Overview of ADHD and Autism
Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are prominent types of neurodevelopmental disorders often diagnosed in childhood. ASD is characterized by difficulties in social interactions, particularly challenges with emotional expression, interpersonal relationships, and give-and-take conversation. Additionally, those with ASD often experience repetitive behaviors (e.g., hand-flapping, rocking) and highly specific, narrow interests. In contrast, ADHD can be characterized by difficulty focusing, forgetfulness, disorganization, impulsive behavior, excessive talking, and trouble being still.
However, there are biological and symptom-related similarities between ADHD and Autism. Notably, ASD and ADHD are both linked to functional differences in the brain’s cerebral cortex (Martinez-Morga et al. 2018). These differences affect the brain’s prefrontal cortex, which is involved in planning, decision-making, and impulse-control. Therefore, deficits in these areas appear in both ADHD and ASD. Additionally, children diagnosed with ADHD and children diagnosed with ASD may also experience difficulty with interpersonal communication and intense interests (Polderman et al. 2014; Staikova et. al, 2013). Furthermore, it is estimated that 28%-44% of those with ASD also have ADHD (Polderman et al., 2014). Children diagnosed with ADHD, ASD, or both are often referred to as neurodivergent, as opposed to children who do not have these traits and are considered neurotypical.
Gender Differences
Both ASD and ADHD are less prevalent in girls compared to boys. ASD appears in approximately 4% of Boys and 1% of Girls in the US (Center for Disease Control). ADHD is more common than ASD and is diagnosed in approximately 15% of boys and 8% of girls nationwide (Center for Disease Control, 2024). Therefore, much of the research on ASD and ADHD development and symptomatology is based on the male presentation. However, girls and women with ASD and ADHD have unique presentations, which often go undetected, especially among higher functioning females with neurodevelopmental disorders. Furthermore, girls and women with ADHD or ASD are more likely to experience co-occurring anxiety, mood, and tic-related disorders than male peers (Mahone & Wodka, 2008; Rynkiewicz et al., 2019). Overall, women and girls with ASD and ADHD are more likely to be misdiagnosed with one of these disorders compared to men and boys.
Furthermore, ASD and ADHD appear differently in girls and women compared to male counterparts. For example, girls with ADHD often present with symptoms of inattention rather than hyperactivity. Symptoms of inattention may be less obvious in a classroom or home setting compared to symptoms of hyperactivity. Symptoms of inattention in girls with ADHD may manifest as careless or sloppy schoolwork, forgetfulness, difficulty with organization, losing possessions and school materials, and difficulty following along in conversations or lectures. In contrast, boys with ADHD are more likely to have difficulty sitting still, playing loudly or roughly, fidgeting constantly, and running, climbing, and jumping at inappropriate times. Girls with ASD may appear more socially avoidant, anxious, and withdrawn compared to boys on the autism spectrum. However, boys may appear more willing to engage in social interactions despite deficits and display fewer internalizing symptoms such as anxiety and depression.
Masking
One key feature of neurodevelopmental disorders, especially among higher-functioning, verbal individuals is masking. Masking is the act of trying to reduce, hide, or control symptoms related to a neurodevelopmental disorder (e.g., interrupting, discussing specific interests, self-soothing with repetitive behaviors) in order to appear more like neurotypical individuals. Those with ADHD and ASD may describe masking behaviors as exhausting, draining, and inauthentic. Additionally, masking behaviors appear more frequently among girls and women with ASD and ADHD compared to male counterparts (Martin, 2024; Rynkiewicz et al., 2019). Increased masking behavior in women and girls is also associated with lack of diagnosis or misdiagnosis (Martin, 2024; Rynkiewicz et al., 2019).
If you are noticing symptoms consistent with ASD or ADHD in your child, connecting with a therapist is a great place to start! Additionally, psychological testing can be helpful in identifying an accurate diagnosis for your child.
At Balanced Minds Psychology & Wellness we specialize in assisting young adults, teens, and children with navigating life’s challenges. If you are ready to start the therapy process, contact us today to start a free consultation, either over telehealth or in person!
Additional Resources
For additional resources on ADHD and ASD, visit the following resources:
Attention-Deficit/ Hyperactivity Disorder
Autism Spectrum Disorder
References
Centers for Disease Control and Prevention. (2024, May 16). Data and statistics on ADHD. Centers for Disease Control and Prevention. https://www.cdc.gov
Centers for Disease Control and Prevention. (2024, January 25). Data and statistics on autism spectrum disorder. Centers for Disease Control and Prevention. https://www.cdc.gov
Lovering, N. (2022, May 10). ADHD masking: What it is and more. Psych Central.
Mahone, E. M., & Wodka, E. L. (2008). The neurobiological profile of girls with ADHD.
Developmental Disabilities Research Reviews, 14(4), 276–284.
Martin, J. (2024). Why are females less likely to be diagnosed with ADHD in childhood
than males? The Lancet Psychiatry, 11(4), 303–310. https://doi.org/10.1016/s2215-
Martinez-Morga, M., Quesada-Rico, M. P., Bueno, C., & Martinez, S. (2018). Neurobiological
bases of autistic spectrum disorder and attention deficit hyperactivity disorder:
neural differentiation and synaptogenesis. Revista de neurologia, 66(S01), S97–S102.
National Autistic Society. (2024). Masking. Masking . https://www.autism.org.uk
Polderman, T. J., Hoekstra, R. A., Posthuma, D., & Larsson, H. (2014). The co-occurrence of
autistic and ADHD dimensions in adults: An etiological study in 17770 twins.
Translational Psychiatry, 4(9). https://doi.org/10.1038/tp.2014.84
Rynkiewicz, A., Janas-Kozik, M., & Słopień, A. (2019). Girls and women with autism.
Psychiatria Polska, 53(4), 737–752. https://doi.org/10.12740/pp/onlinefirst/95098
Staikova, E., Gomes, H., Tartter, V., McCabe, A., & Halperin, J. M. (2013). Pragmatic deficits
and social impairment in children with ADHD. Journal of Child Psychology and
Psychiatry, 54(12), 1275–1283. https://doi.org/10.1111/jcpp.12082
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