April is Autism Acceptance Month, which is a time to uplift, affirm, and validate autistic voices, celebrate autism as a part of human diversity, and promote more community inclusivity and accessibility to support all autistic people.
Did you know that many people who meet criteria for Autism Spectrum Disorder (ASD) are commonly misdiagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and vice versa? It makes sense because both conditions share some characteristics. Dr. Nanika Coor explains some of the similarities and differences between the two conditions.
Project Parenthood is hosted by Dr. Nanika Coor. A transcript is available at Simplecast.
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April is Autism Acceptance Month, which is a time to uplift, affirm, and validate autistic voices, celebrate autism as a part of human diversity, and promote more community inclusivity and accessibility to support all autistic people.
Did you know that many people who meet criteria for Autism Spectrum Disorder (ASD) are commonly misdiagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and vice versa? It makes sense because both conditions share some characteristics. And the research suggests that 50-70% of autistic people also meet criteria for ADHD! But what are the differences between the two and how do they overlap? Well stick around, because today I’m talking about the similarities and differences between ASD and ADHD.
Welcome back to Project Parenthood! I'm your host, Dr. Nanika Coor—clinical psychologist and respectful parenting therapist. Each week, I’ll help you repair and deepen your parent-child connection, increase self-compassion and cooperation from your kids, and cultivate joy, peace, and resilience in your relationship with them.
Autism is characterized by difficulties with neurotypical social communication and social interaction, as well as self-regulation through routine and repetition—like having special interests or repetitive or idiosyncratic stereotyped and restricted behavior. ASD can also affect language and the way a person learns.
Because they occur on a spectrum, the signs and symptoms of autism range in severity between individuals. This means that each ASD person needs a different level of support in daily life, ranging from minimal support to very substantial support.
The signs and symptoms of ASD usually develop by the age of 3 and is a lifelong condition. These kids may have difficulty focusing on things outside of their area of interest; they may be rigidly focused on a certain toy, activity, or repetitive action.
ADHD is characterized by deficits in attention skills and impulse control, along with hyperactivity. An ADHD person may be prone to fidgeting and have difficulty focusing their attention during non-preferred activities, and instead tend to become distracted or daydream. They may lose things easily. Trouble with impulse control means that they may interrupt others, talk incessantly, act without thinking about the consequences, and make careless mistakes or take unnecessary risks. It may be hard to regulate emotions, so a person might have tantrums and meltdowns, and sensory sensitivities may lead to episodes of agitated reactivity.
An ADHD diagnosis includes a classification type based on which symptoms are most prominent. Predominantly inattentive ADHD might look like being easily distracted, not paying attention to details, and having difficulty following the flow of a conversation. Predominantly Impulsive/Hyperactive ADHD could look like a proneness to accidents or injury, difficulty staying still for the duration of a class period, interrupting others, and difficulty waiting their turn. The Combined Type of ADHD includes both elements of inattention and impulsivity/hyperactivity and is the most commonly diagnosed type of ADHD.
Both ASD and ADHD have a genetic component and are often seen in more than one member of a family. Both conditions involve a range of difficulties that can look very different from person to person. Both are neurodevelopmental and lifelong conditions, both involve trouble regulating emotions/behavior, feeling misunderstood, having behavior misunderstood and receiving negative feedback about behavior they can’t control, impacting self-esteem and motivation. Both conditions involve an increased sensitivity to rejection—real, imagined or feared.
ADHDers may have topics about which they are passionate and on which they can hyperfocus, and lose themselves in activity such that they lack awareness of their environment. Similarly, Autistics generally have a special interest on which they enjoy and prefer to hyperfixate on.
Both an ASD and an ADHD child may have difficulty detecting internal body signals, understanding the passage of time (time blindness), and have sensory sensitivities that can overwhelm them. Autistic “stimming” or repetitive movements can look like ADHD fidgeting. Both conditions can affect one’s ability to pay attention to people, socially initiate, or respond in neurotypically expected ways, so both can make elements of life at school or in relationships challenging. All of these similarities mean that ASD is sometimes misdiagnosed as ADHD, and as a result some ASD kids are not getting the supports they need to thrive.
There are a lot of myths and stereotypes about both conditions, like that only young white boys struggle with these conditions. In fact, ASD and ADHD is present in both children and adults of all racial, ethnic, and socioeconomic backgrounds, and both are underdiagnosed in girls and women. However, ASD is four times more common in boys than girls.
For both ASD and ADHD folks, fitting into a world set up for neurotypical people can be challenging when your normal way of being means that conforming to neurotypical expectations can be difficult to impossible. This means that in both conditions there is a tendency to “mask” their symptoms in an attempt to appear more neurotypical, which is so effortful that doing so can lead to burnout.
While a child with ADHD may not be able to concentrate very long on a boring or repetitive task and will often try to avoid such tasks, an ASD kiddo may concentrate for very long periods of time in their areas of interest.
An ASD and an ADHD child may both have communication difficulties, but for different reasons. An ASD child may be less socially aware and therefore miss nonverbal cues like facial expressions, gestures, and postures that convey social meaning among neurotypical people. They might have a hard time identifying emotions in themselves or others, and have a hard time expressing their thoughts and feelings verbally. Eye contact may also be challenging for ASD children. Conversely, an ADHD child is more likely to be socially aware, but their impulsivity leads to lots of verbal expression—including interrupting and cutting people off—or their inattention makes it hard for them to follow the thread of conversation.
While ADHD kids are more likely to gravitate to fun, novel, and exciting activities, ASD children tend to thrive on sameness, regularity, and routine—happily eating the same meal every day or playing with only one kind of toy—and can become dysregulated by unexpected changes in their rituals and routines.
I hope this episode was able to help you understand some of the similarities and differences between ASD and ADHD.
Two things you can do to observe Autistic Acceptance Month are to learn the facts (rather than the myths) about ASD and support organizations that center autistic voices and that are run by autistic people, like NeuroClastic, Inc., which you can learn more about at https://neuroclastic.com/.
If you suspect that your child may have either ASD or ADHD—or both, which is somewhat common—seek a diagnosis, as early intervention can go a long way to helping your child manage the social, behavioral, and learning challenges that may be involved.
Have you ever wondered if you’re raising an ASD or ADHD child? Tell me about it on Instagram @bkparents. You can also reach out to me directly at parenthood@quickanddirtytips.com, or leave a message at (646) 926-3243. And you can learn about my New York State-based private practice at www.brooklynparenttherapy.com. Catch you next week!
Centers for Disease Control and Prevention. (2020). Data & statistics on autism spectrum disorder. Available online: cdc. gov (accessed on 27 October 2021).
Hours, C., Recasens, C., & Baleyte, J. M. (2022). ASD and ADHD comorbidity: what are we talking about?. Frontiers in Psychiatry, 13, 154.
Neff, M. A. ADHD vs. Autism. https://neurodivergentinsights.com/misdiagnosis-monday/adhd-vs-autism