Autism and ADHD have Similar Structural Defects in the Brain

Researchers at the University of Toronto have discovered that autism, attention deficit hyperactivity disorder (ADHD) and Obsessive Compulsive Disorder (OCD) all have “disruptions in the structure of the corpus callosum” in the brain. The corpus callosum is a nerve fiber bundle that links the left and right hemispheres of the brain. Results of the study were reported in the July 1, 2016 issue of the American Journal of Psychiatry.

In the study, the researchers examined the brains of 71 children with autism, 31 children with ADHD, 36 children with OCD and 62 “typical” children using diffusion tensor imaging. Diffusion tensor imaging measures the diffusion of water across the long fibers that connect the nerve cells in the brain’s white matter. There were “widespread disruptions” in the white matter structure in the brains of the children with autism and the brains of the children with ADHD. The OCD brains had “fewer alterations” than the autism or ADHD brains. Researchers also noted that the children who had the “least independence on daily tasks” (as assessed by their parents) were found to have the “most significant disruptions in white matter.”

Researchers noted two caveats. There were changes in only a small section of the corpus callosum in the autism, ADHD and OCD brains; therefore, the clinical meaning of the changes is unclear.  Secondly, “movement in the scanner” by the children could not be ruled out as affecting the differences in the three groups of children.

Sources:   Scientific American August 9, 2016 and August 8, 2016

ADHD May Mask Autism in Young Children

A study published online Sept. 14 and which will be published in the October journal Pediatrics showed that symptoms that were attributed to Attention Deficit Hyperactivity Disorder (ADHD) may conceal autism spectrum disorder in very young children. It took on average 3 years longer for children initially thought to have just ADHD to get an autism diagnosis.

According to Dr. Amir Miodovnik, a developmental pediatrician at Boston Children’s Hospital , “three years is a significant amount of time for the kids to not be receiving therapy.”1 For the study, the researchers looked at data on nearly 1500 children with autism that were part of the 2011-2012 National Survey of Children’s Health. The survey asked parents whether their children were diagnosed with ADHD or autism and at what age the children were at diagnosis. Approximately 43% of the kids had the dual diagnosis.

The study found that more than 40% of the children diagnosed with ADHD and autism had the ADHD diagnosed first. A majority—81%–of the kids initially diagnosed with ADHD were diagnosed with autism after age 6. Children diagnosed with ADHD first were 17 times more likely to be diagnosed with autism after age 6 than those children diagnosed with only autism. The children first diagnosed with ADHD also were 30 times more likely to receive an autism diagnosis after age 6 than children who were diagnosed with ADHD and autism at the same time or initially diagnosed with autism and received an ADHD diagnosis later.

Dr. Miodovnik concludes that “parents who believe a child younger than 5 has ADHD should take their child to a developmental pediatrician, rather than a family physician, to make sure that possible autism will not be overlooked. “ He further stated that if a parent “suspects ADHD in very young children, it’s probably best for them to be evaluated by a specialist, partly to not miss a diagnosis of autism, and also because managing a child with ADHD can be complicated.”1

Such is the case (only with worse delays) in my own family. I did not get an autism diagnosis until age 40 and I got an ADHD diagnosis a few years earlier. My daughter got an ADHD diagnosis at age 6—though the symptoms were apparent a year or two earlier. The autism was diagnosed at age 7 ½ and only because the new psychiatrist I brought her to for ADHD meds recognized the autism in both of us.

Source: 1

Autism, ADHD and Sleep

I have both high functioning autism and ADHD. I have had sleep problems my entire life so I likely have a sleep disorder. It doesn’t help that I was raised to sleep in a quiet environment and when you have ADHD (which causes you to listen to every single creak in your house and every single sound your neighbors make), getting a decent night’s sleep can be tough. There are a variety of remedies to getting a good night’s sleep– and there are enough articles out on the Web about having your room at the right temperature, not watching lots of TV or playing video games before going to bed, getting exercise during the day and not taking a long afternoon nap etc.—so this is NOT one of those articles.

This article addresses what you WON’T see out on the Web routinely. First, I’ll discuss the meds. Physicians like to prescribe Trazodone, which is actually an antidepressant, although it is not used for that anymore, but instead it is used for sleep. I have used this drug for years but it does have side effects.  The most “common1:”

  • Blurred vision
  • Confusion
  • Dizziness
  • Lightheadedness
  • Sweating

Then there are the “less common1” side effects such as:

  • Burning, crawling, itching
  • Decreased concentration
  • Fainting
  • Lack of coordination
  • Muscle tremors
  • Headache
  • Nervousness
  • Shortness of breath ETC.

Then there are the drugs actually designed to fight insomnia like Zolpidem (Ambien). They are designed for the short term and can cause dependence long term. Most common1 side effects are:

  • Clumsiness or unsteadiness
  • Depression
  • Confusion

Then there are the over FIFTY “less common”1 side effects…here are some of the highlights:

  • Abnormal or decreased touch sensation
  • Appetite disorder
  • Confusion about identity, place and time
  • Difficulty with moving
  • Difficulty swallowing
  • False or unusual sense of well-being
  • Hearing loss
  • Lack or loss of self-control

A common over-the-counter drug used for sleep is Diphenhydramine (Benadryl), which is actually an antihistamine, but it has a side effect for many people of making them sleepy. Thus the drug is commonly used in sleep medications. Until the news this year that this medicine has been linked to the increased risk of dementia2, I found Diphenhydramine to be highly helpful as a sleep med to use without a prescription. But, frankly, I’d rather have a sleep problem than dementia.

Additionally, there are a variety of herbal and “natural” remedies used for sleep. The only one I personally found effective was chamomile—which I drink as a tea. I also previously used melatonin for sleep. Melatonin is a hormone that helps to regulate sleep and wake cycles. You can get it over the counter most commonly in 3 mg, 5 mg or 10 mg doses. (Note the update below).

So to summarize, medications (prescription or over-the-counter) can have significant side effects. Herbals are minimally regulated so their side effects may not be well known.  The most effective sleep remedy for me, in particular to counteract my ADHD, has been ear plugs to obliterate outside noise, chamomile tea, a Trazodone pill, along with concentrating on my breathing until I fall asleep.  Sure looking like a sleep disorder.

UPDATE Dec. 24, 2015³:  Turns out melatonin pills are not such a good idea to use on a regular basis as an adult or at all in children. The recommended dosage is 0.3 – 1.0 mg (according to research by MIT in 2001), but what you will find in the stores is 3 mg, 5 mg and 10 mg. Taking melatonin pills on a regular basis can ultimately lead to insomnia during the night and grogginess during the day.  So says neuroscientist Dr. Richard Wurtman of MIT and Michael Grandner, a sleep researcher at the University of Pennsylvania. Long term use also has been linked to reduced natural levels of the hormone in the body. In children, excess melatonin can “affect puberty, disrupt menstrual cycles and impede normal hormone development.”

In my case, I went from 5 mg to 10 mg in the mistaken belief that more melatonin supplement would help me sleep better. Exactly the opposite of what the above researchers are saying. Over time, I experienced increased insomnia at night and sleepiness during the day. But as soon as I stopped taking the melatonin, I slept better at night and was not groggy but more alert during the day. So no more regular melatonin for me.

Further edited Feb. 2019

Sources: Drugs.com1 (Jan 28, 2015)2 (Dec. 16, 2015)³