Have you heard of attention deficit hyperactivity disorder (ADHD)? What about autism spectrum disorder (ASD)? Is it possible to have both of them at the same time?
Many parents have been struggling for years to figure out whether or not their child has ADHD vs autism. They are both developmental disorders that affect a person’s ability to communicate and interact with the world around them, but there are some key differences between the two.1
The presence of impairing symptoms of inattention and/or hyperactivity-impulsivity defines ADHD. You may notice a child has trouble waiting his turn to talk, interrupts people, or doesn’t sit still. They usually onset before age 12.
Yet, you may see trouble focusing on school or work. Sometimes, you may see difficulties with following instructions. It affects 5.9% of youth and 2.8% of adults worldwide. 2
Impaired social communication and interaction deficits characterize autism. It usually occurs with restricted, repetitive behaviors, interests, or sensory symptoms. The children may avoid eye contact. They may have delayed speech. Many times they have trouble understanding other people’s feelings and their own. 3
The notion of ADHD vs autism is prevalent. The symptoms and impairments of both conditions often persist into adulthood. 4
They are more common in boys than in girls. Both have a genetic predisposition – genetics can explain approximately 70–80%. They may show academic, emotional, and adaptive problems in school, at home, and elsewhere. 4
Also, ADHD and autism can occur together as well. Some studies have reported that approximately 1 in 8 youth with ADHD have autism. Yet, ADHD is the most common comorbidity in children with autism. 5
ADHD vs Autism
ADHD and Autism can be different in many ways.
First, let’s talk about social problems.
Like children with Autism, those with ADHD experience significant social difficulties. 6 They may have fewer friends at school. Often, lack of attention may lead a child to miss social cues. Impulsive behaviors may upset their friends. Hyperactivity hinders participation in organized activities and leads to avoidance of other children.
Approximately 50–60% of children with ADHD experience rejection by their peers. While playing, children with ADHD can be bossy, explosive, intrusive, and frustrated without any reason. During organized sports/games, they can be inattentive and violate the rules of the game. 7
Children with autism have social difficulties for other reasons. Rather than the presence of impulsive behaviors or inattention, they don’t have social awareness.
Another difference between ADHD vs autism is in how they pay attention to things.
Children with autism can generally pay attention if they enjoy the activity — such as playing with their favorite toy or puzzle. But, they have problems sustaining attention for non-preferred activities. They show difficulty switching attention. Children with ADHD struggle to focus, no matter if they like the activity or not. 7
Also, children with ADHD vs autism may have low grades at school due to the lack of attention. Lower IQ was much more common among individuals with autism than those with ADHD. 7
Yet, children with autism like order and repetition. They don’t like changes in their routines. Children with ADHD don’t want to do the same things over and over again.
ADHD vs autism is distinct, although symptomatology is overlapping to a large degree. In the next section, we are going to present the symptoms in more detail.
ADHD vs Autism: Symptoms
Both ADHD and autism may present difficulty in social contexts. The core symptom of ADHD is an attention deficit. But children with ADHD vs autism often exhibit social problems like children with ASD.
Even if they have some things in common, they’re still two distinct conditions. Sometimes, the same person can have both. We are going to talk about it later in this text. For now, let’s take a look at the symptoms of each disorder.
A person with ADHD vs autism may experience symptoms of inattention, such as 8:
- Can’t give close attention to details or make careless mistakes in schoolwork, at work, etc.;
- Often has trouble holding attention on tasks or play activities;
- Often does not follow through on instructions. Or does not finish schoolwork, chores, or duties in the workplace (e.g., loses focus or is side-tracked);
- Often has trouble organizing tasks and activities;
- Often avoids, dislikes, or is reluctant to do tasks that need mental effort over a long time. Such as schoolwork or homework;
- Often loses things necessary for tasks and activities. Example: school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and mobile telephones);
- Is often distracted with no effort;
- Is often forgetful in daily activities
Also, they can present symptoms of hyperactivity and impulsivity:
- Often fidgets with or taps hands or feet or squirms in seat;
- Usually leaves seat in situations when you have to remain seated;
- Often runs about or climbs in cases where it is not appropriate. Adolescents or adults might feel restless;
- Often unable to play or take part in leisure activities in silence;
- Is often “on the go” or acting as if “driven by a motor”;
- Often talks too much;
- Often blurts out an answer before the teacher complete the question;
- Usually has trouble waiting their turn;
- Often interrupts or intrudes on others (e.g., conversations or games).
The symptoms of autism are usually identified by two years of age. From that age, parents may note symptoms, such as 9:
- Impaired social interaction;
- Stereotyped, repetitive behaviors;
- Insistence on sameness;
- To have restricted, fixed interests;
- Hypersensitivity or hyposensitivity or interest in sensory inputs.
For example, the child avoids eye contact, struggles with social skills, and has obsessive interests.
Talk to your doctor if you think your child has symptoms of ADHD and autism.
Only a licensed clinician can diagnose ADHD vs autism. The clinician interviews the parent and the patient to give the diagnosis. Rating scales, neuropsychological tests, or methods for imaging the brain cannot diagnose ADHD.
According to the American Psychiatric Association, the main features of the diagnosis are:
- The presence of unacceptable levels of hyperactive-impulsive and/or inattentive symptoms. They must be present for at least 6 months;
- Symptoms occurring in different settings (for example, home and school);
- Symptoms that cause impairments in living;
- Some of the symptoms and impairments first occurred in early to mid-childhood;
- No other disorder better explains the symptoms.
People with autism are very different from one another, and it is not always easy to diagnose it. Various professionals (pediatricians, psychiatrists, or psychologists) can diagnose it. There is a wide range of symptoms. But, social communication and restricted, repetitive sensory-motor behavior characterize the disorder. These symptoms are irrespective of culture, race, ethnicity, or socioeconomic group.
According to the American Psychiatric Association, to diagnose a person with ASD, you need to find evidence of:
- Difficulties, past or present, in social communication and social interaction;
- Must have or have restricted, repetitive behaviors and interests;
- Symptoms must be present in early development;
- Symptoms must cause significant impairment in current functioning;
- Intellectual disability or global developmental delay cannot better explain it.
There are diagnostic instruments available. They allow the clinician, in the caregiver’s company, to observe the behaviors of the child. Diagnoses are more reliable when it is possible to combine reports from the caregiver and the clinician’s observation.
The majority of children with ASD receive the diagnosis at early school age. Later diagnoses often occur when there are more problems involved, such as anxiety or mood disorders. These conditions might have either exacerbate or mask Autism. 9
When they occur together
ADHD vs autism, are two different conditions that can occur at the same time. That’s one of the reasons why sometimes ADHD can be mistaken for Autism. When together, they are more challenging to diagnose than when they occur alone.
Some studies show that between 30 and 50% of people with autism manifest ADHD symptoms. Particularly at pre-school age. So, two-thirds of patients with ADHD show features of autism. 4
The Autism Treatment Network database suggests that when co-occurring, people may have a lower quality of life. Also, they present more significant impairment than in any of these conditions. Both parents and teachers report children with ADHD and autism experience more difficulty in daily life. Yet, there is evidence that the risk for increased psychosocial problems increases.
The co-occurring conditions of ADHD vs autism may be more challenging to treat than when they appear separate. 7
ADHD impacts a person’s wellbeing. It often arises in childhood. It can also be chronic, often continuing through adolescence and beyond. Children may have trouble with schoolwork and relationships. Adults may have problems at work.
Treatment approaches should consider the patient’s age and should include multidisciplinary interventions. For example, behavior therapy is essential for a child aged 6-12 years old. The parents play an indispensable role in the treatment. Yet, in teenagers, psychoeducation is crucial. They should learn the risk of substance abuse and motor vehicle accidents.
The doctor may prescribe medication as well. Several drugs are safe and effective for treating ADHD vs autism symptoms, including psychostimulants. Many medical organizations recommend their use.
Non-pharmacological approaches are especially important for children aged 3–5 years. Medication is not prescribed in these cases. 8
Many children with ASD struggle to communicate and interact with friends and parents. So, early intervention is a priority.
Most of the treatment plan is behavior-based. Its focus is on training the patient to re-learn self-care, language, and social skills. The program usually combines family counseling and therapies. It educates the parents to follow the child’s treatments at home. It also includes a therapeutic approach according to the individual child’s needs. For instance, language, speech, social skills, occupational, and sensory integration. 10
For school-age children and adolescents, the most common interventions are social skills groups. For adults, the development of vocational and adaptive living skills is essential.
There is no drug available to cure this disease. The doctor may prescribe medications to treat the symptoms as they develop. Doctors may prescribe antipsychotic medications for repetitive behavior patterns and aggression. Experts may use selective serotonin reuptake inhibitors stimulants to control problematic behavior. 9
Talk to your doctor if you think you or your child have symptoms of autism, ADHD, or both.
Parents, families, and children with ADHD vs autism, or both, face many challenges. These challenges include social isolation, frustrations, strained relationships, and financial difficulties. If this is your case, talk to people you trust, connect with others, tell your history, become an advocate.
Families and schools should work together to improve the lives of children living with these conditions. This collaboration can provide accurate and realistic information, support, and hope. It makes their lives better.