What does autism and ADHD together look like?

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are separate neurodevelopmental conditions, yet they frequently co-occur at remarkably high rates. This overlap can make accurate diagnosis challenging, but proper identification is crucial for tailoring care and support to meet the unique needs of individuals with both conditions.

The Relationship Between Autism and ADHD

ASD and ADHD share several overlapping characteristics including difficulties with sustained attention, distractibility, impulsivity, executive functioning deficits, social communication challenges, and emotional dysregulation. However, there are also distinct differences - ASD is primarily characterized by restricted interests, repetitive behaviors (stimming), and nonverbal communication issues, while ADHD's core symptoms revolve more around hyperactivity, impulsivity and regulating emotions.

Research shows that around 30-50% of individuals with ASD also meet criteria for ADHD, while 20-50% of those with ADHD are also on the autism spectrum.1,2 Although the conditions are separate neurodevelopmental disorders, their symptom overlap means many individuals meet the diagnostic criteria for both.

Diagnosing Co-Occurring ASD and ADHD

Accurately diagnosing either ASD or ADHD alone when they co-exist can be complicated due to the conditions' similarities. A 2013 study found that individuals with co-occurring ASD and ADHD exhibited greater socio-communicative deficits and repetitive behavior than those with ADHD alone.

Some key differentiators:

• Those with ASD typically show developmental delays from a very young age, whereas those with just ADHD often have typical development prior to symptoms.4
• Highly restricted interests and repetitive behaviors are more unique to ASD.
• Severe hyperactivity and impulsivity levels beyond that seen in ASD point towards ADHD.

A comprehensive multi-disciplinary evaluation by clinicians experienced in both conditions is necessary to accurately differentiate and diagnose the potential co-occurrence.

Managing Co-Occurring Conditions

Having both ASD and ADHD can create significant lifelong challenges across multiple domains. However, research shows utilizing appropriate interventions and supports leads to improved outcomes.5 Recommended strategies include:

1. Establishing predictable routines and structure to provide environmental supports.
2. Using planners, checklists, calendars and technology to aid executive functioning.
3. Breaking larger tasks into manageable steps to reduce feelings of overwhelm.
4. Building in opportunities for special interests, calming activities and sensory breaks.
5. Seeking evidence-based treatments like cognitive behavioral therapy and medication.
6. Ensuring appropriate educational accommodations and supports through an IEP/504 plan.

A 2018 study found psychosocial interventions like cognitive behavior therapy and parent behavior management training improved ADHD and ASD symptoms in youth with both conditions.6

With proper identification, personalized evidence-based treatments and supports tailored to their specific needs, individuals with co-occurring ASD and ADHD can find great success. Early intervention is key.

While the path can be difficult, understanding one's neurodevelopmental profile and taking a strengths-based approach allows those with these conditions to thrive. Professional help from clinicians experienced in complex presentations is essential, as is a strong system of family and community-based support services.

References:

1. Salazar F, et al. (2015). Co-occurring psychiatric disorders in preschool and elementary school-aged children with autism spectrum disorder. J Autism Dev Disord, 45(8), 2283-2294.
2. Antshel KM, et al. (2018). Autism spectrum disorder in adult ADHD populations. World J Biol Psychiatry, 19, S515-S534.
3. Grzadzinski R, et al. (2013). Characteristics of a Gender-Diverse Sample of Children with Autism Spectrum Disorder and Co-occurring ADHD. J Pediatr Neuropsychol, 2(1-2), 8-26.
4. Taurines R, et al. (2012). ADHD and autism: Differential diagnosis or overlapping traits? A selective review. ADHD Atten Def Hyp Disord, 4(3), 115-139.
5. Postorino V, et al. (2017). Clinical differences in children with autism spectrum disorder with co-occurring ADHD. J Clin Child Adolesc Psychol, 46(3), 310-326.
6. Chuang IC, et al. (2018). Effectiveness of psychosocial interventions for children and adolescents with comorbid autism spectrum disorder and ADHD. Clin Child Fam Psychol Rev, 21(3), 418-438.