In a world full of so many different people, it stands to reason that many of those differences exist in development, as well as mental processing. When those differences are clinically significant, terms like neurodivergence and neurodiversity can be applied. And while many clinical labels seem to have a certain stigma attached to them, this terminology is an excellent reminder that we’re all unique, diverse people. For some individuals, that encompasses variations in certain brain functions and thought processes. Just like other areas of diversity, these differences offer more avenues for creativity, in addition to making life more interesting. However, those benefits can be limited if we do not work to grow our awareness, understanding, and acceptance of them. In today’s blog, I want to zoom in on one area where things can quickly become convoluted: Autism Spectrum Disorder, Attention Hyperactivity Deficit Disorder, and general hyperactivity in young males.
While we are just focusing on one specific area of overlap in this piece, please note that many of the themes and features we go over can and do apply to other populations as well. My goal with this is just to be as specific as possible because of the intricate nature of this topic. I have had the blessing of growing up alongside brothers who fall under these umbrellas, as well as working with other individuals who occupy different points on this spectrum. While those opportunities have taught me a lot, I still have a lot to learn, so I am excited to dive into this with anyone who is reading!
I want to start by exploring some of the overlap between ASD and ADHD in particular. These two diagnoses have a lot in common, including their shared membership in both the neurodivergent and neurodevelopmental categories. However, the similarities run deeper than that, as these two diagnose often present similarly. In order to grow our awareness and understanding, we need to consider those shared components.
Many of the symptoms of both diagnoses overlap, including challenges with executive functioning. This can involve obstacles to organization, planning, attention-shifting and self-regulation. Likewise, social interactions may prove difficult at times, although for different reasons (more on that later). While sensory sensitivities are primarily associated with ASD, they can also be present in individuals who are only diagnosed with ADHD. Lastly, hyper-focus can be exhibited in both cases, either on highly restricted areas of interest, stimulating tasks, or both.
There are shared cognitive mechanisms between these two diagnoses, so it makes sense that some behaviors would match that. There is a lot of nuance behind both diagnoses, though, so experiencing some of the above clinical presentations does not necessarily mean that someone qualifies for either diagnosis. With that said, it should be apparent that assessing someone for ASD and ADHD can become confusing quickly. That is, if we do not take time to become aware of the differences between the two.
Earlier I referenced the impact of both diagnoses on social functioning. While both diagnoses are associated with differences in typical social interaction, this tends to occur for different reasons. For ASD, individuals can experience challenges with identifying and understanding certain social cues, or find it difficult to express themselves effectively at times. For ADHD on the other hand, individuals may experience a loss of focus on the conversation, or seem to change subjects/interject abruptly.
Herein lies a key difference: ASD is primarily distinguished by differences in social understanding, while ADHD’s root aligns more with differences in focus and attention. Even in contrasting those two things, I hope you notice that these are not two entirely separate concepts. The overlaps indicate that neurodiversity is just that: diverse. These shared characteristics exist on a spectrum, and are not black and white differences.
Pertaining to focus, ADHD is typically marked by a quickly-shifting attention. This can make it difficult for individuals to hone in on one thing, unless they find it interesting/stimulating. ASD, on the other hand, tends to look more rigid. This can involve focusing one’s attention on one thing fully at a time, and needing to completely shift gears in order to engage with something else.
Other distinctions include ASD features such as stimming, which may manifest similarly to restlessness in ADHD, but serves a different purpose. ASD also offers a wider variety to differences in communication, ranging from difficulties in communicating verbally to interpreting language more literally. There certainly are key distinctions to be made, but, this exploration has reminded me of a beautiful paradox: when we acknowledge and accept differences, we often come to appreciate what is shared as well.
The reason I wanted to integrate hyperactivity in boys into the conversation is because of the added layer of ambiguity it adds. There are many barriers to appropriate diagnosis, and those obstacles can look different based on different populations. Adolescent males are certainly not the only group who are frequently misdiagnosed, but, as I said before, I wanted to hone in on one area to start.
The first reason that population is relevant is due to the increased rate of high energy, risk-taking, and impulsivity displayed. This is especially true in the classroom setting. It is important to note that those presentations are different for each individual and not universal among all young males. However, hyperactivity in boys tends to prime adults toconsider ADHD more commonly, whereas many females go undiagnosed due to the different presentation.
So, what separates “boys being boys,” from an appropriate diagnosis? While this is not a set of hard and fast rules, these guidelines can help when distinguishing possibilities. First, normative levels of hyperactivity tend to decrease with age, may be more dependent on the child’s context, and do not result in consistent, significant impairment. On the other hand, most young males with ADHD will not experience significant decreases in hyperactivity over time, nor is the hyperactivity context-dependent. This, like the majority of mental health diagnoses, is based around the hyperactivity causing impairment/distress. Lastly, ASD related hyperactivity is less about overall distractibility, and more about restlessness tied to regulation or sensory needs.
ASD and ADHD are highly comorbid, meaning that many individuals who have been diagnosed with ASD qualify for an ADHD diagnosis as well. This can complicate things further. However, it also demonstrates that while ASD, ADHD, and normative hyperactivity are distinct entities, they are once again not black and white. The overlapping nature is why it’s so important for us to grow our understanding, both of the diagnoses, and of the people around us. Effort and intentionality are what allow us to be aware and supportive.
In summary, we need to note the following: similarities exist between the three, as well as in other forms of neurodivergence. Differences are mainly marked by the nature of the specific diagnoses. And, whether we are talking about this neurodivergence or diversity in other forms, being willing to learn, accept, and engage with creativity is what ultimately enables us to connect with and support others. This principle is true for entire groups, and for individuals. I hope that this piece has been informative and/or thought-provoking to you. My final charge is this: accept differences, celebrate shared experiences, and overall, appreciate diversity!
