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
| Feature | Attention-Deficit/Hyperactivity Disorder | Autism Spectrum Disorder |
|---|---|---|
| At a glance | Persistent 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 presentation | Inattention: careless mistakes, difficulty sustaining attention, doesn't listen, fails to follow through, organization difficulties, avoids sustained mental effort, loses things, easily distracted, forgetful; Hyperactivity-impulsivity: fidgets, leaves seat, runs/climbs inappropriately, can't engage quietly, 'on the go', talks… | Social communication: reduced social-emotional reciprocity, atypical nonverbal communication, difficulty developing and maintaining relationships appropriate to developmental level; Restricted/repetitive: stereotyped/repetitive motor movements or speech, insistence on sameness/routines, highly restricted fixated interests, hyper- or… |
| Workup / key labs | DSM-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 symptoms present before age 12; (C) Present in >=2 settings; (D) Clear interference with functioning; (E) Not better explained by another disorder. Specify combined, predominantly… | DSM-5-TR: (A) Persistent deficits in social communication and interaction across contexts — all three subcriteria (reciprocity, nonverbal communication, relationships); (B) Restricted/repetitive patterns — >=2 of four (stereotypies, insistence on sameness, restricted interests, sensory differences); (C) Symptoms in early developmental… |
| Imaging | Not routinely indicated | MRI not routine; obtain if focal findings, regression, microcephaly, or macrocephaly with neurologic signs |
| First-line treatment | Behavioral parent training and classroom interventions — first-line in preschool age (4-5 years) and adjunct at all ages; Stimulant — methylphenidate, lisdexamfetamine, mixed amphetamine salts (first-line pharmacotherapy school-age and older); titrate to effect over weeks; School accommodations (IEP/504); psychoeducation; sleep… | Early intensive behavioral intervention — applied behavior analysis (ABA), naturalistic developmental behavioral interventions (NDBI), Early Start Denver Model; Speech-language therapy; occupational therapy for sensory and motor issues; Educational supports — IEP, structured teaching; Family support and psychoeducation; respite care;… |
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