ADHD, ASD and AuDHD

Editor’s Note: HELEN Journal has covered many aspects of both Autism and Attention-Deficit Hyperactivity Disorders. Following is a comparison of the different primary characteristics—and how the two conditions can be co-occurring disorders.

Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are distinct neurodevelopmental conditions with different primary characteristics, although they often co-occur and share some similar outward behaviors. The key difference lies in the core diagnostic criteria: autism is defined by significant challenges in social communication and interaction, along with restricted, repetitive behaviors and interests, while persistent patterns of inattention, hyperactivity, and impulsivity define ADHD. 

FEATURE: Core Challenges

AUTISM (ASD): Social communication/interaction, and repetitive/restricted behaviors.

ADHD: Attention regulation, hyperactivity, and impulsivity.

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FEATURE: Social Skills

AUTISM (ASD): May have difficulty understanding social cues and nonverbal communication (e.g., eye contact, body language).

ADHD: Aware of social norms but may struggle to follow them due to inattention or impulsivity (e.g., interrupting).

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FEATURE: Routines

AUTISM (ASD): Often requires strict routines and sameness for comfort and predictability; changes can be very distressing.

ADHD: Struggles with maintaining routines due to executive function deficits; often seeks novelty and can get bored easily.

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FEATURE: Focus/Interests

AUTISM (ASD): Tends to have intense, long-term focus on specific, often niche, interests that are a core part of their identity.

ADHD: May "hyperfocus" on preferred tasks (interest-based attention) but generally struggles with sustained attention on non-preferred tasks.

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FEATURE: Movement

AUTISM (ASD): May engage in self-soothing repetitive movements (stimming) like hand-flapping or rocking to manage sensory input.

ADHD: May be generally fidgety or restless due to excess energy, as a way to maintain focus.

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FEATURE: Sensory Input

AUTISM (ASD): Often has heightened or reduced sensory sensitivities (e.g., sensitivity to sounds, textures, lighting).

ADHD: May overreact to some sensory input or seek constant stimulation.

Summary of Key Differences in the "Why"

The root causes behind similar behaviors often differ between the two conditions: 

Social Difficulty: An autistic person may have social challenges because their brain processes social information differently and they lack the innate "social knowledge". A person with ADHD might miss social cues because their attention has drifted or they speak impulsively without thinking.

Attention Issues: Inattention in autism may stem from being intensely focused on an internal interest or feeling overwhelmed by external stimuli. In ADHD, it is a core deficit in sustained attention and executive function, making it difficult to maintain focus and organize tasks generally.

Repetitive Behaviors: Stimming in autism is often for emotional and sensory self-regulation. Fidgeting in ADHD is typically a way to release excess energy and help with attention regulation when under-stimulated. 

It is important to note that many individuals can have both conditions, which is sometimes referred to informally as "AuDHD". In such cases, symptoms of both conditions interact, leading to a unique presentation. A qualified healthcare professional can provide an accurate diagnosis and an appropriate support plan.

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