In brief
Many features associated with autism also occur in other mental disorders and developmental disorders or are variants of normal child development. An autism assessment therefore always includes differential diagnostic differentiation: it is checked whether the features can be better explained by another disorder. [1] To be distinguished from this are co-occurring conditions (comorbidities), which can exist in addition to autism. Separating the two is regarded as a major challenge. [1]
This English translation was produced with AI assistance and has not yet been independently reviewed.
Why differentiation is necessary
Because of the high overlap of symptoms with other conditions, differential diagnostic assessment is highly important in the diagnostic process; in principle all other mental disorders come into question. [1] In these disorders, some features resembling those of autism (“autistic like traits”) are common. Differentiation is highly relevant for further treatment. [1]
Common differential diagnoses in children and adolescents
The expert overview names as the most common differential diagnoses in childhood and adolescence: [1]
- intellectual disability without autism,
- developmental language disorders,
- attention disorders,
- attachment disorders,
- social anxiety disorders,
- conduct disorder.
Common differential diagnoses in adults
In adulthood, the following disorders in particular should be clarified: [1]
- personality disorders,
- obsessive-compulsive disorders,
- attention disorders,
- affective disorders (for example depression),
- social phobia,
- schizophrenia.
In adults, early development is often hard to reconstruct. Asking relatives and looking at old documents help; without them, diagnostic differentiation from other disorders is hardly possible. [1] More on this: Assessment in adulthood.
Differential diagnosis or co-occurring condition?
Whether a disorder is present instead of autism (differential diagnosis) or in addition to it (co-occurring condition) cannot always be clearly separated, for example in intellectual disability, delayed language development and attention disorders. [1] According to the expert overview, about two thirds of all people with autism have at least one co-occurring condition. [1] Examples and treatment questions: Common co-occurring conditions in autism and Autism and ADHD.
What this can mean for you
- The result can turn out differently than expected. A thorough differentiation can lead to a different or an additional diagnosis. Both can contribute to suitable support.
- Assessment should be multidisciplinary and carried out by specifically trained professionals. [1]
- Documents help: Reports from nursery, school or earlier treatment support the classification. [1] How assessment works: How an autism assessment works.
Note: This article offers general information. It does not replace personal advice or treatment by professionals.
Sources and literature
- Höhne E, Kamp-Becker I (Klinik für KJP, Universitätsklinikum Marburg): Diagnostik der Autismus-Spektrum-Störung. Pädiatrie (Rosenfluh) 2024;(4+5):27–32. https://rosenfluh.ch/media/paediatrie/2024/04-05/Diagnostik-der-Autismus-Spektrum-Stoerung.pdf – Expert overview (in German)
Terms from this article
- Differential diagnosis
- Distinguishing from other explanations: it is checked whether features that could fit autism are better explained by another disorder. To be distinguished from this are accompanying conditions that exist in addition.
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