Does my child have autism or ADHD?
Autism and ADHD are both neurological disorders. Often, when a child is on the autism spectrum, they may also receive a dual or co-morbid diagnosis of ADHD. Sometimes a child with ADHD may also receive a dual or co-morbid diagnosis of autism. In fact, there are some studies that suggest that up to half of kids on the spectrum, also have ADHD.
Both autism and ADHD are also far more common in boys than they are in girls… or, we may just be missing the signs in girls.
Often, women are misdiagnosed with anxiety and/or depression before they are diagnosed with ADHD. That was true in my case, anyway. I was diagnosed with depression at the age of 14 but wasn’t diagnosed with ADHD and Autism until I was 39.
It helps to know the signs of these two disorders though I mainly cover initial signs of autism on my blog. Here’s how to tell if it’s autism or ADHD.
How to tell if it’s Autism or ADHD
This is a tricky area and there is quite a bit of overlap once you start doing the research. Honestly, this is one of those areas where I can really get lost because there is so much to find out. With my daughter, and her educational evaluations, we have two sets of tests.
One set is filled out by her classroom teachers and the other set is filled out by either myself or her father. Usually it’s me because she’s with more often.
Over the past few years, her test results are indicating more signs of ADHD.
We have yet to pursue the diagnosis (medically) but I have thought about it for her.
Clear signs of autism under the DSM-V criteria
Common or frequently seen signs of autism (as of 2019) include:
- Deficits in Social Interaction
- Deficits in Social Communication
- Deficits in Nonverbal Communication (not to be confused with the inability to communicate verbally or non-speaking)
- Deficits in maintaining relationships
- Restricted Interest
- Repetitive Behaviors
And we know, as parents, that autism often develops early in children. Some studies suggest as young as 9 months for older babies while most children are now diagnosed between the toddler and preschool age groups.
Under the autism spectrum disorder category (DSM-IV), you further have:
- High Functioning Autism (once called Asperger’s Disorder)
- Autistic Disorder (or autism)
- PDD-NOS
With the DSM-V, High functioning Autism, Autistic Disorder are no longer recognized. But rather now, it’s Autism Spectrum Disorder.
Characteristics of ADHD as defined by the DSM-V
We know that ADHD is also a neurological disorder. But, it wasn’t until I started doing more research that I finally realized that there are quite a few similarities. I wanted to know if it was really ADHD or if it was just my daughter’s autism. ADHD primarily affects self-regulation and executive functioning.
- Difficulties with sustained attention
- Distractibility
- High activity level
- Impulse regulation
- Working memory
Quite a bit of this is tied to executive functioning difficulties.
And, there are three identified subtypes:
- Inattentive
- Hyperactive/Impulsive
- Combined
ADHD can be tricky to diagnose in younger kids because well, they’re kids. It can be difficult to distinguish what’s developmentally appropriate vs. neurological difficulty.
Does my child have autism and ADHD?
So where does the overlap happen?
As we noticed above, there are different diagnostic criteria for autism and ADHD.
But there’s also some overlap.
- Poor social skills
- Language delays
- Sensory over-responsitivity
- Attention problems
- Oppositional defiancy
- Emotional regulation difficulties
So how do we know? We need to look at the executive functions and see which one(s) are delayed.
So what does it mean when my child has both autism and ADHD?
For a child who is diagnosed with both autism and ADHD, there may be more significant challenges such as:
- Greater impairments in adaptive functioning
- Lower IQ (but not always)
- Greater severity of autism
My daughter, for example, has a primary diagnosis of autism with additional diagnosis of ADHD, OCD, and anxiety.
Me, on the other hand, my primary diagnosis is ADHD-inattentive with additional diagnosis of Autism Level 1, Anxiety, C-PTSD, and Major Depression.
But how do you know when it’s one or the other, or both?
Extensive testing. If you can find a professional who has experience with both, they are your ideal source. Sometimes, when you have psychological evaluations or educational evaluations, you may have something to go by. T
You want to measure both the strengths and weaknesses so you can get a more complete picture. Makes sense, right?
But testing alone is not enough. The diagnosis process can be long and exhausting. And in many cases? You may not have clear answers right away.
Which one is more important to address?
Honestly, I think that’s a pretty loaded question! And it really depends on the individual and their circumstances. For my daughter, it was more important to address some of the issues with her autism. Her fine motor skills, speech, daily living, etc.
We also went with the advice of her developmental pediatrician, developmental psychologist, and the IEP chairperson. While we may not always agree with the system, at the end of the day, a diagnosis of autism carries more weight in an IEP than a diagnosis of ADHD, OCD, or anxiety. She’s far more likely to receive and access the services she needs with her autism diagnosis, so we address that first.
For us, it’s still taking time for everything to come together. I am holding off on medication with her because, at this point, I don’t feel it’s necessary. With me though? I’m on medication.
However, when you start looking beyond the labels and the diagnosis, you can start focusing on the child. And ultimately, that’s where the focus needs to be. Stop worrying about treating autism or treating ADHD. Focus instead of helping your child. Focus instead on changing the environment around your child.
Focus on what’s going to help your child right now and in the immediate future.
Kori
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