What if it Isn’t Autism? 10 Similar Conditions Black Folks Should Know

It’s estimated that up to three percent of Black children have been diagnosed with autism spectrum disorder (ASD). When it comes to adults, the numbers aren’t as clear. In fact, many people aren’t diagnosed until adolescence or even adulthood. Although early detection can lead to more effective social, language and academic success, many people with autism are misdiagnosed for a prolonged period before they know they’re on the spectrum. To make things more complicated, there are at least 10 conditions that can mimic autism easily so they have to be ruled out.

According to Dr. Joyce Idehen, “Autism spectrum disorder is a neurodevelopmental disorder that affects a child’s ability to communicate, form relationships, and use language with each person having a unique profile of strengths and challenges.”

10 Conditions That Look Like Autism

1. Obsessive-Compulsive Disorder (OCD)

OCD is characterized by intrusive thoughts and repetitive actions. While repetitive actions are typically soothing for those with ASD, people with OCD take no joy in them. These actions are usually compulsive and meant to manage their anxiety. Additionally, OCD tends to come with focused anxiety issues while ASD has a more general effect.

2. Sensory Processing Disorder (SPD)

In SPD, your brain is unable to correctly process sensory input. As a result, you may experience opposing sensations when you touch, smell, see, taste, or hear something. For example, a soft blanket can suddenly feel abrasive. Still, people- especially children- with SPD typically seek out social interactions for sensory input until they become overwhelming. Those with ASD are more likely to avoid it.

3. Antisocial Personality Disorder (ASPD)

People with ASPD generally disregard societal norms and other people’s feelings. They’re likely to lack empathy and manipulate others. While it may seem that people with ASD don’t care about other people’s feelings, that’s only due to their trouble with understanding social cues. In reality, if you have ASD, you may have a high level of empathy and feel people’s emotions deeply.

4. Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a neurodevelopmental disorder that can manifest as difficulty maintaining focus, hyperactivity, and impulsive behavior. While people with ADHD can disrupt social gatherings because of impulsivity, ASD can make them do that because of a lack of interest. Additionally, if you have ASD you’re more prone to fixate on single objects or activities for a prolonged period while ADHD makes you unable to focus on one thing.

5. Intellectual Disability (ID)

People with ID can have limitations in intellectual functioning and adaptive behaviors, making grasping new skills or concepts difficult. While ID usually impacts cognitive, social, and practical abilities, ASD affects communication and social interaction. “Two-thirds of people on the spectrum have average or above-average IQs,” Dr. Idehen says.

6. Speech Delay

Speech delay is a condition that affects verbal abilities and can cause delays in using words, forming sentences, or understanding spoken language. However, that doesn’t mean you’ll have trouble having a conversation as some people with ASD do. If you have ASD, you’ll likely understand spoken language easily but may still be non-verbal.

7. Selective Mutism

In selective mutism, people have an anxiety disorder that stops them from speaking in specific situations. This differs from ASD because those who are non-verbal aren’t bound by a particular scenario.

8. Cognitive Developmental Delay

Cognitive Developmental Delay refers to a slower-than-typical development in intellectual and adaptive abilities. “Cognitive delay can cause learning difficulties, communication problems, and difficulty playing with others. Kids may have difficulty with speech, attention, or focus, and later walking, crawling, or sitting,” Dr. Idehen says.

Depending on its severity or etiology the cognitive delay may not go away either. According to Dr. Idhen, one way to differentiate between cognitive delay and autism is the timing of onset symptoms. “Autistic kids can start showing signs by 12 to 18 months. Cognitive delay can be observed at various stages of life, including infancy,” Dr. Idehen adds.

Most people with cognitive delay often catch up to their peers eventually but ASD doesn’t go away with time.

9. Social Anxiety Disorder (SAD)

People with SAD tend to experience excessive anxiety in social situations. While its resulting social isolation is based on anxiety, isolation from ASD is centered around difficulty communicating and lacking social skills.

10. Reactive Attachment Disorder

Reactive Attachment Disorder is rare but the severe condition comes from unmet basic needs for comfort, affection, and nurturing from caregivers. ASD is a neurological and developmental disorder. While people with Reactive Attachment Disorder may resist comfort and support, those with ASD can have varying reactions to it.

How to Get the Right Diagnosis

In many cases, the symptoms of any condition may be noticed by those who spend the most time with the affected person. For example, teachers, parents, and caregivers may notice changes in children while a partner may notice issues with their loved one. The first place to start is a visit to your doctor for a thorough physical assessment. That will likely be followed by a psychiatric evaluation by a mental health professional, which will compare your symptoms to those that are characteristic of different conditions.

If you think the first diagnosis doesn’t fit, it’s a good idea to point out why. You may have other symptoms that don’t fit with the condition or the medication you’re taking isn’t making you better. Given that some doctors don’t take Black people’s issues seriously, you shouldn’t be afraid to seek a second opinion.

It’s hard enough for Black people to receive the ASD diagnosis they need without having several conditions that can muddy the water. To help you get the right diagnosis, it’s a good idea to know which symptoms can point to a condition that only looks like ASD.

Medically Reviewed By:

Joyce Idehen, MD

Joyce earned her Bachelor's in Nursing from Prairie View A&M before completing her medical degree at the American University of Antigua. She is the Social Media Manager for Black Girl White Coat, a nonprofit that mentors and motivates underrepresented minorities in medicine.