At least 50% of children with autism spectrum disorder also have traits that meet the diagnostic criteria for attention-deficit hyperactivity disorder, and at least 15% of kids with ADHD could also be diagnosed with autism. Despite how prevalent this comorbidity is, it wasn’t until recently that children could be diagnosed with both conditions at the same time.
The Diagnostic Statistical Manual of Mental Disorders, 5th Edition (DSM-5) makes room for kids who have a dual diagnosis of ASD and ADHD. Let’s examine the similarities and differences in these conditions and how to make an assessment plan for at-risk school-aged students.
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Similarities between Autism and ADHD
The differences between ASD and ADHD can be surprisingly subtle — especially when these two neurodevelopmental conditions are combined. Many children on the autism spectrum as well as those with ADHD have sleep problems, mood issues such as anxiety and depression, and social delays. Both conditions appear during toddlerhood or early childhood, though the child may not appear to be struggling until he or she is older. The following points are similarities between ASD and ADHD:
- Focus: Both diagnoses can include trouble with paying attention. Hyperfocus, trouble transitioning, and getting “lost” in a favorite hobby or interest can affect kids with both ASD and ADHD.
- Social skills deficits: Difficulty with social-emotional reciprocity is a core symptom of ASD. Kids with ADHD often have problems socializing as well due to poor impulse control and the fact that they often have trouble paying close attention during conversations.
- Comorbid anxiety: 40% of people with ASD and 25% of people with ADHD also have an anxiety disorder. Many more struggle with depression and obsessive-compulsive traits.
3 Assessment Considerations
Knowing which assessments to use can lead to a quicker and more accurate diagnosis. Take the following considerations into account when assessing a child for ADHD, autism, or both.
1. Assess Early
While severe cases of ASD and ADHD are likely noticed before milder ones, it’s best to be on the lookout for students who may need extra help. Autism can be assessed as early as the preschool years with measures such as the CARS™2.
2. Know the Severity
It’s important to know a child’s diagnosis so that you can help him or her in the most productive way possible — and for the same reason, it’s also crucial to understand the level of severity. Consider using the ADHDT-2 to determine how a child’s ADHD is affecting his or her school performance and life overall.
3. Gain an Understanding of Behavioral Masking
Kids with ASD as well as those with ADHD learn to compensate for their differences early on— and some learn to be such accomplished actors that they can act neurotypical while still struggling with sensory issues, social misunderstandings, mood disorders, and impulse control issues. These kids have simply learned to pretend that they’re ok, but they’re not. Learning to spot which children need assessment in the first place can be the key to changing a child’s time in school for the better.
Learn more about the diagnostic criteria and assessment methods for both autism and ADHD with continuing education and high-quality assessment kits and booklets from Western Psychological Services. We look forward to providing you with materials that will allow your students to achieve their greatest potential!