The Difference Between ADHD and Autism (or Anxiety)
🧩 Why the Confusion?
ADHD, autism spectrum disorder (ASD) and anxiety can all appear as distractibility, restlessness, social difficulty or emotional outbursts. From the outside, they can look nearly identical—especially in young children—yet the underlying reasons (and supports) differ. This guide unpacks core features, red-flag clues, brain science and real-world stories so you can decide which pathway to investigate first—or whether a combined assessment makes the most sense.
1️⃣ ADHD vs Autism
Shared Surface Features
Talks over peers or “misses” social rules
Executive-function challenges (organisation, flexible thinking)
Sensory sensitivities (noise, clothing, food texture)
Distinctive ADHD Signs
Inconsistent attention: hyper-focus on Lego, but loses track of homework in two minutes
Craves novelty: perpetually “on the go,” seeks stimulation
Impulsivity first: blurts, grabs or moves before thinking
Distinctive Autism Signs
Social reciprocity issues: limited eye contact, difficulty reading facial expressions, one-sided conversations
Restricted interests & routines: intense focus on specific topics, distress at small changes
Communication style: unusual tone, literal interpretation, delays in back-and-forth conversation
Quick clue: In ADHD, social mistakes stem from inattention or impulsivity. In autism, they stem from difficulty understanding social cues.
2️⃣ ADHD vs Anxiety
Shared Surface Features
Restlessness or fidgeting
Poor concentration under stress
Irritability and emotional outbursts
Distinctive ADHD Signs
Symptoms present from early childhood
Difficulties persist even when the child feels relaxed
Physical hyperactivity noticeable to others
Distinctive Anxiety Signs
Worries are situation-specific (tests, separation, social judgement)
Symptoms spike before or during feared events, then subside
Physical signs: stomach-aches, headaches, sweaty palms, sleep trouble
Quick clue: If concentration improves once worries are addressed, anxiety—not ADHD—is likely driving the inattention.
3️⃣ Autism vs Anxiety
Autistic children often experience anxiety, but anxiety alone will not create classic autistic traits.
Autism: Social misunderstanding is baseline; the child may not realise why others react negatively.
Anxiety: Child wants to engage but avoids for fear of embarrassment or failure.
Look for:
Autism: repetitive behaviours (hand-flapping, scripting) that self-soothe across settings
Anxiety: avoidance (refusing school camp, clinging to parents) specific to feared situations
4️⃣ Real-World Experiences
Example A – ADHD vs Anxiety
Ella, 9: Her teacher reports constant fidgeting and lost homework. At home she’ll sit for hours designing fashion sketches. The common thread? Homework triggers intense worry about mistakes. Once Ella’s anxiety is treated, she focuses and organises without ADHD medication. An anxiety diagnosis—not ADHD—fits best.
Example B – Autism + ADHD
Luca, 11: Loves Minecraft and can build for hours—but in class he blurts answers, forgets his laptop and panics if the timetable changes. Assessment confirms both autism (social-communication profile, sensory needs) and ADHD (inattention, impulsivity). Dual diagnosis explains why standard autism supports alone never stopped classroom chaos.
5️⃣ The Brain Science in 30 Seconds
ADHD brains show lower dopamine in reward pathways—craving novelty and quick feedback.
Autistic brains feature heightened connectivity in sensory/detail networks, making social signals and change feel overwhelming.
Anxious brains keep the amygdala on high alert; cortisol floods the body, hijacking attention and memory.
Bottom line: these behaviours are neurological, not the result of “naughtiness” or poor parenting.
6️⃣ Quick-Reference Clues (Home vs School)
Home clues
ADHD: talks through movies, starts chores then disappears
Autism: lines up figurines, meltdown if favourite cup is missing
Anxiety: avoids sleepovers, constant “what-if” questions
School clues
ADHD: off-task unless the lesson is a competition
Autism: misreads sarcasm, prefers structured solitary play
Anxiety: perfect homework but silent in class presentations
7️⃣ Can a Child Have More Than One Condition?
Yes—comorbidity is common. Up to 60 % of children with ADHD meet criteria for an anxiety disorder. Around 30–50 % of autistic children also show ADHD symptoms. When presentations overlap, assessment should be comprehensive and multidisciplinary (psychologist + paediatrician, speech pathologist or occupational therapist).
8️⃣ Immediate Action Steps for Parents
Rule out hearing/vision issues with your GP—sensory deficits can mimic inattention.
Trial one change for two weeks (visual schedule, worry journal). If it helps, great; if not, book a consult.
Track triggers in a notes app: When? Where? What happened just before? Patterns guide assessment.
Speak with teachers to gauge how behaviour looks in structured settings.
Educate your child gently: “Everyone’s brain works differently—seeing a specialist helps us learn the best tools for yours.”
9️⃣ Curated Resources
Books: Taking Charge of ADHD – Barkley; The Autism Lens – Ichiguchi; What to Do When You Worry Too Much – Huebner
Websites: ADHD Australia, AMAZE, Raising Children Network
Apps: Headspace Kids (anxiety), Choiceworks (visual schedule), Tody (routine planner)
Support Groups: ADHD Kids Melbourne (Facebook); Aspect Parent Support Network
🔟 When to Seek a Comprehensive Assessment
Symptoms are persistent (6 + months), pervasive (2 + settings) and impairing learning, friendships or daily life
Strategies for one condition aren’t helping—picture remains unclear
Safety risks (self-harm talk, risky impulsive acts) or severe emotional distress emerge
Early clarity prevents trial-and-error and unlocks the right supports—classroom accommodations, therapy plans, or NDIS funding.
✅ Take-Home Message
ADHD, autism and anxiety share surface behaviours, but the why behind those behaviours differs. Accurate diagnosis ensures targeted strategies so children aren’t labelled “lazy” or “naughty,” but empowered with supports that fit their brains.
Gayton Psychology specialises in untangling overlapping presentations in children and adolescents. Unsure which path fits your child? Book a free phone consultation- we’ll guide you to the next right step.
📞 0422 651 697 🌐 gaytonpsychology.com ✉️ katherine@gaytonpsychology.com
The right answers—and the right help—can change a child’s entire trajectory.