Autism Vs Down Syndrome – How to Tell These Disorders Apart

Is Autism the Same as Down Syndrome

Down syndrome and autism spectrum disorder (ASD) are two common developmental disabilities that affect a person’s intellectual abilities and social skills. While there are some similarities between the two conditions, there are also key differences that distinguish them. Understanding the differences between Down syndrome and autism is important for parents, caregivers, and medical professionals to ensure accurate diagnosis and appropriate treatment and support.

Comparing the two conditions highlights their unique characteristics. Down syndrome is a chromosomal disorder caused by an extra copy of chromosome 21, resulting in intellectual disability, distinct facial features, and other health issues. Autism is a complex neurological condition believed to be caused by abnormalities in brain development, characterized by challenges with social communication and restricted repetitive behaviors.

Both conditions share some traits like delayed development and difficulties with language and social interaction. However, the reasons underlying these traits and the ways they manifest can differ. Examining the differences in detail helps provide a more complete picture of each disorder. It also allows parents and doctors to better recognize the symptoms of each condition during diagnosis. Understanding both the similarities and distinctions is key to supporting those impacted by Down syndrome or autism.


Definition and Causes

Down syndrome and autism spectrum disorder (ASD) are both neurodevelopmental conditions that affect a person’s cognitive, communication, and behavioral abilities. However, they have distinct underlying causes and characteristics.

Down syndrome is caused by an extra copy of chromosome 21, resulting in three copies instead of the typical two. This chromosomal abnormality occurs randomly during cell division early in fetal development. The cause of the extra chromosome is usually unknown.

In contrast, the causes of autism spectrum disorder are complex and not fully understood. Autism is not linked to abnormalities of a specific chromosome. Rather, it likely involves a combination of genetic and environmental factors that influence early brain development. The exact genes and environmental contributors have not been pinpointed, though researchers are actively investigating risk factors.

So while Down syndrome has a clear genetic cause, autism has no single known cause. Both conditions lead to differences in brain structure and function that manifest in developmental disabilities. However, the origins of the neurological differences are quite distinct.


Physical Characteristics

Down syndrome is associated with distinct physical features that are not present in autism. Individuals with Down syndrome often have:

  • Almond-shaped eyes with folds on the inner corners
  • Flattened facial profile
  • Small head and ears
  • Short neck
  • Excess skin on the neck
  • Small nose with flattened nasal bridge
  • Small mouth with protruding tongue
  • Short, broad hands with short fingers
  • Short height
  • Low muscle tone

In contrast, autism has no distinct physical features. Autistic individuals have a wide range of physical attributes and appearances. While some autistic people may exhibit minor physical irregularities, these are not consistently associated with autism. Overall, there are no facial features, body builds, or other physical traits that can reliably distinguish someone with autism. The diagnosis is based on behavioral symptoms rather than physical ones.

Aspect Down Syndrome Autism Spectrum Disorder (ASD)
Definition & Causes Chromosomal disorder (extra copy of chromosome 21) Complex neurological condition (unknown single cause)
Physical Characteristics Distinct facial features, low muscle tone, short stature No distinct physical features associated with autism
Intellectual Disabilities Universal, ranging from mild to moderate, consistent profile Broad spectrum, ranging from average to severe, with high variability
Language Abilities Delayed development, smaller vocabulary, simpler sentences Varied, ranging from delayed speech to nonverbal
Social Skills Sociable and friendly, motivated by social interactions Challenges with social communication and interaction
Repetitive Behaviors Not core symptoms but may include repetitive movements Core diagnostic features, includes repetitive and restrictive behaviors
Treatment Physical therapy, speech therapy, early intervention Behavioral therapies, speech therapy, medications, social skills training
Life Expectancy Increased in recent decades, around 60 years Typical life expectancy, is slightly reduced compared to the general population


Intellectual Disabilities

Down syndrome and autism spectrum disorder both involve intellectual disabilities, but there are key differences in the range and severity.

In Down syndrome, intellectual disability is universal – all individuals have some degree of impairment ranging from mild to moderate. The IQ range is typically between 40-70. There is a consistent profile involving verbal scores lower than nonverbal scores.

In contrast, autism represents a broad spectrum. Some individuals with autism have average or above-average intelligence, while others have mild, moderate, or severe intellectual disability. Around 30-50% of people with autism have an intellectual disability. There is significant variability in the profile of strengths and weaknesses. While some have stronger nonverbal skills, others excel in verbal domains or have evenly developed abilities across areas.

Overall, the intellectual disability of Down syndrome is more homogeneous compared to the spectrum seen in autism. However, there can be overlaps in the degree of impairment, with both conditions involving individuals with mild intellectual disabilities. The distinguishing factor is the consistent intellectual profile in Down syndrome versus the greater heterogeneity in autistic profiles.


Language Abilities

Individuals with Down syndrome often experience delayed language development. They tend to have a smaller vocabulary and speak in shorter, simpler sentences compared to typically developing children. Expressive language skills like speaking tend to be weaker than receptive skills like understanding speech.

Many children with autism experience challenges with communication and language. They may have delayed speech acquisition or be nonverbal. Even those who develop language tend to have abnormalities like echolalia, which is repeating words or phrases. Their speech may have an unusual rhythm, tone, or pitch. Autistic children often have trouble using and understanding nonverbal communication like gestures, facial expressions, and tone of voice.

The key difference is that language delays in Down syndrome are primarily due to intellectual disability. Autistic children often have verbal language challenges even if they have average or high intelligence. Their language deficits are rooted in the social-communication challenges that are central to autism spectrum disorder.


Social Skills

Children with Down syndrome are often very sociable and friendly. They tend to be highly motivated by social interactions and relationships. Many children with Down syndrome have outgoing, affectionate personalities and get along well with peers. Adults with Down syndrome also tend to be warm, cheerful, and interested in spending time with others.

In contrast, social skills are a core challenge associated with autism spectrum disorder. Children with autism have difficulties with social communication and interaction. They struggle to engage in back-and-forth conversation, make eye contact, read social cues, understand others’ perspectives, and relate to peers. Many children with autism prefer to play alone and avoid social situations. Adults with autism also tend to have limited social connections and difficulty navigating social norms.

While Down syndrome is characterized by sociable personalities, autism presents challenges like social awkwardness, isolation, and difficulty building relationships. However, social skills training can help children with autism improve their communication, interaction, and ability to relate to others.


Repetitive Behaviors

Repetitive behaviors are common in both Down syndrome and autism spectrum disorder but manifest differently in each condition.

In Down syndrome, repetitive behaviors are not a core symptom of the disorder. However, some repetitive movements like hand flapping, clapping, rocking, or repeating words and phrases may occur. These are typically not disruptive and are considered “stimming” behaviors that provide comfort or sensory stimulation.

In contrast, repetitive and restrictive behaviors are a core diagnostic feature of autism spectrum disorder. These include repetitive body movements like hand flapping, rocking, or spinning, as well as compulsive adherence to specific routines and ritualized patterns of behavior. Repetitive behaviors in autism tend to be more frequent and disruptive and are thought to reflect challenges with behavioral control, anxiety, and sensory regulation.

Individuals with autism often develop specific intense interests in certain topics, objects, or activities that they focus on excessively. For example, obsessively lining up toys or watching the same video repeatedly. Down syndrome individuals do not exhibit this type of restrictive interest.


There are no cures for Down syndrome or autism spectrum disorder, but various therapies can help improve quality of life.

For Down syndrome, common treatments include:

Treatments for autism spectrum disorder include:

  • Behavioral therapies such as applied behavior analysis (ABA) to improve social, communication, and learning skills
  • Speech therapy and occupational therapy
  • Medications to manage associated symptoms like anxiety or hyperactivity
  • Social skills training and therapies to improve social interaction
  • Sensory integration therapy to help process sensory information

While these therapies can be very beneficial for both conditions, there are currently no medical treatments that can cure or fundamentally alter Down syndrome or autism spectrum disorder. Research continues to better understand these complex conditions and develop new therapeutic approaches. The key is starting interventions as early as possible to promote the best possible quality of life.


Life Expectancy

People with Down syndrome often have a shorter life expectancy compared to the general population. However, life expectancy has increased dramatically in recent decades thanks to improved health care and social inclusion. The average life expectancy is now around 60 years, whereas just a few decades ago it was only 25-30 years.

In contrast, most people with autism have a typical life expectancy. Autism is considered a lifelong developmental condition, not a terminal disease. With appropriate support and intervention, people with autism can live long, healthy, and fulfilling lives. Their life expectancy is not inherently impacted by autism unless they have additional health conditions. However, research does suggest that the average life expectancy for people with autism is slightly reduced compared to the general population, often due to factors like accidents, injury, epilepsy, and suicide. But with proper care, most will have normal longevity.

So while Down syndrome is associated with a reduced lifespan, autism itself does not inherently reduce life expectancy. The difference highlights the underlying distinction that Down syndrome is a chromosomal disorder while autism is a developmental disorder affecting communication and behavior. With improved inclusion, health care, understanding, and support, both groups are now living longer lives.



Down syndrome and autism spectrum disorder share some similarities but also have many key differences.

Both conditions involve developmental delays, intellectual disability, and challenges with communication skills. However, there are distinct differences in their origins, physical characteristics, severity, and types of symptoms.

Down syndrome is a genetic condition caused by an extra copy of chromosome 21, leading to distinct physical features and mild to moderate intellectual disability. Autism is a neurological developmental disorder with no known single cause, characterized by challenges with social skills, communication, and restricted/repetitive behaviors.

While autism is considered a spectrum disorder with a wide range of severity levels, Down syndrome has a more consistent presentation of symptoms. Both can present challenges with language and communication, but the specific difficulties differ – Down syndrome impacts speech articulation while autism more greatly affects social communication skills.

Though they share some overlapping traits, the two conditions have markedly different behavioral profiles. Autism involves more repetitive behaviors and sensory issues. While people with Down syndrome usually have mild to moderate intellectual disability, autism ranges from gifted to severely challenged.

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