Autistic and ADHD? That’s AuDHD.
AuDHD Explained I The Overlap of Autism and ADHD – Tiimo App
AuDHD is the intersection of Autism and ADHD, two neurotypes that frequently co-occur. While they’re often seen as opposites – one craving routine, the other drawn to novelty – the reality is far more complex. AuDHD is not Autism plus ADHD; it’s its own experience, where the two neurotypes interact, overlap, and sometimes completely contradict each other.
AuDHD Explained I The Overlap of Autism and ADHD – Tiimo App
Studies suggest that between 20-50% of Autistic people also meet the criteria for ADHD, while 30-80% of ADHDers display Autistic traits – but because diagnostic models were built on outdated, rigid definitions, many people remain undiagnosed or misdiagnosed.
AuDHD Explained I The Overlap of Autism and ADHD – Tiimo App
Autism and ADHD very often co-exist. Research suggests that 50 to 70% of autistic people also have ADHD (Hours et al., 2022), though figures vary between studies. Similarly, it is estimated that two-thirds of those with ADHD have at least one co-existing condition such as autism. In other words, autism and ADHD very frequently present together.
Despite this, autism and ADHD could not be diagnosed together until 2013. The fourth edition of Diagnostic and Statistical Manual listed autism as an exclusion criterion for ADHD (Murphy et al., 2016), and only when the fifth edition was released in 2013 were they recognised as co-existing conditions.
According to the scientific literature, 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD).
Frontiers | ASD and ADHD Comorbidity: What Are We Talking About?
It is estimated that 30-80% of individuals with ADHD are also autistic.
AuDHD, a term combining “Autistic” and “ADHD” (Attention Deficit Hyperactivity Disorder), describes individuals who exhibit traits of both autism and ADHD. Recent research reveals that this combination is more common than previously believed. Studies suggest that between 50% and 70% of autistic individuals also have ADHD, while nearly 10% of children diagnosed with ADHD also meet the criteria for autism.
In conclusion, our results indicate that the often reported co-occurrence of ASD and ADHD might be explained by three distinct pathways: (a) between inattention/impulsivity and social ineptness, and (b) between hyperactivity and stereotypic, repetitive behaviors (c) through verbal IQ.
- ADHD and autism can coexist in individuals, with one part of them desiring routine and sameness while the other seeks novelty and change.
- Receiving accurate diagnoses for neurodivergent individuals can be challenging, as the symptoms of different conditions can overlap and mask each other.
- Stigma and misunderstandings surrounding neurodivergent individuals are pervasive and can lead to discrimination and mistreatment.
- Being twice exceptional, with both ADHD and autism, can result in unique challenges and experiences, including being misunderstood and judged by others.
- When Pathological Demand Avoidance (PDA) is a factor, it can lead to difficulties in regulating the nervous system, and can have a significant impact on daily life.
- Finding a career that aligns with one’s interests and strengths is crucial for neurodivergent individuals.
- Community support and understanding are essential for neurodivergent individuals to thrive and feel deeply understood.
Episode 226: Autism + ADHD = AuDHD — The Neurodiversity Podcast
AuDHD refers to the co-occurrence of autism and ADHD, creating a unique neurodivergent experience. Autism involves differences in communication, sensory processing, and social interaction, while ADHD affects executive functioning, leading to challenges with focus, organization, and impulse control.
While autism or ADHD may be diagnosed individually, the overlap between these conditions often creates a distinct set of traits. For instance, someone with AuDHD might:
- Develop a strong preference for routines (autism) but struggle to stick to them due to impulsivity (ADHD).
- Experience hyperfocus on specific interests (a common trait in both conditions).
- Feel sensory overload, intensified by the combined sensory sensitivities of autism and ADHD.
AuDHD also brings unique strengths, including creative problem-solving, innovation, and the ability to hyperfocus on areas of interest. Understanding this intersection can empower individuals to embrace their strengths while addressing their challenges.
Competing Needs
AuDHD: when your neurotype is the very definition of competing access needs.
The Tweedy Mutant on X
It’s not surprising that people used to think Autism and ADHD couldn’t occur together, because a lot of the traits appear to contradict each other. ADHD likes NEW, Autism likes the SAME. ADHD is IMPULSIVE and spontaneous, Autism likes PLANNING. (A massive over-generalisation of course, but you get the picture). Imagine how disorienting it is to have your brain constantly pulled in two opposite directions.
This can feel like a tug of war in an AuDHD-er’s mind, and it can feel impossible trying to balance two completely opposing needs. Because of this, AuDHD can appear like a different presentation altogether. An individual may feel they don’t relate wholly to autism or to ADHD. The two can mask each other, either compensating for each other’s difficulties or making those challenges even harder. For example, the organisation and focus from the autistic brain may compensate for the disorganisation and chaos of the ADHD brain. Or, the mess and chaos from the ADHD may leave the person in a constant state of overwhelm, feeling unable to function because there is no order.
One vital ingredient for any ADHDer is dopamine, the neurotransmitter responsible for feelings of pleasure and the regulation of attention – there’s never enough and we are always craving it. Much of ADHD’s impulsive and risky behaviour can be attributed to the hunt for more dopamine.
Life as an AuDHD-er is constantly trying to find a balance to satisfy opposing needs. And those needs are changing all the time, depending on the environment, the day and the chapter of life.
They almost hid each other.
01 What is AuDHD (& do you have it)? – AuDHD Flourishing | Podcast on Spotify
ADHD brains are driven by interest-based motivation rather than routine. They thrive on novelty, quick thinking, and movement but struggle with time agnosia, impulsivity, and forgetfulness. ADHDers can be highly social but may struggle with boundaries and impulse control.
Autistic brains are driven by predictability and sensory processing, meaning they often prefer structure, deep focus, and consistency. Sensory input – things like sounds, lights, and textures – can be experienced more intensely (hypersensitivity) or less intensely (hyposensitivity), affecting comfort and focus.
Now, put them together, and you get:
- Craving routine but struggling to maintain one
- Hyperfocusing for hours but forgetting essential tasks
- Wanting deep conversations but burning out from socializing
- Seeking sensory stimulation but also being overwhelmed by it
- Needing predictability but impulsively disrupting your own plans
This internal contradiction is what makes AuDHD such a unique experience – and also why it can be hard to diagnose.
AuDHD Explained I The Overlap of Autism and ADHD – Tiimo App
Novelty: A Key Difference
Autistic people without ADHD generally do not need or desire novelty in the same way that ADHDers and AuDHDers do.
I’m hearing… – Trauma Geek – Trauma and Neurodiversity Education | Facebook
Rooted in Monotropism?
The way that ADHD and autism are characterised in diagnostic manuals is completely different. ADHD is treated as primarily an attentional difference; autism as chiefly social in nature. Where descriptions do overlap, they can seem contradictory: autism is apparently characterised by rigid, restricted interests, while ADHD is said to cause impulsive behaviour and an inability to concentrate.
So the facts that anywhere from 30% to 80% of autistic people seemingly fit the diagnostic criteria for ADHD, and the two clearly run in the same families, might initially seem surprising. It cries out for an explanation. One possibility is that autism and ADHD – or a Kinetic Cognitive Style (KCS), as I prefer to call it – share an underlying cause. Monotropism has been put forward as one candidate for this, for example in Patrick Dwyer’s Revisiting Monotropism.
It is well established that autism can manifest very differently in different people, in ways that can seem contradictory. We know that autism can come with hyperlexia, or serious language difficulties. We know that it’s associated with sensory seeking and sensory avoidance. We understand that it might come with with crystal-clear memories, or forgetfulness. All of these things can coexist in one person, or just a selection.
With this in mind, it is perhaps not such a stretch to suggest that impulsivity, inattention and hyperactivity might share cognitive or neurological roots with their apparent opposites, like inflexibility, hyperfocus and inertia. When and how such traits manifest might depend on a person’s interests and experiences, or it might have to do with innate neurocognitive differences. Understanding this kind of variation fully would take far more research on the life experiences and psychological development of people with a variety of cognitive styles, without assuming that current diagnostic categories reflect objectively real categories of human being.
Impulsivity could come from the monotropic tendency to lose awareness of things as soon as our attention shifts away from them. Inattention is a very familiar thing among autistic people – not an attention deficit, which was never the right term, but profound difficulty steering attention in directions which don’t align with our current interests. Hyperfocusing is common with KCS, as it is with autism.
Hyperactivity can refer to a need to keep moving, which bears a striking resemblance to the autistic need to stim. It can also refer to a cognitive tendency which is a little harder to reconcile with how monotropism has been characterised: a habit of hopping mentally from one thing to another. In contrast, difficulty shifting from one attention tunnel to another has been a central feature of the ways monotropism has been described. This tension is worth digging into.
It might be that a Kinetic Cognitive Style arises out of a combination of a relatively monotropic processing style combined with other factors – difficulty accessing flow states, for example, as suggested by some recent research (Grotewiel et al 2022). There are all kinds of reasons why people might not be able to enter ‘flowy focus tunnels‘, as Jamie Knight calls them. They might have too many distractions, or too much nervous energy; they might not feel safe enough to lose themselves in the flow; they might have had bad experiences being told off for doing so, or been wrenched out of them too many times. They might just be too depleted to be able to connect deeply with their passions, something which also occurs during autistic burnout.
We know that novelty-seeking is a trait that varies greatly between people. It’s also possible that some people just have naturally very mobile attention, which might compensate for the monotropic tendency for attention to get sucked into one thing at a time. And maybe some of that apparent attention-hopping happens within an attention tunnel anyway, and other people just aren’t seeing the connections! KCS might look like polytropism sometimes, but I think that can be misleading. I delayed getting my own autism assessment for years because I mistook my serial monotropism for polytropism: I told myself I was multi-tasking, when it would probably be more accurate to say I repeatedly forgot what I was supposed to be doing.
Meanwhile, it is likely that monotropism doesn’t necessarily give rise to autism in the sense required by diagnostic manuals – but that above a certain level of intensity, or in combination with other factors, it causes the familiar social differences, fixity and so on. An early intense interest in other people, and how they behave, might equip someone with tools that will allow them to avoid being seen as too socially weird. The ability to present a ‘normal-looking’ face to the world is likely a major factor in the under-identification of autistic girls, who face far more social pressure to blend in than boys do. None of this changes a person’s cognitive style; but then, autism, like ADHD, has always been assessed based on outward presentation. One hope for Monotropism as a theory is that it helps us to make sense of these things from an internal perspective, rather than looking only at the surface level.
It is, I think, too early to say with any confidence that autism and ADHD (or KCS) share a common root in monotropism, but the overlapping traits of the people receiving each label clearly demand some kind of explanation, and preliminary results do suggest that each is strongly correlated with monotropism – especially in combination. With any luck, we will see a good deal more research on this in coming years.
More Than the Sum of Its Parts
It seems that the experience of having both autism and ADHD is distinct. In this respect, we might imagine autism as the colour red, ADHD as the colour blue, and AuDHD as purple – more than a sum of its parts; a thing in and of itself. Of course, neurodivergent individuals are likely to have more than two colours, presenting the challenge of being truly intersectional, taking into account all of the colours and shades that make up an individual. The result of this is that some colours get ignored or bracketed so that others can be focused on. I myself am guilty of doing so; I also have dyspraxia, yet rarely refer to myself as a dyspraxic AuDHDer. What influences the conditions we focus on or that we perceive to disable us the most? How can we be fully intersectional and take into account not just different facets of neurodiversity but the interplay between neurodiversity and ethnicity, sex, class, age, other disabilities, and so on?
It’s a very poorly kept secret that many people who are given a diagnosis of autism also meet the criteria for a diagnosis of ADHD. One could be forgiven for assuming this means that people who meet the criteria for both (often termed AuDHD) have two co-occurring conditions. Unfortunately, nothing in life is simple, and the actual answer to this situation is far more complex.
Co-occurring disorders refer to two separate conditions that are occurring at the same time. For example, one might be both asthmatic and diabetic simultaneously. I have chosen this particular example because I want to explore the disconnect between physical health and psychiatric diagnoses.
Diagnosis is a two part system. Step one is research. Clusters of symptoms are matched up to biological signs (known as biomarkers). Where a meaningful relationship can be found between symptoms and biomarkers, you have a disorder. In psychiatry, however, it does not go this smoothly. We can identify clusters of symptoms, usually behaviour or thoughts and feelings that have been deemed troublesome or pathological by those with the privilege of not being oppressed. The problem comes when we try to find a meaningful link with biomarkers.
Despite decades of research, we are not any closer to finding a quantifiable difference in the human body. The research that does exist has been largely inconclusive.
So here’s where autism and ADHD come in. Many of us meet the criteria for both diagnoses. This is because diagnostic manuals specify lists of traits, and if you meet enough of them, you get diagnosed. The problem is that much like pseudoscientific personality tests, humans don’t fit neatly into categories. The criteria for many diagnoses overlap and mic together.
The point I’m trying to make is that AuDHD’ers do not have two conditions simultaneously. In fact, according to the neurodivesity paradigm, there is nothing medically quantifiable. Humans have individual sets of traits that are diverse and interlinked. Remember the saying “if you’ve met one Autistic person, you’ve met one Autistic person”?
That’s because autism doesn’t actually exist. It’s not a physical abnormality, it has no presence. Autistic people exist, and being Autistic is an identity based on shared culture and language. So, what is far more likely is that Autistic and ADHD people are more likely to share particular clusters of traits. You don’t have two conditions, your particular flavour of diversity just happens to tick the right boxes for both.
One could argue that this means a separate diagnosis should be created for people who meet both criteria or that classification should be changed to have them listed as part of a shared spectrum. The problem is that current diagnostic models are unreliable and prone to mistakes. We often find our diagnosis changing from doctor to doctor.
This isn’t necessarily because doctors are bad at their job. It’s because we are trying to pathologise human experience and identity. You can’t measure psychiatric conditions with a blood test, doctors know this, and they’ve been trying to do it for many years. This means that not just diagnosis, but the criteria themselves are at the whim of individuals. Experts and professionals bring their own individual biases to the table, and each one will interpret traits differently.
This is why it’s important that we move towards a demedicalised approach to neurodiversity. We need to stop assigning people fixed identities through diagnosis and instead explore the very real fact that everything about us, including our neurology, changes with time.
People should be allowed to explore their identity and try on whatever labels they feel are right for them.
Autism and ADHD: The myth of co-occurring conditions – Emergent Divergence
Further Reading
- Autism and ADHD: How far have we come in the comorbidity debate? – ScienceDirect
- ADHD as entrepreneurial neurodivergence: re-evaluating ‘ADHD superpowers’, revealing its connections with capitalism: Disability & Society: Vol 0, No 0 – Get Access
- A Causal and Mediation Analysis of the Comorbidity Between Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) – PubMed
- ‘We can look to the AuDHD community to learn more about what the balance of autism and ADHD feels like’ | BPS
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