Adult Autism vs. ADHD: How to Tell the Difference
- Daniel Steinberg, PhD
- 6 days ago
- 2 min read
You’ve read the checklists. You’ve scrolled through neurodivergent TikTok. You’ve taken the quizzes.
And now you’re wondering: Do I have ADHD, autism, or both?
You’re not alone. ADHD and autism often travel in the same circles—clinically and socially. But they’re not interchangeable.
Here’s a breakdown of what overlaps, what’s distinct, and why it matters for diagnosis and support.
1. First: Yes, You Can Have Both
Let’s clear this up. ADHD and autism are distinct conditions, but co-occurrence is common.
Estimates suggest that 30–50% of people with autism also meet criteria for ADHD. The reverse is true as well—many adults with ADHD have traits consistent with autism spectrum disorder.
That said, most people don’t have both. Making the distinction is critical for determining the right support.
2. What Overlaps?
Executive dysfunction: trouble planning, organizing, prioritizing
Social struggles: difficulty with cues, maintaining conversations
Sensory sensitivities: noise, textures, lights
Need for structure: preference for routine or predictability
On paper, these can look nearly identical. But the why behind each issue tends to differ.
3. How Are They Different?
Let’s zoom in on the differences that often emerge in assessment:
ADHD is marked by:
Distractibility and inconsistent attention
Impulsivity and restlessness
Rapid shifts in focus and energy
Autism tends to involve:
Differences in social reciprocity (e.g., reading context, managing back-and-forth conversation)
Deep, sustained interests
Difficulty with abstract social rules or flexible thinking
People with ADHD may struggle to maintain attention in a boring meeting.
People with autism may struggle to understand why the meeting matters socially.
The behavior may look similar—but the cognitive architecture behind it is different.
4. Diagnosis Is Nuanced—And That’s the Point
There is no one questionnaire that can distinguish ADHD from autism in adults.
That’s why formal assessment matters. It involves:
Structured interviews
History gathering across life stages
Differential diagnosis
Rule-outs (e.g., trauma, anxiety, learning disorders)
The goal isn’t just labeling. It’s understanding.
5. Why the Distinction Matters
Treatment: ADHD often responds well to stimulant medication. Autism does not.
Support: Autism may require social communication coaching, sensory planning, or long-term accommodations.
Documentation: Diagnostic clarity affects eligibility for services, accommodations, or insurance coverage.
A misdiagnosis can lead to frustration, wasted effort, or interventions that don’t actually help.
If you see yourself in both descriptions, don’t panic. That’s why evaluations exist—to untangle the threads and give you something better than internet guesswork.
Whether it’s ADHD, autism, or both, the goal is the same: understand how your brain works so you can build a life that works with it—not against it.
A comprehensive, clinician-led evaluation can clarify what’s actually driving your difficulties, rule out lookalike conditions, and provide documentation that supports appropriate treatment and accommodations. I offer structured, evidence-based adult ADHD assessments via telehealth across PSYPACT-participating states, with evening appointments available.
Learn more about the evaluation process or request a consultation here.
Dr. Daniel Steinberg is a licensed clinical psychologist offering telehealth-based ADHD assessments for adults across PSYPACT-participating states. His approach emphasizes clarity, compassion, and clinically sound evaluation.
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