Which of the following is NOT a recommended practice when evaluating ADHD symptoms in a child who also has autism spectrum disorder?

• A. Consider symptom overlap, sensory and communication differences, use ASD-specific scales, gather multi-informant data and assess functional impairment across contexts
• B. Use ASD-specific scales
• C. Gather multi-informant data
• D. Rely solely on ADHD rating scales

Answer: (D)

Evaluating ADHD symptoms in a child with autism requires a broad, context-rich assessment rather than relying only on ADHD rating scales. Symptom overlap between ASD and ADHD can blur distinctions, and how a child shows attention, activity, or impulsivity is often shaped by sensory sensitivities, communication style, and daily routines. Using ASD-specific scales helps ensure the evaluation captures autism-related features that might mimic or mask ADHD, reducing the risk of misattribution. Gathering information from multiple informants—parents, teachers, and other caregivers—across different settings provides a fuller picture of consistency and helps determine whether problems appear across contexts or are specific to one environment. Assessing functional impairment across home, school, and social domains clarifies the real-world impact of symptoms and informs treatment planning. Relying solely on ADHD rating scales misses these important nuances, which can lead to inaccurate conclusions about ADHD in the context of ASD.