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Autism and ADHD: Overlaps and Differences

May 24, 2024

Autism and ADHD are neurodevelopmental disorders that people often compare. Autism Spectrum Disorder (ASD) manifests with challenges in communication, social interaction, and repetitive behaviors. ADHD, on the other hand, involves difficulties in sustaining attention, along with hyperactivity and impulsivity.

Although there are many autism and ADHD overlaps, they are two different conditions, and individuals can be diagnosed with one or both. Supporting those with autism and ADHD requires personalized approaches that acknowledge the unique characteristics of each disorder.

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Autism and ADHD Together: Is it Possible?

According to the 2019 study published by ScienceDirect, autism and ADHD are two disorders that frequently co-occur.

Another study published by the Journal of the American Academy of Child & Adolescent Psychiatry states that ADHD is present in 30–80% of individuals with ASD, and ASD presents in 20–50% of individuals with ADHD.

People often experience symptoms of another disorder even if they don’t have an official diagnosis. These are known as below-threshold cross-disorder symptoms.

So, the answer is a resounding “Yes”! You can have both ADHD and autism together. Among comorbid conditions occurring with autism, ADHD is king.

An ADHD diagnosis happens more with autism than almost any other condition. Here are some of the top comorbid conditions with autism.

  • ADHD: 30-80% 
  • sleep disorders 40-80%
  • Anxiety: 27-42%
  • Depression: 23-37%
  • GI problems: 9-91%
  • Epilepsy: 3-5%

Autism and ADHD: Differences and Similarities

With all that autism spectrum disorders bring on their own, the addition of an ADHD diagnosis can be worrying.

One thing to remember is that a diagnosis doesn’t change your kid or their symptoms. It just explains them and gives you access to the help you need.

Autism and ADHD Overlap

Both autism and ADHD share similar symptoms, although they have different reasons behind them. Many children experience:

  • Social communication impairments
  • Difficulty focusing/intense focus
  • Language skills challenges
  • Executive functioning issues
  • Sensory overload
  • Hyperactivity/impulsivity
  • Lack of eye contact

As explored in a research article published by Sage Journals, social problems are not part of the core diagnostic criteria for ADHD, but children with ADHD experience significant social difficulties. ADHD children are often rejected by their peers and have fewer friends.

Autism and ADHD: Overlaps and Differences https://www.autismparentingmagazine.com/learn-autism-differences/

In many cases, these difficulties are viewed as a direct result of the ADHD core symptoms:

  • inattentive behaviors may lead a child to miss social cues
  • impulsiveness may result in upsetting peers and
  • hyperactivity may lead to avoidance of peers.

Like autism, ADHD is a common neurodevelopmental disorder. They both carry a genetic risk.

As stated in a 2019 research article, the similarities in behavior between ADHD and autism spectrum disorder seem to be connected to shared genetic influences. This means that some of the same genetic factors contribute to the traits seen in both disorders.

For example, people with ADHD and their siblings tend to show more symptoms associated with ASD compared to individuals who are not siblings, indicating a shared family resemblance.

Difference Between Autism and ADHD

So, what are the differences between autism and ADHD? As neurodevelopmental disorders, ASD and ADHD share some phenotypic similarities but are characterized by distinct diagnostic criteria.

According to APA, ADHD is identified by significant challenges in attention, hyperactivity, and impulsivity. On the other hand, autism is linked to difficulties in communication and social interaction skills, alongside repetitive and restricted behaviors and interests.

Autism and ADHD Diagnosis

Correct diagnosis of ADHD and autism together has come a long way. However, more research is needed. 

The Diagnostic and Statistical Manual (DSM-5) allows for dual diagnosis. If your child has an autism and ADHD diagnosis, you may be wondering what problems they will face specifically and what to do to help them.

You are not alone. Many parents have the same questions. Let’s look at the two conditions and brainstorm ideas that could help you and your child.

DSM-5 Criteria for ADHD

To be diagnosed with ADHD, individuals must exhibit a persistent pattern of inattention and/or hyperactivity–impulsivity that hinders functioning or development.

The criteria include:

  1. Inattention – six or more symptoms for children up to age 16 (or five or more for older adolescents/adults), present for longer than six months:
  • Careless mistakes in school or work.
  • Difficulty sustaining attention.
  • Not listening when spoken to directly.
  • Not following through on instructions.
  • Trouble organizing tasks.
  • Avoidance of mentally demanding tasks.
  • Losing necessary items.
  • Easy distractibility.
  • Forgetfulness in daily activities.
  1. Hyperactivity and impulsivity – six or more symptoms for children up to age 16 (or five or more for older adolescents/adults), present for longer than six months:
  • Fidgeting or tapping hands/feet.
  • Leaving a seat in expected seated situations.
  • Inappropriately running or climbing.
  • Inability to engage in leisure activities quietly.
  • Acting as if “driven by a motor.”
  • Excessive talking.
  • Blurting out answers prematurely.
  • Difficulty waiting for turns.
  • Interrupting or intruding on others.
  1. Additional criteria:
  • Beginning of symptoms before age 12.
  • Presence of symptoms in two or more settings.
  • Clear evidence of interference with social, school, or work functioning.
  • Exclusion of other mental disorders as the primary cause.

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DSM-5 Criteria for Autism Spectrum Disorder

According to the CDC, the DSM-5 defines autism as consistent challenges in social communication and interaction across various situations, demonstrated by these examples:

  1. Deficits in Social-Emotional Reciprocity
  • Abnormal social approach
  • Failure of normal back-and-forth conversation
  • Reduced sharing of interests, emotions, or affect
  • Failure to initiate or respond to social interactions
  1. Deficits in Nonverbal Communicative Behaviors
  • Poorly integrated verbal and nonverbal communication
  • Abnormalities in eye contact and body language
  • Deficits in understanding and use of gestures
  • Total lack of facial expressions and nonverbal communication
  1. Deficits in Developing, Maintaining, and Understanding Relationships
  • Difficulties adjusting behavior to suit various social contexts
  • Difficulties in sharing imaginative play or making friends
  • Absence of interest in peers

Treatment for Autism and ADHD

In a study published by Frontiers, we learn some of the current options for the treatment of ADHD in people with autism and ADHD, which include medication and psychosocial interventions.

In a study, they found that more kids with ADHD responded well to a certain treatment (70-80%) compared to a different study on autism (49%).

The study also mentioned that fewer kids stopped the treatment in the ADHD study (1.4%) compared to the autism study (18%). The study noted that the treatment could make irritability better in ADHD, but in some kids with autism, it made irritability worse.

Another study published by SpringerLink talks about treating kids with ADHD and ASD. The study mentions that approaches to treat both ADHD and ASD are kind of similar, using conditioning procedures based on social learning theory.

For ADHD, it involves teaching parents to manage their kids’ behaviors (called ‘parent training’). But for ASD, it’s more about ‘parent education,’ focusing on personalized treatments to help kids develop social skills.

As with all treatments, each individual will react differently to each measure taken to improve their symptoms. Seeking the help of medical professionals is the first line of defense when helping your child with ADHD and autism.

Autism and ADHD: Overlaps and Differences https://www.autismparentingmagazine.com/learn-autism-differences/

Support and Help Are Available

While ADHD and autism are two distinct conditions, they share many similarities. The presence of one increases the likelihood of both.

There is help available. Ask your child’s doctor about their options, including behavioral therapy with a child behavior disorder specialist, a child psychiatrist, and an occupational therapist. All of these medical professionals can help your child improve their symptoms.

FAQs

Q: What is the difference between autism and ADHD?

A: A child with autism may struggle to focus on uninteresting tasks but can become deeply engrossed in activities that capture their interest. In contrast, a child with ADHD often has a short attention span, even when engaged in activities they enjoy.

Q: How to parent a child with autism and ADHD?

A: Parenting a child with autism and ADHD involves establishing a consistent routine. This can be particularly beneficial for children who struggle with transitioning between activities, as a predictable flow can help minimize disruptive behaviors during these transitions.

Q: Is ADHD on the autism spectrum?

A: ADHD and autism are distinct neurological conditions; they are not the same. Despite the differences, overlapping symptoms can lead to a dual diagnosis in some individuals.

Q: What is it like to be autistic with ADHD?

A: The characteristics of autism spectrum disorder and ADHD frequently coincide, with many autistic children exhibiting ADHD symptoms such as restlessness, social challenges, selective focus, and impulsiveness.

Q: What percentage of ADHD people have autism?

A: Scientific literature reports that 50 to 70% of individuals with autism spectrum disorder (ASD) also have comorbid attention deficit hyperactivity disorder (ADHD), according to research.

References:

Overlaps and distinctions between attention-deficit/hyperactivity disorder and autism spectrum disorder in young adulthood: Systematic review and guiding framework for EEG-imaging research, Neuroscience & Biobehavioral Reviews, 2019
https://www.sciencedirect.com/science/article/pii/S0149763418300216?via%3Dihub 

Social Functioning Difficulties in ADHD: Association with PDD Risk. Clinical Child Psychology and Psychiatry. 2009;
https://journals.sagepub.com/doi/10.1177/1359104508100890

Genetic Overlap Between Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in SHANK2 Gene. Front Neurosci. 2021
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111170/ 

American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc.. https://doi.org/10.1176/appi.books.9780890425596

The co-occurrence of autism and attention deficit hyperactivity disorder in children – what do we know?; 2014 
https://www.frontiersin.org/articles/10.3389/fnhum.2014.00268/full

National Institute of Mental Health Collaborative Multimodal Treatment Study of Children with ADHD (the MTA). Design challenges and choices. Arch Gen Psychiatry.
https://pubmed.ncbi.nlm.nih.gov/9294378/

Treatment for co-occurring attention-deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics.
https://pubmed.ncbi.nlm.nih.gov/22678458/

The co-occurrence of autism and attention deficit hyperactivity disorder in children – what do we know? Front Hum Neurosci.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010758 

Research Units of Pediatric Psychopharmacology (RUPP) autism network randomized clinical trial of parent training and medication: one-year follow-up
https://pubmed.ncbi.nlm.nih.gov/23101743/

Diagnosis and treatment of children and adolescents with autism and ADHD. Psychol Sch. 2023 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092654/

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