ADHD or Autism: How Are The Signs Different?

Parents of school-age children who have behavioral difficulties in school often wonder: “Does my child have an Autism Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD)?” Determining if a child has one (or both) of the conditions is important for the child’s wellbeing, but distinguishing between the two can be difficult, especially as children with either condition may have similar symptoms, such as:

  • Trouble paying attention
  • Trouble making or keeping friends
  • Trouble playing with other children
  • Patterns of disruptive behavior

Children can be diagnosed with either ASD and ADHD or both, and treatments can be similar, but these two conditions are distinct, which makes having a correct diagnosis key to ensuring the child receives the most effective care available.

How are ASD and ADHD different?

Autism is a developmental condition of the brain that affects behavior. Children with ASD have poor communication skills and unusual behaviors or interests. Socially, children with ASD often make poor eye contact, don’t use facial expressions appropriately, struggle with pretend play, or don’t understand the feelings of others. Children with ASD often have repetitive behaviors or fixate on unusual things or topics (i.e. a child who never rides the bus has memorized the bus schedule).

Like ASD, ADHD is a behavioral condition. Children with ADHD have problems in three primary areas: inattention, impulsivity and hyperactivity. While children with ADHD may understand expectations, they have trouble following through. They are easily sidetracked and often put off or avoid tasks like chores and homework. Attention problems in children with ADHD may include losing things, forgetting instructions, and switching quickly from one thing to another without finishing either.

Where do I start if I think my child may have ADHD or ASD?

Begin by talking to your child’s teacher. Children with ADHD and/or ASD will struggle at school and when away from home so consulting with teachers, coaches and other childcare providers can be a helpful first step in recognizing problems compared to normal childhood behavior. If your child’s behaviors are causing trouble in two or more settings (e.g., at home and at school), and these issues continue for at least six months, the next step is to make an appointment with your healthcare provider. Your primary physician will refer you to a specialist if ADHD or ASD is suspected.

How will my child be evaluated?

There is no single medical test for ADHD or ASD. Because parents are the experts on their children, an evaluation will include an interview with mom and/or dad to help specialists understand your child. Information from teachers may be required as well. Bringing school records, other evaluations or reports, and medical records to the appointment will help paint a picture of your child and his or her current situation. More than one visit is often necessary before a diagnosis is made. A second interview with your child is usually part of the evaluation. The process could also include genetic testing or psychiatric counseling.

Who can I contact with questions?

If you have a concern about your child, always start with his or her primary care physician. This doctor knows your child well and will be able to help you determine the best next steps.

For information about the Cincinnati Children’s program for diagnosis and treatment of ADHD, contact the Center for ADHD at 513-636-4336. For ASD, contact our Division of Developmental and Behavioral Pediatrics at 513-636-4611.

Leanne Tamm, PhD

About the Author: Leanne Tamm, PhD

Leanne Tamm, PhD, is an associate professor in the Center for Attention Deficit and Hyperactivity Disorder (ADHD) at Cincinnati Children’s. Her research interests focus on numerous aspects of the functioning of children with ADHD including brain-behavior relationships, executive function, efficacy of treatment with contingencies and medication, and prevention/early intervention. Currently Dr. Tamm is investigating non-medication interventions for ADHD, including attention and executive function/metacognitive training for preschoolers.

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