What Does ADHD and Autism Look Like Together: Exploring Their Characteristics

Discover what ADHD and autism look like together, from overlapping symptoms to diagnosis and treatment.

steven zauderer
Steven Zauderer
April 25, 2024
8 min read
min read

Understanding ADHD and Autism

Understanding what ADHD and autism look like when they occur together begins with gaining a fundamental understanding of each condition and the frequency of their co-occurrence. Further, it is crucial to explore the genetic and brain differences that underpin these conditions.

Co-Occurrence Statistics

There is a significant overlap between attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). According to scientific literature, 50 to 70% of individuals with ASD also have comorbid ADHD. On the other hand, it is estimated that 30 to 80 percent of children with autism also meet the criteria for ADHD. Conversely, 20 to 50 percent of children with ADHD meet the criteria for autism.

Studies of families and twins indicate that relatives of people with either condition have an increased risk of having both, lending support to the shared roots between autism and ADHD.

Genetic and Brain Differences

Both autism and ADHD are thought to involve multiple genes, many of which may individually exert small effects. Some genetic variants have been found to be shared between autism and ADHD, but specific risk variants that are shared have not been conclusively identified [2].

In terms of brain differences, imaging studies have shown both shared and distinct brain alterations in autism and ADHD. People with autism tend to have a larger amygdala, while people with ADHD tend to have smaller total brain volume.

These genetic and brain differences provide some insight into the underlying mechanisms of these conditions and how they might interact when they co-occur. Understanding these differences is crucial for improving diagnostic accuracy and tailoring effective treatment strategies.

Recognizing Symptoms

When exploring the question of 'what does ADHD and autism look like together', it's essential to understand that both conditions share some common symptoms but also have unique characteristics.

Overlapping Behaviors

ADHD and autism spectrum disorder (ASD) often present overlapping behaviors, which can make it difficult to differentiate between the two conditions. According to a scientific research, 50-70% of individuals with ASD also have comorbid ADHD, highlighting the significant overlap between the two conditions.

Behavioral similarities between ADHD and ASD often include difficulty with social interactions, problems with communication, and a tendency towards repetitive behaviors. Additionally, both conditions can lead to difficulties with attention, although the underlying cause of these attention issues may differ between the two.

For instance, behaviors that appear similar in individuals with autism or ADHD may stem from different underlying causes. Inattention in a person with autism may result from sensory overload, whereas inattention in a person with ADHD may result from difficulty in processing and attending to social cues.

Unique Characteristics

Despite the overlaps, each condition also has unique characteristics that help distinguish one from the other.

Autism is often associated with a lack of social reciprocity, difficulty in understanding social cues, and repetitive behaviors or interests. On the other hand, ADHD is often characterized by hyperactivity, impulsivity, and difficulty in maintaining attention.

One key difference observed in brain imaging studies is that individuals with autism tend to have a larger amygdala, while those with ADHD tend to have a smaller total brain volume.

It's important to remember that each person with ADHD, autism, or both will exhibit a unique combination of symptoms and behaviors. No two individuals will have the exact same experience or presentation, which is why comprehensive evaluations by trained professionals are so crucial in the diagnosis process.

By understanding the overlapping and unique characteristics of ADHD and autism, it becomes easier to recognize the symptoms and seek appropriate treatment and interventions.

Diagnosing ADHD and Autism

Identifying the co-occurrence of ADHD (Attention Deficit Hyperactivity Disorder) and autism can be challenging due to the overlap in symptoms. It requires a comprehensive understanding of both conditions and a thorough evaluation process.

Comprehensive Evaluations

Diagnosing ADHD and autism together necessitates a comprehensive evaluation by a healthcare professional knowledgeable about both conditions. The aim of these evaluations is to establish a child's strengths and weaknesses through various test measures. These measures document symptoms, executive function, social delays, communication delays, and other symptoms.

Children diagnosed with ADHD typically exhibit signs such as restlessness, impulsivity, and difficulty paying attention, which may cause them to behave differently from their peers at a young age. Autism signs might be noticeable before the child's second birthday, with affected children potentially avoiding eye contact, displaying interest in repetitive movements, and having delayed or absent speech development.

Challenges in Diagnosis

There are challenges in diagnosing ADHD and autism concurrently due to symptom overlap between the two conditions. Professionals often assess for one diagnosis at a time, which can potentially lead to a misinterpretation of symptoms. It is recommended to request testing for both conditions if one feels their existing diagnosis does not fully describe their experience.

Furthermore, symptoms that manifest in individuals who meet the criteria for either autism or ADHD may be emphasized more than a unique combination of symptoms that do not neatly fit into one diagnostic category. This can lead to symptoms that do not fit neatly into one diagnostic 'box' being overlooked or misunderstood [5].

Additionally, before 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) did not allow individuals to meet the criteria for both autism and ADHD simultaneously, even though the comorbidity rate was already at 45%.

These factors highlight the importance of a comprehensive evaluation process and ongoing research in understanding what ADHD and autism look like together. It also emphasizes the need for healthcare professionals to be well-versed in both conditions to ensure an accurate diagnosis.

Treatment Approaches

When addressing the co-occurrence of ADHD and Autism, a variety of treatment approaches may be employed to manage the symptoms and improve overall functioning. These approaches can be broadly categorized into pharmacological interventions and psychosocial therapies.

Pharmacological Interventions

Pharmacological treatment, primarily involving traditional ADHD medications, is a common approach for managing the symptoms of ADHD and Autism. Research indicates that such treatment is effective in reducing impairments associated with core ADHD symptoms such as inattention, hyperactivity, and impulsivity, as well as improving functioning in both children and adults.

In the context of co-occurring ADHD and Autism, nonstimulant medications such as atomoxetine and guanfacine have been investigated. These medications have shown positive effects in reducing hyperactivity and impulsivity in individuals diagnosed with both disorders [6].

However, while medication often forms part of the treatment plan for ADHD, it's important to note that children with Autism might respond better to non-medication alternatives due to limited medication options for Autism. Stimulant medications, commonly used to treat ADHD, may be less effective and cause more side effects when used to treat patients with both ADHD and Autism.

Psychosocial Therapies

Despite the prevalence of pharmacological interventions, the need for psychosocial therapies in managing ADHD and Autism cannot be understated. While there has been relatively less research on this front, psychosocial interventions have the potential to address co-occurring symptoms of ADHD and Autism directly.

Psychosocial therapies involve a variety of approaches, including cognitive behavioral therapy, social skills training, and parent training programs. These interventions can help individuals improve their social and communication skills, manage their behaviors, and cope with the challenges posed by their conditions.

In deciding the appropriate treatment approach, it's crucial to consider the individual's unique needs and circumstances. A comprehensive evaluation by a team of experienced professionals can provide valuable insight into the most effective strategies for managing the co-occurrence of ADHD and Autism. Regardless of the treatment approach chosen, it's important to remember that both pharmacological and psychosocial interventions can play a vital role in improving the quality of life for individuals with ADHD and Autism.

Cognitive Profiles

When exploring the question 'what does ADHD and autism look like together', it's essential to consider the cognitive profiles of individuals with both conditions. These cognitive profiles encompass executive functioning and cognitive flexibility, two areas often impacted when ADHD and autism co-exist.

Executive Functioning

Executive functioning is a key area of cognition that can be impacted in individuals with co-occurring ADHD and autism. This area of the brain is responsible for skills such as decision-making, impulse control, time management, focus, and organization skills, all of which can be impaired in individuals with ADHD and autism [4].

Impairments in executive functioning can manifest in various ways. For example, children with ADHD often exhibit behaviors such as difficulty focusing on tasks, being easily distracted, impulsivity, and physical restlessness. On the other hand, individuals with ASD may overfocus on tasks, struggle with transitioning between tasks, have rigid routines, and display heightened sensitivity or insensitivity to various stimuli. (Source)

Cognitive Flexibility

Cognitive flexibility is another important aspect of the cognitive profile of individuals with co-occurring ADHD and autism. This cognitive function refers to the ability to shift thinking or attention in response to changing goals and environmental stimuli.

According to research, those with co-occurring ADHD and ASD may struggle with cognitive flexibility, demonstrating difficulties shifting attention to a different task or adapting to changes in routines or environments. This could manifest in behaviors such as inflexibility in routines, intense focus on specific topics or interests, and difficulty transitioning between tasks.

These cognitive profiles underscore the need for comprehensive evaluations and personalized intervention strategies to support individuals with co-occurring ADHD and autism. Understanding these cognitive characteristics can help promote better educational strategies, therapeutic interventions, and support measures to enhance the quality of life for individuals with these co-existing conditions.

Life with Coexisting ADHD and Autism

Living with coexisting ADHD and Autism Spectrum Disorder (ASD) can present unique challenges. However, with the right strategies and resources, one can manage the symptoms and navigate daily life more effectively.

Coping Strategies

When dealing with the coexistence of ADHD and autism, it is essential to have coping strategies in place. These strategies could include a combination of pharmacological interventions and psychosocial therapies.

Pharmacological treatment, such as ADHD medication, can be beneficial in removing obstacles caused by ADHD symptoms like inattention, hyperactivity, and impulsivity. Nonstimulant medications, such as atomoxetine and guanfacine, have shown positive effects in reducing hyperactivity and impulsivity in individuals with both ADHD and ASD [6].

However, children with ASD might respond better to non-medication alternatives due to limited medication options for ASD. Stimulant medications, commonly used to treat ADHD, may be less effective and cause more side effects when used to treat patients with both ADHD and ASD.

In addition to medication, psychosocial therapies can be effective coping strategies. These include behavioral therapies, speech therapy, occupational therapy, educational interventions, and parent training. These interventions can help improve communication skills, manage challenging behaviors, and enhance social interaction abilities.

Support and Resources

Living with coexisting ADHD and autism can be challenging, but one doesn't have to navigate this journey alone. There are several resources available that offer support and guidance.

These resources include medical professionals, such as physicians, psychologists, and therapists, who can provide diagnosis, treatment, and ongoing management support. Therapists can provide a range of therapies tailored to the individual's needs, including cognitive-behavioral therapy, speech and language therapy, and occupational therapy.

Support groups can also be invaluable resources. They provide a safe space to share experiences, learn from others going through similar experiences, and receive emotional support.

In addition, numerous online resources, books, and educational materials can provide information and practical strategies for managing both ADHD and autism. These resources offer knowledge and tools to better understand the conditions, manage symptoms, and improve quality of life.

In conclusion, while living with coexisting ADHD and autism can be challenging, with the right coping strategies and resources, individuals can effectively manage their symptoms and lead fulfilling lives.








steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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