Autism and ADHD Social Communication: Same Look, Different Cause

You come out of a meeting and you know that something went wrong inside it but you cannot find where. Either you talked too much, or you did not talk at all, or you laughed at the wrong time, or you read the expression on someone's face late.

People with an autism diagnosis and people with an ADHD diagnosis both describe this feeling. They describe it in the same sentence. The mechanism underneath is not the same.

I do not have an autism diagnosis. I have my ADHD diagnosis, and for years I read what I lived through on the social side as "bad manners." Learning the difference in social communication between these two topics changed that reading. Below I write what the research says; I mark my own side separately.

The same scene, two different reasons

The most useful distinction lies not in the behavior but in the reason underneath the behavior.

In ADHD most of the social difficulty comes from impulsivity and attention. You interrupt, you miss half of the other person's sentence, you jump from topic to topic, you cannot wait your turn. You know the rule. Knowing does not stop you.

In autism, on the other hand, the reading of social cues, the building of reciprocity and the inferring of what is not said are central. The rule is not clear; it is implicit and changes with context. The difficulty is not in the application but in the rule itself being invisible.

The two do not exclude each other. The review by Antshel and Russo (2019) explains that the co-occurrence of the two profiles is not exceptional and that when they occur together the social picture becomes more complex.

Where it snags: the ADHD side

This is the place where I can speak from my own side.

Waiting your turn. I predict the end of the sentence and the moment I predict it I start talking. I know I have interrupted at the very moment I interrupt. In the article interrupting during arguments I wrote why this is not a sign of disinterest.

Missing things while listening. The other person's first sentence triggers an association, you go after that association, and when you come back the conversation has moved three steps on. From the outside this looks exactly like "not listening." The article seeming not to listen in a relationship covers this part.

Talking too much. When excitement rises the speech speeds up and the stopping point is missed. What comes afterward is usually shame.

The bill that comes afterward. You manage well in the setting, you collapse when you get home. This is called social battery, and in ADHD the rate at which it runs out is higher than assumed.

Where it snags: the autism side

Here I speak secondhand, because there is no use to anyone in describing as if I had lived something I have not.

The headings that come up often in the autism literature are these: inferring what is not said being demanding, indirect expressions such as metaphor and implication requiring a separate processing step, eye contact being tiring rather than comforting, and the uncertainty of guessing when the turn changes in a reciprocal conversation.

And there is this: in a social setting, the conversation itself does not come alone. Light, sound, smell and bodily posture are being processed at the same time. Sensory load directly lowers social performance. I covered this link in detail in the article sensory differences in autism and ADHD.

And there is the matter of timing. Reciprocal conversation runs on decisions made in under a second: when you will come in, when you will fall silent, when you will nod. Most of these decisions are made not by thinking but automatically. When it is not automatic, the same work has to be done consciously, and this turns a forty-five-minute chat into a forty-five-minute calculation.

The result of this produces the following strange picture: no problem is visible in the setting, and afterward the person cannot recover for days. Someone looking from the outside saw a successful conversation; someone looking from the inside put in a shift.

What needs attention is this: when these headings are read as a list of deficiencies they are misunderstood. The research of the last decade changed direction at exactly this point.

Misunderstanding is two-sided

The most important conceptual change in the field took place here.

Milton (2012) proposed that the misunderstanding between autistic and non-autistic people is not a one-sided inadequacy but a mutual mismatch. He named this the double empathy problem. That is, while the autistic person struggles to read the person in front of them, the person in front of them struggles to the same degree to read the autistic person.

This claim was later tested experimentally too. In the study by Crompton and colleagues (2020), a story was passed from person to person in chains. In chains made up of autistic people, the loss of information turned out similar to that in non-autistic chains. Information was mainly lost in mixed chains, and the rapport participants felt toward each other in mixed pairings was also reported as lower.

The study by Sasson and colleagues (2017) showed another face of the matter: first impressions formed within seconds of autistic people turn out markedly more negative, and these impressions lower the other side's willingness to continue the interaction. What is interesting is this: when the same content is presented in writing, this negative difference disappears.

Part of social difficulty does not sit inside the person but between two people. This makes it hard to put the responsibility on one side, and it is good that it does.

What this distinction is good for in practice

It looks like an abstract conceptual debate, but its everyday result is very concrete.

If the difficulty is only inside the person, the solution becomes "socialize better." That is, making the person mask more. I wrote about the cost of this in the article masking in autism and ADHD.

If the difficulty sits in between, the solution becomes changing the environment itself: sharing the agenda in advance, treating written communication as legitimate, using a clear sentence instead of implication, not making eye contact compulsory.

This second path is less tiring and works better.

Two things not to confuse

Social anxiety and social difficulty are not the same thing. In social anxiety the skill is in place, and what stands in the way is the fear of being evaluated. The distinction sometimes becomes clear with this question: if someone guaranteed that nobody in the setting would judge you, would you relax? In anxiety the answer is mostly yes; in the other, the picture does not change.

Wanting to be alone and exhaustion are not the same thing. A person can like people and still be unable to recover for two days after a three-hour meeting. Not wanting and not being able to bear are different things.

Introversion and social difficulty are not the same thing. An introvert may not gain energy from a social setting but knows what to do in it. The matter here is not an energy preference but processing load.

These three distinctions matter in practice, because a different thing helps each. In anxiety, approaches aimed at anxiety; in exhaustion, the budget and recovery time; in processing load, changing the structure of the environment. A difficulty put in the wrong box causes years of struggling with the wrong solution. For me, this ended with seeing that what I had thought for years was social anxiety was actually a cycle of shame born of impulsivity.

What an assessment looks at

Making the distinction on the social side does not happen in a single interview, because adults show their best selves in the interview room.

Some of what is looked at: how peer relationships in childhood developed, the history of joint attention and reciprocal play, how friendships were formed and how they ended, in which context the difficulty appears. The developmental history is decisive here.

And there is the matter of order: if there is already one diagnosis, the second often stays in its shadow. The social difficulty of someone with an ADHD diagnosis can automatically be attributed to impulsivity. Asking about this openly is reasonable. I described the general framework of the assessment process in the article autism diagnosis in adulthood.

What works in daily life

Even though the mechanism differs, some arrangements work on both sides:

• Agenda in advance. Knowing what will be talked about both makes preparation possible and lowers the momentary processing load.
• Writing is a legitimate channel. Opening a hard subject in writing is not escape, it is a channel preference. The finding of Sasson and colleagues (2017) supports this preference.
• Ask for a clear sentence. The sentence "don't come if you don't want to" is misunderstood on both sides. "I'd prefer you come, but it's fine if you don't" is longer and cheaper.
• Set an end time. Meetings with a known end time last longer, because the load of uncertainty is lifted.
• Empty out the time after. Do not put work after a heavy social day. Recovery time is not a whim, it is a line in the calendar.

From this list, the item I benefited from most was "agenda in advance." In my own company I send the agenda in writing for client meetings and present it as professionalism; the truth is I do it to lower my own processing load. The side effect was nice too: the meetings got shorter and the other side comes better prepared.

The second thing that helped me most was "empty out the time after." I used to put another meeting right after an intense one, and in the second I could hardly be of any use. Now I put at least an hour in between and spend that hour talking to no one. This looks like an hour lost in the calendar; in reality it is a day saved.

To sum up

Social difficulty is real in both profiles, but it is not the same thing. In ADHD, not being able to apply the rule comes more to the fore; in autism, the rule being implicit does. And what research has added in recent years is this: part of the misunderstanding sits between the two sides.

I covered the possibility that the two occur together, and how the picture then becomes complicated, in the article on AuDHD, and why the two are confused in the article are ADHD and autism the same thing. If you are wondering how to treat someone close to you, the article being close to someone with AuDHD covers that side.