ADHD and Autism in Children and Adults: The Missed Diagnosis with Thomas E. Brown, Ph.D.

Published 2022-02-03
Asperger syndrome was removed from the DSM in 2013 in favor of the umbrella diagnosis of autism spectrum disorder, which many researchers and clinicians see as a mistake. In this hour-long ADDitude webinar, Thomas E. Brown, Ph.D. describes his work with high-IQ students and adults who did very well in their earlier school years, but who had increasing difficulty academically and socially as they navigated middle school, high school, college, and/or employment.

7:12 Various Kinds of Smarts
11:10 Case Examples
33:45 How Many Children with Autism Spectrum Have ADHD?
37:09 Treatment for ADHD with Asperger Syndrome

Related Resources:
1. Is My Child with ADHD on the Autism Spectrum?…

2. ADHD and Adult Autism: Symptoms, Diagnosis & Interventions for Both

3. Self-Test: Autism Spectrum Disorder in Adults…

4. Self-Test: Autism Spectrum Disorder in Children…

5. eBook: "The Truth About Autism in Adults"

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All Comments (21)
  • It’s.just. Beth
    So here’s the thing. Those of us that HAVE learned how to memorize social cues and trained ourselves what is expected behavior in social situations (masking) get incredibly burned out and go into shutdown mode. These shutdowns can last an hour, weeks and sometimes months. We absolutely can not force ourselves to interact causing us to lose jobs, friendships and/or have issues at school. You can teach a person all day everyday how they “should” act or behave but if is not in alignment with who they are and what their true nature is then you’re causing more harm than good. As to the parents that praise their child and then the child has expectations for themselves that are too high…. I guess this can partly be true, but for those of us with Aspergers, we naturally have high expectations for ourselves. Most things that are intellectual come to us fairly easy so when we come across something that doesn’t we get extremely disappointed in ourselves. We then project that onto people who could potentially help us, thinking they will also be disappointed that we didn’t know it and we freeze. Not asking for help. I did not grow up with parents who praised me and still have this issue in myself.
  • I am one of the missed diagnosis people you describe. My father also. He got his diagnosis after he turned 60. The adhd ruined most of his life it was very sevre and untreated.

    I had top grades all through school except in math because I hated math and had no interest or patience for it. I had no idea it was adhd or even what that was. I got through all the way to university with straight A grades but inside i knew i was coasting and struggling. I have managed to ge through life in spite of not knowing the name of my "demon" , but not well. Its been an absolute battle. But I have become a master of masking, hiding my shortcomings, emotions, addictions and problems.

    But i have, in spite of abnormally high iq, not been able to finish any higher education to speak of, unfinished projects pile up, no social life to speak of, financial difficulties and general under achievement and not being able to fulfill my potential. People around me always ask me about what happened to all the great things I was lined up to achieve in life: " oh I thought you where at uni" or "oh I thought she was at the music academy". I feel I have tapped into about 5 to 10 % of my potential. I have been surviving, not living. My mental noise, restlesness and suffering have gotten in the way completely. I'm 39 yrs old now and about to start diagnosed treatment. I'm so hopeful and excited and hope and treatment can change my life in a big way. I am dying to see my life's work come to fruition: I hope the help I can get will be the key to my focus and ability finish work/ achieving my goals.
  • This made me emotional. This talk explains exactly how my life went. Started school at the top of the class. Everything was so easy, I could read anything , was even taken around the school, class to class, to read for all the teachers. Felt like a performing monkey. As I grew older I became very anxious and preferred to withdraw. As I was older, my artistic ability seemed to stand out and I was treated like a prodigy by my teachers. However, I didn’t really have parents and ended up in a lot of trouble because the world became more confusing as people were also. Trying to cope with it all made me suicidal. I eventually was institutionalised for suicidal tendencies and depression. All this probably could have been so different if only I had some understanding as a child and given proper care. But then that can be the case for any child I guess.
  • Donna Hilton
    My sons were both diagnosed with ADHD, but not ASD. One still rocks and chews things up, he's 31. He sometimes has extreme anxiety to the point that I was afraid that he was schizophrenic. The other one chews toilet paper and has extreme anxiety, he is 29. They both still live at home. Neither was diagnosed with autism.
  • Ilana Jensen
    Thank you so much! I’m 43 and have searched for answers almost my entire life. Just knowing and having people that post things that help are so relieving! Thank you, thank you, THANK YOU!
  • D. S.
    Dr. Brown, thank you for your scholarship, your clinical skills, your great understanding, wisdom, compassion, and kindness, and for all of your excellent work over the years. You have made a profoundly positive difference in the lives of so many in this world, and we are forever grateful to you.
  • Scotty Robbins
    Where I come from in California I went to two behavioral learning schools, they were all on a singular bracket to show signs of mainstreaming into regular schools. But the problem is that the school had tested me for ADHD and found that it was conclusive, but the other needs I had which fell under nervous conditions and a and we're not diagnosed have affected me tremendously in my life. What startles me is that I have an excessively high vocabulary however I don't fit their model and I've been looking for how to prove what disabilities I have involving my social anxiety as well as my overall approach to people, there are times that I will spend weeks or months or excessive amounts of time avoiding social situations. Such as going to the store going to the doctor my last doctor's appointment was 3 years in waiting. I've been a part of the kcsos facility and have been a student for their program all the way up until 8th grade and then in high school I was part of the sales program which helped people with special needs. The issue with that is they overinflated the grades for participation you got graded more so for just participation rather than passing the class. I would like further knowledge on understanding what could be wrong because I feel that I was swept under the rug.
  • D. S.
    Dr. Brown, thank you so much for all of your excellent work, and for your tireless efforts to share your knowledge and wisdom with the world.
  • Karen Organ
    14:40 don’t worry children can bully and terrorize children with ASD that are not considered intelligent. I went to a Catholic elementary school and high school and since my parents were divorced the school treated me as if I was evil. My marks were nothing to write home about and no one ever considered me special.

    When I moved to a new area my previous area was about a year ahead and so I requested to be placed in the next year, but they would not so instead I just went into advanced placement everything, 17 courses over four years. Chemistry, Physics, Math, French immersion, English, and History: I also was in a handful of sports; The environmental group; I worked two jobs (I made pizzas, and I was in the reserves — part time infantry); and I dated. My marks ranged from 78% to 95% in these enriched courses. So I went from a place where I got 19% in religion ka ass because I got thrown out for the term, or had to redo French because I missed so many classes and failed, or were placed in remedial English until the teacher decided I didn’t belong there and not only did I get put back in college prep but I didn’t have to write my exam that year because I got over 85%. I’ve tested as an IQ of 135, I have PTSD, severe ADHD as well as Aspergers and high functioning autism.

    Basically I’m saying you could be completely neglected at home, never seen a special, never received any sort of support or words of encouragement and still be severely bullied and beaten at school.

    Even at work, I managed to be the youngest in my basic training course in the military at 17 and still I came in first in my class. I was able to secure a United Nations contract that was highly competitive before leaving high school and despite these achievements my immediate supervisor use me as a sin eater for his narcissistic abuse and one of my section mates charged a rifle and pointed at me the first Saturday I was overseas. A number of other incidences occurred, and no one intervened even though a lot of people saw it.

    Through a rehabilitation program I was trained to be a jeweller even though I had no previous art experience. I didn’t do great at the art school, average marks, but I was with people that have been drawing and painting all their lives. I was at the university in computer science with a fine arts minor my case manager decided I should be a bench jeweller because I did well in the introductory jewellery course.
  • Melissa C.
    I’m late diagnosed with both. I fell between the cracks because of being female and a very highly camouflage/masking ability.
  • Kate Gladstone
    You say (timestamp 9:25-9:31) that the American science writer/SF writer Isaac Asimov was one of several famous people who “have come out and said they have Asperger.” Since Asimov died in 1992, and Asperger Syndrome wasn’t diagnosed in America till two years after his death (1994: DSM-IV), when and where was Asimov diagnosed with Asperger in time to “come out” with it before his death?
  • SailorYuki
    My son has been diagnosed with ASD and ADD, he has speech impairments that makes it difficult for others to understand him. His psychologists think he's either average or below average in IQ, but me and most others, including his speech pathologist, claim he's gifted.
    How do we figure it out? At what point do we make an accurate assessment?
    He's just 6,5 years old, is very knowledgeable in many subjects and understands three languages as well as uses very advanced language, such as words and grammar compared to other kids his age. He prefers adults over other kids and has trouble with social interactions. He's usually very bored and uninterested in school.
  • Jennifer Nelson
    I also agree that it was a mistake to remove Asperger's from the DSM. I have received pushback about this opinion in many of the autism groups I am in. Many people are offended And associate the distinction with an "I'm better or smarter than you attitude" But that is simply not the case. Not having that distinction has been more harmful in my opinion for those who are not diagnosed to believe me when I tell them I am autistic. I am constantly met with disbelief.
  • CreativeOne1970
    I’ve been given a diagnosis’s of Attention Deficit Disorder I’m 51, I was told I have A.D.D when I was 13. My pediatrician told my mother and wrote a letter and gave it to her to keep so I could get further help in school. He also gave me another letter when I was 20. Same letter. So I could get help in college. Had to prove I had a disability to the college. And now at 51 I’ve been told I have Social Pragmatic Communication Disorder. However I have a lot of Autistic traits. But they will not give me a diagnosis’s of Autism or that I’m on the Autism spectrum. I still need help I need an answer ?
  • I tried to get my son diagnosed. I told them I suspected ASD and that there were likely some learning disabilities as well, because his reading and writing skills were vastly different. They didn't even test him for any learning disabilities, or ASD. I don't know where to turn now. Neither of us have 'the spoons" to deal with those struggles again.
  • Hope C.G.
    What if you are an adult that relates to many things in Asperger's and ADHD, but haven't been tested for anything?
  • DJP
    Other kids are mean towards those who they find different - it's as simple as that. Don't blame the victims of mean kids and bullying. Sure, people can be insensitive and not think through what they say, but that does not make them exempt blame. I believe "asperger kids" go though life with very high expectations put upon them and then they expect the same level of thoughtfulness and restraint from others around them. And when that doesn't happen we get mad. And often quite rightfully so.
  • Acid Rain
    Damn this hits home hard, I was diagnosed at 4yo and as well in later years as ADHD, PTSD, GAD highish IQ of 119 yet im a complete failure alcoholic, prior poly drug addict, been in jail for more than 5 years and have nothing, due to my inactive nature, I can't even make phone calls at times, or even keep an appointment. Yet give me a scheme to make money and I can do it, its a disaster of a life to live.