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Why Misdiagnosis Occurs So Often With ADHD and ASD

We’ve come a long way when it comes to mental health awareness. But there are still plenty of perspectives that need attention. For example, it’s widely accepted that some medical conditions have similar signs and symptoms. It requires proper assessment and observation to make an accurate diagnosis. That said, many folks do not yet realize that the same goes for mental health issues.

For example, attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are very distinct conditions. However, there is a big overlap of symptoms. In addition, as many as half of those diagnosed with ADHD will also be found to have ASD. Let’s take a closer look at this reality.


boy covering earsLet’s first clarify what each disorder is.

ADHD is a chronic condition. It almost always begins in childhood and can often be identified via signs like difficulty concentrating, hyperactivity, and impulsiveness. While ADHD typically persists into adulthood, it’s much easier to diagnose in children.

ASD is a developmental disorder that seriously affects the nervous system. While symptoms and severity can range widely, ASD most frequently impacts one’s communication and social skills.

ASD and ADHD: Shared

Of course, each case is different but the most common shared symptoms relate to, not surprisingly, one’s communication and social skills. This can manifest as:

  • Misunderstanding social cues
  • Focus levels are atypical — from unfocused to hyper-focused
  • Avoiding eye contact
  • Hyper-sensitive to sensory input
  • Impulsivity and hyperactivity — especially in social settings

Clinicians suspecting the presence of ASD will specifically look for these signs. However, such signs are also quite common with ADHD. Needless to say, this can significantly contribute to misdiagnosis.

How Can You Tell ASD and ADHD Apart?

As noted, this is sometimes easier said than done. But here are three areas to consider, especially when assessing children:

How The Child Focuses

Generally speaking, a child with ASD can have an almost obsessive focus if they like the topic or task. They often have very specific topics they’ll talk about or interact with. With ADHD, hyper-focus still exists, but the disorder causes more generalized focus issues for all efforts. It often manifests as multitasking to the point of having several unfinished tasks or projects all at the same time. 

How The Child Communicates

As discussed above, communication is a flashpoint for both conditions. At times, the challenges will look similar but the differences are fundamental. Both groups can appear unaware of the presence of other people in their vicinity. With ADHD, children know someone is nearby but they struggle with focusing on them. Kids with ASD can be completely unaware that they are not alone.

Does The Child Seek Structure?

While structure is just what kids with ADHD need, they often resist it. Meanwhile, ASD is a condition that can lead a child to develop a firm need for routine and repetition. The topic of structure can thus be a strong indicator of which disorder is present.

But What If ASD And ADHD Are Both Present?

Once again, this can be the case as much as 50 percent of the time. If so, the approach may include:

  • Simultaneous treatment for both conditions
  • Integrating behavioral therapy and medication
  • Encouraging daily self-care
  • Learning lifestyle changes and healthy coping skills

Diagnosing ASD And ADHD

This effort requires practitioners to move beyond the realm of textbook strategies. The typical approach blends observation and group-based context. A child must be observed in a variety of settings, and this requires help from several people. Input from parents and other caretakers is vital. In addition, siblings and teachers can offer valuable feedback, too.

All of this adds up to create a more nuanced perspective. When combined with proper tests and evaluations, the odds of an accurate diagnosis improve. Do you want to know more about child therapy? Let’s connect and talk soon.

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