More often than not, parents and caretakers of neurodiverse individuals often wonder if their child may also have other neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder, commonly referred to as ADHD. In fact, many ask what the differences between autism vs ADHD are and whether or not these two diagnoses are related.
Recent research shows that 1.2% of all U.S. children aged 3-17 currently have both ASD and ADHD diagnoses, highlighting how autism and ADHD can co-occur. This guide will help you recognize the distinct signs of each one and understand when professional evaluation might be beneficial for your child.
Both autism and ADHD share surprising similarities, yet they require different approaches to support your child’s individual needs. Overlapping behaviors, like interfering behaviors related to listening and relationship building, can make it hard to distinguish between autism vs ADHD.
Here’s the truth (and a little bit of encouragement!): Understanding the differences between autism and ADHD isn’t about labels. In fact, it’s all about finding the right path forward for your family. At the end of the day, every child has so much beauty to offer, and with the right direction, your little one can explore the world in his or her own unique, wonderful way.
Let’s get started!
Common Overlapping Signs in Autism vs ADHD
It’s no secret that autism and ADHD can look remarkably similar on the surface.
For example, children with either diagnosis may have a hard time focusing, such as during story time or when it’s time to follow multi-step instructions. Other common interfering behaviors in children may include emotional outbursts from feeling overwhelmed or restricted in certain environments.
Key Differences: Autism vs ADHD Compared Side-by-Side
While the surface behaviors might appear similar, the underlying reasons and patterns are distinctly different. For example, traits of autism such as social communication interferences, restricted interests, and repetitive behaviors, are specific to autism spectrum disorder (ASD) and differ from the experiences typically seen in ADHD.
Autism Hallmark Signs
- Social communication interferences: Limited eye contact, trouble understanding social cues, and interferences with back-and-forth conversation
- Repetitive behavior: Repetitive behaviors such as hand-flapping, spinning objects, and/or an intense focus on specific interests are defining characteristics of ASD
- Routine preferences: Strong need for predictability, and may show distress when schedules change
- Sensory sensitivities: Over- or under-responsiveness to sounds, textures, lights
ADHD Hallmark Signs
- Attention: Trouble focusing on tasks, easily distracted, forgetful in daily activities
- Hyperactivity: Excessive fidgeting, hard time sitting still, constantly “on the go”
- Impulsivity: Acting without thinking, interrupting others, does not wait turns
- Predominantly hyperactive-impulsive presentation: Characterized by excessive motor activity, impulsivity, fidgeting, and self-control interferences
- Executive function challenges: Trouble with organization, time management, and planning
Understanding these core differences helps parents recognize which diagnosis might better explain their child’s experiences.
Executive Functioning in Children: What Sets Autism and ADHD Apart
Executive functioning is a set of mental skills that help us manage time, pay attention, switch focus, plan and organize, remember details, and control our impulses. For children with neurodevelopmental disorders like ASD, as well as ADHD, executive functioning can look very different.
For instance, children with ADHD often struggle with inattention symptoms such as trouble focusing, forgetfulness, and difficulty organizing tasks. Furthermore, impulse control for kids with ADHD can lead to behaviors like excessive talking, interrupting others, or acting without thinking.
In contrast, children with autism may experience executive functioning differences that are closely tied to repetitive behaviors and a strong preference for routines. For example, a child with ASD might become very upset if their daily schedule changes or if they are asked to switch from one activity to another.
Emotional dysregulation is another area where executive functioning plays a role. Children with ADHD may have sudden emotional outbursts or difficulty calming down after becoming upset. Children with ASD, on the other hand, may react strongly to sensory overload, leading to meltdowns or withdrawal.
Importance of the Right Diagnosis: ADHD vs Autism
Since a range of neurodevelopmental diagnoses can impact executive functioning, including ASD, ADHD, and even co-occurring disorders like oppositional defiant disorder, bipolar disorder, or language disorders, an accurate diagnosis is essential. A thorough evaluation by a pediatrician, psychologist, or psychiatrist can help identify any co-occurring disorders that may be present.
Treatment for executive functioning challenges is most effective when tailored to the child’s specific diagnosis. Children with ADHD often benefit from behavioral therapy, such as cognitive-behavioral therapy, to improve attention and impulse control. For children with autism, child-centered behavioral therapies like applied behavior analysis (ABA) and occupational therapy for autism can address repetitive behaviors, social interaction needs, and help build flexible thinking skills.
Ultimately, understanding how executive functioning presents in autism vs ADHD allows families and professionals to create targeted plans that address the child’s individual needs. With accurate diagnosis, differential diagnosis, and the right combination of therapies, children with ADHD, ASD, or both can develop stronger executive functioning skills and blossom in their day-to-day life.
All About the Autism vs ADHD Diagnoses
The diagnostic process becomes complex because both conditions affect brain development and can influence similar behaviors. Research indicates that 43.8% of children with autism also have co-occurring ADHD, making it essential to understand how these two diagnoses interact.
Historically, autism and ADHD were considered mutually exclusive diagnoses, meaning a person could not be diagnosed with both ASD and ADHD at the same time. However, changes in diagnostic criteria, particularly with the release of DSM-5 in 2013, now allow for dual diagnoses of ADHD and ASD. This update in diagnostic criteria has enhanced the accuracy of diagnosing children with ADHD vs autism (or both!).
Real Family Scenarios: Autism vs ADHD in Action
Consider Emma, a 5-year-old who has trouble sitting through circle time at preschool. Her teacher notices she rocks back and forth and covers her ears during singing activities. When approached for group play, Emma prefers to line up blocks by color rather than engage with peers. Her behavior interferences stem from sensory overload and deficits in social communication and instances of restricted/repetitive behavior.. These are all common signs of autism.
In contrast, 6-year-old Marcus also struggles with attention, but for different reasons. He’s eager to join playground games but often forgets the rules mid-game. He interrupts conversations enthusiastically and has a hard time waiting his turn. Children with ADHD like Marcus may quickly lose interest in activities or games, especially if they lack variety or stimulation. These are classic ADHD presentations.
So, what does it look like when a child experiences both autism and ADHD?
When Children Have Both: Autism vs ADHD Co-Occurrence
Some children receive both diagnoses, which isn’t uncommon. When autism and ADHD co-occur, families often see a complex mix of social communication and attention interferences, as well as hyperactivity presentations. These children might have intense interests (autism) but struggle to focus on less preferred activities (ADHD).
Luckily, by understanding co-occurrence, it will help families develop comprehensive support strategies that address both sets of needs rather than focusing on just one. Creating a personalized journey for your child, developed by experts and ABA therapists at organizations like Bierman Autism Centers, is essential to ensure interventions are tailored to the child’s unique diagnosis and circumstances, supporting their daily functioning and overall quality of life.
How ABA Therapy Supports Children with Autism vs ADHD Traits
Applied behavior analysis, or ABA therapy, offers research-backed strategies that greatly benefit children regardless of their specific diagnosis. ABA is a naturalistic approach that focuses on teaching functional skills while reducing interfering behaviors through positive reinforcement, play, and structured learning opportunities. A key goal of ABA is to teach and reinforce positive behaviors, helping children with autism and ADHD traits build skills that support their daily functioning.
For children with autism, ABA helps develop communication skills, social interaction abilities, and adaptive behaviors. For those with ADHD traits, ABA strategies can improve attention span, reduce impulsivity, and strengthen executive functioning skills.
Bierman’s playful learning framework keeps sessions active and fun while systematically building focus, language, and social engagement. This approach recognizes that children learn best when they’re motivated and enjoying the process, whether they’re working on autism-related goals or ADHD-related experiences.
Supporting Your Child Moving Forward
Whether you have a child with autism, ADHD, or both, early intervention makes a meaningful difference. Focus on building your child’s strengths while addressing areas of need through kind, positive, and structured support. It’s also important to monitor and support any co-occurring neurodevelopmental disorders that may require additional attention as part of ongoing care.
Remember that every child’s journey is unique. The key is finding approaches that work for your specific child and family situation.
If you’re seeking clarity about your child’s needs and want to explore how ABA therapy might help, Bierman Autism Centers offers comprehensive evaluations and personalized therapies. Our experienced team understands the complexities of autism and ADHD, providing families with the support and guidance they need to succeed. Contact us today by calling 800-931-8113 or visit our contact page to take the first step towards supporting your child’s exciting life journey.
Frequently Asked Questions
What are the main overlapping signs between autism vs ADHD?
Although autism and ADHD share some overlapping signs, such as attention, social, and behavioral interferences, they are classified as separate neurodevelopmental disorders with distinct diagnostic criteria. Children with either diagnosis might struggle to sit still, have difficulty following multi-step instructions, or experience emotional outbursts when routines change unexpectedly.
What are the key differences in social communication between autism and ADHD?
Children with autism typically have a hard time with back-and-forth conversation, eye contact, understanding social cues, interpreting nonverbal communication, and maintaining reciprocal social interactions.
In contrast, children with ADHD are often eager to engage socially but may interrupt conversations enthusiastically and may not want to wait their turn. Individuals with ADHD typically approach social interactions with impulsivity and may not pick up on subtle social signals.
Can a child have both autism and ADHD at the same time?
Yes, research shows that 43.8% of children with autism also have co-occurring ADHD, highlighting the frequent co-occurrence of ADHD and autism.
The diagnostic criteria for these traits have evolved over time, especially with updates to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the statistical manual published by the American Psychiatric Association. Changes in the diagnostic and statistical manual have impacted how clinicians identify and classify ADHD and autism, including dual diagnoses. Historically, autism was classified under pervasive developmental disorder, a term that has since been integrated into the broader ASD category.
Co-occurrence of ADHD and autism can persist into young adults, requiring ongoing support and tailored interventions as individuals transition from adolescence to adulthood.
Why is it difficult to distinguish between autism and ADHD?
The diagnostic process is complex because both autism and ADHD affect brain development and can influence similar behaviors. Diagnosing ADHD can be even more complex when traits overlap with those of autism. It is also important to note that some children develop coping strategies that mask their core traits, or they may present differently in various environments.
How do repetitive behaviors differ between autism and ADHD?
Children with autism display repetitive behaviors like hand-flapping, spinning objects, and intense focus on specific interests, which are often driven by sensory needs or routine preferences.
Meanwhile, kids with ADHD may also exhibit repetitive behaviors, but these are primarily seen as hyperactivity, such as excessive fidgeting and the need to move or wiggle rather than sit still.
When ADHD is compared to autism, the nature of repetitive behaviors differs: ASD often involves sensory-driven actions, while ADHD tends to show more movement-based, impulsive behaviors.
How can ABA therapy help children with autism or ADHD traits?
ABA therapy uses evidence-based strategies with positive reinforcement to teach functional skills. For children with autism, it helps develop communication and social skills, while for those with ADHD traits, it can improve attention span, reduce impulsivity, and strengthen executive functioning skills.
