What is the difference between ADHD and Autism, and why is it so hard to tell?
- Mar 19
- 6 min read
Updated: 6 days ago
Why ADHD and Autism Can Be Hard to Differentiate
ADHD and autism are distinct, yet they share so many overlapping traits that diagnosis can sometimes be challenging.
If you've ever wondered why these two are often confused, you're not alone. Even experienced professionals sometimes struggle to determine whether an individual has ADHD, autism, or both.
Research indicates that individuals with autism frequently exhibit key characteristics associated with ADHD. However, the reverse is not as common—typical autistic traits are less frequently observed in those diagnosed with ADHD. Estimates suggest that between 50-70% of people with autism also meet the criteria for ADHD.
Understanding the root causes behind behaviours can be key to distinguishing ADHD from autism
Whilst there may be seeming similarities in the traits presented, it can be helpful to understand the causes behind these traits, as this can provide an insight into the differences between ADHD and autism.
👉Social challenges:
Both can involve social difficulties, but for different reasons. A person with autism might struggle to interpret social cues, such as body language, tone of voice or indirect ways ways of speaking. While someone with ADHD may have difficulty following conversations due to impulsivity, or '*distraction'.
*To add some detail here- distraction isn't about a person not wanting to listen or not valuing the conversation. The challenge is around the ability to block out irrelevant stimuli . This can result in unintentionally tuning into other conversations, noticing movement in the environment or the story being shared by a friend may be trigger ing 5 more stories that the ADHDer is reminded of!
👉Attention:
When it comes to attention, both ADHD and autism can involve hyperfocus. However, research on sustained attention tasks has produced mixed results. Studies indicate that autistic individuals tend to spend more time on tasks and demonstrate greater accuracy on certain cognitive assessments. However, for individuals with ADHD, factors such as novelty and personal interest in the task can significantly influence performance.
👉Routine and change:
Many autistic individuals thrive on stability, predictability, and set routines, often feeling overwhelmed when faced with sudden changes.
On the other hand, those with ADHD tend to seek novelty, new experiences, and stimulation, sometimes struggling with repetitive tasks or rigid structures.
Other factors in identifying the difference between ADHD and autism
Differentiating ADHD and autism can be challenging, partly because they don’t always present in the stereotypical ways—especially in women.
For instance, while autistic girls may have deep, focused interests, these often align with socially accepted topics such as animals, a specific band, or makeup art. As a result, their special interests may be less noticeable compared to the stereotypical example of trains.
Other stereotypes further complicate identification. The assumption that autistic individuals are always rigid and that ADHDers are inherently impulsive is an oversimplification. In reality, some autistic individuals can be quite spontaneous, while some people with ADHD develop structured routines to help manage their experiences.
Additionally, both share overlapping traits, including sensory sensitivities, hyperfocus, executive function challenges, and difficulties with emotional regulation. These similarities can blur the distinctions between the two.
To add another layer of complexity, the way these traits manifest can evolve over time. Many individuals with ADHD or autism develop coping strategies or "mask" their challenges, particularly in social situations—something especially common among women. This makes it even more difficult to distinguish between the two, particularly in adulthood.
How Can You Tell the Difference?
Amidst all this confusion, here are a few key ways to identify the difference:
Note: only a trained professional can diagnose ADHD or autism
Social Differences:
Autism: Struggles with reading social cues, interpreting emotions, or understanding unwritten social rules.
ADHD: May struggle in social settings due to impulsivity, distractibility, or difficulty staying engaged.
Routine & Change:
Autism: Prefers predictability, routines, and stability. Sudden changes can be distressing.
ADHD: Seeks novelty and stimulation, can become bored with repetitive tasks or rigid structure.
Attention & Focus:
Autism: May hyperfocus on special interests but struggle to shift attention to unrelated tasks.
ADHD: Can hyperfocus as well but is more prone to distraction and difficulty maintaining focus on tasks that aren’t interesting.
Sensory Sensitivities:
Autism: Can have extreme sensitivities to sounds, textures, lights, or other sensory input.
ADHD: May also experience sensory sensitivities but often seeks sensory stimulation as well (e.g., fidgeting, seeking movement).
What is AuDHD?
Before 2013, doctors had to diagnose either ADHD or autism based on the "best fit," even if a person clearly displayed traits of both. This led to many misdiagnoses and gaps in support. Since then, it has become possible to receive a dual diagnosis—often called "AuDHD"—for individuals who meet the criteria for both. This can also explain the apparent rise in both autism and ADHD.
This recognition has been a game changer for many neurodivergent people. It acknowledges that some individuals experience traits of both autism and ADHD simultaneously, rather than fitting neatly into one category.
What It Feels Like to Have AuDHD
Having both ADHD and autism can feel like your brain is being driven by opposing forces. One part may crave structure, stability, and predictability, while another part thrives on novelty, spontaneity, and excitement.
But it's not as simple as the individual being a bit autistic in one context and a bit ADHD in another.
Here's a great metaphor and more information on AuDHD in this article 👉
'It seems that the experience of having both autism and ADHD is distinct. In this respect, we might imagine autism as the colour red, ADHD as the colour blue, and AuDHD as purple – more than a sum of its parts; a thing in and of itself.'
Some common experiences of people with AuDHD:
Being Overwhelmed by the World but Still Seeking Stimulation
Loud noises, bright lights, and chaotic environments might be overstimulating—time to be alone and recover can be important but too much alone time can feel frustrating and under stimulating. It's a constant balancing act between seeking sensory input and feeling overwhelmed by it.
Hyperfixation vs. Task Paralysis
You might hyperfixate on a topic, spending hours or days learning everything about it—only to later struggle with initiating even the simplest tasks, feeling completely stuck.
Social Challenge
You may deeply analyse social interactions, trying to decode body language and hidden meanings, but then impulsively interrupt conversations or blurt things out without thinking.
Struggling with Routine and Spontaneity
While part of you thrives on predictability, having the same routine every day might feel boring or restrictive, leading to an ongoing cycle of setting up routines and then abandoning them.
Feeling Like You Don’t Fully Fit into Either Category
ADHD and autism communities can have different ways of understanding their experiences, and sometimes AuDHDers feel like they don’t quite belong in either. You might relate to autistic struggles with sensory processing but also identify with ADHD impulsivity and hyperactivity.
Final Thoughts
ADHD and autism may be different experiences, but their overlap makes diagnosis tricky especially when this is treated separately rather than holistically. Valuable insights can also be found within the ADHD and autistic communities themselves. These communities often highlight shared experiences that may not be fully captured by current diagnostic criteria, such as emotional dysregulation, difficulty identifying feelings, justice sensitivity and rejection sensitivity. Engaging with lived experiences can provide a deeper understanding of the nuances and overlaps between the two.
For some, the answer isn’t one or the other—it’s both. AuDHD comes with its own unique challenges, but with understanding and the right support, individuals can find their own ways to thrive.
How do you experience ADHD, autism or AuDHD?
References:
Craddock, E. (2024). Raising the voices of AuDHD women and girls: Exploring the co-occurring conditions of autism and ADHD. Disability & society, 39(8), 2161-2165
Hours, C., Recasens, C., & Baleyte, J. M. (2022). ASD and ADHD comorbidity: What are we talking about?. Frontiers in psychiatry, 13, 837424.
Mayes, S. D., Calhoun, S. L., Mayes, R. D., & Molitoris, S. (2012). Autism and ADHD: Overlapping and discriminating symptoms. Research in Autism Spectrum Disorders, 6(1), 277-285.
Owens, A. ADHD and Autism: A Paradoxical Experience.
Townes, P., Liu, C., Panesar, P., Devoe, D., Lee, S. Y., Taylor, G., ... & Schachar, R. (2023). Do ASD and ADHD have distinct executive function deficits? A systematic review and meta-analysis of direct comparison studies. Journal of attention disorders, 27(14), 1571-1582.
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