Health Wise: Is it ASD or Something Else? Look-alikes and Tagalongs

In our last blog, we talked about the importance of early detection of Autism Spectrum Disorder (ASD) for access to support and resources. If you missed that email, you can find the blog posted here.

Within that topic, we referenced testing for ASD - a psychological evaluation that explores whether criteria have been met for a diagnosis. Often, in the absence of official ASD testing, the condition can be misdiagnosed and thus, incorrectly and inefficiently treated. There are a number of conditions that share symptoms with ASD but have entirely different treatment protocols. Similarly, if symptoms of ASD are present, but an ASD diagnosis is ruled out by testing, other conditions may be mimicking the symptoms of ASD. In those situations, it may be important to get a comprehensive evaluation to hone in on the true problem.

Some common conditions that may get confused with Autism include:

• ADHD - Characterized by inattention, hyperactivity, and/or impulsivity. ADHD also causes difficulty with social interactions, emotion regulation, becoming overwhelmed easily, and unresponsiveness when spoken to. These symptoms are quite similar to those in ASD.
• Social Anxiety - Characterized by fear and avoidance of social interactions, difficulty socializing, and feeling overwhelmed in gatherings and crowds. ASD often gets confused with this condition, as on the surface they may look very similar. Motivations and brain processes differ greatly between the conditions.
• Oppositional Defiant Disorder - Children with ODD may fail to respond, become excessively angry and non-compliant, and may appear to have no regard for others. Children with ASD may have very similar behaviors, but significantly different intentions.
• Obsessive Compulsive Disorder- OCD is characterized by obsessive thinking, repetitive, rigid, and odd behaviors, and irrational rules and preferences. Similarly, individuals with ASD may get stuck in thoughts and behaviors and have rigid rules and routines.
• Personality Disorders - due to difficulties with empathy, perspective taking, and social interactions that is characteristic of ASD, it can be confused with personality disorders, especially ones like Antisocial (disregard for social norms and rules, low empathy), Borderline (drastic mood changes, unstable social relationships), and Schizoid (lack of desire for social interactions) Personality Disorders.

There are also a number of conditions that co-occur along with Autism or are secondary, stemming from the Autism, that are important to take note of for effective treatment. The main ones include:

• ADHD - Since both ADHD and ASD are developmental disorders (largely stemming in the brain prior to birth) and both affect some overlapping parts of the brain (like the prefrontal cortex), they co-occur relatively frequently.
• Anxiety - Anxiety occurs alongside many other conditions, due to its tendency to form when we feel that we cannot control certain aspects of our life and our brain, putting us on edge. Individuals with ASD may be anxious in loud or crowded situations, distrust themselves, and worry about “messing up” due to their symptoms and difficulties.
• Depression - Similar to anxiety, depression tends to occur along with other conditions, often making us feel down, like things are unlikely to improve, question our self-worth, and drain us of joy and comfort. People with ASD can feel exhausted and overwhelmed by many social situations and their mood is often impacted.

Many of these conditions can have overlapping symptoms but drastically different implications and treatments. Therefore, accurate differential diagnosing is crucial to provide the best care. While treatment for the primary condition may improve many symptoms, secondary conditions that are untreated can stall overall treatment outcomes. Getting an accurate diagnosis is the first step in successful treatment, opening the door for resources and preventing wasted efforts and suffering caused by misdirected treatment.

Take a moment to consider if anyone in your life may be uncertain about their diagnosis or struggling to see benefits from treatment. Could a thorough psychological assessment help identify the missing pieces? There are many treatment centers in the area that also provide this type of assessment, and it isn’t just about diagnosis. In our experience, people who understand themselves better are also able to be self-advocate better and utilize available treatments more effectively.

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