ADHD, Autism… Or Both
Written by neuropsychologist, Dr. Renay Gartner
Trying to understand if what you're seeing is ADHD, autism, or both is truly disorienting. If you’re feeling unsure and overwhelmed, it’s for good reason. The endless newsletters, reels, and blogs offering quick-fix answers and very strong opinions often leave us feeling pulled in different directions, unsure of what information to trust and the best path forward. Instead of a clear picture, we’re left with edgeless puzzle pieces.
From the outside, Attention Deficit Hyperactivity Disorder (ADHD) and autism can look strikingly similar. No wonder it’s hard to tell them apart! Challenges with staying focused in school, making and keeping friends, and having big emotions show up across both diagnoses. When you add in how often ADHD occurs in those with autism (~ 40% to 70%, though most people with ADHD don’t have autism), it is easy to understand why families feel stuck and confused trying to make sense of it all.
Determining the differences between autism and ADHD is not about labels for the sake of labels. Rather, it’s about clarity and compassion. It’s about seeing the whole child - their unique strengths and what gets in their way when trying to make friends, follow a school plan, or reach their goals. And with the correct diagnosis, you can get the support that really works for your child and family.
It also plays an important role in identity. A thoughtful, accurate diagnosis can help young people and their families better understand themselves and take pride in their neurodiversity.
A Deeper Look
While the symptoms of ADHD and Autism overlap, the underlying reasons behind them can differ. Let’s explore the behaviors that appear the same on the surface, but have differences underneath.
Attention and Executive Functioning: Children with ADHD are often easily pulled off task by what’s happening around them. A noise in the hallway or something more interesting nearby can quickly shift their focus. Sustaining attention, especially on tasks that feel long or uninteresting, can be particularly difficult.
Autistic children may also appear inattentive, especially during conversations or in groups. However, their attention may be directed inward toward their own thoughts or a specific interest. The challenge is shifting attention from what they are focused on internally to what is happening in their environment.
You also might notice that your child with ADHD or Autism often looks away from you while you’re talking. Kids with ADHD may be easily distracted by other things around them, pulling their attention in different directions. For kids with Autism, they might not find the visual information (your eyes or facial expressions) as helpful or necessary to understand what you are saying - what appears as “inattention” may not have to do with attention at all.
Impulsivity: A child with ADHD may interrupt, blurt out, or act before thinking because inhibiting (slowing down or stopping) their response is difficult. An Autistic child might interrupt or speak at unexpected moments, but this often reflects difficulty in interpreting or understanding social rules.
Planning and Organizing: Children with ADHD frequently struggle to organize materials or ideas, get started on tasks, and work through multi-step problems efficiently. For Autistic children, planning challenges may appear when tasks are unfamiliar or outside of comfortable routines.
Emotion Regulation: This is one of our favorite topics to discuss because it plays an important role in ADHD, even though it isn’t part of the formal diagnostic criteria. Many children with ADHD can become easily frustrated, angry, or overly emotional, especially when they feel interrupted, stressed, or challenged. These behaviors often reflect difficulty managing strong emotions and regulating their responses. This is why it is critical to have a rich understanding of the role of emotional dysregulation in the assessment of ADHD.
Autistic children can also experience big emotional reactions, such as frustration, irritability, or excessive tearfulness. Yet, these responses may be tied to different prompting events. Confusion about social cues, difficulty understanding what is happening in a situation, sensory preferences, or unexpected changes in routine can all contribute to emotional overwhelm.
Social Challenges: Like emotion regulation, we’re always eager to discuss social differences, preferences, and challenges among children with ADHD and Autism. It’s a common misconception that social uniqueness or challenges equal Autism. Social challenges are an extremely important aspect of understanding and assessing for ADHD.
A child with ADHD might interrupt others or miss social cues, negatively impacting friendships. They can struggle to wait their turn in back-and-forth conversations or miss the best moment to share their thoughts due to inattention and impulsivity, which makes it hard to be part of social groups or participate in class. The more social experiences they miss or misinterpret, the harder it is to feel successful in social situations… leading to more challenges.
Autistic children have underlying challenges with social communication and reciprocity. In fact, it’s a core feature of the diagnosis. Difficulties with eye contact, gestures, and understanding social cues can make interactions with same-age peers more complex. As a result, joining group activities, responding effectively in conversations, or maintaining friendships may require additional support.
Taken together, symptoms associated with ADHD and Autism can make it harder to stay focused on non-preferred tasks, pause before responding, manage strong emotions, and recognize social cues. Yet interventions may differ depending on what’s underlying or prompting these challenges.
What gets in the way?
While we’re at it, we might as well dig into some of the common myths. Sometimes these messages are well-intentioned and can even feel validating at first. Over time, these messages can unintentionally minimize family experiences, make it harder for families to get accurate diagnoses, and create unnecessary tension at home when strategies or approaches don’t work.
So we’re taking the time to clear up a few misunderstandings we’ve seen and heard to help reduce stigma around neurodevelopmental differences and bring the focus back to what really matters. When families and kids understand the real drivers behind the challenges they are experiencing, they are better equipped to handle them with empathy, effective support, and realistic expectations.
Myths about social struggles
Some people assume that if a child struggles socially, it must mean Autism, but social difficulties are not unique to Autism. Children with ADHD, anxiety, other developmental challenges, or simply individual differences may also find certain social situations difficult, just for different reasons.
For example, in ADHD, inattention, impulsivity, and emotional dysregulation can lead to behaviors like interrupting, difficulty with back-and-forth conversation, or missing social cues. While Autism is characterized by differences in reciprocal social communication and interaction, ADHD is rooted in executive functioning challenges. As a result, similar behaviors may appear on the surface, but the underlying causes are different.
That’s why it’s important to understand what’s driving a child’s behavior, not just how it looks.
Myths about attention
The most common misunderstanding about ADHD we hear is that “inconsistent attention means a child doesn’t have ADHD.” While difficulty focusing is a core feature, ADHD also involves challenges with impulsivity, hyperactivity, emotional regulation, and social interactions.
Attention in ADHD isn’t simply “on” or “off.” It often fluctuates based on interest, motivation, and environment. A child may focus deeply on something they enjoy, yet struggle to engage with tasks that feel less interesting or more demanding. In that sense, ADHD is better understood as involving inconsistent or variable attention, rather than constant inattention.
Simply put, ADHD isn’t about being unable to pay attention; it’s about difficulty regulating attention. This can show up in many everyday ways, from forgetting a gym bag, to losing track of a conversation, to struggling to remember multiplication tables.
Myths about “How it Looks”
There are lots of misconceptions about what ADHD and Autism “look like.” So many, in fact, that we can’t cover them all here. The reality is that Autism and ADHD (and the combination of the two) can look very different from one child to another. Some Autistic young people have more overt communication differences or repetitive behaviors, while others (especially those with Level 1 Autism) may have more subtle challenges. ADHD can vary just as much. Some children show more obvious hyperactivity and impulsivity, while others have quieter difficulties such as distractibility, forgetfulness, or trouble following through on tasks. Every child is unique, and these diagnoses can show up in a wide range of ways.
How a child presents can also depend on their environment. A child may seem to manage well in one setting but struggle in another, especially as expectations differ. Some children with Autism may work very hard to study their peers and “go through the motions” of social interaction, which can make their symptoms less noticeable. Because of this, it can be misleading to look at behavior in only one setting. A thorough evaluation across multiple environments helps ensure the child receives the right support.
Let’s Wrap Up
It’s hard to say how much clearer this article made ADHD and Autism for you, but we certainly hope that it helped. If you’re curious if your child has ADHD, Autism, or both, don’t just rely on your gut (although, it’s very helpful)… and definitely don’t rely on social media. Go get a comprehensive neuropsychological evaluation.
A comprehensive evaluation includes a detailed developmental history, behavioral observations, standardized testing, and input from multiple sources (think: teachers, therapists, etc.). A neuropsychologist is trained to bring hours and hours of data together to provide a detailed snapshot of your child’s strengths and barriers. At Mind, we spend time helping you connect your personal experiences to what shows up in the testing. Then we help your young person understand their own experiences. Yes, we sit down with kids and walk them through their strengths and barriers. We even take it another step and meet with your child’s school to make sure everyone in their system has all the information they need to provide the best support possible.
