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  • Writer's pictureDr. Amanda Neal

Autism, OCD, & ADHD - A diagnostic guide in adolescence (Part 3)

teenager with autism

Today we're talking about Obsessive-Compulsive Disorder (OCD)!

OCD is characterized by the presence of obsessions (intrusive, distressing thoughts) and compulsions (repetitive behaviors or mental acts). In adolescents, OCD is diagnosed when these symptoms significantly interfere with daily functioning.

Specific diagnostic criteria include:

  • Obsessions: Adolescents with OCD experience intrusive, unwanted, and distressing thoughts that cause anxiety or discomfort. Common obsessions include fears of contamination, harming others, or catastrophic events.

  • Compulsions: To alleviate the distress caused by obsessions, individuals with OCD engage in repetitive behaviors or mental acts, such as excessive hand washing, checking, or counting.

  • Time Consuming: OCD rituals can be time-consuming, often taking up more than an hour per day. Adolescents may struggle to concentrate on other tasks due to the demands of OCD.

Differences from Autism:

Nature of Repetitive Behaviors:

While both ASD and OCD may involve repetitive behaviors, the nature of these behaviors differs. In ASD, repetitive behaviors often include stimming, such as hand-flapping or rocking. In OCD, repetitive behaviors are driven by specific obsessions, such as counting to alleviate a fear of harm.

Similarities between OCD, ADHD, & ASD:

  • Anxiety: Adolescents with ADHD may experience high levels of anxiety, especially in response to academic or social pressures, which can resemble the anxiety seen in those with OCD.

  • Difficulty with Attention and Focus: Individuals with both ADHD and ASD may experience social difficulties, but the nature of these challenges is different. In ADHD, social difficulties often stem from impulsivity, inattention, or hyperactivity. In ASD, challenges are more related to deficits in social communication, understanding social cues, and forming relationships.

Diagnosing neurodevelopmental and psychiatric disorders in adolescents, such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), and Obsessive-Compulsive Disorder (OCD), is a complex and nuanced process.

Each condition has distinct diagnostic criteria, but they can also exhibit overlapping features, making differential diagnosis crucial. Identifying the key differences and similarities among these disorders is essential for accurate assessment and effective treatment planning. Early identification and intervention can significantly improve outcomes and quality of life for adolescents with these conditions.


Dr. Amanda Neal
Dr. Amanda Neal

Dr. Amanda Neal, Psy.D. is a postdoctoral clinical psychologist who provides psychotherapy and testing for adolescents, adults, and parents in Pleasantville and virtually in New York State. She specializes in the assessment and treatment of Autism Spectrum Disorders, Attention Deficit Disorders, Obsessive Compulsive DIsorder, and Anxiety Spectrum Disorders.

Learn more about Dr. Neal at

(914) 488-4343


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