ADHD & Autism: Understanding the Differences

by Team Stamurai

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are neurodevelopmental disorders. Do autism and ADHD share any signs & symptoms?

Well, yes.

For instance, children with ADHD may seem hyperfocused on a subject for a short span, and children with ASD may also have a hyperfocused interest in one subject or object. In both cases, ADHD and ASD children may exhibit signs of speech delay. Therefore, parents often have difficulty discerning which neurodevelopmental disorder their kid has. Most people do not know about the difference between ADHD and autism in adults or children.

Can a child have autism and ADHD at the same time? The short answer is a ‘yes.’ A child can have ADHD and ASD at the same time. Since diagnosing the two conditions together wasn't allowed by APA before 2013, the research community is yet to know much about the prevalence of both conditions.

When ADHD and ASD co-occur, it is important to speak to an experienced speech therapist or SLP for timely advice. The co-occurrence of autism and ADHD demands separate treatment and therapy activities that address each symptom.

When you ask whether it is autism or ADHD that your child may be struggling with, you should first try to understand the basics.

What Is ADHD?

ADHD is a common neurodevelopmental disorder. Although it is now commonly diagnosed in children, even adults can have ADHD. The number of adults receiving an ADHD diagnosis in the US is increasing steadily. It affects around 25% of adults and 9.4% of children. ADHD mainly affects a person's attention span, impulse control, and activity (hyperactivity) levels. Its defining trait includes a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with the functioning and development of an individual.

According to John Hopkins Medicine, currently, there are three types of ADHD –

  • Inattentive
  • Hyperactive-impulsive
  • Combined

The inattentive or hyperactive-impulsive symptoms should be present before the child turns 12 years old. These symptoms should be present in two or more settings, such as – home and school. For conclusive diagnosis, these symptoms should interfere with the individual's quality of social, academic, and/or occupational setting. These symptoms should not occur with other mental health or developmental disorders. It is not a curable condition. However, it is manageable through behavior modification techniques and medication.

What Is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is also a common neurodevelopmental disorder. Someone with ASD exhibits persistent deficits in social communication and interactions. According to DSM 5, the person experiences deficits in social-emotional reciprocity, non-verbal communication, and developing and maintaining relationships.

The child or adult with ASD will also show restricted and repetitive patterns of behavior, interests, and activities, in at least two of the following ways –

  1. Repetitive or stereotyped motor movements, use of objects or echolalia (repetition of words/phrases without context)
  2. Inflexibility or insistence on sameness in their routines, and ritualized patterns of behavior.
  3. Fixation with particular objects, topics, or subjects.
  4. Hyper- or Hypo-reactivity to sensory input. For example, intolerance towards specific noises, indifference to pain and changes in temperature, excessive smelling or touching of specific objects, and aversion towards certain food and textures.

The symptoms of ASD should be present in the early developmental period. They should cause significant impairment in social communication, occupational spheres, and other necessary areas of functioning. These deficits or disturbances should not be better explainable by intellectual disabilities and other mental health conditions.

Attention-Deficit/Hyperactivity Disorder vs Autism Spectrum Disorder: Difference in Attention Span

A child with ADHD may have a problem paying attention to a topic for a long time. The child may be distracted easily.

A child with ASD may have an interest in only a few topics. They may have an interest in science but struggle with literature and math. They may "obsess" over things they enjoy.

The easiest way to spot the difference is when they are doing their homework.

A child with ADHD may have trouble finishing their homework irrespective of their subject.

A child with ASD may finish working on subjects they like and may not engage in the ones that don’t interest them.

ADHD Vs Autism: Difference in Communication

A child with ADHD may show the following signs during communication –

  • Talking continuously
  • Interrupt others
  • Talk too loudly
  • Speak without noticing how their words affect others

Children with ASD may have the following signs during communication –

  • Face difficulty expressing their thoughts and emotions
  • No use of facial expressions, gestures, or changes in intonation while talking
  • Struggle to make and hold eye contact
  • Fixate on a specific topic and continue talking even when others show no interest

Children with ASD typically also have problems initiating conversations & responding to social interactions. In social situations, they may not understand turn-taking or imaginative conversations.

Differences between ADHD and ASD in Routine & Structure

Children with ADHD typically become bored quite quickly with the same routine. That is one reason they struggle in the classroom. Distraction sets in when there’s boredom. Without the introduction of novelty and variety, you may find it impossible for a child with ADHD to partake in lessons.

Children with autism typically find comfort in routines. They do not like changes in their environment. Most children with autism insist on following a fixed schedule every day. They may want to eat the same food for dinner every day, read the same book, or play the same games day after day. It is a part of the ritualized repetitive behavior they exhibit.

What is the Relationship Between ADHD & ASD?

How many children have ADHD and autism both? How often are autism and ADHD present together? Well, currently, the CDC estimates that around 14% of all children with ADHD in the US also have ASD. Other sources confirm that the numbers are as high as 15 to 25%.

Although both are neurodevelopmental conditions, researchers don't yet fully understand the causes of ADHD and ASD. So, if you ask - “Will my child have both autism and ADHD?” - there is no sureshot way to predict if a child with ADHD will also have ASD and vice versa. However, if you notice signs of either of the disorders in your child, you should speak to an SLP and child psychologist as soon as possible.

ADHD and ASD: Diagnosis

A child with signs and symptoms of ADHD or ASD should always be evaluated and assessed for both. You may start with your pediatrician and ask for recommendations for specialists accordingly.

For diagnosis of ADHD in a child, the specialist will ask the parents or guardians several questions about the child's behavior. They will speak directly with the child. A specialist can provide an ADHD diagnosis only after a thorough evaluation and assessment.

Similarly, for a child with autism, the speech-language pathologist or child psychologist will first talk to the parents. Next, they will speak to the child and make their observations. Parents will have to answer comprehensive questionnaires on the child's behavior. The specialist will use more tests and tools and offer an ASD diagnosis only after a complete assessment.

It is indeed possible for a child to have ADHD and autism. In such cases, your specialist will talk to you about speech therapy, play therapy, and special education for your child.

Support and Treatment

The most common form of support and treatment for individuals with ADHD includes medication and behavioral therapy.

The support, treatment, and therapy for individuals with ASD include –

  • Psychological and behavioral counseling
  • Sensory integration
  • Speech therapy
  • Educational interventions
  • Play therapy

Parents of children with ADHD and/or ASD should stay in touch with an SLP or speech therapist. They should learn more about the conditions, their long-term impacts on a child's life, and the importance of therapy.

Parents of young children should actively watch and learn from their therapy sessions. They can also help children with autism, for instance, practice speech therapy exercises at home. SLPs working with special needs children always recommend that parents and children continue speech therapy activities for ASD at home.

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