ADHD and autism

Young children might be impulsive and messy, concerningly quiet, or somewhere in between. They go through periods that require patience and develop gradually. But sometimes, a child’s behaviour can be so difficult to handle that daily life becomes a significant struggle, and at that point you might start considering whether the child has a neuropsychiatric disorder, such as ADHD or autism. For the most part, assessments and additional support are first carried out and provided when children are school-aged, although some kids are diagnosed well before then.

Neuropsychiatric diagnoses

Getting a diagnosis doesn’t mean your child is sick or that anything is wrong – rather, it is a way to describe the challenges that help to explain why things have been so difficult. A diagnosis can provide a parent with tools for managing life and help the child receive the necessary support to blossom and be themselves. Especially if you think your child may have autism, getting an early diagnosis can be particularly helpful. To be assessed for ADHD or autism and receive a neuropsychiatric diagnosis, the child’s difficulties must present severe issues in daily life.

It is important to remember that people with this kind of diagnosis can be extremely gifted in certain areas, and don’t necessarily have any problems at all in the right circumstances. For some, it might feel like a superpower, as over time they find the proper tools for handling things that were an issue. At the same time, for parents it can often be a struggle to see things this way, because life seems to be punctuated by occasional problems or conflict.

ADHD in children

It is thought that about one in twenty children have ADHD (attention deficit hyperactivity disorder). ADHD does not wane with age; the issues often persist into adulthood, but tend to diminish as people learn to understand and handle different situations and scenarios. There are several causes of ADHD, one of which is genetics.

There is no simple test to determine whether a child has ADHD; rather, the assessment process is complex, consisting of several components, because ADHD presents differently. If there are severe problems in daily life, a meticulous investigation will be carried out, including interviews of people in the child’s life, psychological tests and medical assessments, and from there, it is determined whether the child has ADHD.

Difficulties with certain things could be symptoms of ADHD and common early signs include:

• Attention. The child struggles to concentrate (even for short periods of time), to sit still, listen, or to receive instructions.
• Impulse control. The child reacts without thinking and has rapid mood swings.
• Overactivity. Social interaction with other children is difficult and never quite relaxed; play is often fragmented and interrupted.

Different types of ADHD

ADHD can look very different and there are three different types:

• combined type
• primarily inattentive type
• primarily impulsive/hyperactive type

In the past, children were diagnosed with ADD if they were easily distracted and stopped paying attention. This is now referred to as ADHD, primarily inattentive type, which can most easily be described as ADHD without hyperactivity.

DAMP is another older term that has now been changed. These days, this is seen as a type of ADHD that also includes issues with certain movements. The child might also have difficulty interpreting impressions from sight, sound and touch. Instead of DAMP, today we refer to this as ADHD combined with DCD (developmental coordination disorder).

No matter what difficulties the child has, you are always entitled to help from your paediatrician. It is also a good idea to look into support at your preschool or nursery school, for example, if they need help from an adult with play or routines and structure. How you and others treat a child with ADHD matters.

It might also be the case that a child with ADHD-related issues no longer meets the criteria after a number of years.

Autism in children

Autism is a neuropsychiatric disorder. Among other things, children with autism struggle to understand and interpret the world around them.
If you can’t quite connect with your child, you may start wondering whether they have autism and if there is a test for autism in children. It might be helpful to know that it is difficult to conclude with certainty that the issue is autism in babies and very young children. But there are signs to watch for.

From 18 months of age, some early signs of autism might be that your child:

• does not react to their name.
• will not maintain eye contact with you the way other children do.
• does not play pretend, for example, that a block is a car.
• does not point to things to draw your attention to them.

Later on, children with autism commonly show symptoms such as:

• late or absent speech and language development.
• playing differently than other children, mainly with hard objects and often in solitude, for example, spending a long time spinning the wheels of a toy.
• reacting differently to unexpected or soft sounds.
• moving in an unusual way, for example rocking, walking on their toes, or waving their arms.
• having some kind of special interest, such as a fascination with a particular game or activity.
• frustration with changes to routines or when things are moved around at home.
• struggling to understand linguistic implications – for example: “can you open the window?” might be interpreted as a yes or no question, rather than as a request. For that reason, it is better to say “please open the window” toa child with autism.

It’s also important to remember that personality and developmental phases play a role; some children might demonstrate many of these signs without having autism. But if you are concerned, then contact your clinic or a child psychologist for an assessment.

An autism diagnosis is usually made between four and five years of age, but the signs tend to appear already around age two or three. Early diagnosis is often important for being able to help with play and communication, and for you and others to better understand the child. The cause of autism is unclear, but genetics do play a role. Autism is more common among boys than girls

About half of all children with autism have some form of intellectual disability. It is important for children with autism to have regular routines in familiar surroundings, both at home and at preschool or nursery school. Special education can offer support for the child. In the past, when children with autism were of normal or high intelligence, this was referred to as high-functioning autism; these children were sometimes diagnosed with Asperger’s syndrome. Asperger’s syndrome is no longer a diagnosis and we now use the diagnosis of autism paired with the degree of severity.

No matter the challenges or diagnoses, it is important to remember that every child is unique and deserves the best support for their circumstances.

Please note that all information above is based on Swedish recommendations.