Asperger’s Vs. ADHD: Differences, Diagnosis, & Treatment

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder resulting in inattention, disorganization, and/or impulsivity. People with ADHD often struggle to stay on task, keep track of time, or remember important events. Hyperactivity may also look like overactivity, fidgeting, and an inability to wait for one’s turn.¹ Symptomology varies by person and manifests differently in relationships, academics, and work.

Children with ADHD frequently experience executive dysfunction, sometimes causing difficulties staying focused, excessive activity, or impulsivity. As children transition into adolescence and adulthood, the hyperactivity component may diminish, while challenges with attention, organization, time management, and otherwise may persist.

Common symptoms of ADHD include:²

• Short attention span
• Physical, verbal, or emotional hyperactivity
• Impulsivity, which may manifest as recklessness
• Fidgeting or restlessness
• Disorganization and difficulty prioritizing tasks
• Poor time management and time blindness
• Frequent mood swings and emotional dysregulation
• Forgetfulness and poor working memory
• Trouble multitasking and executive dysfunction
• Inability to control anger or frustration
• Trouble completing tasks
• Frequent procrastination
• Distractibility
• Difficulty awaiting turn

What Is Asperger’s Syndrome?

Asperger’s syndrome*, now an autism spectrum disorder (ASD), is a developmental condition that manifests as problems with social interactions, restricted interests, and repetitive behaviors (sometimes in the form of autistic stimming).³

Although “Asperger’s” is outdated, professionals still recognize the condition as a form of autism. Behaviors associated with Asperger’s typically manifest in early childhood but may not be diagnosed until later in life. The condition is 4.2 times more prevalent in boys, sometimes leading to diagnostic delays for many females.

Common symptoms of Asperger’s syndrome include:⁴

• Inappropriate or minimal social interactions
• Conversations about a certain topic or interest
• Troubles understanding emotions
• Less facial expression than others
• Unusual, flat, high-pitched, quiet, loud, or robotic speech
• Not using or understanding nonverbal communication, such as gestures, body language, and facial expression
• Intense obsessions with one or two specific, narrow subjects
• Becoming upset at any small changes in routines
• Memorizing preferred information and facts easily
• Clumsy, uncoordinated movements, including difficulty with handwriting
• Difficulty managing emotions, sometimes leading to verbal or behavioral outbursts, self-injurious behaviors, or tantrums
• Not understanding other peoples’ feelings or perspectives
• Hypersensitivity to lights, sounds, and textures (sensory overload)

*Though this article references Asperger’s syndrome, note that the condition is considered inclusive within the autism spectrum.

Asperger’s Vs. ADHD: What Is the Difference?

The differences between Asperger’s and ADHD are numerous. In a nutshell, Asperger’s syndrome primarily affects social interaction and communication, whereas ADHD primarily affects attention regulation and impulse control.

Differences between Asperger’s and ADHD include:

Social Interaction

Individuals with Asperger’s syndrome often struggle with social interactions, understanding social cues, and maintaining eye contact. In contrast, individuals with ADHD generally have fewer social impairments, although they may struggle with impulsivity or interrupting others in conversations. However, with either condition, individuals desire social interactions and can maintain healthy, positive relationships.

Communication

Another difference between ADHD and Asperger’s relates to communication. Those with Asperger’s tend to struggle with pragmatic language skills, such as understanding sarcasm or nonliteral language. Those with ADHD typically do not have significant difficulties with language comprehension or literal language understanding.

Special Interests

Special interests are a common characteristic of Asperger’s and refer to intense and focused areas of fascination or expertise that captivate autistic individuals. Children, for example, often display a deep level of knowledge and enthusiasm about their special interests, ranging from specific topics, like trains or dinosaurs, to complex subjects, like mathematics or computer programming. Special interests provide a sense of comfort, engagement, and fulfillment for autistic individuals, and they often spend significant time learning, discussing, or engaging with their chosen topics.

Contrastingly, ADHD hyperfixation describes the intense focus and engagement individuals with ADHD may experience. However, hyperfixation in ADHD is typically more transient and fleeting, producing a temporary state of heightened attention to the exclusion of other tasks or responsibilities. Unlike autistic special interests, ADHD hyperfixation may change frequently and lacks the depth and persistence typically associated with special interests.

Repetitive Behaviors

For individuals with Asperger’s, repetitive behaviors often serve a self-stimulatory or self-soothing function. These behaviors may include repetitive hand movements (e.g., flapping or twisting), rocking back and forth, or words and phrases (echolalia). These behaviors help regulate sensory input or reduce anxiety.

On the other hand, repetitive behaviors in ADHD are typically more related to impulsivity and hyperactivity. Examples can include fidgeting, tapping, or excessive talking. A need for constant stimulation or difficulty with self-control often drives these behaviors.

Executive Functioning

ADHD is commonly associated with difficulties in executive functioning, such as organization, time management, and planning. While individuals with Asperger’s may also experience challenges in these areas, these complications are more prominent in ADHD.

Hyperactivity & Impulsivity

Hyperactivity and impulsivity are hallmark symptoms of ADHD not typically associated with Asperger’s. Individuals with ADHD may have trouble sitting still, fidgeting, or acting impulsively without thinking.

Similarities Between Asperger’s & ADHD

Asperger’s and ADHD share many similarities, such as difficulties in social interactions and struggles with attention and focus. Individuals with Asperger’s or ADHD may also experience disorganization and poor time management. These symptoms can impact daily functioning and may require specialized support and interventions.

Similar characteristics between Asperger’s and ADHD include:

• Social interaction difficulties (e.g., awkwardness)
• Attention and focus issues (especially on tasks that don’t interest the person)
• Executive functioning challenges
• Sensory sensitivities
• Emotional regulation difficulties

What Causes ADHD & Asperger’s?

Research is still ongoing regarding the causes of ADHD and Asperger’s syndrome. However, evidence suggests a combination of genetic, neurological, and environmental factors precede the development of either condition.

Experts believe ADHD has a significant genetic component.⁵ This component is complex, as no singular contributing gene results in the condition. Rather, research has identified several genes that may play a role in the development of ADHD, affecting neurotransmitter regulation and brain development. Other factors, such as prenatal exposure to tobacco smoke or alcohol, premature birth, low birth weight, and environmental toxins, may increase the risk of ADHD.⁶

Studies suggest that Asperger’s syndrome also has a strong genetic basis, with multiple genes affecting brain development and neural connectivity.⁷ Prenatal factors like maternal infection or exposure to certain medications may also influence development.

How Are ADHD & Asperger’s Diagnosed?

A psychiatrist, psychologist, mental health counselor, or developmental specialist may diagnose ADHD and Asperger’s syndrome. Diagnosis includes an assessment of symptoms conducted at intake, followed by interviews and screening tools.

The diagnostic process may vary depending on the healthcare professional and the individual’s unique circumstances. Professional evaluation is crucial to obtaining an accurate diagnosis and appropriate support.

A diagnostic exam for ADHD or Asperger’s may include the following:

• Comprehensive clinical assessment: Professionals provide developmental history evaluations, including interviews with the person and their caregivers (as appropriate), to gather information about symptoms and behaviors.
• Behavioral observations: A diagnosing professional may request direct observations of the individual’s behavior in different settings, such as home and school, to assess social interactions, communication abilities, and attention-related difficulties. While the office may provide some insight, real-life settings are more accurate and offer a realistic portrayal of one’s day-to-day.
• Rating scales and questionnaires: A diagnostic exam may also include standardized rating scales completed by the individual, caregivers, and teachers. These provide additional information about symptoms and impairments.
• Psychological testing: Psychological tests assess cognitive abilities, executive functioning skills, and emotional functioning.
• Diagnostic criteria: The healthcare professional will refer to the diagnostic criteria outlined in the DDSM-5-Tr to determine if the individual meets the criteria for ADHD or autism (which includes Asperger’s).
• Differential diagnosis: In a differential diagnosis, the healthcare professional carefully evaluates the symptoms and behaviors exhibited by the individual to differentiate between ADHD and Asperger’s.

Can You Have Both Asperger’s & ADHD?

It is possible for Asperger’s and ADHD to co-occur in some individuals, which can further complicate the diagnostic process. In fact, approximately 50-70% of those diagnosed with autism present with comorbid ADHD.^8,9

In this case, a helpful supplement to professional diagnosis would entail maintaining a log (e.g., diary, journal) of daily interactions. These logs may reveal the most accurate as consistent themes emerge and align with either Asperger’s syndrome or ADHD.

How Are Asperger’s & ADHD Treated?

Treatment for Asperger’s syndrome and ADHD differ, as each condition presents distinct challenges. However, both conditions can benefit from a combination of interventions that address the individual’s specific needs and symptoms.

For ADHD, treatment often involves a multimodal approach that may include behavioral interventions, educational support, family member training, and medication (as appropriate). For Asperger’s syndrome, treatment typically involves a comprehensive approach tailored to the individual’s strengths and challenges.

To find a neurodiversity-affirming therapist, individuals should communicate their preferences and needs as best as possible. Asking doctors, family members, or neurodiversity organizations for recommendations can help get you started. An online therapist directory allows you to narrow providers by specialty, experience, location, and insurance.

Treatment for ADHD

Treatment for ADHD typically involves a combination of behavioral interventions, educational support, and, in some cases, medication. Behavioral interventions, such as behavioral therapy and parent training, focus on improving organization, time management, and self-regulation skills. Educational accommodations can help optimize academic success.

Medications for ADHD, including stimulants and non-stimulants, can be prescribed to manage symptoms and improve focus, attention, and impulse control. Research consistently indicates that medication can significantly improve ADHD symptoms for many individuals.¹⁰ Work closely with your provider for appropriate medication management, as these drugs can yield negative implications.

Treatment options for ADHD may include:

• Cognitive behavioral therapy (CBT): CBT for ADHD helps individuals develop strategies to manage impulsive behaviors, improve time management and organization skills, and address negative thought patterns that may contribute to emotional and behavioral challenges.
• Dialectical behavioral therapy (DBT): DBT incorporates mindfulness, emotional regulation, and interpersonal effectiveness skills to help individuals with ADHD manage their emotions, reduce impulsivity, and improve relationships.
• Stimulants: Stimulant medications*, such as Adderall, are effective in reducing ADHD symptoms. They work by increasing neurotransmitters in the brain, improving attention, focus, and impulse control.¹¹
• Nonstimulants: Non-stimulants, such as atomoxetine, may be prescribed as an alternative for individuals who do not respond well to or prefer not to take stimulant medications. These medications also target neurotransmitters in the brain to help manage ADHD symptoms.
• Behavior therapy: Behavior therapy focuses on teaching and reinforcing positive behaviors and strategies using token economies, reward systems, and behavior contracts.
• Parent/guardian training and education: Parents and guardians can learn strategies to help manage their child’s ADHD symptoms, implement consistent routines and structure, and provide behavioral support at home and school.
• School accommodations: Collaborating with educators to implement accommodations, such as providing a quiet workspace, extra time for assignments, or breaking tasks into smaller steps, can support academic success for individuals with ADHD.

*These medications have a black box warning, the most serious kind of warning from the FDA for risk of medication misuse or abuse. 

Treatment for Asperger’s

Treatment for Asperger’s often involves a multidisciplinary approach tailored to address the individual’s specific challenges while enhancing strengths, such as behavioral, language, occupational, and cognitive-behavioral therapies. Each aims to improve social interactions, communication skills, sensory sensitivities, and overall quality of life.

Research suggests that early intervention and therapy yield positive treatment outcomes.⁴ Family members can play a crucial role by providing emotional support, participating in therapy sessions, and learning about Asperger’s. They can also assist in implementing therapeutic strategies at home and advocating for appropriate accommodations and support.

Treatment options for Asperger’s may include:

• Social skills training: Social skills training helps individuals with Asperger’s develop and improve their social communication and interaction abilities. It focuses on teaching appropriate social behaviors, understanding nonverbal cues, and building skills for effective social interactions.
• Applied behavior analysis (ABA): ABA is a highly structured and evidence-based therapy that uses behavioral principles to teach and reinforce positive behaviors while reducing problem behaviors. ABA helps individuals with Asperger’s acquire new skills, improve communication, reduce challenging behaviors, and enhance their overall quality of life.
• Cognitive behavioral therapy (CBT): In this case, CBT helps individuals with Asperger’s manage anxiety, develop coping strategies, and improve emotional regulation and problem-solving skills.
• Sensory integration therapy: Sensory integration therapy aims to help individuals with Asperger’s manage sensory sensitivities and difficulties. It involves activities and exercises that provide sensory input to help regulate sensory responses and improve sensory processing abilities.

In My Experience

In my experience, seeking a formal assessment from a healthcare professional is essential when living with ADHD or Asperger’s syndrome. A comprehensive exam can provide an accurate diagnosis and guide the development of an individualized treatment plan. Remember, finding relief and support is possible with the right interventions. Understanding and managing these conditions leads to improved quality of life and well-being for many, but that all begins by taking the first step.