Want to understand - in simple, clear terms - the real difference between ADHD (Attention Deficit Hyperactivity Disorder) and ASD (autism spectrum disorder)? Especially as more children are entering are classrooms with a diagnosis?
Understanding how these two conditions affect students is key to helping them manage their emotions and behaviour. So in this episode we’ve condensed and simplified everything you need to know, giving you the knowledge you need to support the pupils in your classroom.
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Show notes / transcription
Don't forget, kids can have a diagnosis of both autism and ADHD and that is quite common.
Emma Shackleton 0:06
And as with all behavioural special needs, every child is different. And that's why there is no one size fits all approach to supporting pupils with autism or ADHD.
Simon Currigan 0:19
Hi there and welcome to school behaviour secrets, we're up to Episode 13. And this podcast is your deep dive into how to support your students with their emotions and behaviour in school. We're recording exclusively from behaviour towers, please excuse the mess. We haven't had time to tidy up since the cats had a fuss on the carpet. I'm here with my co host, Emma Shackleton. Hi, Emma.
Emma Shackleton 1:20
Simon Currigan 1:20
I'd like to ask you a question. Do you like to plan ahead or are you more impulsive?
Emma Shackleton 1:27
I'd say it kind of depends on the situation and the context. I do love to plan ahead. I like to know what's coming next. And I definitely feel better when I've got a schedule to follow and that I'm prepared for it. However, I do also have quite a low boredom threshold. So there are times where I'm more spontaneous and impulsive. Just to change things up a bit. What about you, Simon?
Simon Currigan 1:52
I guess I'm a bit more impulsive. But I think that's probably because I can be because my wife is quietly planning everything in the background. We get our ability to plan ahead from a part of our brain called the prefrontal cortex. And the prefrontal cortex is just one part of the brain that's wired differently in kids with ADHD and autism. Now, these conditions are quite different, but they often get mixed up by teachers and parents. So in today's podcast, we're going to look at how ADHD and autism are different. And by the end of the show, you should have a very clear picture in your head about what ADHD is and how it affects our students. And likewise for autism.
Emma Shackleton 2:32
Yes, but before we go any further, if you enjoy the show today, don't forget to give us a rating and review on Apple podcasts. Every review tells Apple to recommend the podcast that other listeners so they find the show and start getting the help they need to support the children in their classrooms, too.
Simon Currigan 2:51
So let's grab this unruly chicken we call behaviour give its wings, a calming stroke, and see if we can make an egg pop out. Over to you Emma, you want to kick off?
Emma Shackleton 3:00
Thank you. Okay, so ADHD stands for attention deficit hyperactivity disorder. And what's interesting is that ADHD is actually an umbrella term that encompasses more than one condition. So people can have ADHD, or ADD without the hyperactivity, and it's all referred to as ADHD. So the in your face hyperactive element doesn't need to be present for somebody to be diagnosed with ADHD.
Simon Currigan 3:35
And it's surprisingly common. In fact, it's the most common brain based disorder in children and adolescence. If you look on the NHS website, they talk about 3 to 5% of kids being affected by ADHD. So that's about one in 20. But that's based on the numbers of families and kids that were walking through psychiatrists doors. The CDC in America did a screening in 2010. And what they found was when they looked at the entire community, and they screen loads and loads of kids to see, you know, who would qualify for a diagnosis of ADHD, whether or not they had a referral, they discovered that it affects 11% of kids. So that's about one in 10. So in an average class of 30 kids, we're talking about three kids per class. Now, that doesn't mean they've got a diagnosis, but it means they would qualify for a diagnosis of ADHD. And I think what's the most surprising statistic about ADHD is there was a study by the British prison service that was screening their prisoners to find out possible causes for difficult and challenging behaviour. They found one in four inmates screened positive for a childhood history of ADHD. And another interesting statistic is that ADHD is more than twice as common in boys as it is in girls.
Emma Shackleton 4:51
Ah, so let's look at the cause of ADHD then. So some people are quite surprised to learn that ADHD is not caused by poor parenting. It's not related to food or food sensitivities or poor diet. It's not caused by too much screen time. Those are all actually myths. Sure, they might influence behaviour in a negative way. But true ADHD has only one cause it's genetic. So ADHD is a condition that babies are born with.
Simon Currigan 5:25
And it affects your prefrontal cortex. So your prefrontal cortex deals with things like planning ahead, emotional regulation, impulsivity, attention, and in terms of attention there that can be focusing your attention down to a task, and blocking out sensory information, things like breaking a task down into its constituent parts, learning to link cause and effect. With kids with ADHD, the prefrontal cortex is wired differently. So when you look at scans, it has fewer brain cells in it, it's literally lighter, and has less blood flow going to it, we can think about the prefrontal cortex as being responsible for executive functions. When we speak about executive functions. Here we're thinking about executive in terms of government or the people in charge of a company that people are bosses around. In a Thomas the Tank Engine analogy, your prefrontal cortex is the Fat Controller, who organizes and manages our thoughts and actions.
Emma Shackleton 6:20
Who doesn't love a Thomas the Tank Engine analogy,
Simon Currigan 6:23
If you're talking about ADHD, you've got to reach for a Thomas the Tank Engine analogy.
Emma Shackleton 6:27
So let's think about what ADHD might look like in terms of behaviour in the classroom. Well, if you've ever taught a child with ADHD, I bet they pop right into your head right now. behaviours that you're likely to see in school are things such as the pupil really struggling to sit still finding it hard to concentrate, maybe excessively talking, shouting out, people with ADHD find it difficult to wait their turn, they often act without thinking through the consequences, and they have little or no sense of danger. So they are the children who if the football goes over the fence at play time, they're straight up and over to get that ball. They don't think about the consequences of climbing a fence or what might be on the other side. Or what could go wrong. The idea pops into their head. And they instinctively and impulsively follow that through if they've got the hyperactivity element, they are the ones who are often tapping, moving squirming. They're often described as constantly on the go, or as if they're driven by a motor. And these are the kids who might blurt out the answer before you've even got to the end of the question.
Simon Currigan 7:43
Another classic behaviour for kids with ADHD is talking in a very loud voice, especially in classroom conditions where it's expected that the kids are to be working more quietly, maybe during a test or doing some silent reading. You might see kids with ADHD make careless mistakes. And they tend to dislike tasks which involve attention to detail, they're unable to stick at tasks that are time consuming. And also you may find that they get lost in the middle of tasks or instructions, you may give them something to do. And they complete the first couple of steps. And then it will get lost and distracted in the middle of the task. They can also have difficulties with the organization. So breaking a task down into its constituent parts or even fetching the resources they need in the right kind of order to complete a task. And also, when you're speaking to them, even one to one you get the feeling that they're not listening to you that the words aren't sinking in. And you might also find that they're forgetful or keep losing things. And they're constantly changing activity or task. I remember observing a child with ADHD in reception once and it was free choice activity time. And he had chosen to go and play with a Lego. And even though he chosen to go there, he couldn't wrestle his attention down to the Lego and then he flipped it to doing some coloring in and he was there for about 20 seconds. And he couldn't cope with coloring in then he moved to another activity and he was getting frustrated with himself. He was choosing these activities, but he just couldn't focus his attention. So he flitted from one thing to the next.
Emma Shackleton 9:07
And I think what's interesting there Simon is the in reception, there might be quite a lot of children who were doing that flitting in that butterflying from one activity to another but with ADHD, that would be every single day, every single activity all of the time and that stays with them as they go through the school. So as their peers mature and learn to settle down and be able to concentrate for longer periods of time. A child with ADHD is still going to have that very flitty nature and be wanting to move around and go from one task to another. The real big one to watch out for with ADHD is emotional regulation. ADHD affects the prefrontal cortex. It's like there's no handbrake. It's really difficult for them to pull their emotions back. Often people with ADHD really regret that the way that they behave. They really don't mean to be disruptive or offensive, but they just can't help it. Children with ADHD might make the same mistakes over and over again. So for example, maybe they find it hard to share or they spoil a game, they know that this is the wrong thing to do. And they feel sorry that they've upset others. But then the very next day, they go and do that all again. This, of course, then can lead to low self esteem. Because the child engaged in an activity, they knew it was the wrong thing to do, but they just impulsively did it. And then they regretted it afterwards.
Simon Currigan 10:37
And of course, we're comparing the kids to their peers here. So what looks like inattention in a seven year old is going to look way different to inattention in a 12 year old. Every child is different, and their ADHD affects them in different ways. They're all individuals. But one characterization I've heard time and time again from teachers that we work with in schools is that the child's a cup bottle of pop, you know, they can't contain their energy, they can't contain their enthusiasm. And in terms of their emotional regulation, sometimes you just see them explode. I just like to take a pause for a moment and say that if you're finding this podcast useful, then you're going to love what we've got waiting for you in our inner circle program. The inner circle is your one stop shop for all things behaviour. It's a comprehensive platform, filled with videos resources, from behaviour inspiration to get you unstuck with classroom behaviour. We've got training resources on de escalation, supporting kids with anxiety support strategies for conditions like autism, ADHD, and PDA. practical ways of helping pupils deal with strong emotions, assertive behaviour management techniques for managing the whole classroom setting out your classroom environment for success. Resetting behaviour with tricky classes, and more. Our online videos walk you through practical solutions, step by step. Just like Netflix, you can turn an inner circle subscription on or off whenever you need to, with no minimum contract. Plus, you can now get your first seven days of inner circle for just one pound. Get the behaviour answers in you've been looking forward today with inner circle visit to beaconschoolsupport.co.uk and click on the inner circle picture near the top of the homepage for more information.
Emma Shackleton 12:24
Okay, let's take a look now at autism. So Autism is commonly referred to as ASD autistic spectrum disorder. Some people prefer the term a sc. So autistic spectrum condition. And it's important to remember that autism is not a single disorder, but it's like a spectrum of closely related disorders with a shared core of symptoms. So everybody on the autism spectrum has problems to some degree with social interaction, empathy, communication, and flexible behaviour. But the level of difficulty and the combination of symptoms varies tremendously from person to person. So if you think of each of those elements as like a dial, the dials for each person are going to be tweaked to a different setting for each individual. So that explains why two people with exactly the same diagnosis will not necessarily demonstrate the same behaviours, the prevalence of autism is thought to be around one to 2% of the population, though diagnosis rates are increasing. And that's why we've decided to focus on autism. And that's a whole other episode.
Simon Currigan 13:42
The cause of autism is not as many people believe it's nothing to do with the MMR injection, please let that belief go. And it's nothing to do with parenting. And it's nothing to do with food or diet, it appears to be genetic. So we inherit the genes for autism from our parents, just as we do for conditions like ADHD. There may also be issues around premature birth, which are worth looking into. Kids who are born prematurely at around 27 weeks or so are way more likely to go on to develop autism, the diagnosis rates are about one or 2%. For the general population. If you're born at 27 weeks or earlier, that number shoots up to about 30%. So as well as autism being caused by genetic factors, we need to look at the impact on that sort of development outside the womb on how their brains are developing. And this could be another big possible cause of autism.
Emma Shackleton 14:37
This is then perhaps where some of the confusion arises. Because just like with ADHD, autism relates to how people's brains are structured. Children and adults who were diagnosed with autism have what's commonly known as a triad of impairment. three key areas of difference of difficulty from a neuro typical person. The first area is social understanding. So that means miss reading social cues, not being able to interpret social situations, not understanding what they have to do in a particular situation, even when they've been in that situation before, and not understanding how to engage appropriately with others. Really tricky for people with autism, because they appear to not be able to read very subtle cues that other people are easily able to read. So they don't understand, for example, when it's their turn in a conversation, or they might find it hard to understand that a conversation has got to flow back and forth, back and forth. Instead, they might prefer to dominate that conversation, they might like to talk about what they want to talk about and have very little awareness of the listener and what they might be hearing. So social understanding is one of those areas. Communication can also be affected. So that's receptive language and expressive language. So it's understanding and processing what has been said. And then using appropriate words to communicate what they want to say as well. And processing time is often increased for people with autism. And then in flexibility, this is a really key one, a huge dislike of change, and a real need and desire to have things a certain way. You will often see young children with autism, for example, who very much like to stick to a routine, they like to repeat processes over and over and over again. In their play, For example, rather than interacting with their peers or joining in with what others are doing, they'll often have very favorite activities that they like to return to day after day after day. Interestingly, only a few weeks ago, actually, I observed a boy in a reception class who's got a diagnosis of autism. And every single day, he goes over to a certain shelf, he gets a little basket that's got cubes in there and little basket that's got numbers on a card. And every day, he likes to make little towers of cubes that match the number on the card. And every day, he'll choose the same color cubes, made the little towers, match them up with the card. And this is almost like soothing for him. He's got other skills, he can do other things. But this is what he likes to revisit time and time again. Now, if that basket wasn't there, if the cubes weren't there, if the cards weren't there, or actually, if somebody came and interrupted that activity, he would get quite distressed, because he likes to have things in the same way, day after day after day.
Simon Currigan 17:48
So that's the triad of impairment, the sort of three classic key areas of difference. But actually, we can broaden that out into a pentagon of impairment, because there are two more things that you will commonly see in kids with autism. And the first is sensory needs, so they might be hypersensitive to certain senses. It's almost as if your volume for certain senses has been turned up. So you might hear common classroom sounds really, really loud. Or you might interpret them as being the classic joke on their spinal tap, it's like the sound has been turned up to 11. If someone brushes past you in the cloakroom, if you're hypersensitive to it, you might react as if someone's just punched you in the arm. So you're super sensitive to certain senses. But you can also be hypo sensitive, which means you're under sensitive. So you may not have the sensation of your body sinking into a chair and feel the chair underneath you holding you up, you might not have a particularly strong sense of taste. So you can be over or under hyper or hypo sensitive to certain senses. And the other, the last part of the Pentagon of impairment is theory of mind. And that's essentially empathy. That's being able to put yourself in other people's shoes and see a situation from someone else's point of view. And as a result, you might end up blaming others for things that you've had some responsibility for, not being able to see your role in a situation. And if you can't take responsibility for what's happened, then often it's very difficult to learn from it and move on.
Emma Shackleton 19:16
And the fact is that social interaction is so so complex, and there are so many subtle nuances. And that's what makes it really tricky, isn't it? people with autism just don't read those cues. They don't see those things going on, and they're unable to imagine what it's like to be somebody else. They very much see things entirely from their own perspective.
Simon Currigan 19:38
I was observing a child the other day on the playground, actually, and they were playing a game of football and he dominated the game and he was grabbing the ball off the other children. All he could see when the other children got upset was they didn't like him. They didn't want him to win, but he couldn't see his part in that he was disrupting the game and taking more turns than the other children
Emma Shackleton 19:56
Because society requires so much in interaction with other people. And because it's so difficult to interpret those reactions from other people, it can be really stressful for people with autism. So they experience a high level of stress and anxiety. And this then is what can lead to meltdowns or refusals. Sometimes you'll see autistic children completely shutting down, just avoiding eye contact, avoiding interaction not talking, not looking, not moving. Or they might go into that flight response where they will run away or try to get away from the cause of the stress, maybe run out of class. Also, you might see controlling behaviours. So trying to boss people around wanting things to be done in a particular way, finding it very difficult when there's a change or something unpredictable happens. And that inflexibility of thinking so only being able to see things maybe from one perspective their own, not being able to appreciate any other people's perspective, and it feeling stressful and painful to them. It's distressing, because it's so difficult to make sense of.
Simon Currigan 21:04
So although these conditions have similar causes for the behaviours that you'll see in the classroom, it basically comes down to differences in brain wiring, they are quite different.
Emma Shackleton 21:15
So ADHD affects hyperactivity, for some, impulsivity and attention.
Simon Currigan 21:21
Autism is more complex, it affects social interaction, the ability to use language in flexibility, sensory needs and empathy.
Emma Shackleton 21:30
But both conditions can lead to explosive behaviour. with ADHD. It's more from that lack of emotional regulation. And with autism, it's from stress induced anxiety.
Simon Currigan 21:42
And don't forget, kids can have a diagnosis of both autism and ADHD. And that is quite common.
Emma Shackleton 21:49
And as with all behavioural special needs, every child is different. And that's why there is no one size fits all approach to supporting pupils with autism or ADHD.
Simon Currigan 22:02
If you work with kids with challenging behaviour, and you're not sure why they're acting the way they are, we've got a download that can help. It's called the SEN Handbook, and it will help you link the behaviours you've seen in the classroom with possible causes like autism or ADHD. The idea here isn't for us as teachers to make a diagnosis. We're not qualified to do that. But if we can link behaviours to possible causes quickly, it means we can get the right help from professionals and get early intervention strategies in place. It's a completely free download, go to our website beaconschoolsupport.co.uk. Click on the free resources tab near the top and you will see the SEN handbook near the top of the page. I'll also put a direct link to the SEN handbook in the show description.
Emma Shackleton 22:50
And in the next episode, we're going to be talking to Dr. Jerome Kagan retired Emeritus Professor from Harvard, who spent his career researching and writing books on human development from infancy through to adulthood. He was once described as the most revered developmental psychologist in the world, this interview is going to be controversial. So you don't want to miss it, because he's going to present the view that attachment theory is wrong. And we should all just let it die. Yes, you did hear that correctly.
Simon Currigan 23:25
I can hear people bashing their keyboards on Twitter as we speak. So to make sure you catch this interview, open your podcast app now. And tap the subscribe button in a friendly platonic way. Nothing aggressive, and your podcast app will automatically download each and every episode of school behaviour secrets, so you never miss a thing.
Emma Shackleton 23:46
And finally, if you find today's episode useful, please leave us an honest rating and review on Apple podcasts. This makes a huge difference because when you rate and review as it makes it more likely that school behaviour secrets will be recommended to other listeners, and then other teachers and school leaders can find the show and start getting the help they need to support the children in their classrooms, too.
Simon Currigan 24:11
Thanks for listening to school behaviour secrets. Have a great week and we look forward to seeing you in the next episode. Bye now
Emma Shackleton 24:18
(This automated transcript may not be 100% accurate.)