ADHD and autism are often confused, even by non-autistic psychiatrists. This leads to misdiagnosis or a lack of diagnosis, because the confusion creates misinformation. Read on to learn the difference between autism and ADHD.
Behavior differences in similar autism and ADHD traits
At a glance, autism and ADHD traits have a lot of overlap, so it looks like someone might be both autistic and have ADHD. It may also look like someone has to only be one of these diagnoses, when it’s not so easy.
Organization
Autistic people
- need structure, routine, sameness and organization
- thrive in strict structured environments and fail where the structure is too flexible
ADHD
- thrives on a lack of structure
- too much structure feels stifling and they can’t function well
Autism + ADHD
- disorganized organizers, who might struggle to read maps but knows exactly where random items are in the midst of their clutter
- need routine and spontaneity
- get bored with routine and sameness, but struggle with change
- heavy structure causes severe anxiety, like the world is closing in on them
- lots of chaos/doom piles, like multiple junk drawers for the world to see
Hyperfixations vs. special interests
Autistic people and those with ADHD obsess over things that catch their interest, but in different ways. Both enjoy talking about these obsessions, but the interests affect their lives differently.
Click here for more details about special interests vs hyperfixation.
Autistic special interests
- have special interests, which run their entire life
- whole world revolves around their special interests
- highly motivated by special interests
- can last a lifetime
- can never learn enough about them
ADHD hyperfixations
- focus and obsess over one thing for hours, days or weeks at a time
- interest fizzles out after they learn everything there is to know
Autism + ADHD
Autistic people with ADHD tend to experience both. In the moment, differentiating between a special interest or hyperfixation can be difficult. They might know which one they’re experiencing until interest dissipates.
Rejection-sensitive dysphoria
Rejection-sensitive dysphoria (RSD) is an overwhelming feeling or response to criticism. For example, a person with RSD would become overly upset or feel depressed for days if they feel they are excluded from a conversation between co-workers.
Autism
- need to relate the situation to themselves so they can fully empathize
- hate feeling left out, too
- are overwhelmed with guilt upon the realization that they have done the same thing to someone else
- begin to panic about how this is why they’re such a bad friend, person, etc.
ADHD
- spiral into self-blame and a panic attack about how everyone hates them, they’ll never have friends, etc.
- object permanence prevents them from remembering that people and things exist even when they can’t see them
Autism + ADHD
- experience rejection-sensitive dysphoria tenfold, their emotions in a whirlwind
Sensory experiences
Autistic people
- angry panic attack-type responses where they’re unable to regulate their emotions
- eventually meltdown or shutdown
- makes it difficult to stay focused
- e.g. heat causes sensory overload which causes a meltdown
- e.g. sound causes sensory overload, which triggers a meltdown/shutdown
ADHD
- struggle to pay attention
- might shutdown, shutting everyone else out in the process
- e.g. heat makes focusing difficult
- e.g. sound causes distractions
Autism + ADHD
- both of the above explanations
- e.g. heat causes sensory overload, which causes distractions/meltdowns
- e.g. sound causes distractions and triggers meltdowns
Socializing
Autistic people
- interrupt because they struggle with social awareness and sharing their thoughts
- social cues
- social protocols
- body language, etc.
- struggle to
- make eye contact
- maintain proper tone
- understand body language
- don’t know what their face/body looks like during conversations
- know social rules for some situations, especially if practiced beforehand — but not if conversation switches
- social anxiety due to conversation change
- excited at mention of special interest
- trouble focusing on what they’re not interested in
ADHD
- interrupts due to
- impulsiveness
- distractions
- excited about topic they suddenly thought of
- interrupts so they don’t forget
- trouble focusing due to distractions and impulse control
Autism + ADHD
- distracted by
- trivial topic that is relevant to current conversation like a fourth cousin two times removed
- other sounds and sensory input in vicinity
- clapping
- lights
- mirrors and shiny objects
- non-autistic person’s “hmm”, “yep”, “mhm” as they’re talking
- eye contact and someone’s body language
- gets anxious from
- constant eye contact
- sensory overload
- conversation not going according to plan
- may forget what they were talking about after interrupting
- easily excitable about certain topics
- previously mentioned struggles of separate diagnoses
Autistic masking vs. ADHD facing
Autistic masking and ADHD facing is also commonly known as masking, facing and passing per each diagnosis. The terms are used interchangeably in certain situations, but autistic masking and ADHD facing is used specifically to describe the nuances.
For the sake of this post, passing means passing as neurotypical/less neurodivergent/acceptable to society.
Autistic masking
- mimics surroundings to fit in
- have little understanding of what they’re mimicking
- puts self in situations where they’re overstimulated and/or manipulated
- feels like they can’t be themselves
- has been masking so long they don’t know who their true self is
- don’t feel safe to be themselves
- appears to be high-functioning or to need little support
- internally struggling
- pretending to be okay when they’re not
- perceived to be doing well and happy
- ignoring instincts when uncomfortable or in pain
- may pretend nothing happened if they run into something or trip in public
- survival mechanism from learning as a child they are not able to be themselves and receive love, acceptance and safety
- on the verge of meltdowns/shutdowns/extreme depression
- unfortunate ticket to autism burnout (also known as autism regression or autism fatigue)
ADHD facing
- mimics behaviors of people around them to fit in
- eager to please and be rewarded (dopamine)
- feels like they can’t be themselves
- ignores their own needs, since everyone else does anyway
Another example of ADHD vs. autism differences
Driving
Autistic people may drive extra safely, but require special preparation to avoid meltdowns on the road.
People with ADHD may be excited about driving and impatient. They may experience road rage.
Autistic people with ADHD may be excited to drive, but seesaw between the above experiences. They may not know when they’re going too fast or too slow.
Are you wondering if your child is dealing with ADHD vs Autism or perhaps both? Use this information as a guide to get started in discovering the ways that neurodiversity affects your family and how you can be most supportive.
Click here for a free PDF printable checklist of the 7 steps to take when your child needs residential treatment.
More Related Posts:
Autism Special Interests vs ADHD Hyperfixation: What is the Difference?
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