Autistic Pride Day 2020: How autism is different from ADHD, and why understanding that is crucial for effective therapy

Attention deficit hyperactivity disorder (ADHD) and autism are unfortunately common disorders in children. On the surface they may look very similar — both can lead to impaired attention, decreased interaction with people and decreased social performance. However, they are very different in how they affect a child’s behaviour.

Ahead of Autistic Pride Day (18 June), let us take a closer look at various aspects of these two behaviour disorders. It is important to make this differentiation early as treatment interventions are different and early treatment has the best impact.

Representational image. Unsplash@Michał Parzuchowski

Attention: Children with ADHD have impaired attention and are hence not able to concentrate on a task, like studying or reading. Their attention shifts from one thing to the other. Children with autism, however, may appear to be inattentive as only a few things interest them. However, when engaged in a task that they like, they are able to provide sustained attention and focus and they may excel in art, music, science or maths.

Communication: Children with ADHD may talk a lot, shift from topic to topic, may want to have the last word and may speak with disregard to the audience. In contrast, children with autism have difficulty in communicating, associating with people, understanding emotions and gestures and doing role play or imitation. It is in social engagement and forming a relationship that they have their biggest limitations.

Discipline: Children with ADHD are not able to maintain discipline in situations like a classroom or a formal setting. They quickly get bored with any activity and constantly need to shift to a different activity. Children with autism may obsess with their chosen activities and it may be difficult to engage their attention in things that they may not like.

Hyperactivity: Children with ADHD are hyperactive. When put in a room they may touch many things inside without need and fidget from one thing to the other. Children with autism will be withdrawn and may sit in one corner in a seemingly self-absorbed manner.

Social relations: Making or engaging in a social relationship is the major bane of autistic children. They have major trouble in interacting with people and beyond immediate family, they may have very few people they can connect with. They are often loners. Children with ADHD do not have a problem in engaging with people. They may try to dominate or monopolise conversations, but they have problems in sustaining interest in people.

Performance: Children with autism can be divided into high functioning and low functioning autism. Some children may have speech impairments. Low-functioning autistic children lag behind their peers in overall performance. High-functioning autistic children may do well in their chosen tasks. Children with ADHD do not have as much of a speech problem and appear intelligent. However, their lack of focus impairs their overall achievement.

Overlap: There may be significant overlap in both the disorders. Many children with ADHD will meet criteria for autism and vice versa. A psychologist will be able to differentiate and diagnose the two by doing the relevant tests. In some cases, there may be an overlap between the two conditions. This overlap may have significant implications as both conditions may require different treatments. Also, there are other behavioural disorders that may overlap with these disorders, complicating diagnosis and assessment.

Therapy: Correct diagnosis of these disorders has significant implications as research has shown that early interventions have the best outcomes among these children. Correct diagnosis also helps in deciding the way forward in the type of cognitive rehabilitation and choice of medication as some aspects of both conditions can be managed with the use of medications and therapy. An understanding of these differences is thus vital for creating good treatment outcomes and a better quality of life for these kids.

This article was written by Dr Praveen Gupta, Director and HOD, Neurology, Fortis Memorial Research Institute, Gurugram. 

For more information, read our article on Autism.

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