Autism and ADHD

For many people, a neurodevelopmental diagnosis is not a single, neat label. The human brain is complex, and it is very common for the traits of different neurodevelopmental conditions to exist alongside each other. One of the most frequent of these overlaps is between Autism Spectrum Condition (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD).

It is increasingly recognised that a person can be both autistic and have ADHD. This dual diagnosis, sometimes referred to as AuDHD, presents a unique profile of strengths and challenges. This article, aimed at people with co-occurring autism and ADHD, their families, and professionals, aims to provide clarity on this common overlap, exploring the characteristics of both conditions and strategies for effective support.

A Brief Overview of Autism and ADHD

Before exploring the overlap, it is helpful to briefly understand each condition on its own:

• Autism Spectrum Condition (ASC) is a lifelong neurodevelopmental condition that affects how a person communicates and relates to other people, and how they experience the world around them. It is characterised by differences in social communication and interaction, and by restricted and repetitive patterns of behaviour, interests, or activities, as well as sensory sensitivities.

• Attention-Deficit/Hyperactivity Disorder (ADHD) is also a neurodevelopmental condition. It is typically characterised by a persistent pattern of inattention, hyperactivity, and impulsivity that is more frequent and severe than is typically observed in people at a comparable level of development.

The Overlap: Where Autism and ADHD Meet

So why are these two distinct conditions so often found together? It is thought that both share some underlying genetic and neurological factors. This can lead to an overlap in traits and behaviours that can sometimes make it difficult to tell them apart. Common areas of overlap include:

• Executive Function Challenges

  Both autistic people and people with ADHD can experience significant challenges with executive functions-the brain's "management system". This can include difficulties with planning, organisation, time management, working memory, and initiating tasks.

• Attention Regulation

  Both conditions can affect attention, but in different ways that can look similar on the surface. An autistic person may have an "intense focus" on their special interests, while a person with ADHD may experience "hyperfocus" on a novel and stimulating task. Conversely, an autistic person might be easily distracted by sensory stimuli in their environment, which can present like the inattention seen in ADHD.

• Social Challenges

  People with either condition can find social interactions difficult. They may struggle to follow conversations or may miss social cues, leading to difficulties in forming and maintaining relationships.

• Fidgeting and Restlessness

  The need for movement in a person with hyperactive-type ADHD can look very similar to the self-regulating repetitive movements (stimming) used by an autistic person.

Key Differences: Unpacking the Nuances

Despite the overlaps, there are key differences in the underlying reasons for some of these behaviours. Understanding these nuances is crucial for accurate diagnosis and support.

• Social Difficulties in Autism

  Social challenges often stem from a difficulty in intuitively understanding unwritten social rules and interpreting non-verbal communication like body language or tone of voice.

• Social Difficulties in ADHD

  Social difficulties can often be a result of executive function challenges. For example, a person with ADHD might interrupt conversations impulsively or miss parts of a conversation due to inattention, not because they do not understand the social rules.

• Response to Routine in Autism

  Autistic people often thrive on predictability and can find unexpected changes to their routine deeply distressing. A consistent routine provides a sense of safety and reduces anxiety.

• Response to Routine in ADHD

  The relationship with routine can be more complex. While structure can be very helpful for managing ADHD challenges, the ADHD brain often craves novelty and can become easily bored with repetitive tasks, making it difficult to stick to a rigid routine.

• Focus and Attention in Autism

  The intense focus associated with autism is typically directed towards a person's long-term, specific special interests. They can immerse themselves in this topic for hours with great passion.

• Focus and Attention in ADHD

  Hyperfocus is also interest-driven, but the interests themselves may change more frequently. A core challenge of ADHD is difficulty sustaining attention on tasks that are not novel or inherently interesting.

Living with AuDHD: The Experience of Both

What is it like to experience the world with both autistic and ADHD traits? People with this dual diagnosis often describe a feeling of being in a constant internal "push-and-pull".

• The autistic need for a predictable, consistent routine can be in direct conflict with the ADHD brain's need for novelty and stimulation.

• The autistic need for a calm, low-sensory environment can clash with the ADHD need for movement and external stimulation to maintain focus.

• A person might struggle with social anxiety because they do not understand the social rules (autism), while at the same time finding it hard not to interrupt others impulsively (ADHD).

This internal conflict can be incredibly confusing and exhausting, and it highlights why a one-size-fits-all approach to support will not work.

Strategies for Support: A Combined Approach

Supporting a person with both autism and ADHD requires a flexible and integrated approach that respects both sets of needs.

• Create Structure with Flexibility

  Build routines that provide a predictable framework for the day (supporting the autistic need for structure), but ensure there is built-in choice, novelty, and flexibility within those routines (supporting the ADHD need for stimulation).

• Holistic Executive Function Support

  Use tools like visual planners, checklists, and timers, which are beneficial for both conditions. Breaking tasks down into small, clear steps can help with both task initiation (an ADHD challenge) and reducing the feeling of being overwhelmed (an autistic challenge).

• Meeting Sensory and Movement Needs

  Recognise that a person may need both a quiet space to retreat to when sensorily overwhelmed (autistic need) and opportunities for movement breaks to regulate their attention and energy (ADHD need). Fidget tools can be helpful for both.

Embracing the Whole Profile

Understanding the interplay between autism and ADHD is essential for providing effective support. It is not about treating two separate conditions, but about understanding a single, complex neurotype with a unique set of needs.

By using integrated strategies that honour both the autistic need for predictability and the ADHD need for stimulation, you can help autistic people manage their challenges, harness their strengths, and build a life that works for them.