Flow and Similar Attentional States in Autism and ADHD: A Scoping Review of Similarities and Differences.

Flow is a state of optimal engagement. Autistic individuals and individuals with attention-deficit/hyperactivity disorder (ADHD) might have variations in flow-like experiences, such as hyperfocus, autistic inertia, and monotropism, that diverge from traditional or typical definitions. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically reviewed 43 publications, including empirical studies, reviews, and other literature, to examine these constructs. Results showed that attentional experiences associated with neurodivergence overlap with, but also differ notably from, typical flow. Autistic inertia hinders task initiation and transitions, in contrast to flow's seamless engagement. Monotropism involves rigid, directed focus and repetitive, tenacious engagement, whereas flow allows for flexible adaptations to challenges. Hyperfocus is like flow regarding intense concentration and immersion but is often involuntary, lacks clear goals, and is associated with emotional dysregulation. Although commonalities exist across these attentional experiences, the greatest overlap occurs within autistic inertia, monotropism, and hyperfocus. Attention in autistic and ADHD individuals might be more dynamic than previously believed, with potential for transitions between these experiences. This fluidity can enhance focus and productivity but may also lead to negative outcomes, such as overly rigid fixation or difficulty engaging with and disengaging from tasks. Clarifying these differences and overlaps can inform tailored interventions and supports, helping neurodivergent individuals manage focus, reduce task-related stress, and optimize productivity.