Confusable diagnoses · PANCE / PANRE

Attention-Deficit/Hyperactivity Disorder vs Autism Spectrum Disorder

Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.

Attention-Deficit/Hyperactivity Disorder vs Autism Spectrum Disorder at a glance

  • Attention-Deficit/Hyperactivity Disorder: Persistent inattention and/or hyperactivity-impulsivity present before age 12 with cross-setting impairment.
  • Autism Spectrum Disorder: Persistent deficits in social communication plus restricted/repetitive behaviors present in early development.
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Side-by-side comparison

FeatureAttention-Deficit/Hyperactivity DisorderAutism Spectrum Disorder
At a glancePersistent inattention and/or hyperactivity-impulsivity present before age 12 with cross-setting impairment.Persistent deficits in social communication plus restricted/repetitive behaviors present in early development.
Classic presentationInattention: careless mistakes, difficulty sustaining attention, doesn't listen, fails to follow through, organization difficulties, avoids sustained mental…Social communication: reduced social-emotional reciprocity, atypical nonverbal communication, difficulty developing and maintaining relationships appropriate…
Workup / key labsDSM-5-TR: (A) >=6 inattention and/or >=6 hyperactivity-impulsivity symptoms for >=6 months in children, or >=5 for individuals age 17 and older; (B) Several…DSM-5-TR: (A) Persistent deficits in social communication and interaction across contexts — all three subcriteria (reciprocity, nonverbal communication,…
ImagingNot routinely indicatedMRI not routine; obtain if focal findings, regression, microcephaly, or macrocephaly with neurologic signs
First-line treatmentBehavioral parent training and classroom interventions — first-line in preschool age (4-5 years) and adjunct at all ages; Stimulant — methylphenidate,…Early intensive behavioral intervention — applied behavior analysis (ABA), naturalistic developmental behavioral interventions (NDBI), Early Start Denver…

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Educational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.