Managing Hyperactive Autism: Strategies and Support

Hyperactivity in Autism: The Difference Between ADHD and Autism

Autism Spectrum Disorder (ASD), a neurodevelopmental disorder, was first described by Leo Kanner in 1943. It was characterised as deficits in verbal and nonverbal social communication along with repetitive and restrictive patterns of behaviour.

Parallely, Hans Aspergers also described a similar pattern of symptoms in children and termed it Asperger's syndrome.

Asperger's syndrome and Kanner’s syndrome also called “classic autism”were both deserved as separate disorders in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) under the category of Pervasive Developmental Disorders (PDD), up until 2013.

With the advancement of research, “Autism Spectrum Disorder (ASD)” was included as a unified umbrella term in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).

The DSM-5 describes two core symptoms—social communication deficits and repetitive behaviours and restricted Interests, that must be present since early childhood as well as impairment in daily functioning for someone to be diagnosed with autism spectrum disorder (ASD).

The symptoms of autism spectrum disorder (ASD) vary widely in individuals and they also manifest at different levels of severity.

Hyperactivity is one of the many co-occurring conditions with autism spectrum disorder (ASD). Children with hyperactive autism are impulsive, restless and hyperactive to an unusual degree.

Understanding the relationship between hyperactivity and autism spectrum disorder (ASD) and the complex interplay of symptoms helps one gain a better understanding of the disorder.

This aids in developing better strategies for intervention and thereby providing the appropriate support needed by individuals with hyperactive autism to live a fulfilling life.

What is Hyperactivity?

As mentioned before, children with hyperactive autism are impulsive, restless and hyperactive to an unusual and abnormal degree. Hyperactivity is also characterised by difficulty remaining focused and sustaining attention, impulsivity and excessive movement.

Commonly, hyperactivity is associated with Attention-Deficit/Hyperactivity Disorder (ADHD), also a neurodevelopmental disorder. However, hyperactivity is also known to appear as a symptom in other neurodevelopmental disorders, including autism.

Individuals with hyperactivity have trouble sitting still and are almost always fidgeting. They might hate tasks that require focus and for one to sit for long periods.

They exhibit constant restlessness and an inability to stay still. These signs of hyperactivity are so persistent and intense that they impair social, occupational and other areas of functioning.

Hyperactivity in ADHD and ASD: Overlap and Difference

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are two of the most common neurodevelopmental disorders.

While hyperactivity is more likely to be associated with attention-deficit/hyperactivity disorder (ADHD), it can also be a sign of autism spectrum disorder (ASD). This can make screening and diagnosis difficult.

Therefore, it becomes important to understand the differences between these two neurodevelopmental disorders, their overlap, and how hyperactivity manifests in these disorders.

Since the symptoms of autism spectrum disorder (ASD) can manifest in varied ways, it has become important for healthcare professionals to take into account the context in which hyperactivity takes place. This, along with developmental history and other coexisting behaviours can help one to make an accurate diagnosis.

Hyperactivity in autism spectrum disorder (ASD) is more likely to be associated with difficulty in controlling motor movements, exhibiting repetitive patterns of behaviour and difficulty related to sensory processing.

In attention-deficit/hyperactivity disorder (ADHD), unlike autism spectrum disorder (ASD), hyperactive behaviour is associated with high energy levels, disruptive behaviour, and difficulty in paying attention and staying still.

Individuals with attention-deficit/hyperactivity disorder (ADHD) always seem like they are “on the go.” They constantly feel the need to move and do not perform well in tasks and activities that require them to stay still. They also show excessive motor activities.

In autism spectrum disorder (ASD), individuals might exhibit repetitive behaviours. These behaviours might manifest in the form of hand flapping, rocking back and forth, spinning in one place as well an inability to sit still.

Children with autism spectrum disorder (ASD) who have hyperactivity as one of their symptoms might also mainly have issues with sensory processing, such as getting easily overwhelmed by certain sensory stimuli. They might therefore engage in self-stimming.

Stimming or self-stimulation is relative body movements or movement of any inanimate objects such as marbles, rubix cubes or rocking or spinning, that many individuals in the autism spectrum display. Research states that the reason why a person engages in stimming varies with different people.

In attention-deficit/hyperactivity disorder (ADHD), hyperactivity co-occurs with impulsivity and inattention. In autism spectrum disorder (ASD), it manifests due to sensory needs along with the need to establish motor control and regulation.

Causes of Hyperactivity in ASD

Hyperactivity in individuals with Autism Spectrum Disorder (ASD) can stem from various interrelated factors.

Neurological differences are a primary cause, as individuals with autism spectrum disorder (ASD) often exhibit unique brain structures and functions that process sensory information, emotions, and impulses in ways that can lead to hyperactive behaviour.

Genetics also play a significant role, with certain genetic variations linked to both autism spectrum disorder (ASD) and hyperactivity, suggesting a hereditary component.

Research suggests that hyperactivity is caused by to lack of secretion of the neurotransmitter called dopamine. The frontal part of the brain seems to be also involved with hyperactivity.

Moreover, co-occurring conditions, particularly attention-deficit/hyperactivity disorder (ADHD), are prevalent among those with autism spectrum disorder (ASD).

Attention-deficit/hyperactivity disorder (ADHD) is characterized by impulsivity, inattention, and hyperactivity, which can significantly contribute to hyperactive behaviours in these individuals.

Sensory processing issues are another major factor. Individuals with autism spectrum disorder (ASD) frequently experience either heightened or diminished sensitivity to stimuli, leading them to seek sensory input or react strongly to sensory overload, manifesting as hyperactivity.

Environmental and behavioural factors also influence hyperactivity; changes in routine, unfamiliar environments, or social demands can cause stress and lead to hyperactive responses.

Communication challenges compound these issues, as difficulties in expressing needs or feelings can result in frustration, with hyperactivity serving as an alternative form of expression or coping mechanism.

AuDHD: Comorbitiy between ADHD and ASD

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are also highly comorbid (the presence of two disorders simultaneously).

According to Hours et al., (2022), almost 40% of people with autism spectrum disorder (ASD) also are given the diagnosis of attention-deficit/hyperactivity disorder (ADHD).

Before 2013, the Diagnostic and Statistical Manual of Mental Disorders precluded a dual diagnosis of autism and attention-deficit/hyperactivity disorder (ADHD), yet the comorbidity rate was still 45%.

Both conditions share traits such as inattention, atypical movements (fidgeting or stimming), social difficulties, learning differences, and sensory sensitivities.

Despite these overlaps, research indicates that attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are distinct diagnoses rather than points on a single spectrum.

Diagnosing both conditions accurately can be challenging due to symptom overlap. Diagnostic scales typically focus on symptoms characteristic of either autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD), potentially missing a combination of traits.

This overlap means professionals might assess for only one disorder, often leading to an incomplete diagnosis. If a person feels their current diagnosis doesn’t fully capture their experiences, they should consider testing for the other condition.

Autistic individuals with attention-deficit/hyperactivity disorder (ADHD) often face additional challenges, such as sensory issues and executive dysfunction, which can complicate daily tasks in a world designed for neurotypical individuals.

Support services are crucial for those struggling with these difficulties. Recent trends show more women being diagnosed with autism, reflecting a broader understanding of how these conditions manifest differently across genders.

Both attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are diagnosed by qualified professionals using various tools.

For attention-deficit/hyperactivity disorder (ADHD), common measures include the Conners Rating Scales, Tests of Sustained Attention, and the Behavior Rating Inventory of Executive Functioning (BRIEF). These tools assess attention, task completion, and executive functioning skills.

Autism spectrum disorder (ASD) diagnosis often involves the Autism Diagnostic Observation Schedule, Autism Spectrum Rating Scales, and the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum.

Evaluators might also use cognitive assessments (IQ tests) and screens for co-occurring mental health issues like anxiety or depression to provide a comprehensive evaluation and support plan.

If you suspect a dual diagnosis, seeking a thorough evaluation from a qualified professional is essential.

Treatment Methods for Hyperactivity

Autism spectrum disorder (ASD) is a lifelong condition, but hyperactivity associated with it can improve over time. Hyperactivity in individuals with autism spectrum disorder (ASD) is often a symptom rather than a defining characteristic.

Medication is frequently recommended for managing hyperactivity, but psychological support from professionals is also crucial. This support aids in the child’s development and assists family members in better regulating their behaviour.

Specific methods tailored to individuals with autism spectrum disorder (ASD) and hyperactivity should be followed. It is important to avoid treatments based on anecdotal advice or internet sources.

Each child's treatment should be personalised based on thorough evaluations by specialists. Once a child’s condition is clearly understood through professional testing, appropriate treatments can be determined and implemented.

In conclusion, managing hyperactivity in individuals with autism involves a multifaceted approach. While medication is often necessary, psychological support plays a vital role in overall development.

Engaging a child with activities designed for their specific needs can improve attention and aid in social integration, ultimately leading to better outcomes for both the child and their family.


Addressing hyperactivity in individuals with autism spectrum disorder (ASD) necessitates a comprehensive evaluation by healthcare professionals to identify and manage the underlying causes, ensuring interventions are tailored to meet the individual's specific needs and support their overall well-being.

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