Differences between ADHD and ASD

Can a child have both ADHD and ASD? The short answer is yes and the sooner it’s diagnosed, the better. 

Kathy Marshack Dr. Amir Miodovnik, a developmental pediatrician at Boston Children’s Hospital authored a study, which shows that symptoms of ADHD may, in fact, conceal ASD in very young children. The study appeared in the October 2015 print issue of Pediatrics. 

Dr. Miodovnik concluded that the ADHD symptoms sometimes masks “Autism” in very young children. A doctor may stop looking when he or she sees ADHD symptoms and then they miss that the child is also suffering from “Autism Spectrum Disorder”

The study found out that it took an average of three years longer to diagnose “Asperger Syndrome” in children with ADHD. This delay can have a big impact on the future of the child with many researches showing that the earlier you implement therapies for autism, the better children do in terms of outcome. 

For this study, researchers looked at data on nearly 1,500 children with “autism” drawn from the 2011-2012 National Survey of Children’s Health. 

About 43% of these children have been reported to have both ASD and ADHD. More than two out of five children were diagnosed with ADHD first. About 81% of them were diagnosed with “autism” after age 6. Children already diagnosed with ADHD were nearly 17 times more likely to be diagnosed with “Asperger Syndrome” after age 6 compared to children who only received a diagnosis of “autism”. You can continue to read more about this study here.


What similar symptoms do “Asperger Syndrome” and ADHD have?

ASD and ADHD are different neurological disorders, however they do have some symptoms in common.

  • Hyperactivity
  • Impulsivity
  • Inattentive
  • Social awkwardness
  • Difficulty in interactions with others


What are some differences between ADHD and ASD?

”Asperger’s Syndrome”

  • All-absorbing interest in specialized topics, like sports statistics or dinosaurs
  • Lack of nonverbal communication – eye contact, facial expressions, body gestures
  • Lack of empathy or understanding others’ feelings
  • Monotone pitch or lack of rhythm when speaking
  • Missed motor skill development mile markers, such as catching a ball


  • Easily distracted and forgetful
  • Problems processing information accurately and quickly
  • Touching or playing with everything especially in a new environment
  • Very impatient and can’t wait their turn
  • Over-reacting when upset or bothered, without consideration for others


The similar symptoms make it harder and more complex to diagnose “Asperger Syndrome” in children with ADHD. Read these two blogs to understand a few of the challenges people with these disorders are facing: Male and Female Differences in “Autism Spectrum Disorder” and Do You Live in the ADHD or “ASD” Time Zone?

Dr Miodovnik recommends that parents who believe that a child younger than five has ADHD should take their child to a developmental pediatrician, rather than a family physician, to make sure that possible autism will not be overlooked. He also recommends this, because managing a child with ADHD can be complicated.

If you have a loved one that has been diagnosed with “ASD”, you will also benefit from learning how science is unlocking the key to understanding “Asperger” behavior. My book, Out of Mind – Out of Sight: Parenting with a Partner with Asperger Syndrome (ASD), explores the science behind Asperger’s. If you want to understand your “Aspie” better, this is a must read.

Kathy Marshack

6 Replies to “Differences between ADHD and ASD”

  1. Certainly that is the case in my experience and with adults too. In these cases the ADHD aspect seems to dominate.

    Often one sees references to men with Aspergers being nerdy geeks with obsessive interest in organizing collections of things but there are others who come across to NT men not as nerdy geeks but rather as OTT alpha males, especially in contexts where they sense a vector of superiority over others, e.g. being a team leader at work or in their home. Rather than being socially awkward they present as socially expansive and uninhibited in their interactions with others.

    Very commonly in these contexts they who will come up behind other men and put their hands all over their backs including the small of the back, showing them to their workstation etc.

    Whenever a man touches another man, especially in such configurations, the man initiating the touch is indicating to the man being touched that he, the initiator, has the power and the status in their interaction, top dog if you will, but that they are pleased to have the underdog in their hierarchy and space (as long as they abide by that status). In summary these Aspie men present as insufferably patronizing “father knows best” paternalistic types to other men. With NT women coming into such a context the Aspie will tend to avoid using touch to communicate to one they perceive as subordinate but will still adopt a father knows best patronizing tone.

    Try to describe the experience of such interactions to others who have *not* been on the receiving end of such behavior and the Cassandra phenomenon kicks in “Oh don’t be so sensitive, they were *just* being friendly” say those who have never experienced it.

    Now interestingly in these cases such men are not recognized to be Aspies but most everyone will refer to them as being hyperactive, and some will recognise the ADHD. But once one has had experience with more than one or two Aspies and can detect patterns then scratch the surface a bit and Aspergers shows through with these OTT socially expansive ADHDs.

    1. This articulates my experiences with my Aspie/ADHD husband I think. I would feel like he was constantly trying to assert his superior knowledge or expertise on to me, which was a facade that left me scratching my head as to what he was trying to do. Counseloring left me feeling worse. It wasn’t until another family member started to notice this also did I start to feel same again! Everytime he places his hands on me I feel he’s trying to assert dominance instead of romance?

      1. Counselors have no idea if they have no experience with helping NT people having to deal with Aspies and feeling worse after their victim blaming sessions is very common.

        1. I’m sorry to say this is so true John. Therapists are trained to help you take responsibility for your own actions. They learn techniques that are also used by narcissists to make you feel guilty for being you. When a therapist tries to get you to take responsibility for your part in the problem with your “Aspie” it can feel very similar to the blame you experience at the hands of your EmD family member.

  2. Patronizing! Oh, my children say all the time that my husband comes across like that. He does, but doesn’t realize it, nor does he seem to want to view it from another’s perspective. He knows his intentions are good, so that’s all he seems to be concerned with. How they receive it he views as their problem. I’m trying to teach my children that their pain is real even if their dad’s intentions are good. They need to acknowledge their pain. I’m not sure how to help them with their relationship with him—or if I can. It’s difficult.

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