The difference between ADHD and autism

What is it?

A neurodevelopmental condition that makes it hard for kids to concentrate, pay attention, sit still, and curb impulsivity.

A range of neurodevelopmental conditions that causes challenges with social skills, communication, and thinking. Repetitive behaviors are also part of autism spectrum disorder (ASD).

Signs you may notice, depending on your child

• Seems forgetful, easily distracted or daydreamy
• Appears not to listen and has trouble following directions
• Is prone to tantrums and meltdowns due to frustration or lack of impulse control
• Struggles with organization and completing tasks
• Has trouble staying on task unless an activity is very enjoyable
• Struggles with social skills
• Struggles to sit still during quiet activities, such as mealtimes or during independent work time at school
• Has trouble waiting his turn and being patient
• Is constantly “on the go” or moving; fidgets and needs to pick up and fiddle with everything
• Interrupts people, blurts things out inappropriately, and may struggle with nonverbal cues
• Acts without thinking and may not understand the consequences of his actions
• May overreact to sensory input, like the way things sound, smell, taste, look, or feel
• Plays roughly and takes physical risks

• Avoids eye contact and/or physical contact
• Has delayed speech (or no speech) or repeats phrases over and over
• Is prone to meltdowns due to sensory processing issues, anxiety, frustration, or communication difficulties
• Gets upset by changes in routine
• Struggles with social skills
• Uses excessive body movements to self-soothe (e.g., rocking, flapping hands)
• Has obsessive interests and experiences perseveration
• Is constantly “on the go” or moving; fidgets and needs to pick up and fiddle with everything
• Is very advanced verbally, but struggles with nonverbal cues
• Has trouble showing understanding of other people’s feelings and his own
• Reacts strongly to the way things sound, smell, taste, look, or feel (sensory processing issues)
• Has trouble with safety and danger awareness

Possible emotional and social impact

Trouble following social rules can make it hard to make and keep friends. Frequent negative feedback for acting out or not paying attention can impact self-esteem and motivation, making a child feel he’s “bad” or “no good.” (Read more about ADHD and emotions.)

The main struggles of ASD involve social understanding, communication and repetitive routines or behaviors. Many kids with ASD — even those without significant cognitive challenges — have trouble making friends, understanding how to relate to other people and making sense of social cues.

Professionals who can help

• Pediatricians, neurologists, developmental-behavioral pediatricians, nurse practitioners, child psychiatrists: Diagnose ADHD and prescribe medication. Can also look for other issues like anxiety.
• Clinical child psychologists: Provide behavior therapy to teach kids to manage their actions and interactions. Provide cognitive behavioral therapy to help with emotional issues related to their ADHD. Diagnose ADHD and mental health issues that may co-occur, like anxiety. May also evaluate for learning differences.
• Pediatric neuropsychologists: Diagnose ADHD and common mental health issues that may co-occur. May also evaluate for learning differences.
• Educational therapists, organizational coaches: Work on organization and time management skills.

• Pediatricians, neurologists, developmental-behavior pediatricians, child psychiatrists, psychologists: Identify possible signs of autism and may diagnose. May also refer for early intervention services.
• Clinical child psychologists, social workers: Provide therapy or social skills training to help kids improve social interactions. Provide cognitive behavioral therapy to help with emotional issues related to autism. Diagnose other issues that may co-occur with autism, including ADHD. May also evaluate for learning differences.
• Pediatric neuropsychologists: Diagnose autism and common issues that may co-occur, such as anxiety and ADHD. May also prescribe medication as needed.
• Occupational therapists: Help kids learn coping skills for challenging situations. Provide sensory integration therapy or a sensory diet to help kids respond to sensory input in more appropriate ways.
• Speech therapists: Work on speech-language and pragmatic language skills to help kids communicate and understand others more easily.

What the school may provide

A child might be eligible for an IEP under the category of “other health impairment.” Accommodations can also be provided under a 504 plan. Examples might include:

• A seat close to the teacher and away from distractions
• A quieter work space to get work completed without distraction
• A signal, nonverbal cue, or picture card to get the child’s attention
• Help breaking long assignments into smaller chunks
• Written or picture schedules for daily activities
• Movement breaks

A child might be eligible for an IEP under the category of “autism.” Special education may be provided along with accommodations. They are very specific to each child, but examples can include:

• A seat closer to the teacher and to classroom materials
• A work space with limited auditory and visual distractions
• Visual prompts and color coding to highlight and teach new information
• A sensory diet and activities throughout the day
• Social stories to present new ideas and situations
• Being provided with choices to ease anxiety
• Being provided with “wait time”

What you can do at home

• Set clear rules and expectations for your child.
• Create daily routines to provide structure.
• Break directions and tasks into smaller chunks.
• Teach your child to use visual prompts like checklists, picture schedules and sticky notes to help him focus, stay organized and get things done.
• Allow for flexibility during homework time for brain and movement breaks.
• Create an organized homework and study area.
• Give advance warning about changes in the schedule and explain what to expect in new situations.

• Set clear expectations and create daily routines.
• Break directions into smaller chunks and use picture prompts.
• Have a plan to manage meltdowns.
• Use a visual timer or signal to make it easier to transition from one thing to the next.
• Role-play and teach scripts for social situations.

These are some common examples. But because ASD looks so different in each child, the support provided at home varies a lot from child to child. Parents will often work with a psychologist or other clinicians to create a support plan.