Last Modified: May 2, 2023 | Published: July 26, 2022

Autism or ADHD?

Misdiagnosis can be a very frustrating experience. Although Autism and ADHD share a lot of commonalities, there are some distinct differences. Read on to learn how to tell between the two.

Autism is a diagnosis identifying difficulty with social reciprocity and restricted or repetitive patterns or interests.

ADHD is a diagnosis recognizing inattention, hyperactivity, and/or impulsivity that impacts a child across more than one setting or environment. At times, ADHD can also cause social impairment. Similarly, there are times when autism attributes can lead to attention challenges. Even when taking into account these differences, it can be difficult for parents and teachers to observe how these disorders show up in the classroom and on the playground.

Autism 101

Children with Autism Spectrum Disorders often struggle with conversational reciprocity. When evaluated through social tasks, a child may fail to let the other person have a chance to speak. He may give a lecture about the Hubble Telescope or tell you every detail about his pet dog. When you say in turn “Oh, I have some pets,” this statement is often met with no response. Other times, it might be met with a change of subject or an awkwardly long pause followed by a forced, “Oh, cool.”

Children with autism tend to have challenges with flexible conversation because taking others’ perspectives is challenging. It is also hard for children with autism to read other people because they rarely pay attention to nonverbal cues. Children with ASD also struggle to make well-coordinated eye contact, so they can miss the clues indicating that their conversation partner is bored. These children also tend to have restricted interests. They really enjoy talking about a certain subject, which may quickly bore another child who does not share that interest. Although kids with ADHD may have some challenges with communication as well, the social skills challenges seen in autism are required for the diagnosis and are much more severe than social problems in kids with ADHD.

ADHD 101

Kids with ADHD struggle with issues like inattention, impulsivity, and  hyperactivity. Like Autism, the inattention associated with ADHD can lead to some more mild social challenges. For example, failing to pay attention to other people can impact the quality of conversations. Another common challenge of these kids is a “bull-in-a-china-shop” mentality.  They may accidentally interrupt others or bump into them, and this behavior can impede social experiences.

However, unlike in autism, social skills are not necessarily impacted by ADHD. Kids with ADHD may have many close and deep friendships. They generally can hold a back-and-forth reciprocal conversation with a peer. Although they may be energized about a certain topic for a while, they can easily shift to topics of interest to others. 

Kids with ADHD tend to enjoy slightly less structured time such as PE class, Art Class, the cafeteria and the playground. They may thoroughly enjoy any opportunity to play with other kids. This proclivity seen in ADHD is in contrast to Autism where any less structured time tends to be quite stressful. In fact, many kids with Autism will go to great lengths to avoid the cafeteria and the lunchroom, preferring instead to eat lunch in the office. 

When Autism & ADHD Overlap

Many children with autism are first diagnosed with ADHD. That diagnosis is not necessarily wrong. Up to 60% of children on the autism spectrum may also have ADHD.

Here are a couple instances where a diagnosis can get into a gray area.

  • Focused attention: Children on the spectrum tend to be internally distracted, and they often become hyper-focused on something in their own heads. In those moments, they might look like they’re struggling to focus, which is a sign of ADHD.
  • Defiant behavior: Sometimes, children with Autism struggle to shift attention effectively. For example, long after the rest of the class has completed an activity, this child may find herself still deeply engrossed. To the untrained eye, this behavior may seem like the result of inattentive or defiant behavior.

What to Do If You Are Confused About Overlapping Diagnoses

These complexities make it incredibly important to have a thorough evaluation with a trained clinician – someone who really understands autism and all its related symptoms and diagnoses. 

To learn more about ADHD and Autism, check out our courses at: . If you want to know some of the signs and symptoms associated with ADHD, try the inattention and impulsivity section of the Cadey app at:

If you are concerned about your child, do not delay taking action. Psychologists are available to provide referrals to diagnostic psychologists in the chat window of the Cadey App. An accurate diagnosis followed by effective treatment can truly help a struggling child grow up to live their best life.