Overlap Between the Fetal Alcohol Spectrum Disorder (FASD) and Attention Deficit Hyperactivity Disorder (ADHD)

Abstract: Background: Fetal alcohol spectrum disorders (FASD) and attention-deficit/hyperactivity disorder (ADHD) present overlapping cognitive and behavioral characteristics, leading to challenges in differential diagnosis. Existing literature indicates a high rate of comorbidity but also points to distinct neurodevelopmental profiles. Methods: We comprehensively review the current literature to delineate the similarities and differences between FASD and ADHD. Specifically, we focus on studies that investigate the cognitive and behavioral measures commonly utilized in the diagnostic processes of these conditions. In addition, we present a case study to illustrate how these similarities and differences are reflected in clinical assessment and diagnosis. Results: The literature review highlights overlapping symptoms such as impulsivity and inattention, while identifying unique markers, particularly in executive functioning, adaptive behavior, and prenatal history. The case study demonstrates how these features complicate clinical decision-making, especially in the absence of confirmed prenatal alcohol exposure. Discussion: The findings underscore the diagnostic complexity posed by the overlap of FASD and ADHD symptoms. We consider it essential to address these challenges for accurate diagnosis and developing targeted, effective intervention strategies.