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AuDHD: When Autism and ADHD Occur Together

Autism and ADHD could not be diagnosed together until 2013. What the overlap looks like day to day, and why the two sets of needs pull against each other.

4 min read

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Key takeaways

  • Until 2013 the diagnostic manual did not permit autism and ADHD to be diagnosed in the same person, so a generation of people were assessed for one and told the other did not apply.
  • Estimates of how often the two occur together range from roughly 38 percent to 50 to 70 percent depending on how the studies were done, which is a wide enough spread that any single figure you are quoted should be treated with caution.
  • The practical difficulty is not that you have two diagnoses, it is that the two sets of needs conflict: a preference for sameness sits against a need for novelty, and advice written for one can make the other worse.
  • This conflict is the reason strategies that work well for autistic people alone, or for people with ADHD alone, often fail here, and why a plan has to be built around the pull between them rather than around either pole.
  • There is no separate AuDHD diagnosis and no separate assessment for it, so the route is an assessment for each, ideally with a clinician who is willing to consider both at once.

AuDHD is an informal name for having both autism and ADHD, and it is not a diagnosis: no manual lists it, and a clinician will record two separate diagnoses instead. The word exists because the experience of having both is not the two descriptions added together, and people needed something to call the difference.

Why nobody was diagnosed with both before 2013

The previous edition of the diagnostic manual forbade it. Its rules did not allow ADHD to be diagnosed in someone who already had an autism diagnosis, so a clinician who saw both in front of them was not permitted to write both down, and the fifth edition removed that restriction in 2013. [apa-dsm5]

This is worth sitting with if you were assessed as a child. Being told that autism explained everything, or that ADHD did, may have been the manual talking rather than a finding about you. It is also why the research literature before 2013 is thin here: you cannot easily count a combination the diagnostic system says cannot exist.

How often the two actually occur together

The honest answer is that the range is wide and the studies disagree. A meta-analysis pooling 63 studies put the current rate of ADHD among autistic people at about 38 percent, [rong-2021-prevalence] while a 2022 review of the literature reports the figure as 50 to 70 percent. [hours-2022-comorbidity]

Both are real numbers from real reviews, and the gap between them is mostly about method: who was sampled, whether ADHD was measured by questionnaire or full assessment, and whether the count was current or lifetime. What you can take from it is the direction rather than the value. This is common rather than rare, and any single percentage quoted at you without a method attached is being presented with more confidence than it has earned.

Why one number cannot answer this, shown as two reviews splitting the same population differently Illustrative
38 to 70 per cent, depending on the study
  • Meets ADHD criteria on the lower estimate 38%
  • Falls inside the disputed range 32%
  • Does not meet ADHD criteria on either 30%

A schematic of the disagreement described in this section, drawn to show the shape of the gap rather than measured data.

The part that actually makes daily life hard

It is not having two diagnoses. It is that the two sets of needs pull in opposite directions, so a strategy that helps one can directly worsen the other.

A preference for sameness sits against a hunger for novelty. The routine that makes the week survivable is the same routine that becomes unbearable by Thursday. Sensory sensitivity says the room is too loud; understimulation says the room is too quiet, sometimes within the same hour. Planning ahead is both the thing that helps most and the thing that is hardest to do.

The practical consequence is that advice written for one condition alone tends to fail. Autism support that removes all unpredictability can flatten a week until nothing gets started at all. ADHD support built on variety and stimulation can leave the days with no anchor and end in shutdown. Neither is bad advice; each is half an answer.

Does this pull sound familiar?

For anyone who has been assessed for one of the two and felt the description only half fitted.

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What building a plan around the conflict looks like

The useful move is to stop treating the two as separate problems with separate solutions and start treating the tension between them as the thing being managed. That is a different question from which condition is primary, and it is usually a more answerable one.

In practice this means a structure with deliberate slack in it rather than a rigid one: the anchor points fixed, the middle left loose. It means changing one variable at a time, because with two sets of traits interacting it is genuinely hard to tell what helped. And it means expecting an inconsistent response to any given strategy rather than reading inconsistency as failure.

Getting assessed for both

There is no AuDHD assessment, because there is no AuDHD diagnosis. The route is an assessment for autism and an assessment for ADHD, and the thing worth doing is saying at the outset that you want both considered rather than accepting the first fit.

That request matters more than it should. Assessment services are often organised around one condition or the other, and a service set up to answer the autism question can reasonably answer it well and never ask the second one. Being explicit costs nothing and is frequently the difference between a partial answer and a complete one.

When to seek help

Speak to a doctor if the difficulty is affecting work, study, relationships or your ability to look after yourself, and say plainly that you want both conditions considered rather than one. Bring specific examples rather than a self-description, since the assessment rests on what actually happens in your days. If you are having thoughts of harming yourself, treat that as urgent and contact your local emergency services or a crisis helpline.

How MyFreud can help

Tracking day to day is unusually useful here, because the central difficulty is a pattern that only shows up over weeks: which days the routine held, which days it broke, and what was different about them. That is exactly the evidence an assessment asks for and exactly the thing that is hard to reconstruct from memory. Our autism guide covers the wider picture, including autism in women and sensory overload.

Download MyFreud and start today: App Store or Google Play.

Frequently asked questions

What does AuDHD mean?

It is an informal term for having both autism and ADHD. It is not a diagnosis in its own right and appears in no diagnostic manual, so a clinician will record autism and ADHD as two diagnoses rather than one combined label. The word is useful anyway, because the experience of having both is not simply the two descriptions added together, and people needed something to call it.

Can you be diagnosed with autism and ADHD at the same time?

Yes, and this has only been true since 2013. The previous edition of the diagnostic manual contained a rule preventing ADHD from being diagnosed alongside autism, so before then a clinician who recognised both was not permitted to record both. If you were assessed as a child before 2013 and told one explained everything, that conclusion may have been a rule rather than a finding about you.

Why do autism and ADHD strategies contradict each other?

Because they answer opposite problems. Much autism support reduces unpredictability: fixed routines, advance notice, the same meal, the same route. Much ADHD support introduces stimulation and variety to hold attention. Apply the first without the second and you get a routine so flat that nothing gets started; apply the second without the first and you get days with no anchor at all.

Does having both change what treatment helps?

It changes the order and the fit rather than the options. Medication for ADHD is still the medication for ADHD, and support for autism is still that support, but the sequencing matters more and the response is less predictable, so changes are usually made one at a time with a longer wait to judge each one. Discuss this with a doctor rather than adjusting anything yourself.

Is AuDHD more common in women?

Both conditions have been historically underdiagnosed in women and girls, so more women are being recognised in adulthood now. That is a change in who gets assessed rather than firm evidence that the combination itself is more common, and the honest answer is that the population figures are not yet good enough to say.

References

  1. 1.Rong Y, Yang CJ, Jin Y, Wang Y ( 2021). Prevalence of attention-deficit/hyperactivity disorder in individuals with autism spectrum disorder: a meta-analysis. Research in Autism Spectrum Disorders. doi:10.1016/j.rasd.2021.101759
  2. 2.Hours C, Recasens C, Baleyte JM ( 2022). ASD and ADHD comorbidity: what are we talking about?. Frontiers in Psychiatry. doi:10.3389/fpsyt.2022.837424
  3. 3.American Psychiatric Association ( 2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association. psychiatry.org .