Labels like Autism (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) can help us identify areas of behaviour that require support, but they could also be limiting.

For some people, they might not fit either condition, exactly.

Yet, there’s something clearly not right – both cognitively and behaviourally.

Perhaps you’ve wondered why you’re both able to focus deeply, but also become easily distracted – socially awkward yet crave connection?

If this sounds like you, it could be you’re experiencing both autism and ADHD, which has begun to be referred to by some as ‘AuDHD.’

This term recognises individuals who have traits of both ASD and ADHD

Defining AuDHD?

While AuDHD is not an official medical diagnosis, it serves as a useful shorthand for recognising the similarities and overlap between the two conditions, as well as how often they can co-occur. This makes it easier for individuals to better advocate for their more complex needs and gain the support they require.

Autism spectrum disorder and ADHD are both neurodevelopmental disorders that impact an individual’s behaviour, communication and social interactions. However, they remain distinct diagnoses with differing diagnostic criteria.

Autism is most often characterised by difficulties in social communication and interaction along with restricted and repetitive behaviours or interests. In contrast, ADHD is most often defined by inattention, hyperactivity and impulsivity that disrupt functioning.

Despite them being separate conditions, there is a historic pattern of co-occurrence between ASD and ADHD, with some studies suggesting that 30-80% of individuals with ASD also meet the criteria for ADHD. In the past, this overlap created confusion concerning how to attribute certain symptoms. It was seen as one or the other. Not both.

The Significance of the Term “AuDHD”

Prior to 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) did not allow for the simultaneous diagnosis of both conditions. This led to potential misdiagnoses, where individuals were only recognised as having either autism or ADHD, despite exhibiting symptoms of both.

This lack of acceptance can leave individuals feeling marginalised and unable to find either solidarity through shared experiences, or validation through an official diagnosis, which would lead to a pathway for treatment allowing them to lead higher-functioning lives.

And so, as the needs of the individual aren’t being met, this can lead to further complications, such as increased distress and emotional dysregulation, anxiety and depression through, not being understood and being labelled as “wrong.” When, in actuality, the complexity of their mental health isn’t being fully understood.

Signs and Symptoms of AuDHD

Differentiating AuDHD from ASD & ADHD

Since the confusion between AuDHD, ASD, and ADHD is rooted in the overlap between symptoms, let’s explore what each of these individual conditions looks like and how they can contrast with one another.

Autism Spectrum Disorder (ASD):

• Persistent deficits in social communication and interaction across multiple contexts
• Restricted, repetitive patterns of behaviour, interests, or activities
• Symptoms present from early childhood and impair everyday functioning
• May have difficulty understanding and responding to social cues
• Often have intense, highly focused interests
• May experience sensory processing differences

Attention-Deficit/Hyperactivity Disorder (ADHD):

• Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
• Symptoms may include difficulty sustaining attention, distractibility, forgetfulness, fidgeting, excessive talking, and impulsive behaviours
• Often struggle with organisation, time management, and task completion
• May have difficulty regulating emotions and may experience mood swings
• Symptoms can vary depending on the subtype (inattentive, hyperactive-impulsive, or combined)

AuDHD (Co-occurring ASD and ADHD):

• Exhibits a combination of traits from both ASD and ADHD
• May have more social motivation than individuals with ASD alone, but still struggle with social interactions due to ADHD-related impulsivity or inattention
• May have intense special interests similar to those in ASD, but also have difficulty sustaining focus on less engaging tasks due to ADHD
• Can experience more severe sensory overload due to a combination of autistic sensitivities and ADHD-related hyperactivity
• Often faces more significant executive functioning challenges compared to individuals with either ASD or ADHD alone
• May require tailored support and interventions that address the unique interplay of ASD and ADHD symptoms

The Unique Challenges of Living with AuDHD

We’re going to explore some of the unique challenges that someone with ADHD might face. However, it’s important to highlight there are many different ways in which ADHD can present.

If we reference Dr Amen’s 7 types of ADHD, how ADHD presents can become a little more complex than simply the 3 commonly accepted types by the DSM-5.

(You can check out the article linked that will give you a full breakdown of these types.)

AuDHD in the Workplace: Challenges & Strategies

Here are some accommodations that could be beneficial for an individual with autism, which might not be as useful for someone dealing with ADHD:

• • Providing a quiet, private workspace: This could be helpful, for individuals with autism who are sensitive to sensory inputs and get easily distracted by noise or visual mess. Yet for people dealing with ADHD, being alone without structure and accountability could result in reduced drive and responsibility.
  • Allowing the use of noise-cancelling headphones: Allowing the use of noise-cancelling headphones can be beneficial for autistic employees to block out distracting sounds. However, individuals with ADHD may find wearing headphones or struggle with internal impulsive distractions and restlessness.
  • Providing detailed, written instructions and agendas: Giving written instructions and agendas would be a great support strategy for autistic employees who prefer clear communication over ambiguity. On the other hand, those with ADHD might feel overwhelmed by lengthy written documents and could benefit more from concise bullet point lists or visual aids.
  • Establishing a consistent routine and schedule: Establishing routines for autistic employees who thrive on predictability and structure can be incredibly supportive. However, individuals with ADHD may require flexibility and variety to maintain interest and motivation as rigid schedules can feel confining to them.
  • Providing advance notice of changes: Autistic individuals often struggle with unexpected changes and may need time to mentally prepare. However, employees with ADHD may adapt quickly to changes and even thrive on spontaneity and novelty.

It’s important to mention all of these support strategies in contrast, as someone who identifies with AuDHD or is co-presenting with both ADHD and ASD may oscillate between needing support in both of the areas mentioned, depending on their needs on any given day.

However, as these are both spectrum-based conditions, the support required will vary from person to person.

AuDHD & Relationships: Navigating Difficulties

For those with co-occurring ADHD and ASD, the presence of two different symptom sets from these conditions can make forming and maintaining Interpersonal connections a significant challenge.

Some difficulties that may be faced include capacity for reciprocal conversation, impulsivity, sensory overload and emotional dysregulation.

AuDHD in Communication:

• Those with AuDHD may struggle with back-and-forth conversation, often talking excessively or interrupting others due to impulsivity associated with ADHD, while also having difficulty interpreting nonverbal cues and using repetitive or robotic language, which is more characteristic of ASD.
• Sensory sensitivities related to ASD can lead to distraction or distress in social situations, further impacting communication.

Real-World Example of AuDHD in Communication:

During a work meeting, Sarah was in discussion with her colleagues about an ongoing project. She often found herself interjecting to express her thoughts a little too enthusiastically. Sarah tended to speak rapidly, veering off topic and sometimes missed her colleagues’ subtle signals, indicating they had something to add. The bright lighting and ambient noise in the room added to Sarah’s challenge of staying fully engaged in the conversation.

AuDHD in Social Interactions:

• Individuals with AuDHD may have a combination of social challenges, such as difficulty reading social cues (ASD) and impulsive behaviours that upset peers (ADHD)
• While those with ADHD alone often have a higher motivation for social interaction, the presence of ASD traits can lead to reduced social motivation and increased difficulty navigating social situations
• Co-occurring AuDHD can lead to greater social impairments than either condition alone, affecting the ability to form and maintain friendships

Real-World Example of AuDHD in Social Interactions:

John, a college student, spends time with his friends after studying. Although he tries to engage with them with the best of his authenticity, he has difficulty keeping up with the conversation and sometimes interjects with abrupt, irrelevant comments. When one of his classmates shares an anecdote, John misses the cue and replies with an ill-timed joke, leading to an uncomfortable silence and leaving him feeling isolated from the rest of the group.

AuDHD in Conflict Resolution:

• Impulsivity and emotional dysregulation associated with ADHD can lead to increased interpersonal conflicts.
• Difficulty with perspective-taking and understanding others’ emotions, which are more characteristic of ASD, can make resolving conflicts challenging.
• Rigid thinking patterns and difficulty adapting to change, often seen in ASD, may further complicate conflict resolution.

Real-World Example of AuDHD in Conflict Resolution:

Lisa finds herself in an argument with her partner about the household chores. Feeling frustrated and overwhelmed, she impulsively blurts out hurtful comments without taking her partner’s feelings into account. As her partner tries to share their side of the story, Lisa finds it challenging to empathise and remains stuck in her own perspective. Her rigid style of thinking hinders compromise, leading to an escalation of the conflict with both of them both feeling unheard.

Seeking an AuDHD Diagnosis

While the information in this article can be useful in helping you determine whether you might require an assessment for co-occurring ASD and ADHD, self-assessment does not qualify as a clinical assessment.

As both ASD and ADHD are complex neurological conditions, they cannot both be accurately explained in a single blog post in a way that speaks to every individual’s unique neurodivergence and the support you may require.

If you suspect either yourself or someone close to you may have ADHD, you would be best served by seeking support through a proper clinical assessment. However, it’s important to note that there is no single, definitive “AuDHD test.”

Instead, the diagnostic process typically involves a comprehensive evaluation by professionals who are knowledgeable about both ASD and ADHD.

Why a Comprehensive Assessment Matters

If you choose to seek a diagnosis, it’s important to find professionals who have long-standing working experience in the field with individuals who have both ASD and ADHD.

The professionals you may wish to seek out would include psychologists, psychiatrists, neurologists, or other medical professionals who specialise in neurodevelopmental conditions.

These experts will be best equipped to recognise the unique presentation of AuDHD and provide an accurate diagnosis through a comprehensive evaluation.

The diagnostic process may involve a combination of methods, such as:

Clinical interviews:

Clinical interviews may be structured or semi-structured, depending on the needs of an individual, which may also include their family members to help gather information about developmental history, current symptoms and level of capacity. There are interviews specifically designed to assess ASD and ADHD such as the Autism Diagnostic Interview-Revised (ADI-R) and the ADHD in Adults (DIVA), which can both be useful in identifying AuDHD.

Behavioural observations:

Clinicians may observe the individual’s behaviour in various settings, such as during an office visit or in a classroom to assess for signs of ASD and ADHD. Standardised observation tools, like the Autism Diagnostic Observation Schedule (ADOS) and the Classroom Observation of Student Behavior (COSB), can help identify behaviours characteristic of AuDHD.

Psychological and neuropsychological assessments:

There are a wide range of tests that can be used to evaluate skills, decision-making abilities, interpersonal interactions and emotional control. Assessments like the Wechsler Intelligence Scale for Children (WISC) or Adults (WAIS) the Delis-Kaplan Executive Function System (D-KEFS) and the Social Responsiveness Scale (SRS) can offer insights into a person’s particular strengths and challenges with AuDHD.

Medical examinations:

There might also be the need for physical examinations such as neurological assessments, and other laboratory tests that can help rule out overlapping symptoms with other conditions such as thyroid disorders, sleep disorders and other genetic conditions. This route can also help identify the need for further assessment for other co-occurring conditions like anxiety or depression, which are common in individuals with AuDHD.

Rating scales and questionnaires:

There is also a set of standardised rating scales and questionnaires that might be used such as the Conners’ Rating Scales for ADHD and the Autism Spectrum Quotient (AQ), which may be completed by the individual, family members, and teachers to help provide any over contextual information about symptoms and general functioning within various settings

Self-Acceptance & Empowerment with AuDHD

Due to the nature of how AuDHD is often overlooked or misdiagnosed, leading to a lack of awareness around one’s condition and therefore a lack of social acceptance, it can result in poor self-image which can result in self-judgement and harsh self-criticism.

This lack of self-acceptance can create a complex in which one feels unlovable because they’re always getting things ‘wrong.’

Even though medical diagnosis can be their own form of limitation, they can also be extremely liberating in that they allow for a greater understanding of ‘why’ you engage in certain behaviours and that you’re not actually a bad person, you’re actually just wired differently.

Quite literally, wired differently, neurologically. Neurodivergent.

Acknowledging the way that you act through the lens of a psychological diagnosis can help relieve some of that shame. It can be the beginning of the self-acceptance process.

Because self-acceptance is a process that does take time and patience.

One which involves challenging the negative self-talk, that has been created due to unsupportive relationships. Or, those in which there wasn’t a full understanding of your needs.

The big takeaway here is that when you accept yourself, you accept your needs, which then allows you to advocate for them and yourself in a more confident and empowered way.