発達障害：ADHDとASDの共通点と相違点

メンタル・イデア・ラボの本城ハルです。

⚠︎：発達障害は先天的な脳の発達の偏りなので、親の躾や環境、また、本人のせいでもありません。発達障害をややこしくしているのは、無理解、無知からくる不適切な対応などでさまざまな神経症や精神疾患を併発したことによる二次障害といえます。

今回はＡＤＨＤとＡＳＤ(自閉症スペクトラム)の両発達障害を“共通点”と“相違点”からみていきたいと思います。

ここでは＜こだわり＞＜不注意＞＜衝動性＞＜パニック行動＞＜整理整頓＞の５つの項目でみてみます。

　　　　　　　　　＜こだわり＞
【共通点】
興味関心があることには熱中(過集中)し、時間が経つのも忘れてのめり込む。

【相違点】
ＡＳＤは同じ動作を繰り返す、決められた手順が安心する、匂いや肌触りなど特定の感覚刺激に強いこだわりを持つが、ＡＤＨＤにはない。
　　　　　　　　　　＜不注意＞
【共通点】
忘れ物をしやすい、物を失くす、気が散りやすいといった不注意の表れ方が似ている。

【相違点】
ＡＤＨＤは忘れっぽい特性から忘れ物をするが、ＡＳＤは一つのことに捉われ、その他が抜け落ちやすいことから忘れ物をする。
　　　　　　　　　　＜衝動性＞
【共通点】
ＴＰＯにそぐわない失礼な行動、言動をする、大声を出す、話に割り込む、会話に被せて自分の話をするなどがある。

【相違点】
ＡＤＨＤはわかっているけど衝動的に言ったり、行動に移してしまうのに対し、ＡＳＤは「他者に失礼なことをした、言った」という認識がなかったり、あっても薄い。不安や恐怖を感じるとパニック(脳内大混乱でも行動として表に表れない人、言葉にすることができず、ただただ無言になってしまう人もいる)に陥りやすい。
　　　　　　　　＜パニック行動＞
【共通点】
自分の思い通りにならなかったり、予想外の出来事に対してパニックや癇癪を起こす。

【相違点】
ＡＤＨＤはすぐにキレることや癇癪を起こし、感情をストレートにぶつけてくることが多いのに対し、ＡＳＤは言われた内容や特定の音、強い光、騒がしさなどに瞬間的に反応したり、急な予定変更や想定外の出来事に対処できず(脳内キャパシティーオーバー)パニックを起こす。
　　　　　　　　　＜整理整頓＞
【共通点】
他者から見てどちらも一見散らかっているように見える。

【相違点】
ＡＤＨＤは無秩序に散らかっているので、どこに何があるのか自分ですら把握しておらず、しょっちゅう物が行方不明になっては物を失くし、脳内もさまざまな情報が散らかっている。ＡＳＤは、一見無秩序に見えても“自分だけがわかる”秩序の中で散らかっているので、その中にある必要な物の場所はしっかり把握している。

◇

また、ＡＤＨＤとＡＳＤを重複して持っている発達障害の人も多いので、“〇〇はＡＤＨＤ、△△はＡＳＤから”のように、人によって多種多様で複雑な表れ方をします。片付けられないからＡＳＤ、すぐにキレるからＡＤＨＤとは限らないのです。

どちらからの特性が表れているのかによって取れる対策も周りの対応策も変わってくるので、気になる人はきちんと【大人の発達障害】を診ることができる専門病院やクリニックで相談、心理検査(成人はWAIS Ⅳ、１７歳ぐらいまではWISC Ⅳ)を受けてみることをお勧めします。あるいは国立障害者リハビリテーションセンターの【発達障害情報・支援センター】で相談窓口を検索できます。

◇

幾つかの共通する特徴を持つ『自閉症』『高機能自閉症』『アスペルガー症候群』を【広汎性発達障害】と呼び、同一線上にある“連続体”という捉え方から、昨今『自閉症スペクトラム』という呼び方をしています。一方で“自閉症”という単語が含まれていることから「わかりづらい」「誤解を招きやすい」「説明しにくい」「違和感がある」という声もよく聞かれます。こうしたことから、今後このコラムでは自閉症スペクトラムという表記ではなく、【アスペルガー(ＡＳＤ)】という表記に統一したいと思います。

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