]

@@ADHDDude he’s doing a lot of climbing in school, such as climbing bookshelves and desks, etc. I don’t find that normal. It screams adhd to me, I’m so torn.

[@Jaisha26]

@@saras4349 Did you find answers?

[@alighavami135]

Can MRI change the diagnosis of ADHD vs ASD?

[@ADHDDude]

No it cannot

[@moggingyou]

I never said a single word to my psychologist or any adults but talked alot at home. which i believe was due to selective mutism. i had behavioral issues at school and that’s it. no sensory issues no problems with eye contact no special interests no stimming. that didn’t stop me from getting an ASD diagnosis though and the psychologist one time asked me if i “was faking it” i genuinely believe that almost anyone who is shy or awkward will get diagnosed with autism

[@ADHDDude]

I think that's pretty accurate right now