How Are Adhd And Asd Similar And How Are They Different
ADHD and ASD share many similarities, and the conditions are often comorbid with each other. Between 30 to 50 percent of children with ASD also show ADHD symptoms, and two-thirds of children with ADHD display features of ASD. Both disorders are more common in boys than girls, and children with either disorder have difficulty communicating with peers and paying attention, and are prone to impulsivity or restless behaviors. Symptoms of either disorder significantly interfere with a childs emotional development and performance in school and activities that take place in and outside the home.
However, there are some key differences between ADHD and ASD. When children with ADHD struggle in social environments, it is not from lack of understanding the rules. Children with ASD, on the other hand, inherently dont understand the rules and have difficulty recognizing social cues that make the rules apparent. A good example of this distinction is taking turns. A child with ADHD may overstep their bounds or have difficulty waiting for their turn, despite intuitively knowing they should, while a child with ASD does not understand the concept of taking turns altogether.
Both disorders can be diagnosed in early childhood, although ADHD can be more challenging to diagnose since children can similarly act out from being sleep deprived or just being kids. Both disorders have varying degrees of severity, which may also impact when the child is diagnosed.
Asd And Adhd Case Definition
We used information from the National Patient Register , in which diagnoses were recorded according to the International Classification of Diseases, Ninth Revision and ICD-10 and from the Prescribed Drug Register . A recorded diagnosis of ASD in the NPR at age 1 year was used to define ASD cases., A recorded diagnosis of ID at age 3 years in ASD cases was used to define low- vs high-functioning ASD cases. According to ICD-9 and ICD-10 criteria, an ASD diagnosis explicitly precludes an ADHD diagnosis. Hence, we used additional information from the PDR for the definition of ADHD cases, as these are almost exclusively prescribed for ADHD in children and adolescents in Sweden. A recorded diagnosis of ADHD in the NPR or a recorded prescription of an ADHD medication in the PDR at age 3 years was used to define ADHD cases.
Two additional definitions of cases were used in sensitivity analyses to assess the robustness of our results. First, ADHD case definition was based only on information from the NPR, without using information from the PDR, to ensure that the possible overlap reflects clinically diagnosed cases. Then ASD and ADHD cases were defined as individuals having at least two recorded diagnoses in the NPR, without using information from the PDR, to test whether a stricter definition of cases would lead to similar results.
How Are They Diagnosed
If you think your child has either ADHD or autism, talk to your doctor about what testing they will need. There’s no one thing that can say whether a child has either condition, or both. You can start with your pediatrician, who may refer you to a specialist.
To diagnose ADHD, doctors look for a pattern of behaviors over time, like:
- Being distracted or forgetful
- Having trouble waiting for a turn
- Fidgeting or squirming
They’ll ask for feedback from parents, teachers, and other adults that care for the child. A doctor will also try to rule out other possible causes for the symptoms.
An autism diagnosis starts with a parent answering a questionnaire about the child, often about behaviors that started when they were very young. Further tests and tools may include more questionnaires, surveys, and checklists, as well as interviews and observed activities.
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Attention Deficit Hyperactivity Disorder
ADHD is a persistent pattern of hyperactivity, inattention, and impulsivity that interferes with normal functioning. The core symptoms are inattention, hyperactivity, and impulsivity. The onset of symptoms occurs before the age of 7. The presence of symptoms should be observed in at least two environments. There must be conclusive evidence of impaired function. The symptoms should not be caused by any associated psychiatric condition.
Excessive restlessness, constant overactivity, poor attention, learning difficulties, impulsivity, restlessness, a tendency to accident, disobedience, and aggression are the most prominent characteristics. The prevalence rate of ADHD changes depending on the criteria used in diagnosis. Men are more likely to have ADHD than women. There is a 1:3 ratio.
ADHD has biological, psychological, and environmental causes. Biological causes include genetic, structural, and functional brain anomalies, irregularity in dopamine synthesis, and low birth weight. Psychological reasons include physical, sexual, or emotional abuse, corporate growth, and poor family interactions. Environmental causes include exposure to various drugs and alcohol in the prenatal period, perinatal obstetric complications, early life brain damage, nutritional deficiencies, low socioeconomic status, and lead toxicity.
Adult Autism And Adhd
Though little research exists on autism and ADHD in adults, some studies estimate that the disorders coexist at rates between 20% and 37%.12
ADHD is characterized by symptoms of inattention, hyperactivity, and/or impulsivity different from the social communication symptoms and restricted behaviors associated with autism.
Still, some ADHD symptoms relate to the diagnostic criteria for autism. Not listening when spoken to directly, for example, is indicative of inattention, a common ADHD symptom. But given the strong social demands embedded in rating a person on this symptom, it could also indicate autism. If an adult is not making eye contact during a conversation, then it may give the appearance of not listening when spoken to directly. Differential psychiatric assessments as well as other diagnostic tools can help clinicians determine whether this symptom stems from distractibility or from deficits in social-emotional reciprocity and nonverbal communication .
Its critical for clinicians to consider whether an ADHD symptom appears in non-social situations. If a patient reports feeling distracted when working alone and without social demands, that may indicate ADHD more than autism. Distractions should be further analyzed is the patient daydreaming, or are they being pulled into a sound they hear that may be bothering them? The latter may indicate sensory sensitivity related to autism.
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Symptoms Of Autism And Adhd
Both autism and ADHD are described as neurodevelopmental disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders .
The descriptions of the two disorders don’t overlap at any point, so it would be reasonable to conclude that they are entirely different from one another. In fact, until 2013, it was not permissible to diagnose both autism and ADHD in the same person.
In 2013, however, dual diagnoses became an accepted practiceand the number of people with dual diagnoses grew. The Centers for Disease Control and Prevention notes that about 14% of children with ADHD also have autism diagnoses . More than half of children with autism may have symptoms of ADHD.
Verywell / Michela Buttignol
While the symptoms of ADHD and autism may not look the same on paper, they can look very similar in person.
Traits like distractibility and impulsivity, for example, are part of the ADHD diagnosis. While they’re not part of the autism diagnosis, they appear in most people with autism. Speech delays and idiosyncrasies are part of the autism spectrum disorder diagnosis and not the ADHD diagnosis. Yet, people with ADHD often have speech delays.
Both ADHD and autism are usually diagnosed in childhood, and symptoms are likely to continue throughout patients’ lives.
Can You Have Adhd And Autism
Yes, itâs possible to have both conditions.
Itâs common for children with an autism spectrum disorder to also have signs of ADHD. Also, some kids whoâve been diagnosed with ADHD may also have a history of autism, with symptoms like trouble with social skills or being extra sensitive to textures of clothes.
One study found that children diagnosed with both conditions were more likely to have a combined type of ADHD, which includes hyperactive and impulsive symptoms plus trouble paying attention.
Some doctors have experience treating both conditions. If you canât find one who does, you may need to meet with more than one professional, like:
- Your childâs pediatrician
- A mental health specialist who treats ADHD and autism
Work with your childâs care team to find a treatment plan thatâs right for your little one. It might include both behavior therapy for autism and medication for ADHD.
Some doctors say that ADHD medication is important for children who have both conditions. ADHD drugs may help for certain autism symptoms that sometimes overlap with ADHD, like being hyper, impulsive, or inattentive. Stimulant ADHD medications may cause more side effects and might not work as well as they would for a child who has ADHD alone, though.
Clinical Epidemiology: “Early diagnosis of autism and impact on prognosis: a narrative review.”
Pediatrics: “Timing of the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder.”
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Conners Parent Rating Scale
As an analog to the dimensional CSBQASD score, we used the Conners Parents Rating Scale Revised-Long Version as a dimensional index of ADHD severity. Specifically, we used the combined raw score of the ratings on the DSM inattentive and DSM hyperactive/impulsive subscales as our measure of ADHD symptoms. In addition, we investigated the individual impact of the subscales by including their raw scores as separate regressors in supplementary analyses .
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Understanding The Complicated Interplay Of Autism And Adhd
This article has been clinically reviewed on April 15, 2022.
Until 2013, diagnosing both autism spectrum disorder and attention-deficit/hyperactivity disorder wasnt possibleeven if a patients symptoms suggested comorbidity. The Diagnostic and Statistical Manual of Mental Disorders was the first edition of the American Psychiatric Association guide to acknowledge what many clinicians had foundthat a single diagnosis just didnt capture the full range of symptoms some patients experienced.
Today, a dual diagnosis of ASD + ADHD is a valid diagnostic option. In fact, current research indicates that 30%80% of autistic individuals have the diagnostic symptoms of ADHD, and 20%50% of children with ADHD have the diagnostic symptoms of ASD . That overlap can make reaching the right diagnosis harder, especially when ASD and ADHD result in similar-looking behaviors.
This article takes a look at these two neurodevelopmental conditions. Understanding where they converge and where they diverge may help to clarify whether the most accurate diagnosis is ASD, ADHD, or both.
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Parasomnias Such As Sleepwalking Or Nightmares And/or Night Terrors
Both children with ADHD and ASD experience a higher rate of parasomnias, including sleepwalking and nightmares or night terrors. Up to 50 percent of autistic children experience one of these. Fortunately, the vast majority of these parasomnias go away before age 10 or earlier. However, in the case of autistic children, being unable to communicate their fear can heighten their anxiety and complicate their parents understanding what needs to get treated.
What Happened To Aspergers Syndrome
In 1944, Hans Asperger first described Aspergers syndrome in children who:
- Had strong vocabulary and language skills
- Had a distinct use of language and tone of voice
- Were socially isolated from their peers
- Performed repetitive behaviors
In 2000, the American Psychological Association included AS in the umbrella term of pervasive developmental disorders alongside autistic disorder associated with these three main difficulties: communication, social interaction, and restricted interests. AS was both related to and separate from autism at that time.
The newest version of the APAs Diagnostic and Statistical Manual, published in 2013, does not include Aspergers. Instead, it uses the term autistic spectrum disorder , which encompasses several distinct disorders, including AS. People previously diagnosed with AS received a new diagnosis of ASD. The APA believed this change could help those with AS more easily receive community and school services.
The clinical use of the term Aspergers has mostly gone away however, it is still frequently used by people previously diagnosed with AS and their families. Many believe it is a much better description for their condition than the general term autism. Many still call themselves Aspies. Today, many lay people still use the term Aspergers, while medical professionals do not.
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Double Diagnosis: When Your Child Has Adhd And Autism
Nearly a third of children with autism have ADHD symptoms, yet until recently, medical guidelines didn’t allow for both to be diagnosed in the same child. Learn how one mom found the comprehensive treatment her son needed for both disorders.
Beau Baldassari, 8, part of a military family, showed his parents early on that he didn’t respond well to the frequent moves that are part of a military career. “One month before the move, he became angry all the time, defiant, just the definition of a behavior problem,” said Beau’s mother, Ally Baldassari. She didn’t know it at the time, but Beau was showing the first indications that he was suffering from both autism and Attention Deficit/Hyperactivity Disorder, or ADHD.
Medical guidelines regarding autism, ADHD, and attention deficit disorder have changed in recent years. Previously, psychiatrists were unable to diagnose a child as having autism or autism spectrum disorders , as well as ADHD or ADD. But a study published in the June 2013 edition of the journal Autism has found that nearly one in three children with autism also have some form of ADHD symptoms. Faced with this, the latest version of the Diagnostic and Statistical Manual of Mental Disorders , which lays out guidelines for diagnosing psychiatric disorders, now allows doctors to issue a joint diagnosis of autism and ADHD.
Adhd Vs Autism: Similarities And Differences
Autistic women and women with ADHD can share the following traits:
ADHD is diagnosed when a patient has symptoms of inattentiveness, hyperactivity, and/or impulsivity. For an ASD diagnosis, however, the patient must have clinically significant difficulty with social interaction or communication, and unusually restricted or repetitive patterns of behavior or interests. In fact, many autistic people have a special interest a topic or subject that they are heavily invested in and are more knowledgeable about than most.
Autistic individuals are also more likely to have sensory processing disorder, discomfort making/maintaining eye contact, and hyper-logical methods of thinking, with a tendency to be extremely literal.
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The Similarities Between Autism And Adhd
Both ADHD and autism share traits and symptoms. Like autism, ADHD is a common neurodevelopmental disorder. They both carry a genetic risk.
The phenotypic overlap between ADHD and ASD appears to be explained by aetiological overlap, at least partly, in terms of shared genetic influences between traits of both disorders. For example, individuals with ADHD and their siblings display more ASD symptoms than non-sibling controls, suggesting shared familiality. Neurosci Biobehav Rev. 2019
Adhd & Autism: Similarities
One of the connections between the two conditions is that both have been linked to genetic causes, so they tend to run in families. Some similarities between ASD and ADHD include the following:
- Impulsive behavior
- Inability to sit down for long periods
ASD and ADHD affect the brains executive functioning, which governs focus and organization, time management, decision making, and impulse control. This means that many children who grow up with either ASD or ADHD or both struggle with understanding and acting on social skills. ASD and ADHD more often occur in boys than girls.
Such are the similarities between the two conditions that researchers published in the Journal of Attention Disorders noted that the two disorders may be a continuum and have a common origin.
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Why Can It Be Hard To Diagnose An Adult With Asd And Adhd
It can be difficult because if someone has mild symptoms of either or both conditions, they may have already come up with ways to make up for them. Someone with both ADHD and ASD may be friendly to others, for example, but just come across as a little âoff.â It may be harder to pick up on concentration difficulties if a person is involved in an activity that really interests them. People with both conditions may also appear less distracted than someone with âtraditionalâ ADHD, because they may tend to become preoccupied with a task more easily, or resist stopping.
Itâs also challenging to diagnose people who also have intellectual disabilities, since the symptoms of ASD and ADHD may overshadow them. Some research suggests that 70% of people with an intellectual disability and ADHD also have ASD. But this may not always be the case. If a person has severe intellectual impairment, for example, and doesnât speak , then they may get upset when they canât communicate something. This looks like hyperactivity, but it really isnât.
The Relationship Between Adhd And Autism
When a school-aged child cant focus on tasks or in school, parents may think their child has attention deficit hyperactivity disorder . Difficulty concentrating on homework? Fidgeting and difficulty sitting still? An inability to make or maintain eye contact?
All of these are symptoms of ADHD.
These symptoms do match what most people understand about the common neurodevelopmental disorder. Even many doctors might gravitate toward that diagnosis. Yet, ADHD might not be the only answer.
Before an ADHD diagnosis is made, its worth understanding how ADHD and autism can be confused, and understand when they overlap.
There are three types of ADHD:
- predominantly hyperactive-impulsive
- predominantly inattentive
The combined type of ADHD, where you experience both inattentive and hyperactive-impulsive symptoms, is the most common.
The average age of diagnosis is 7 years old and boys are much more likely to be diagnosed with ADHD than girls, although this may be because it presents differently.
Autism spectrum disorder , another childhood condition, also affects an increasing number of children.
ASD is a group of complex disorders. These disorders affect behavior, development, and communication. About 1 in 68 U.S. children has been diagnosed with ASD. Boys are four-and-a-half times more likely to be diagnosed with autism than girls.
Heres a comparison of the two conditions and their symptoms:
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