OCD, Autism, and ADHD: How to Differentiate and Learn About the Overlap

Disclaimer & note on language:

For clarity, I use diagnostic terms like OCD and ADHD, and “Autistic” or “Autism.” References to ASD or Autism Spectrum Disorder are direct quotes or sources and do not mean that we endorse deficit-based framing. This content is educational, not diagnostic or therapeutic.

The Venn Diagram, and some of the information contained in this post has been adapted from Neff, 2022. 

---

This post provides an overview of the common traits and key differences between these conditions. For a deeper dive into practical strategies, real-world examples, and professional insights, I’ll be exploring these topics in my upcoming presentation at the MN OCD Conference.

Key Differences in Brief

OCD

• Driven by fear or anxiety (ego-dystonic)

• Repetitive behaviors aim to reduce distress or prevent feared outcomes

• Examples: mental reviewing, checking, cleaning, silent rituals

Coaching reflection prompt:

Think of a behavior you repeat. Is it fear-driven? How could understanding the motivation change how you respond?

Training/consulting takeaway:

Teach therapy participants, staff, or teams to identify fear-driven patterns versus other motivations to prevent misinterpretation.

ADHD

• Driven by attention, energy, or motivation (ego-syntonic)

• Traits: distractibility, hyperfocus, impulsivity, executive functioning differences

Coaching reflection prompt:

Notice when attention shifts or hyperfocus occurs. How does energy or motivation influence your behavior?

Training/consulting takeaway:

Create strategies that leverage strengths (hyperfocus, creativity) and address challenges (task initiation, organization).

Autism

• Driven by regulation, sensory needs, or interest-based engagement

• Traits: routines, pattern-focused thinking, sensory differences, strong interests

Coaching reflection prompt:

Identify a routine or interest that helps you feel steady. How could you build on this for daily regulation?

Training/consulting takeaway:

Support therapy participants, students, or staff by respecting routines and sensory preferences while introducing flexibility strategically.

Where OCD, ADHD, and Autism Overlap

• Repetitive behaviors, executive functioning differences, sensory sensitivities, anxiety, perfectionism

• The motivation matters most: fear, regulation, or attention/energy

Example:

• Hand-washing → OCD: fear of contamination

• Hand-washing → Autism: sensory comfort

• Hand-washing → ADHD: distracted and restarting task

Activity:

Map behaviors you notice (your own or in therapy participants) to the underlying motivation. Discuss insights or journal reflections.

Co-Occurrence

• OCD and autistic traits often co-exist (Meier et al., 2015; Wikramanayake et al., 2018)

• Up to 30% of people with OCD also meet criteria for ADHD (Meier et al., 2015)

Coaching takeaway:

Recognize overlap in yourself — it’s normal and not a flaw.

Professional training/consulting takeaway:

Awareness of co-occurrence prevents misdiagnosis and improves support strategies.

Why Understanding Motivation Matters

Instead of labeling behaviors superficially:

• Fear/anxiety? → points towards OCD

• Self-regulation or interest? → points towards Autism

• Attention/energy-driven? → points towards ADHD

Application:

Motivation guides intervention, accommodation, and strategy — for yourself, clients, or teams.

Supporting Neurodivergent Brains

Coaching:

• Identify personal patterns and strengths

• Develop personalized strategies for regulation, focus, and executive functioning

• Build self-understanding and autonomy

Professional training/consulting:

• Teach strategies for recognizing motivation behind behaviors

• Adapt coaching, therapy, or team interventions

• Use frameworks to support diverse neurotypes

Interactive Venn Diagram Exercise

For yourself, or with your therapy participants, you can create your own personalized venn diagrams.

Instructions:

1. Similar to the graphic above, draw three circles on a paper, one to the left, one to the right and one below - with all three overlapping

2. Write the title "OCD, Autism, and ADHD — How to Differentiate"

3. In the left circle write: "OCD: Fear-driven, reduces anxiety"

4. In the right circle write: "Autism: Self-regulating, comforting, pattern-based"

5. In the bottom circle write: "ADHD: Attention- or energy-driven, interest-based"

6. In the over lap right "overlap: Repetition, routines, sensory differences, emotional intensity"

7. Place observed behaviors (self or therapy participants) in the appropriate circle. Identify overlaps and discuss strategies for support.

Want more?

In my upcoming presentation, I’ll be discussing:

• How to tell the difference between overlapping traits

• Real-world examples of misinterpretation, and

• Practical, affirming ways to adapt therapy and daily supports

If you’d like to attend head here to get your ticket!

For individuals seeking coaching:

Explore 1:1 coaching at The Divergent Grove (un)Learning Collaborative. Develop personalized strategies, understand your patterns, and leverage your strengths.

For professionals (training or consulting):

Request a consultation with me, or a training for you and/or your staff or to learn frameworks for supporting neurodivergent clients, students, or teams. Apply evidence-based, and neurodivergent-affirming strategies for ADHD, OCD, and Autism overlap in your professional practice.