In this chapter the author provides a case study of Richard, treated for both attention deficit hyperactivity disorder (ADHD) and Asperger syndrome. When he first entered the author's consulting room Richard was well dressed in a business suit with tie. Richard mentioned that he had previously been diagnosed with ADHD and had been taking prescribed medication for it. To provide more information about himself Richard handed the author a report from a psychological evaluation he had undergone ten years earlier. The author then administered the Brown Executive Function/Attention Rating Scale to assess Richard’s current level of ADHD impairments. For his ADHD Richard had been taking Vyvanse 60 mg each morning and felt it helped his focus somewhat, but did not provide much benefit for his alertness. In their next session Richard began by telling the author that he had been thinking a lot about the Asperger diagnosis and realized that he has had those problems for a long time.