Predominantly Inattentive ADHD? Asperger's? Making the Diagnosis

One of the common differential diagnoses of Inattentive ADD children is Asperger's Syndrome. It is imperative that these two problems not be confused as the interventions that work for Asbergers's are quite different from the interventions that address the core problems of the Predominantly Inattentive child or adult.

There is a commonality of symptoms between Asperger's and Predominantly Inattentive ADD Individuals. A study done on teacher evaluations of children found that a least some of the time, teachers misclassified an predominantly inattentive child as having Asperger's symptoms and vice versa.

Some of the major symptoms of Asperger's syndrome include the following:

1.  A qualitative impairment in social interaction.

2.  Restricted interests characterized by an "encompassing preoccupation with one or more interest(s) that is abnormal either in intensity or focus. 

3.  An uneven profile of abilities with remarkable long-term memory, exceptional concentration when engaged in their special interest.

4.  Unusual speech patterns with regard to tone, pitch, or accents.

5.  Awkward repetitive gestures, body postures, or facial expressions.

Predominantly Inattentive children do not have problems interacting socially.  They do not lack empathy and in fact can sometimes be overly tuned in to people's feelings and emotions.  They can be very astute regarding the 'feelings' going on in a classroom while totally missing whatever curriculum topic is being discussed.

Predominantly inattentive individuals do not focus on any one area of interest and in fact often have trouble sustaining interest in any activity unless external reinforcements are part of the activity.  The inattentive child will play for hours at a time in their imagination but will not have a particular topic area which will drive their interest as does the child with Asperger's.

The Asperger's individual's ability to hold a fact in their memory is legendary.  If they are interested in say trains, they can give you the names, dates, and location of the invention of this engine or that with amazing and consistent recall.  The Predominantly Inattentive person has to work extremely hard to memorize anything as one of their major impairments is memory.

The speech pattern of individuals with Asperger’s syndrome is quite distinct.  It sounds almost robotic or mechanical.  Predominantly Inattentive individuals have normal speech.  The repetitive gestures that you see in Asperger's Syndrome is also unique, Predominantly Inattentive individuals do not tend to perform repetitive actions.

Other symptoms of Asperger's Syndrome can occur with some frequency in Individuals who are Predominantly Inattentive.  These symptoms include:

1.  Poor handwriting.

2.  Clumsiness. Poor Motor Coordination.

3.  An aversion to bright lights, loud noises, and touch.

4.  Above average vocabulary skills.

The inattentive child will benefit greatly from being too engaged in the process of learning.  Teachers can engage a child with Predominantly Inattentive ADHD by following these suggestions from the Child Development Institute:

Pause and create suspense by looking around before asking questions.

Randomly pick reciters so the children cannot time their attention.

Signal that someone is going to have to answer a question about what is being said.

Use the child’s name in a question or in the material being covered.

Ask a simple question (not even related to the topic at hand) to a child whose attention is beginning to wander.

Develop a private running joke between you and the child that can be invoked to re-involve you with the child.

Stand close to an inattentive child and touch him or her on the shoulder as you are teaching.

Walk around the classroom as the lesson is progressing and tap the place in the child’s book that is currently being read or discussed.

Decrease the length of assignments or lessons.

Alternate physical and mental activities.

Increase the novelty of lessons by using films, tapes, flash cards, or small group work or by having a child call on others.

Incorporate the children’s interests into a lesson plan.

Structure in some guided daydreaming time.

Give simple, concrete instructions, once.

Investigate the use of simple mechanical devices that indicate attention versus inattention.

Teach children self monitoring strategies.

Use a soft voice to give direction.

Employ peers or older students or volunteer parents as tutors.

The interventions for Asperger's syndrome are quite different and can be found on this page:  http://www.aspergersyndrome.org/.

Individuals with Predominantly Inattentive ADD (ADHD-PI) must be properly diagnosed.   Having an understanding of the differences between ADHD-PI symptoms and Asperger's Syndrome symptoms will make it easier to arrive at an accurate diagnosis.