Autistic Spectrum Disorder (ASD)
and Attention Deficit/Hyperactivity Disorder
(AD/HD): A Comparison
Sally Bloch-Rosen, Ph.D.
Licensed Clinical Psychologist
Educational Director
William Beaumont Hospital Center for Human Development
1695 West Twelve Mile Road, Suite 120
Berkley, MI 48072
Difficulty Adjusting to Changes & Making Transitions
Autistic Spectrum Disorders
Attention/Deficit Hyperactivity
Disorder
● Prefer sameness due to cognitive
deficits which limit abilities to adapt
spontaneously to change.
● Prefer novelty, but have difficulty
realigning behavior in changing
circumstances.
● Subjectively more apt to be described
as anxiety-provoking.
● Subjectively, more apt to be described
as exciting.
Inattention & Distractibility
Autistic Spectrum Disorders
● Distracted by objects and movement of
objects.
● Attend to atypical stimuli and,
therefore, appear quite inattentive.
● Prone to “tune out” due primarily to
difficulties in mentally imposing
organization on their environment.
Attention/Deficit Hyperactivity
Disorder
● More apt to be distracted by the
activities of other people.
● Attend to stuff that most kids would find
compelling.
● “Tune out” because of mental fatigue,
have missed too many bits and pieces
of information to make sense of the
input, etc.
Repetitive/Annoying Behaviors
Autistic Spectrum Disorders
● Often represent a self-stimulatory
behavior and more often has an odd
quality.
● Resistant to incentives and rewards.
● Examples: head banging, hair pulling,
Attention/Deficit Hyperactivity
Disorder
● Often represents a discharge of energy
to permit greater mental focus.
● More success using reinforcers.
● Examples: foot tapping, pencil gnawing
Responsiveness to Reinforcement
Autistic Spectrum Disorders
Attention/Deficit Hyperactivity
Disorder
● More difficult to find out exactly WHAT
● More typically respond to reinforcers
they find reinforcing (may be somewhat
that “make sense” and are consistent
unusual).
with rewards that most other children
desire.
● Often prefer to stick with the same
● Need to change reinforcers frequently.
reinforcer, and then after many trials,
may suddenly find it no longer
rewarding.
Response to Rules
Autistic Spectrum Disorders
Attention/Deficit Hyperactivity
Disorder
● LOVE rules. Rules help them to bring
order to what they perceive as a
chaotic environment.
● Often the “little policemen” of the
school, may be unnecessarily rigid or
persnickity as to the details of a rule.
● Not quite so fond of rules, may have
difficulty conforming to rules due to
impulsivity.
● May stretch the rules as much as
possible.
2
Language and Communication
Autistic Spectrum Disorders
● Usually reflects preoccupation with
area of special interest and is wanting
in terms of meaning.
● Nonverbals like facial expression,
often do not match inner feeling states.
● Pervasive probelms in pragmatics –
using language to accomplish a
practical goal.
● Speech usually marked by unusual
prosody and inflection.
Attention/Deficit Hyperactivity
Disorder
● May go from one topic to another, but
intent to communicate is clear and
within normal limits.
● Usually inner feeling states are
apparent – may have trouble
modulating or suppressing expression
of emotion.
● Typically do not show a significant
problem in pragmatics, may be skilled
at “wearing down” adults using
language.
● Unusal speech patterns not associated
with core diagnostic features.
Social Skills Deficits/ Difficulties In Establishing and/or
Maintaining Peer Relationships
Autistic Spectrum Disorders
● Social relatedness problems arise from
difficulties dealing with novelty AND
using nonverbals to regulate social
interactions.
● Do not “get it.”
Attention/Deficit Hyperactivity
Disorder
● Social relations dirupted by problems
with impulsivity, turn-taking, etc. which
can disrupt the flow of social
relationships.
● Have a more solid grasp of nonverbal
communication but may have
difficulties with response inhibition
which prevent competent execution of
their knowledge.
3
Cognitive Markers
Autistic Spectrum Disorders
Attention/Deficit Hyperactivity
Disorder
● Poor grades in math due to difficulty
grasping mathematics concepts,
especially as concepts become more
abstract.
● Poor grades most commonly arise out
of careless errors in computation.
● No consistently observed difficulty in
conceptual math for AD/HD.
● Sloppy handwriting, motor planning
deficits, never liked to color, fine motor
deficits.
● Not much improvement with
medication.
● May or may not have motor
planning/fine motor deficits.
Handwriting sloppy often due to a
tendency to rush through.
● Often more of a significant
improvement with psychostimulant
treatment.
● May be accident prone because they
assume a fast pace of activity, act
without fully thinking through possible
consequences. Gross motor
immaturities may or may not be
present.
● Difficulties with gross motor skills
(sometiems with islands of
competence) but often seen as clumsy
or accident prone (due primarily to
cognitive impairments.)
● Difficulties in sports because they are
often viewed as meaningless activities.
● Difficulties participating in sports may
emerge due to problems sustaining
atention (as in baseball) or due to
response inhibition which reduces the
capacity to work as a team.
4
5