ASD and ADHD Overlap and Co-occurrence
Definitions and overlap
Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two common conditions that very often co-occur and present together.
ADHD affects about 25% of school-age children in Jordan. Kids with ADHD often have trouble focusing, are very energetic, act impulsively, and have strong emotional reactions. These challenges can significantly impact their ability to keep up with their peers in various settings, such as school and home.
ASD is a condition that affects how someone perceives and interacts with the world. Around 1 in 100 people have ASD worldwide. Children with ASD may experience challenges with social interactions and communication, have sensory sensitivities, engage in repetitive behaviors, and fixate on specific interests.
Both ADHD and ASD are neurodevelopmental disorders. A number of scientific studies have shown that the two conditions often coexist, with some suggesting a prevalence of up to 30%. With ADHD or ASD, brain development has been affected in some way. Most importantly, that includes the brain’s executive functioning, which is responsible for decision making, impulse control, time management, focus, and organization skills as well as language, memory, and social skills
Diagnosis Challenges
Children with both conditions are often diagnosed later than those with one condition due to overlapping symptoms which makes it challenging to differentiate between ASD and ADHD.
Studies suggest that ADHD symptoms can mask the presence of ASD, leading to delayed diagnosis.
Similarities and Differences
Differences
ASD
ADHD
Strong preference for routines and difficulty with changes or disruption of plans.
Struggles with organization and completing tasks.
Is prone to meltdowns due to sensory processing issues, anxiety, frustration, or communication difficulties.
Is prone to tantrums and meltdowns due to frustration or lack of impulse control.
May have delayed speech, limited use of gestures, or no speech.
May talk excessively, interrupt others.
Highly restricted, fixated interests that are excessive in intensity or focus.
Difficulty maintaining attention, easily distracted
Detail oriented and can get caught up with small details.
Misses details and makes careless mistakes.
Similar Symptoms: Both ADHD and ASD can present challenges with attention and focus. Children with these conditions may exhibit repetitive behaviors and face social interaction difficulties, although the reasons and manifestations differ. Emotional regulation issues are common in both, leading to strong emotional reactions in various situations.
Causes and Risk Factors
Genetic Factors: Both ASD and ADHD have strong genetic components and tend to run in families.
Environmental Factors: Factors such as advanced parental age, prenatal exposure to certain substances, and complications during pregnancy may contribute to the development of both conditions.
Brain Structure: Differences in brain development and structure have been observed in individuals with ASD and ADHD.
Impact on Daily Life
School: Both conditions can impact academic performance. Children may benefit from Individualized Education Plans (IEPs) and school accommodations.
Social: Social challenges are common in both conditions. Social skills training can be beneficial.
Behavioral: Behavioral therapy can help manage symptoms and improve daily functioning.
Diagnosis and assessment process
At Mind Clinic, the diagnosis of ASD and ADHD involves a comprehensive evaluation by a team of specialists, including:
Psychiatrists: Conduct detailed assessments, by discussing concerns and reviewing developmental history with parents followed by conducting detailed observations and assessments.
Therapists: Provide therapy and support for developmental, behavioral and emotional challenges as well as parent training.
Nutritionist: Provides support related to relationships with food and any difficulties related to eating such as food aversions and sensitivities.
Screening Tools: Use of psychometric screening tests to help identify symptoms of ASD and ADHD; Autism spectrum rating scale ASRS and the CONNERS 4 for ADHD are the main tests used at Mind clinic.
Multidisciplinary Team Review: Collaborate to confirm the diagnosis and develop a treatment plan.
Management and Interventions
Treatment at Mind Clinic is tailored to each child's age and needs and may include:
Behavioral Therapy: to improve social, communication, and learning skills.
Social Skills Training: Helps children develop and practice social interactions.
Emotional expression and distress tolerance: helps children recognize their feelings, understand where they come from, and express them in ways that are both appropriate and effective.
Time management skills.
A personalized intervention plan is created to address specific goals and is regularly reviewed and adjusted based on progress.
There are no medications to “cure” ASD or ADHD as they are not considered diseases. Medical therapy can be used in some cases to help with symptoms of ADHD such as inattention and hyperactivity or for co-morbid conditions including anxiety, depression or self-injurious behaviors.
References
Centers for Disease Control and Prevention. (2020, December 9). Clinical testing and diagnosis for autism spectrum disorder. Retrieved from https://www.cdc.gov/autism/hcp/diagnosis/index.html
Sokolova, E., et al. (2017). A causal and mediation analysis of the comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 47(6), 1595-1604.
Understood. The difference between ADHD and autism. Retrieved from https://www.understood.org/en/articles/the-difference-between-adhd-and-autism
Dr. Laith. التوحد (Autism). Retrieved from https://www.drlaith.com/autism/
CHADD. ADHD and autism spectrum disorder. Children and Adults with ADHD. https://chadd.org/about-adhd/adhd-and-autism-spectrum-disorder/
Aspect. (2017). Autism and ADHD [Fact sheet]. https://www.aspect.org.au/uploads/documents/Fact%20Sheets/Factsheet_Autism-and-ADHD_20171113.pdf
Stevens, T., et al. (2016). The comorbidity of ADHD in children diagnosed with autism spectrum disorder. Research in Autism Spectrum Disorders, 31, 11-18.
Vermont Family Network. (2013). ASD VT fact sheet for parents. Retrieved from https://www.vermontfamilynetwork.org/wp-content/uploads/2019/05/ASD-VT-Fact-Sheet-for-Parents-final-10.4.13_ENG.pdf