How Can You Tell ASD from ADD/ADHD in a Young Child?

It is entirely possible for children to have both ASD and ADHD. In fact, it is actually quite common for the two disorders to co-occur. A National Institutes of Health study published in 2014 showed that 18 percent of children diagnosed with ADHD actually showed symptoms of ASD.

If you’ve found yourself here, reading this page, you’re asking yourself:

Which – if any- of these disorders does my child have and how can I tell?’

Early diagnosis and intervention of behavioral and neurological disorders is imperative. Proper treatment can actually reduce the severity of the symptoms, no matter what the diagnosis might be.

If you’re concerned your child may have one or both of these disorders, the earlier you voice these concerns to a doctor, the better. The young brain is an adaptable brain and early treatment options may help reduce the severity of symptoms as your child ages. In some cases, the faulty neural connections in the brain can actually be rerouted.

Though the final diagnosis should come from a healthcare professional, the first steps in unraveling the mystery often come from a parent’s own detective work. Parents play a crucial role in identifying the symptoms because as a parent, you know your child better than anyone.

Parents should not lose hope in the case of a dual diagnosis. This just means that treatment and therapy will need to be more individualized and in many cases, more intensive.

Understanding the Different Diagnoses: ADD, ADHD and ASD

Before we can whittle down the differences between ADHD/ADD and ASD, it is important to understand the relationship between ADHD and ADD.

The terms ADD (Attention Deficit Disorder) and ADHD are often confusing because many people consider them the same. In actuality, ADD is a sub-classification of ADHD and is now recognized predominately in children who show a general lack of attentiveness, but not necessarily other behavioral problems. They may be labeled as ‘daydreamers,’ and tend to find it difficult to follow directions, stay on task and struggle with responsiveness. These are the kids that sometimes come across as being perpetually bored and listless. Many times, these kids are never diagnosed because they are missing the key trait in ADHD – hyperactivity.

If your child can’t stop fidgeting, interrupts and can’t seem to wait their turn, you may be seeing signs of one of the other subtypes of ADHD as defined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders): Predominately Hyperactive-Impulsive Presentation or ADHD Combined Presentation.

Now the real detective work begins. Does your child have ADD/ADHD or ASD? Any good detective knows you need to start with gathering facts long before jumping to any conclusions.

Some of the more common symptoms and behaviors seen in children with ADD/ADHD include being easily distracted… moving quickly between tasks… quickly getting bored… inability to stop talking, interrupting or blurting things out… constantly moving and unable to sit still… problems with basic social skills… a failure or inability to react to other people’s feelings.

With ASD, the symptoms and behaviors often seen include trouble making eye contact… social withdrawal… repetitive movements… delays in major developmental milestones like walking and talking… constantly moving and unable to sit still… hyper-focused on a single task or item… a failure or inability to react to other people’s feelings.

Clearly, there are quite a lot of similarities between the two diagnoses when making a side-by-side comparison of symptoms. However, the important distinctions arise in how these symptoms manifest in behaviors.

Breaking Down the Differences Within these Similarities

  1. Focus

    ADD/ADHD – A common concern for a parent whose child has ADD/ADHD is that the kid simply will not stay focused. Getting through an art project or puzzle you thought would be fun may be something they show zero interest in. And it’s a page of math homework, you can forget about it. This can turn routine things into a monumental task for both parent and child in these cases.

    ASD – For a parent whose child has ASD, the complete opposite is often true. These children become so hyper-focused on one task that it is often difficult, if not impossible to move them along to something else. They may refuse to do what they need to be doing because they can’t pull their focus off of what has their attention. For instance, a child with ASD who has an interest in art may sit and draw for hours on end and may even throw a tantrum when being asked to do something different.

  1. Impaired Social Skills

    ADD/ADHD – Both children on the autism spectrum and those with ADHD can have impaired social skills. There are, however, some pretty big differences in how their socially clumsy behaviors show up, and why. A child with ADHD may want to hang out with friends but they often lack the self-control and social skills to blend in. Their outgoing nature may be the thing that gets them noticed by other kids early in the school year, but in some cases they may struggle to maintain friendships over the long term. Kids with ADHD can be overly aggressive in trying to be noticed, they may lack basic conversational skills and often interrupt, talk too much or let emotions get the best of them.

    ASD – On the other hand, a child with ASD may show little if any interest in interacting socially, or if they do, they may be completely socially oblivious and even offensive at times. A child on the spectrum is more likely to be withdrawn from social situations, often preferring to be alone with the things that interest them and giving no energy to developing relationships, but this isn’t universally true. A kid on the high-functioning end of the spectrum may actually be very interested in engaging socially, but struggles to do so successfully since they tend ot monopolize every conversation they’re in by talking endlessly about themselves or their own interests, showing no interest in what others are saying, or responding to people’s feeling in ways that come across as obtuse and even uncaring.

  1. Hyperactivity

    ADD/ADHD – Your child is probably running circles around you all day long. Just being around the constant noise and ceaseless activity can be exhausting. Children like this often lack impulse control so when the desire to move around comes, they’re off and running. This can be especially disruptive in a classroom when a child gets up in the middle of a discussion seemingly oblivious to the speaker because something or someone on the other side of the room caught their attention.

    ASD – Hyper-focus is a common characteristic of kids with ASD, but so is hyperactivity, though it can take on a different appearance than it does with kids with ADD/ADHD. Hyperactivity among those with ASD is often a way to release the tension that comes from the stress of extreme sensory sensitivity or anxiety that comes from a break in their routine. This usually rears its head in the form of nervous ticks like hand-flapping or repetitive motions like constant rocking or fidgeting around.