When a school-age child can’t focus on a task, parents may think their child has attention deficit hyperactivity disorder (ADHD). Difficulty concentrating on homework? Fidgeting and difficulty sitting still? An inability to make or maintain eye contact? All are symptoms of ADHD.
These symptoms do match what most people understand about the common childhood behavior disorder. Even many doctors might gravitate toward that diagnosis. Yet, ADHD might not be the only answer.
Before an ADHD diagnosis it’s worth understanding how ADHD and autism, a neurodevelopmental disorder, can be confused.
ADHD versus autism
ADHD is a common childhood behavioral disorder. Approximately 11 percent of American children between the ages of 4 and 17 are diagnosed with ADHD.
There are three types of ADHD:
- mostly hyperactive-impulsive
- mostly inattentive
- combined hyperactive-impulsive and inattentive
The average onset age is 7 years old. Boys are more likely to be diagnosed with ADHD than girls.
Another childhood condition, autism spectrum disorder (ASD), also affects an increasing number of children.
ASD is a group of complex neurological disorders. These disorders affect behavior, development, and communication. One in 68 American children has been diagnosed with ASD. Boys are four-and-a-half times more likely to be diagnosed with autism than girls.
Symptoms of ADHD and autism
ADHA and ASD share many common symptoms. That’s why it’s not unusual for one condition to be mistaken for the other in the earliest stages.
|ADHD symptoms||Autism symptoms|
|being easily distracted||✓|
|frequently jumping from one task to another or quickly growing bored with tasks||✓|
|unresponsive to common stimuli||✓|
|difficulty focusing, or concentrating and narrowing attention to one task||✓|
|intense focus and concentration on a singular item||✓|
|talking nonstop or blurting things out||✓|
|trouble sitting still||✓|
|interrupting conversations or activities||✓|
|lack of concern or inability to react to other people’s emotions or feelings||✓||✓|
|repetitive movement, such as rocking or twisting||✓|
|avoiding eye contact||✓|
|impaired social interaction||✓|
|delayed developmental milestones||✓|
When they occur together
There may be a reason why symptoms of ADHD and ASD can be difficult to distinguish from one another. Both can occur at the same time. A doctor may decide only one of the disorders is responsible for your child’s symptoms. Not every child can be clearly diagnosed. In those cases, children may have both conditions.
One study in Pediatrics found that 18 percent of children with ADHD exhibited behavior traits of ASD. Those children also had more debilitating symptoms than children who did not exhibit ASD traits. In other words, children with ADHD and ASD symptoms were more likely to have learning difficulties and impaired social skills than children who only have one of the conditions.
Understanding the combination
For many years, doctors were hesitant to diagnose a child with both ADHD and ASD. For that reason, very few medical studies have looked at the impact of the combination of conditions on children and adults.
The American Psychiatric Association (APA) stated for years that the two conditions couldn’t be diagnosed in the same person. In 2013, the APA changed its stance. With the release of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the APA states that the two conditions can co-occur.
In a 2014 review of studies looking at the comorbidity of ADHD and ASD, researchers found that between 30 to 50 percent of people with ADHD also have symptoms of ASD. Researchers don’t fully understand the cause for either condition, or why they occur together so frequently.
Both conditions may be linked to genetics. One study identified a rare gene that may be linked to both conditions. This finding could explain why these conditions often occur in the same person.
More research is still needed to better understand the connection between ADHD and ASD.
Getting the proper treatment
The first step in helping your child get the proper treatment is getting a correct diagnosis. You may need to seek out a child behavior disorder specialist. A lot of pediatricians and general practitioners don’t have the specialized training to understand the combination of symptoms. Pediatricians and general practitioners may also miss another underlying condition that complicates treatment plans.
Managing the symptoms of ADHD can help your child manage the symptoms of ASD, too. The behavioral techniques your child will learn may help lessen the symptoms of ASD. That’s why finding the proper diagnosis and getting adequate treatment is so vital.
Behavior therapy is a possible treatment for ADHD, and recommended as the first line of treatment for children under the age of 6. For children over the age of 6, behavior therapy is recommended besides medication.
Some medications commonly used to treat ADHD include:
- methylphenidate (Ritalin, Metadate, Concerta, Methylin, Focalin, Daytrana)
- mixed amphetamine salts (Adderall)
- dextroamphetamine (Zenzedi, Dexedrine)
- lisdexamfetamine (Vyvanse)
- guanfacine (Tenex, Intuniv)
- clonidine (Catapres, Catapres TTS, Kapvay)
Behavioral therapy is also often used as a treatment for ASD. Medication may also be prescribed to treat symptoms. In people who have been diagnosed with both ASD and ADHD, medication prescribed for symptoms of ADHD may also help some symptoms of ASD. Your child’s doctor may need to try several treatments before finding one that manages symptoms, or there may be multiple treatment methods used simultaneously.
There’s no cure for ADHD or ASD, but with treatment many of the symptoms can be managed. Be patient and open to trying various treatments. You may also need to move to new treatments as your child gets older and symptoms evolve.
Scientists are continuing to research the connection between these two conditions. Research may reveal more information about the causes and more treatment options may become available.
Talk to your doctor about new treatments or clinical trials. If your child has been diagnosed with only ADHD or ASD and you think they may have both conditions, talk to your doctor. Discuss all your child’s symptoms and whether your doctor thinks the diagnosis should be adjusted. A correct diagnosis is essential to receiving effective treatment.