Childhood trauma can develop in ways that impact mood, sleep, executive function, learning abilities, and social interaction. Many of these symptoms overlap with signs of autism spectrum disorder (ASD), which can lead to false positives when using a single diagnostic tool.
Learn how to differentiate between trauma symptoms, reduce the rate of false positives, and connect your patients with a more accurate diagnosis.
Overlapping Signs Between Trauma and ASD
There are several overlapping signs between trauma and ASD. Both trauma and ASD can exhibit in familiar patterns:
- Delays in motor skills, emotional regulation, behavior, or speech and language ability
- Disruption in attachment behavior
- Alexithymia, or trouble recognizing or naming emotions
- Low coping skills and emotional control, particularly when dealing with frustration
- Sleep impairment
It is important to note that trauma symptoms can emerge weeks, and even months, after the incident. Further complicating matters is that trauma, when experienced at a key brain developmental stage, can cause lasting changes to brain chemistry and structure (De Bills et al., 2014). These changes may be similar to the variations in brain structure development that have been linked to some autistic traits, though more research is required (Arunachalam Chandran et al., 2021).
What is established, however, is that both trauma and ASD can lead to developmental delays, which may make it more difficult to provide an accurate diagnosis in children and young adults.
How to Differentiate Symptoms for Accurate Diagnoses
While a robust approach towards differentiating between symptoms of PTSD and trauma and signs of ASD will be required, there are a few simple ways to improve diagnosis accuracy.
Place Greater Emphasis on Identifying ASD Characteristics First
Studies have suggested placing greater emphasis on characteristics unique to autism, such as non-verbal communication and restricted interests, can help distinguish between ASD and attachment disorders (Zeanah et al., 2016).
Take a Full Patient History
In a review, other frequently recommended methods to distinguish between the conditions include taking a detailed history from the individual and their parents and/or caregiver(s) (Sarr et al., 2024).
Expand Diagnostic Methods for a Multidisciplinary Approach
The literature also suggests that involving measures, observations, diagnostic criteria and consulting with a multidisciplinary team are also crucial in differentiating between autism and trauma-related conditions (Sarr et al., 2024).
Be Aware of Each Diagnostic Tools Limitations
Each tool has its strengths and weaknesses. Being fully aware of both will allow you to pre-empt limitations ahead of time, and prepare a more comprehensive approach towards diagnosis for each individual patient.
Use Multiple Diagnostic Criteria
Single tools do not, and often should not, be removed from your diagnostic assessment method. Rather than replace individual tools, expand your practice with trauma screening or resilience assessment tools.
Expand Your Diagnostic Criteria with WPS
While trauma and ASD can exist simultaneously in one patient, incorrectly attributing signs for autism (or vice versa) can lead to poor patient outcomes. Relying on a single diagnostic method is insufficient, even with the gold-standard ADOS-2.
Psychologists, clinicians, and therapists would benefit from adding either a trauma screening tool to their diagnostic practice, or a resilience assessment, like the Risk Inventory and Strengths Evaluation (RISE™).
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