Autism Behavior or Mental Health Symptom?

Children with autism can display symptoms that mirror those of other disorders, including ADHD and anxiety. Here, two experts from Harbor Oaks Hospital offer insight on the overlap.

The nonverbal child. The student who refuses to sit down during class story time. The kid who struggles to interact with peers on the playground.

Each child on the autism spectrum presents differently. And while cases vary in severity, one thing is common among most children on the spectrum: their symptoms overlap with those of other mental and behavioral disorders.

“More than 90 percent of children with autism have at least one co-occuring disorder,” says Dr. Sanjeev Venkataraman, the medical director of child and adolescent psychiatry at Harbor Oaks Hospital, which is located in New Baltimore and offers comprehensive inpatient treatment programs for ages 4-17. “You have to be more on the alert for any other co-occurring illnesses,” he adds.

Overlapping diagnoses

Attention deficit hyperactivity disorder, also known as ADHD, is the No. 1 co-occurring disorder – impacting an estimated 30 to 60 percent of those with autism, according to Autism Speaks. Anxiety comes in second, impacting up to 42 percent of individuals with autism.

“We look at the characteristics of autism and one of the big ones is restricted or repetitive behaviors, so some people say that this child with an autism diagnosis is obsessive or engaging in OCD-type behaviors and anxiety seems to be a close second,” says Melissa Cottengim, a board certified behavior analyst, who provides behavior analytic services to patients at Harbor Oaks Hospital.

In these cases, it’s important to look at the child’s behavior and the pattern of behavior in order to weed out whether they are autistic or suffering from another disorder.

Here, both experts offer insight on assessing your child’s symptoms and getting the best care for him or her to thrive.

Early diagnosis

Early identification is key to helping children with autism, Dr. Venkataraman says.

“I think that it’s very important to diagnose autism early because nowadays once you get diagnosed with autism, a lot of services come with that,” he adds. These services include ABA therapy, speech and language services and Head Start programs, which can greatly benefit a child with autism.

While a lack of interaction and language skills are common signs of autism, not every child shows these signs.

“I think the kids that get missed are the more higher functioning or more average kids who have language skills and then they go to school and they have problems relating to other kids, getting into arguments and fights and being very rigid,” he says.

Parents might then get a call from their child’s teacher regarding defiant or hyperactive behavior – but they could be signs of something more.

Plan of action

A conversation with your child’s doctor is the first step in your child’s treatment. In some cases, parents can work with a developmental pediatrician.

“They are much more informed and willing to look at these things and they can then guide you from there on out,” Dr. Venkataraman says.

An individualized approach to care is imperative.

“I think a comprehensive team is really the best and most preferred because these kids are very complex,” Cottengim says. “Usually it’s not just one diagnosis or one need alone” that these children have.

In order to treat the individual person, all aspects of his or her life – including behavioral and emotional needs – must be taken into consideration. Harbor Oaks Hospital uses a multidisciplinary approach to develop an individualized plan for each child.

Parents play an important role in assessing their child’s behavior and providing notes to the therapy team, particularly if their child is nonverbal.

While it can be difficult to cope with an autism diagnosis, don’t lose hope.

“The diagnosis isn’t a death sentence,” Cottengim says. “Once you have that label, it offers up services and support.”

Harbor Oaks is located at 35031 23 Mile Road in New Baltimore. For more information, call 866-258-3079 or visit


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