ADHD and ASD Together

Attention Deficit Hyperactivity Disorder (ADHD) is a common diagnosis among school-aged children, with an estimated 11 percent of children receiving this diagnosis. However, what many parents, teachers, and school counselors may not realize is that children with ADHD may also manifest symptoms of Autism Spectrum Disorder (ASD). Comorbidity, or the presence of two or more co-occurring diseases or disorders, is becoming increasingly recognized in the diagnosis of both ADHD and ASD.

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Comorbidity of ADHD and ASD A 2014 review of studies looking at comorbidity found that “between 30 and 50 percent of individuals with ASD manifest ADHD symptoms (particularly at pre-school age), and similarly, estimates suggest two-thirds of individuals with ADHD show features of ASD.” This research also suggests that children with this comorbidity often have more severe levels of dysfunction, making early and accurate diagnoses and effective treatments all the more important.

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Similarities and Differences Both ADHD and ASD present with difficulties in attention, difficulties communicating with peers, impulsivity, various degrees of restlessness or hyperactivity, and a known genetic predisposition. They are also more common in boys and present, at least partially, at preschool age. Both cause significant behavioral, academic, emotional, and adaptive problems in school, at home, and elsewhere.

 

However, there are also key differences in the diagnosis and presentation of these disorders. ADHD is defined by impaired functioning in the areas of attention, hyperactivity, and impulsivity, whereas ASD is characterized by core social dysfunction and restrictive-repetitive behaviors. This includes behaviors such as unresponsiveness to common stimuli, intense focus and concentration on a single item, repetitive movement, avoiding eye contact, and withdrawn behaviors.

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Diagnosis and the DSM-5 Prior diagnostic standards made the diagnosis of one an exclusion for the other. However, the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, included criteria that allowed clinicians to diagnose an individual with both disorders at the same time. This allows for a more accurate understanding of the impact of ASD and ADHD as comorbid conditions, and opens the possibility for more effective treatment options.

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Strategies for Success Partnering with school counselors is an important way for parents to help their children with these comorbid conditions succeed. A common approach that counselors use for helping kids with ADHD is through the use of evidence-based interventions (EBIs), which include behavioral techniques that are effective for children with ASD as well.  

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Additional strategies parents can use at home to help their children include:

• Providing positive communication and reinforcement

• Creating and maintaining as much structure in their day-to-day lives as possible

• Posting lists, rules, and schedules to help with organization

• Encouraging physical exercise as a release

• Learning more about available behavior parent training programs