What Every Parent Should Know About Autism VS ADHD Symptoms

Understanding Neurodevelopmental Disorders

Differentiating Autism and ADHD

When comparing autism vs ADHD symptoms, it’s essential to understand the key differences between these neurodevelopmental disorders.

Autism Spectrum Disorder (ASD):

• Social Interaction: Children with autism often experience delays in social skills, with signs possibly appearing as early as six months old. These include problems with eye contact, understanding social cues, and forming relationships with peers.
  
• Communication: Challenges in language and non-verbal communication are common. There can be delays or difficulties in speaking, along with struggles understanding or using gestures.
  
• Behavioral Patterns: Repetitive behaviors, such as hand-flapping or focused interests, are often observed. Sensory sensitivities, like being overly sensitive to lights or sounds, are also common.

Attention Deficit Hyperactivity Disorder (ADHD):

• Attention and Hyperactivity: The main symptoms include inattentiveness, hyperactivity, and impulsivity. Children might have trouble focusing, following instructions, or staying still.
  
• Behavioral Challenges: These children often act impulsively, might be overly talkative, and struggle with organizational skills and planning, which are part of executive functioning.
  
• Social Functioning: While they understand social rules, implementing them can be challenging due to distractions and impulsive behavior. They may interrupt conversations and exhibit off-task behavior.

Impact on Daily Functioning

Both autism and ADHD affect daily functioning but in different ways.

Autism:

• Routine and Structure: Children with autism thrive on routines. Changes in their environment or routine can lead to significant stress.
  
• Social Interaction: Difficulty in understanding social norms limits interactions with peers, often leading to isolation. These children might seek out adults over those their age, or struggle privately despite outward efforts to socialize.
  
• Communication: Due to language and non-verbal communication challenges, everyday interactions can become difficult, impacting their ability to express needs or understand others effectively.

ADHD:

• Focus and Attention Span: Short attention spans and distractibility make focusing on tasks difficult. This can affect school performance and completing daily activities effectively.
  
• Hyperactivity: Constant need for movement can be disruptive in structured environments like classrooms or during family activities.
  
• Impulsivity: Acting without thinking can lead to risky behaviors or social conflicts.

Disorder	Key Symptoms	Social Impact	Treatment Options
Autism	Social skill delays, communication challenges, repetitive behaviors	Struggles with peer interactions, seeks structured routines	Behavioral therapy, speech therapy, social skills training
ADHD	Inattention, hyperactivity, impulsivity	Difficulty following social rules, disruptive behavior	Medication, behavioral therapy, organizational skills training

For deeper insights into the differences between autism and ADHD and similarities between autism and ADHD, visit our related articles.

Diagnosis and Criteria

DSM-5 Criteria for Autism Spectrum Disorder

The Diagnostic and Statistical Manual, Fifth Edition (DSM-5) provides standardized criteria to diagnose Autism Spectrum Disorder (ASD). The diagnosis both encompasses broad areas and includes specific observable behaviors. Here are the key criteria (CDC):

Persistent Deficits in Social Communication and Interaction:

• Deficits in social-emotional reciprocity, ranging from abnormal social approach to reduced sharing of interests.
  
• Deficits in nonverbal communicative behaviors used for social interaction.
  
• Deficits in developing, maintaining, and understanding relationships.
  

Restricted, Repetitive Patterns of Behavior, Interests, or Activities (must show at least two of these):

• Stereotyped or repetitive movements, use of objects, or speech.
  
• Insistence on sameness, inflexible adherence to routines, or ritualized patterns.
  
• Highly restricted, fixated interests that are abnormal in intensity or focus.
  
• Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment.

Severity Ratings:

• The new DSM-5 identifies 3 levels of severity to describe the support required by individuals with ASD.

Criterion	Requirement
Social Communication Deficits	All 3 deficits
Restricted Repetitive Patterns	At least 2

DSM-IV Criteria for ADHD

The previous edition of the DSM (DSM-IV) outlines the criteria for diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD). The diagnosis divides into two main presentations: Inattentive and Hyperactive-Impulsive. The key criteria for diagnosing ADHD are highlighted below:

• Inattentive (must show at least six of the following symptoms for at least six months):
  
  • Fails to give close attention to details or makes careless mistakes.
    
  • Difficulty sustaining attention in tasks or play activities.
    
  • Does not seem to listen when spoken to directly.
    
  • Does not follow through on instructions and fails to finish tasks.
    
  • Difficulty organizing tasks and activities.
    
  • Avoids, dislikes tasks requiring sustained mental effort.
    
  • Often loses things necessary for tasks and activities.
    
  • Easily distracted by extraneous stimuli.
    
  • Often forgetful in daily activities.
    
• Hyperactive-Impulsive (must show at least six of the following symptoms for at least six months):
  
  • Fidgeting with or tapping hands or feet, or squirming in seat.
    
  • Leaves seat in situations when remaining seated is expected.
    
  • Runs about or climbs in inappropriate situations.
    
  • Unable to play or engage in activities quietly.
    
  • “On the go” or acting as if “driven by a motor”.
    
  • Talks excessively.
    
  • Blurts out answers before questions have been completed.
    
  • Difficulty waiting for their turn.
    
  • Interrupts or intrudes on others.

Criterion	Requirement
Inattentiveness	At least 6 symptoms for 6 months
Hyperactivity-Impulsivity	At least 6 symptoms for 6 months

By understanding these diagnostic criteria, parents, educators, and professionals can better navigate the complexities of autism vs ADHD symptoms. This knowledge not only aids in accurate diagnosis but also helps in formulating effective treatment plans. For more insights, check out our article on autism and ADHD in adults.

Overlapping Symptoms

Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) share some overlapping symptoms. Understanding these shared characteristics can be crucial for proper diagnosis and management.

Challenges with Sensory Inputs

Individuals with both ASD and ADHD may face significant challenges with sensory inputs. This can result in difficulties prioritizing sensory information, leading to a crowded mind and trouble focusing on one task. People with either condition may respond poorly to stimuli that neurotypical individuals handle well, while being hypersensitive to stimuli that neurotypical people usually ignore.

Though hypo- or hypersensitivity to stimuli is not part of the DSM criteria for ADHD, many with ADHD report it as a challenge, such as struggling to concentrate amidst distracting sounds. For those with ASD, sensory sensitivity is a well-documented characteristic, affecting their daily functioning in various environments.

Symptom	ADHD	ASD
Hypersensitivity to stimuli	Sometimes	Common
Struggles with focusing	Common	Common
Difficulty filtering out distractions	Common	Common

Social Skills and Interaction

Social skills and interaction are areas where both ASD and ADHD present challenges, albeit in distinct ways. Individuals with ADHD often struggle with impulsivity and maintaining attention, which can make social interactions haphazard and inconsistent. They may interrupt conversations, miss social cues, or switch topics abruptly, all of which can be confusing or off-putting to their peers.

Conversely, those with ASD frequently experience fundamental difficulties in social communication and interaction. They might have a hard time understanding non-verbal cues, making eye contact, and engaging in reciprocal conversations. The nuances of social norms can be perplexing, leading to social isolation or awkwardness.

Difficulty	ADHD	ASD
Impulsivity in conversations	Common	Sometimes
Missing social cues	Sometimes	Common
Consistency in interactions	Sometimes	Often inconsistent
Understanding non-verbal cues	Sometimes	Often difficult

Understanding these differences and similarities can help guide the right approach for managing each condition.

In summary, recognizing the overlapping symptoms of ASD and ADHD in areas like sensory inputs and social interaction can aid in more accurate diagnosis and effective intervention.

Co-Occurrence and Challenges

ASD with Elevated ADHD Symptoms

The co-occurrence of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) presents unique challenges for individuals, parents, and professionals. This dual diagnosis can complicate both the identification of symptoms and their subsequent treatment. Understanding the prevalence and specific difficulties associated with this co-occurrence is crucial.

According to PubMed Central, 94% of the ASD+ADHD group met the autism spectrum cutoff criterion on the communication + social interaction score on the ADOS. This was significantly higher compared to the 40% within the ADHD only group and the 29% in the No Diagnosis group.

Group	Communication + Social Interaction Deficits (%)
No Diagnosis	29%
ADHD Only	40%
ASD Only	98%
ASD+ADHD	94%

Youth diagnosed with ASD demonstrated the highest communication and social interaction deficits, with the dual diagnosis group (ASD+ADHD) following closely behind.

Impairments and Psychopathology

Individuals with both ASD and ADHD face more difficulties in daily situations compared to those with only one disorder. Reports from parents and teachers indicate higher levels of additional psychopathology, reduced quality of life, and poorer adaptive functioning in these individuals.

Additionally, the diagnostic categories significantly influence impairment in social communication and social interaction. The ASD group exhibited the highest level of impairment, followed by the dual diagnosis group (ASD+ADHD), and then the ADHD and No Diagnosis groups.

Significant differences were observed in ADOS communication and social interaction scores between various groups:

Group	Communication/Social Interaction Scores
No Diagnosis	Low
ADHD Only	Moderate
ASD Only	High
ASD+ADHD	High

These impairments often lead to increased usage of psychiatric medication, as the complexity of symptoms is greater in individuals with both disorders.

In cases where ASD and ADHD coexist, the approach to treatment has to be more comprehensive, addressing both the core symptoms of each disorder. Professionals and caregivers need to be aware of similarities between autism and ADHD to effectively manage the overlapping symptoms while focusing on individual therapy.

Understanding the complexity of co-occurrence and the associated challenges can help in formulating better intervention strategies to improve the quality of life of affected individuals.

Treatment Approaches

Psychopharmacological Treatments

Pharmacological treatments play a significant role in managing the symptoms of both autism and ADHD, particularly in aiding sensory processing and improving focus. Medications commonly used for ADHD, such as stimulants, may assist by prioritizing sensory input, which can help individuals with ADHD and sometimes those with Autism Spectrum Disorder (ASD) to filter out distracting stimuli.

Some medications also help manage co-occurring symptoms in individuals with ASD. These may include high energy levels, inability to focus, self-harming behavior, anxiety, depression, seizures, sleep problems, or gastrointestinal issues. It’s crucial for individuals to work with a healthcare provider experienced in treating ASD to monitor progress and reactions, ensuring that the benefits of medication outweigh any potential negative side effects.

Behavioral and Developmental Approaches

Behavioral and developmental approaches are foundational in treating symptoms of ASD. Among these, Applied Behavior Analysis (ABA) is notable for its effectiveness. ABA encourages desired behaviors while discouraging undesired ones to improve a variety of skills. Progress is tracked and measured to ensure efficacy. Two prominent ABA teaching styles are discrete trial training (DTT) and pivotal response training (PRT).

ABA Teaching Style	Description
Discrete Trial Training (DTT)	Breaks down skills into small, teachable components.
Pivotal Response Training (PRT)	Focuses on pivotal areas of development like motivation and response to multiple cues.

Developmental approaches focus on improving specific developmental skills in individuals with ASD, such as language and physical skills, often in combination with behavioral approaches. Speech and language therapy is the most common developmental therapy, enhancing the understanding and use of speech and language through verbal or alternative forms of communication. Occupational therapy is also integral, teaching skills for independent living.

Managing Symptoms

For parents and caregivers navigating the complexities of autism and ADHD in children, understanding effective strategies for managing symptoms is vital. Here, we explore educational treatments, medications, and social-relational approaches to help mitigate challenges associated with these neurodevelopmental disorders.

Educational Treatments

Educational treatments are designed to support children both academically and socially, addressing specific challenges that arise from autism and ADHD.

Applied Behavior Analysis (ABA)

Behavioral approaches like Applied Behavior Analysis (ABA) have the most evidence for treating symptoms of autism. ABA employs techniques such as Discrete Trial Training (DTT), which breaks down tasks into simple steps, and Pivotal Response Training (PRT), which focuses on critical areas like motivation and response to multiple cues. These techniques aim to improve a wide variety of skills by encouraging desired behaviors and discouraging undesired ones.

ABA Technique	Focus Area	Goal
Discrete Trial Training (DTT)	Task Breakdown	Simplifying tasks
Pivotal Response Training (PRT)	Motivation & Responses	Enhancing engagement

Developmental Approaches

Developmental therapies focus on enhancing specific abilities such as language and motor skills. The most common therapies for ASD include:

• Speech and Language Therapy: Helps with understanding and using verbal or alternative communication forms.
  
• Occupational Therapy: Teaches skills necessary for independent living.

These approaches are often combined with behavioral methods to offer comprehensive support.

Medications and Social-Relational Treatments

Medications play a crucial role in managing symptoms that co-occur with autism and ADHD. Working with a healthcare provider experienced in these conditions is essential.

Medications

Various medications can help manage symptoms such as high energy levels, inability to focus, self-harming behavior, anxiety, depression, seizures, sleep problems, and gastrointestinal issues.

Symptom	Possible Medication
High energy levels & Inability to focus	Stimulants like Methylphenidate
Anxiety & Depression	SSRIs (Selective Serotonin Reuptake Inhibitors)
Seizures	Anti-epileptics
Sleep problems	Melatonin

It is imperative to monitor progress and reactions to medications to ensure the side effects do not outweigh the benefits.

Social-Relational Treatments

These treatments aim to improve social skills and interactions, which are areas often impacted by both autism and ADHD.

• Social Skills Training: Teaches children how to interact more appropriately with peers and adults.
  
• Cognitive Behavioral Therapy (CBT): Helps children manage their behaviors and understand the consequences of their actions.
  
• Parent Training: Equips parents with strategies to support their child’s development and manage challenging behaviors at home.

SOURCES:

https://www.utmb.edu/pedi_ed/GENPEDS/ADHD/page_06.htm

https://www.psychologytoday.com/us/blog/1-2-3-adhd/202004/making-sense-sensory-overload-in-autism-and-adhd

https://pmc.ncbi.nlm.nih.gov/articles/PMC3441928

https://www.research.chop.edu/car-autism-roadmap/diagnostic-criteria-for-autism-spectrum-disorder-in-the-dsm-5

https://pmc.ncbi.nlm.nih.gov/articles/PMC4709846

https://www.cdc.gov/autism/treatment/index.html

https://www.additudemag.com/autism-and-adhd/?srsltid=AfmBOop3gwoKapgu_v8fGQ99dV-4z5S9dYb49ZGr38t9iDsHsuwDT260

https://www.merckmanuals.com/professional/pediatrics/learning-and-developmental-disorders/attention-deficit-hyperactivity-disorder-adhd