Autism vs. ADHD: Key Differences, Overlaps & Support for Patients and Teens

It’s easy to confuse ADHD with autism since both overlap in some ways. They both influence behavior, communication, and attention. Adding to this, it is common for autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) to co-occur, which makes diagnosing either one challenging. 

Although distinguishing between the two is challenging, there are notable differences, too. Understanding the differences between the two can help ensure that your child or teen gets the right support. 

Key differences between autism vs ADHD

Both ASD and ADHD are neurodevelopmental disorders that affect how a child acts, thinks, and learns. While there are similarities, there are also distinct differences, especially relating to emotional regulation, sensory processing, and social skills.

Let’s take a closer look. 

Social interaction and communication

Social skills are a key area where differences occur in these two disorders. 

• Autism: A child with autism may have trouble recognizing and understanding social cues and norms. This may include difficulty making eye contact. They may have trouble “reading” facial expressions and other nonverbal communication cues. 
• ADHD: Children with ADHD are aware of social norms, but impulsivity makes it difficult to follow them. They may come across to others as overly talkative or say things impulsively that are not socially acceptable. 

Attention, focus, and hyperfocus

Both autism and ADHD affect attention and focus, but in different ways. 

• Autism: Children with ASD can develop intense interests in specific topics. For instance, they may spend hours watching the same show repeatedly. 
• ADHD: Children with ADHD struggle to focus their attention. They may find it very hard to focus on boring tasks, yet will hyper-focus on preferred activities. Unlike kids with autism, who tend to focus intently on “boring” things, kids with ADHD tend to focus on activities that are very exciting, like video games. 

Repetitive behaviors and routines

Both kids with autism and ADHD may show repetitive behaviors ("stimming"), but they do them for different reasons. 

• Autism: Children with autism need schedules and predictability. They may need to take the same route to school every day, eat the same foods, and follow strict daily routines. When this doesn’t happen, they may engage in repetitive behaviors, such as rocking or hand-flapping, to self-regulate.. 
• ADHD: Kids with ADHD also engage in repetitive behaviors ("stimming"), but this is to help them stay alert or for self-regulation if they are upset. Unlike kids with autism, they may crave new experiences and novelty.

Sensory processing

Children with ASD and ADHD both have trouble processing sensory information, such as lights, sounds, textures, and movement, but for different reasons. These differences also vary in how they occur. 

• Autism: In ASD, these problems come from the brain's inability to organize sensory information. This is a core feature of autism. The brain has difficulty organizing sensory information, which can lead to hypersensitivity and hyposensitivity. A child with autism may be overly sensitive or under sensitive to sensory information. 
• ADHD: Kids with ADHD have trouble with executive function, concentration, and controlling their emotions. This makes it hard for them to process sensory information. They are not necessarily overly sensitive, but they have difficulty processing sensory information. 

Executive function and time perception

Executive function and time perception are very important for staying organized and recognizing the passage of time. Kids with autism and ADHD may struggle in these areas. 

• Autism: Children with ASD experience rigid, inflexible thinking and need consistency and routine. As far as time perception, children with ASD experience difficulties in time perception due to sensory processing deficits, being unaware of internal bodily signals, and the subjective aspect of time.
• ADHD: Children with ADHD are more flexible and like different experiences, but they may have a hard time transitioning between activities due to poor planning and disorganization. They may also struggle with time perception challenges. Problems with time perception (‘time blindness’) are common in ADHD and linked to executive-function deficits.

Emotional regulation and rejection sensitive dysphoria

Emotional regulation challenges are present in ASD and ADHD, but for different reasons. 

• Autism: Kids with autism have trouble with emotional regulation due to frustration and difficulty with social cues. They may have trouble interpreting social cues. This can cause them to misinterpret social interactions. For example, a child with autism may believe that a friend is mad at them when this is not the case, which may trigger emotional outbursts.
• ADHD: ADHD kids struggle to deal with frustration and anger, which may lead to destructive, impulsive behavior and mood swings that last a long time. They also can be very sensitive to perceived rejection, failure, or criticism. This is called rejection sensitive dysphoria (RSD). 

Overlapping traits and co-occurrence

ASD and ADHD have similar traits, including challenges with emotional regulation, 

attention, sensory processing, and social interaction. This can make distinguishing between them difficult and may lead to misdiagnosis or delayed diagnosis.

Genetic and neurobiological overlap

Research indicates that both conditions exhibit significant heritability. However, certain chromosomal areas remain exclusive to each individual. In many cases, these disorders occur together frequently in families, suggesting a potential genetic overlap. 

AuDHD profile

AuDHD is not a clinical diagnosis; rather, it’s an informal name used to describe a mix of autism and ADHD traits in a child. AuDHD kids struggle with conflicting needs. For example, a key feature of ADHD is a need for new experiences and impulsivity, while a preference for routine is an ASD trait. Children with both ASD and ADHD can focus intensely on activities that interest them, but grow bored with other tasks.

Many AuDHD kids want to connect with their peers but struggle to do so. Many of them want interaction, a trait linked to ADHD, but find it confusing and emotionally draining due to difficulties in interpreting social cues related to ASD.

Children diagnosed with both conditions often have a more complex presentation, and AuDHD children usually experience more severe symptoms and functional impairment.

Children with both autism and ADHD often suppress their neurodivergent behaviors to avoid bullying and rejection. To fit in with neurotypical peers, they may “mask” or hide their autistic traits, like special interests and stimming, as well as ADHD characteristics like impulsivity. This masking is a response to the overwhelming challenges they face.

Statistics on co-diagnosis

There’s a high rate of co-occurrence between ASD and ADHD. Research shows that around 38 to 40% of kids with ASD also have ADHD. According to CDC survey data, an estimated 7.1 million U.S. children (≈11.4%) have ever been diagnosed with ADHD (2022 data). Older analyses of pooled 2016–2018 survey data reported that about 13.9% of children with an ADHD diagnosis also had an ASD diagnosis. Generally, those with both diagnoses tend to be older than those with ASD alone.

How are autism and ADHD diagnosed?

While these two disorders share some overlapping symptoms, the process for diagnosing each is different. 

Autism diagnosis

Autism is typically diagnosed by a clinician or clinic that specializes in this disorder. The evaluation may include both: 

• Developmental history (parents' descriptions of their child's development)
• Behavioral observation (an observation of a child’s behavior by a professional) 

Other information may be used in the diagnosis. This may come from the child’s teachers, pediatrician, and other caregivers.

Clinicians may also use screening tools such as the Autism Spectrum Quotient (AQ), which measures specific autistic traits, including social skills, attention switching, and imagination.

Another typical tool is the CAT-Q screening tool that measures how much a child with ASD "camouflages" their traits in social situations.

ADHD diagnosis 

A mental health clinician, psychiatrist, or psychologist typically diagnoses ADHD using psychometrics assessments and scales, such as the Conners 4th Edition. They also conduct interviews with parents, teachers, and other caregivers to diagnose ADHD. The behaviors or symptoms must be present in at least two settings (home, school, church, community) to qualify for a diagnosis. 

There is no specific test that evaluates for AuDHD. For a proper diagnosis, clinicians must use several screening tools. Since the publication of the DSM-5, physicians can diagnose both conditions in the same person.

Differential diagnosis tips

To help differentiate between ASD and ADHD, it's important to consider the root causes of the symptoms. While both can present social challenges, in ADHD, these typically stem from inattention and impulsivity. In contrast, children with ASD have ongoing social difficulties due to problems with social communication and understanding social interactions. 

When assessing a child for either condition, consider their developmental history. Early significant delays may suggest ASD, while symptoms of ADHD often appear around preschool age, when children are expected to follow classroom directions.

Treatment and support strategies

For both disorders, a treatment plan may include medication, behavioral therapy, or a combination of both. Creating a supportive home and learning environment is also important.

Autism support

Treatment for autism focuses on improving social interactions, communication, and daily living skills. Specific therapies include: 

• Neurodivergent affirming therapy: This therapy can help kids with autism better understand their sensory and communication needs and develop skills to improve functioning at home and school, and support their needs. 
• Parent coaching: This therapy can help parents learn ways to better support their child, such as through positive reinforcement and improved communication.
• Social skills training: This therapy helps kids with autism improve social skills and communication. 
• Speech and language therapy: This helps improve both verbal and nonverbal communication in autistic kids. 
• Medications: FDA-approved medications like risperidone (Risperdal) and aripiprazole (Abilify) are sometimes prescribed to help manage self-harm, irritability, and aggression in children with ASD.

ADHD support

Treatment for ADHD addresses a child’s attention, behavior, and emotional regulation. Some treatments include: 

• Behavioral therapies: Children with ADHD can improve their symptoms through Neurodivergent affirming therapy or cognitive behavioral therapy (CBT). Both of these therapies can also be helpful for kids who have ADHD, autism, or both. 
• Medications: Stimulant medications like methylphenidate (Ritalin) and amphetamine (Adderall) are common treatments for ADHD. These medications alter brain neurotransmitters to reduce hyperactivity and impulsivity. They are prescribed by a psychiatrist or a psychiatric nurse practitioner (PMHNP). There are also non-stimulant options if your child has a hard time with stimulant-related symptoms. You and your child’s psychiatrist or medication provider can come up with a plan that best suits your child’s needs and medical history. 

School and home accommodations

Children with ASD and ADHD need a home and school setting that is supportive. Simple instructions, routines, and even visual aids help children control their feelings, calm down, and focus better. A quiet place to work also helps with hyperactivity and distractions.

When you see your child trying to stay focused or control their emotions on their own, be sure to praise them. Positive reinforcement can help your child create good habits and reduce unwanted behaviors.

To support your child in the classroom, ensure they have either an IEP (Individualized Education Plan) or a 504 plan. An IEP provides specialized services for children with disabilities, while a 504 plan offers accommodations to help remove learning barriers.

Tips for parents, teens, and young adults

Here are some tips for supporting a child with ADHD or autism.

Autistic kids crave structure and routine. They benefit from clear expectations, structure, and skills training. Clear expectations are also important. Tips include:

• Identify and support your child’s sensory needs. 
• Use visual aids to help support differences in communication. 
• Provide encouragement and assistance during social interactions. Avoid pressuring your child to “mask” or to act “normal” in social interactions. 
• Create a strong social support system. Isolation is a real problem for kids with ASD. Social support can help them feel less alone.
  

Children with ADHD also benefit from clear structure and expectations. Here are some other tips: 

• Use positive reinforcement to help encourage positive behavior. 
• Assist with organization and difficult tasks. Teach them how to break down tasks and focus on one thing at a time so they don't get so overwhelmed.
• Introduce grounding techniques and visual charts to help them learn to identify emotions. 
• Encourage your child to use movement and other physical activities to help with hyperactivity and emotional regulation. 

How Emora Health can help

If you are concerned about your child’s behavior, social skills, or would like to receive testing for ASD or ADHD, contact Emora Health. We'll work to match your child with a licensed psychologist or professional who specializes in ASD or ADHD.

At Emora, getting help couldn’t be easier. We have no waitlists or long delays. Our services are covered by many insurance plans. You may pay as little as $0 out of pocket, depending on your plan. 

Our therapists provide support for the whole family. That way, the entire family can learn how to support your child.