By Dr. Ray Christner, Psy.D., NCSP, ABPP
As a parent, there’s nothing more important than ensuring your child’s health and well-being. So, when you start noticing behaviors that seem out of the ordinary or delays in key developmental milestones, it can be an incredibly worrying time. Perhaps your child struggles to focus and follow instructions, is constantly fidgeting or on the go, shows deep and sustained focus on certain topics or routines, or seems to struggle with social interactions, making eye contact, or engaging in reciprocal conversations.
These are just some of the potential signs that your child may be exhibiting characteristics of Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism. As alarming as those terms may sound, it’s crucial to understand that they represent forms of neurodiversity — natural variations in how a child’s brain functions and processes information. With the proper guidance, interventions, and support systems in place, children with ADHD and autism can absolutely thrive.
Early intervention can make a world of difference in your child’s development, self-esteem, and long-term success. However, if early intervention is no longer possible, remember that there are still ways to help your child.
How to recognize potential signs of ADHD and autism
As a parent, you know your child better than anyone. If you notice behaviors that seem out of the ordinary, trust your instincts and be aware of the key traits of ADHD and autism.
With ADHD, the primary characteristics to look for are inattention, hyperactivity, and impulsivity. Children with ADHD often have difficulty staying focused, following instructions, and seeing tasks through to completion. They may be easily distracted, frequently shift between activities, and struggle with organization. Physically, they tend to fidget, squirm, talk excessively, and have trouble staying seated. Impulsive behaviors like blurting out, interrupting others, and difficulties waiting their turn are also common.
The hallmark symptoms of autism involve challenges with social communication and interaction, along with restricted interests and repetitive behaviors. Children with autism may avoid eye contact, have difficulties engaging in back-and-forth conversations, struggle to read nonverbal social cues, and often focus intensely on highly specific topics or interests. Sensory sensitivities, preference for adherence to routines, and repetitive motor movements (i.e., stimming) like rocking or hand-flapping are also potential signs.
It’s important to note that symptoms can manifest differently in each child based on factors like age, gender, and severity level. Some children exhibit obvious signs early on, while others may have more subtle characteristics that develop gradually over time. Keeping an open mind and detailed observations is crucial.
First steps after noticing signs
If you’ve observed behaviors in your child that may indicate ADHD, autism, or other developmental differences, it’s important to take prompt action. The earlier an evaluation can take place, the sooner you can get your child the support and interventions they need to reach their full potential.
Here are the recommended first steps:
- Start a detailed log of observations: Begin writing down specific examples of the behaviors you’re noticing, including when they occur, how often, what seems to trigger or escalate them, and note any patterns or contexts where the behaviors are more pronounced. This documentation will prove invaluable during the evaluation process.
- Speak to your child’s pediatrician: Schedule an appointment and explain your concerns honestly and specifically, providing the examples you’ve logged. Your pediatrician can conduct an initial screening, rule out any potential medical causes, and provide referrals to local psychologists or developmental specialists for a comprehensive evaluation.
- Request evaluation from school support teams: If your child is school-aged, reach out to their teacher, school psychologist, or administrator about pursuing an evaluation through the school’s multi-tiered system of support (MTSS) or child study team. They can observe your child in an academic setting and work with you on the next steps.
- Importance of ruling out other potential explanations: During the evaluation process, professionals will look to rule out any alternative explanations for the behaviors, such as learning disabilities, anxiety, depression, adjustment difficulties, or giftedness. An accurate diagnosis is crucial for tailoring the right interventions and support plan.
While this period of uncertainty can produce fear and anxiety, try to approach it with an open mind. The ultimate goal is getting answers and creating an environment where your child can thrive.
The evaluation process
Once you’ve taken those first steps, your child will likely undergo a comprehensive evaluation by one or more qualified professionals. This multidisciplinary approach is critical, as ADHD and autism can involve a complex array of symptoms and developmental areas.
The core evaluation team may include clinical psychologists, developmental pediatricians, neurologists, and/or psychiatrists. They will conduct interviews with you and your child, have you complete rating scales and questionnaires about your child’s behaviors across settings, and observe your child’s social interactions, communication, and activity levels.
Specific diagnostic tools, such as the ADHD Rating Scale, Conners Rating Scale, Autism Diagnostic Observation Schedule (ADOS-2), and Autism Spectrum Rating Scale (ASRS) help systematically measure and assess symptom presence and severity. Cognitive, academic, speech/language, and neuropsychological testing may also be used to identify strengths and challenges.
Throughout this process, providers will look for patterns of behavior that align with the diagnostic criteria for ADHD, autism, or other neurodevelopmental profiles. No single test can diagnose these conditions on its own — careful analysis of the comprehensive evaluation findings is required. An accurate diagnosis lays the groundwork for effective intervention planning.
Next steps after diagnosis
Receiving a diagnosis of ADHD or autism can understandably bring about a range of emotions for parents — relief at finally having answers, grief over hopes and dreams, and anxiety about the future. Remember that whatever you are feeling is valid.
The most important next step is to partner with professionals to develop a comprehensive treatment and intervention plan tailored to your child’s unique needs. For ADHD, evidence-based interventions often include:
- Medication (stimulants, non-stimulants) to improve focus, impulse control
- Behavior therapy to develop self-regulation skills
- Educational/academic accommodations and supports
- Parent training on structuring the environment
For autism, common supports may involve:
- Applied Behavior Analysis (ABA) therapy
- Social skills intervention
- Neurodiversity-affirming interventions
- Speech and language therapy
- Occupational therapy for sensory and fine motor needs
- Structured educational support
The goal of any intervention and support plan is to minimize the core difficulties of the diagnosis while capitalizing on the child’s strengths. Early, intensive intervention during key developmental windows is crucial for achieving the best long-term outcomes. Consistency across home, school, and community settings is also vital.
How parents can be advocates
Although the journey after an ADHD or autism diagnosis can seem daunting, remember that you are your child’s greatest advocate. With the proper education, mindset, and support systems, your child can thrive.
First and foremost, commit to learning everything you can about your child’s diagnosis. Read books, join online communities, and connect with other local families. The more you understand the neurological underpinnings, the better you can separate your child’s positive qualities from their challenges.
Additionally, help foster your child’s interests, celebrate their unique strengths, and shape environments that minimize stigma. Nurturing their self-confidence and sense of self-worth is vital.
As your child gets older, start teaching self-advocacy skills by having open conversations about their diagnosis and academic accommodations and strategizing ways to self-regulate attention or sensory needs in the classroom. With your guidance, they can learn to capitalize on their neurodiversity and advocate for appropriate support.
Most importantly, stay closely involved with your child’s intervention team and educational providers. View it as a collaborative partnership where you can share observations and advocate for the services, accommodations, and instructional approaches that allow your child to blossom. With perseverance and the proper support systems in place, your child has an incredibly bright future ahead.
– Dr. Ray W. Christner, Psy.D., NCSP, ABPP, is a licensed psychologist and a certified school psychologist in Pennsylvania, a nationally certified school psychologist, and a nationally registered health service psychologist. He specializes in clinical and school psychology, and he is board-certified in behavioral and cognitive psychology. He maintains a private practice in Hanover, Pennsylvania, and provides telepsychology services in 39 states. Dr. Christner’s clinical work includes psychotherapy, psychological/neuropsychological testing, and consultation services. He works with children, adolescents, and adults with psychological, developmental, social, behavioral, and learning differences. Dr. Christner is the co-host of the podcast “Psyched to Practice.”
