Can ADHD be mistaken for Autism?

Are some kids dealing with Autism misdiagnosed with ADHD?

Yes, absolutely!  There are overlapping conditions between the two.  Read on to read the full comparison by  The Diagnostic and Statistical Manual of Mental Disorders (DSM5)

How are these two disorders similar?

Many of the symptoms associated with Autism Spectrum Disorder are confused for ADHD, such as difficulty in settling down or focusing on something, ability to pay attention, impulsivity and social awkwardness.  These are the executive functioning skills: time management, organization, self-reflection, emotional regulation, and focus.

Yes, Autism and ADHD can look a lot similar as children with either has difficulty focusing. They have issues communicating; they might struggle with their schoolwork and so on. Although the two conditions share a lot of common symptoms, the two are very different conditions. Autism is a kind of developmental disorder that can impact language skills, social interactions, behavior and learning ability. ADHD affects the way the brain develops and grows. It is also possible at times that someone on the Autism spectrum is dealing with both, which would be called a comorbid condition.

So, how can we differentiate between the two conditions?

Look at the checklists below and compare and observe the behavior. All those dealing with autism struggle to focus on things that they dislike. For instance, if they don’t like to study, they cannot focus on reading for comprehension.  When they asked to read, they might fixate on things they like, such as watching a cartoon or playing their favorite game. Students dealing with ADHD lose interest in the initial phase and they try to avoid things asked to focus on. They can look similar.  The difference will be the severity in the autistic person and the other traits listed below.

You can also look at the way the person learns to communicate.

Although in both conditions, children struggle to communicate with others, those dealing with Autism are generally highly focused in their own world. They struggle to put words to their thoughts and fail to express their feelings. They also find it difficult to make eye contact with someone. On the other hand, a child dealing with ADHD can talk non-stop and can be very social. They can be talkative and challenging to stop them once they stop.

While an autism child loves to repeated events, those dealing with ADHD like to move onto the next interest. A child coping with Autism might like the consistent routine of things, whereas those with ADHD do not like to do the same thing over and over again. They like to explore new things often.

While these are samples that help differentiate between ADHD and Autism, there are many more characteristics considered before a diagnosis could occur.

The first and most important thing to do is to visit the doctor.  Let the expert decide what your child is going through if you suspect either condition. To diagnose ADHD, doctors generally look at the behavioral pattern of the child over time, for instance – not following the instructions, being forgetful, not listening to parents, fidgeting and so on. They ask for feedback from parents and teachers and draw a conclusion based on their observation and symptoms. The feedback for Autism is much more complicated.   Look below at the full DSM5 criteria the professional use to determine if it is ADHD or Autism.

 

Here are the full Diagnostic Criteria for Autism Spectrum Disorder from the www.cdc.gov site

  1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
    1. Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
    2. Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
    3. Deficits in developing, maintaining, and understand relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

Specify current severity:

Severity is based on social communication impairments and restricted, repetitive patterns of behavior.

  1. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
    1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
    2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
    3. Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests).
    4. Hyper- or hyperreactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

Specify current severity:

Severity is based on social communication impairments and restricted, repetitive patterns of behavior.

  1. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
  2. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  3. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level

 

DSM-5 Criteria for ADHD

People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with functioning or development:

 

  1. Inattention: Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
    1. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
    2. Often has trouble holding attention on tasks or play activities.
    3. Often does not seem to listen when spoken to directly.
    4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
    5. Often has trouble organizing tasks and activities.
    6. Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
    7. Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
    8. Is often easily distracted
    9. Is often forgetful in daily activities.
  2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
    1. Often fidgets with or taps hands or feet, or squirms in seat.
    2. Often leaves seat in situations when remaining seated is expected.
    3. Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
    4. Often unable to play or take part in leisure activities quietly.
    5. Is often “on the go” acting as if “driven by a motor”.
    6. Often talks excessively.
    7. Often blurts out an answer before a question has been completed.
    8. Often has trouble waiting their turn.
    9. Often interrupts or intrudes on others (e.g., butts into conversations or games)
The accurate diagnosis of the condition starts when you start talking to the doctor about behavior, what he/she dislikes, what they struggle with.  Apart from the symptoms and behavioral patterns, some more tools and tests are conducted to understand what the client is dealing with.

Fortunately, there are many resources available today to help distinguish the two conditions and behavioral plan options to help live the most productive and fulfilled life.

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