Embracing Hope Book

Autism often doesn’t occur alone. Many individuals on the spectrum experience co-occurring conditions that affect their physical, emotional, and mental well-being. These are called comorbidities.

Common Co-Occurring Conditions:

• • ADHD (Attention-Deficit/Hyperactivity Disorder)
  • Anxiety and Depression
  • Sensory Processing Disorder (SPD)
  • Obsessive-Compulsive Disorder (OCD)
  • Epilepsy and Seizure Disorders
  • Gastrointestinal Issues
  • Sleep Disorders
  • Motor Coordination Difficulties
  • Feeding or Eating Challenges

These conditions can intensify stress for the individual and the family, and sometimes mask or confuse the presentation of autism.

Why Misdiagnosis Happens

Misdiagnosis is especially common in individuals who:

• • Mask their symptoms (common in girls and high-masking individuals)
  • Present with high verbal skills but hidden social confusion
  • Experience severe anxiety or emotional dysregulation
  • Have overlapping traits with other neurodevelopmental or psychiatric conditions

Common Misdiagnoses:

• • Social Anxiety instead of autism
  • Oppositional Defiant Disorder (ODD) instead of meltdowns due to sensory overload
  • ADHD only, overlooking social or communication challenges
  • Bipolar Disorder, confusing mood regulation with autistic shutdowns or rigidity

When autism is missed, individuals may receive the wrong support or interventions that don’t work.

Why Getting It Right Matters

Correct identification leads to:

• • More tailored support plans
  • More compassionate understanding from caregivers and professionals
  • Access to autism-informed therapies and accommodations
  • Reduced frustration and isolation for the individual

Support by Severity Level

The DSM-5 outlines three levels of support needed based on how autism affects daily life. But support isn’t only about severity; it’s about individual fit. Here’s how to think about support across levels:

Level 1: Requiring Support

• • Needs help with social nuance, organization, and flexibility
  • May benefit from:
    • Social skills coaching
    • Executive functioning strategies
    • Clear routines with minimal surprises
    • Visual schedules and flexible structure

Level 2: Requiring Substantial Support

• • Needs consistent help with communication, transitions, and behavior regulation
  • May benefit from:
    • • Speech and language therapy
      • Occupational therapy for sensory processing
      • Predictable routines and co-regulation strategies
      • Structured social and group activities

Level 3: Requiring Very Substantial Support

• • Needs intensive support across settings
  • May benefit from:
    • • 1:1 support staff or aides
      • Assistive communication devices (AAC)
      • Full team coordination (school, home, healthcare)
      • Sensory accommodations across all environments

The presence of comorbidities and the complexity of autism require us to look beyond checklists. Misdiagnosis delays care. The right diagnosis isn’t about a label — it’s about unlocking understanding, compassion, and the right tools.

Autism support isn’t one-size-fits-all. It’s a journey built around each unique brain. That’s the heart of neurodiversity.