Have you ever witnessed a child in a classroom who is constantly fidgeting? Or perhaps you’ve seen a child playing alone in the corner of a playground? Many children struggle to focus or have difficulty making friends at times, but when this becomes “normal” daily behavior, it could be a sign of attention-deficit hyperactivity disorder (ADHD). Now, here’s where things get confusing! Many children with autism spectrum disorder (ASD) display similar traits, which leads many parents to question: is ADHD a form of autism?
In short, the answer is “no”. While autism and ADHD are both neurological conditions, they’re not the same thing. There are, however, many overlapping symptoms between ADHD and autism and it’s not uncommon for people to have a dual diagnosis.
In this article, we’ll look at the characteristics of ADHD and highlight both the similarities and the differences between this disorder and autism. Hopefully, by the time you’ve finished reading, you’ll be able to help dispel the myth that ADHD is a form of autism.
Dual diagnosis of autism and ADHD
Clinical reports and case studies show many children display both symptoms of ADHD and ASD. For this reason, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) now allows for a dual diagnosis of ADHD and autism provided that diagnostic criteria are met, which was previously prohibited (in the fourth edition). This updated feature means children can be evaluated for both autism spectrum disorder and ADHD at once. According to the DSM-V, ADHD is characterized by pervasive and impairing symptoms such as inattention, hyperactivity, and impulsivity. Meanwhile, the criteria for ASD are difficulties in social communication and social interaction, restricted and repetitive patterns of behavior.
According to Gnanavel, et al. (2019), between 60-100% of children with ADHD have some form of comorbidity that accompanies the condition, one of which is autism. Studies from the United States claim that in children diagnosed with autism disorder, about 42% have ADHD comorbidity.
However, to determine whether ADHD is a form of autism, we need to zone into the key traits of ADHD in comparison to autism and highlight the significance behind their commonality.
Exploring shared traits: Is ADHD different from autism?
Autism spectrum disorder (ASD) is similar to ADHD based on the shared symptomatology.
A common challenge linked to both conditions is social difficulties. For ADHD in particular, children diagnosed with this condition experience social deficits and difficulty forming relationships due to traits such as impulsivity, and intrusive behavior during conversation or play. Whereas for ASD, social difficulties are usually due to communication issues, inability to understand abstract thoughts or behavior, difficulty understanding body language, and difficulty making eye contact, etc.
According to Karla Pretorius, a Research Psychologist and Co-founder of AIMS Global, a person diagnosed with ADHD struggles to focus on tasks for long periods of time: “They are distracted by a thought, which can lead to a shift of their focus immediately from one task to another within minutes.” Karla highlights the difficulty that many individuals experience in an effort to sustain focus. “To get back to the task at hand… it requires someone diagnosed with ADHD to consciously be aware of their shift of attention and reasons for this,” she adds.
So, while a person with ADHD might jump from one activity to the next, a person on the autism spectrum is likely to prefer routine and display repetitive behavior. Both of these traits can easily result in similar challenges.
Difficulty completing tasks is one such challenge. Both conditions can involve an intense focus on specific activities and disinterest in others. Individuals with ADHD experience difficulty maintaining attention and staying focused on a specific task they’re not interested in, while those with autism might show a similar trait as they have very specific interests and the desire to focus only on interest-based tasks.
Karla, who has ADHD herself, explains: “Those diagnosed with ADHD often have a remarkable and sustained focus on interest-based activities…unfortunately, most of the topics individuals diagnosed with ADHD focus on aren’t of much use for their long-term goals and aspirations.” In the same breath, autistic children experience symptoms such as fixation, or special interests in items or subjects they’re particularly drawn to, this can include toys, books, puzzles, trains, or hangers, etc.”
Unlike children with ADHD, autistic children dislike change and find it difficult to adapt to a different routine than the one they’re used to; hence it’s crucial for parents to teach autistic children new routines in an effort to become more flexible.
Conversely, individuals with ADHD can work well with a set routine for a while, but they can easily become tired of it. Karla shares: “Individuals diagnosed with ADHD usually work well with a set routine, but they might become bored easily with this too.”
“Many believe that the ADHD brain struggles to anticipate future events or plan for these accordingly,” she adds. “It is possible to be completely focused on the current topic, but this might be the least important one to encourage growth in your educational or professional career.”
Causes of ADHD and autism
The causes of neurological conditions including ADHD and autism are under constant debate. Some studies suggest a nature/nurture component as the cause of ADHD. The facts sustaining this argument are still being investigated, however, some medical professionals lean towards this theory. According to Dr. Tasnuva Sarwar Tunna, PhD, a pharmacist, scientist, and health coach, people are holistic beings attuned by the world around them.
Dr. Tunna believes it’s probable that, to some degree, individuals with ADHD and/or autism have genetically inherited the condition from a parent. On the other hand, from the nurture perspective, some traits are a result of environmental influences.
“A child/individual with ADHD, ADD, or ASD will have high stress levels and anxiety which come out as hyperactivity, talking too fast and too much, behavior and learning problems, etc. If parents, school, and society create stressful situations and the environment is not calming and grounding then kids show more hyperactivity and other ADHD traits,” says Dr. Tunna.
Is my child with ADHD on the autism spectrum?
A child with autism can have ADHD or not; a diagnosis of ADHD is separate from an autism diagnosis and having ADHD does not necessarily mean that your child is autistic or vice versa. ADHD and autism can co-occur but, like any other condition, each needs to be evaluated separately to provide an accurate diagnosis.
As always, it is important to visit your child’s medical practitioner and schedule an evaluation to determine whether your child has one or both conditions. This is especially important given that the two conditions have overlapping symptoms that may be perceived as one or the other, or both.
Interventions to improve symptoms of ADHD
If your child with autism has also received a diagnosis of ADHD (or the other way around), here are some interventions suggested by Dr. Tunna to assist with managing ADHD symptoms.
- Reduce stress in the environment by building a stable, nurturing routine where the child feels taken care of and understood
- Remember stress response from (over)expectations and verbal/physical or other forms of pressure work in the opposite way to helping the child
- A clean, nutritious and easily digestible diet rich in nutrient-dense home prepared meals (preferably gluten/grain-free and dairy-free [except butter, ghee, and yogurt]) works wonders to remove the ongoing brain fog and focus. Probiotics and probiotic-rich food can help too
- Regular massage with lavender essential oils in sesame base (250ml sesame + 20ml lavender) can help release anxiety and bring sleep. It can also reduce hyperactivity
- The emotional and mental stability of the parents is very important for the child to feel secure, understood, heard, and accepted without guilt, shame, and blame
In conclusion
Is ADHD different from autism? The answer is simply “yes”, the two conditions are separate from the other although there may be overlapping similarities.
With any medical condition, it’s important to seek professional evaluation for accurate diagnosis. Although ADHD and autism have overlapping traits, the two can occur without the occurrence of the other.
Parents are advised to observe their children’s symptoms to aid a clinician in determining a correct diagnosis. Remember, although it may feel overwhelming to suspect your child has ADHD and/or autism, a diagnosis can offer clarity and help you access resources to aid your child’s development.
References
Gnanavel, S., Sharma, P., Kaushal, P., & Hussain, S. (2019). Attention deficit hyperactivity disorder and comorbidity: A review of literature. World journal of clinical cases, 7(17), 2420–2426. https://doi.org/10.12998/wjcc.v7.i17.2420
Trisha Korioth, T., (2013) DSM-5 finally released: Look for changes in autism, ADHD criteria. AAP News, 34(6), https://www.aappublications.org/content/34/6/1.2
Mohammadi, M. R., Ahmadi, N., Khaleghi, A., Zarafshan, H., Mostafavi, S. A., Kamali, K., Rahgozar, M., Ahmadi, A., Hooshyari, Z., Alavi, S. S., Shakiba, A., Salmanian, M., Molavi, P., Sarraf, N., Hojjat, S. K., Mohammadzadeh, S., Amiri, S., Arman, S., & Ghanizadeh, A. (2019). Prevalence of Autism and its Comorbidities and the Relationship with Maternal Psychopathology: A National Population-Based Study. Archives of Iranian medicine, 22(10), 546–553.
