What Is AuDHD? Meaning, Symptoms, and Diagnosis - Attachment Project

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AuDHD – the combination of the autism (ASD) and attention deficit hyperactivity disorder (ADHD) neurotypes has seen a startling rise over the past decade. But what is AuDHD? This article covers any questions you may have on ADHD and autism comorbidity.

Not so long ago, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) were widely viewed as mutually exclusive disorders. After all, each has its own specific symptoms and life-affecting characteristics.

However, in recent years, the co-occurrence of autism and ADHD is so commonly recognized in the general population that it spawned its own term – “AuDHD.” But it’s not just a social media trend; AuDHD has also been unequivocally confirmed in research.

So, if you or someone you love has wondered why social communication difficulties frequently accompany feelings of hyperactivity and difficulties focusing, AuDHD may be present.

AuDHD Meaning and Implications

Simply put, AuDHD is a combination of the word “autism” and the acronym “ADHD.” Therefore, someone with AuDHD has both neurotypes. Although studies vary according to how frequently the conditions co-occur, the most recent estimates are that approximately 70% of people with ASD also have ADHD. Yet, despite this high percentage, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) didn’t include a diagnosis of AuDHD until as recently as 2013.

For people with AuDHD, life can feel like a constant contradiction. Their brains are hardwired to both want routine and fight against it. Therefore, catering to the needs of both conditions often means accounting for opposing needs.

For instance, the ASD side of someone’s brain may require them to set a strict schedule to cater to sensory challenges and feelings of overload. However, if they make a schedule that’s too rigid, the ADHD elements of their brain may battle to stay focused. Of course, such contrasting needs can create daily struggles and feelings of “not being good enough” – potentially leading to psychological distress.

Plus, considering how distinct the symptoms of both ASD and ADHD can be, receiving an AuDHD diagnosis can be difficult. We’ll discuss the process of AuDHD diagnosis later in this article.

As an extra note, a little-known piece of information is that an individual’s attachment style can influence the outcomes of their ASD and ADHD prognosis.

Main AuDHD symptoms

ASD and ADHD are quite paradoxical in nature: How can someone be both rigid in regards to routine and social structures, yet also find such routines and structures extremely difficult to follow? This paradox is due to how the symptoms of each disorder tend to be polar opposites.

For example, The American Psychological Association (APA) defines ASD as “a group of disorders…characterized by difficulties with social communication and social interaction along with restricted and repetitive patterns in behaviors, interests, and activities.”

As a note, autism, Asperger’s syndrome, and childhood disintegrative disorder (CDD) aren’t considered to be distinct diagnoses anymore – they are diagnosed under the umbrella term of ASD.

In contrast, the APA defines ADHD as a “behavioral condition that makes focusing on everyday requests and routines challenging.” This definition goes on to explain how individuals with ADHD experience organizational, planning, and focusing difficulties.

So, considering how disparate both of these neurotypes are, exactly what is AuDHD? And how can the symptoms of both of these neurotypes combine to create an AuDHD diagnosis?

The main symptoms of AuDHD combine the predominant ones of both ASD and ADHD – so they demonstrate a strong need for routine, but also a susceptibility to disruptions.

The Symptoms of AuDHD

AuDHD can manifest differently in each individual, demonstrating distinct patterns of behaviors, emotions, and executive functioning. However, the following are considered to be the main symptoms of AuDHD.

- Executive functioning challenges (a skill set that includes factors such as working memory, self-control, and cognitive flexibility)
- Sensory challenges (such as difficulties with touch, taste, and sound)
- Repetitive body movements (known as “stimming”)
- Learning difficulties
- Social challenges
- Emotional dysregulation (such as angry outbursts)
- Impulsivity
- Inattention

The first three symptoms would typically be associated solely with ASD, whereas the bottom two would be considered purely ADHD symptoms. Yet, the three middle symptoms (learning difficulties, social challenges, and emotional dysregulation) would commonly be seen in both neurotypes.

The overlap of symptoms between both neurotypes to create the dual condition of AuDHD demonstrates the need for specific and tailored intervention strategies. These strategies should be dynamic to fit the changing needs of the individual.

Plus, although the main symptoms of AuDHD may sound damning, there is a bright side that is important to highlight: People with AuDHD often report high levels of creativity. Therefore, tapping into this creativity may help such individuals manage and cope with the stress of their comorbid disorders.

Before we discuss these strategies, let’s consider the differences between AuDHD and “pure” ADHD.

AuDHD vs ADHD: What Are the Differences?

As mentioned previously, the symptoms of ASD and ADHD are typically at odds with each other. Therefore, there are some stark differences between “pure” ADHD and AuDHD.

People with ADHD have challenges with attention, impulsivity, and hyperactivity. In contrast, AuDHD introduces additional complexities by amalgamating the traits of autism with ADHD. The traits of autism include rigidity around routine, sensory difficulties, and self-stimulating behaviors such as stimming.

Therefore, the main difference between AuDHD and pure ADHD is that those with AuDHD have comorbid symptoms of autism along with their ADHD symptoms. The cognitive patterns associated with both neurotypes are linked. However, the neurological and developmental reasons for this are still not fully understood.

So, while people with ADHD have difficulties with routines, people with AuDHD simultaneously need routines but have difficulties adhering to them. This can create an extra layer of frustration and psychological distress – especially as AuDHD went unrecognized for a considerable amount of time.

AuDHD and Autism Comorbidity

As reported previously in this article, it’s thought that the prevalence of AuDHD and autism comorbidity could be as high as 70%. Meaning that this percentage of people with ASD have co-occurring ADHD.

Furthermore, despite a relative lack of recognition, it is widely believed that ASD is also frequently comorbid with conditions other than ADHD. Other autism comorbidities include developmental conditions such as dyslexia, dyspraxia, and epilepsy. Plus, according to research, although ASD is generally reported more in males than in females, females with ASD may be more likely to have comorbid disorders.

Similarly, it’s thought that “pure” cases of ADHD are also uncommon. Aside from ASD, ADHD is also commonly comorbid with developmental language and motor issues.

Furthermore, the neurotypes of both ASD and ADHD are comorbid with mental health issues such as anxiety, depression, and oppositional defiant disorder.

Of course, such high levels of comorbidity for both ASD and ADHD means that people with AuDHD could also potentially have other developmental or mental health issues. This suggests that interventions should take this high level of comorbidity into account, and factor in appropriate psychosocial, behavioral, and potential pharmacological elements.

AuDHD Test: What Is the Diagnostic Process?

There’s no such thing as an “AuDHD test.” This is because AuDHD is not, as of yet, recognized as a singular diagnosis in clinical settings.

However, if you’re concerned that you may have AuDHD, you can speak to your GP regarding a referral to appropriate professionals for separate ASD and ADHD diagnoses. Alternatively, if you’re concerned about your child, you can either speak to your GP or – if your child is school-aged – you can ask for a referral through their school.

Once referred, the diagnostic process for comorbid ASD and ADHD involves more than just taking an assessment or observing behaviors. It’s typically a multidisciplinary process – and is also dependent on the age of the individual.

Clinicians, including medical and mental health professionals, utilize standardized questionnaires, behavior rating scales, and environmental observations to collect information. This way, “snapshots” are gathered from as many domains of the individual’s life as possible to facilitate an overall impression and accurate diagnoses of both ASD and ADHD.

During the diagnostic processes, assessments and observations such as the following will be used to test for the presence of comorbid autism and ADHD. The assessments and methods used will depend on the region and age of the individual.

Testing for ASD may include measures such as:

- The Autism Spectrum Rating Scales. As a purely observational assessment, information is collected from caregivers, teachers, and other caregiving professionals to determine if a child’s behaviors align with those of ASD.
- The Autism Diagnostic Observation Schedule (ADOS). This measure involves the individual completing a series of tasks designed to assess cognitive functioning, behavior, and communication. A trained assessor observes their performance according to the criteria for ASD diagnosis.

Testing for ADHD may include measures such as:

- The Behavior Rating Inventory of Executive Functioning (BRIEF). The BRIEF assesses the ability to sustain attention, break down tasks into smaller components, and complete a target of focus. Different versions of the assessment are available for different ages.
- Conners Rating Scales. Used to assess social, behavioral, and academic functioning, this test includes both self-report and observational methods to assess for symptoms that align with those of ADHD.

Once a diagnosis of comorbid ASD and ADHD (AuDHD) has been reached, the following options for treatment may be considered depending on the individual’s presenting symptoms.

Treatment for AuDHD

Typically, treatment for AuDHD still predominantly utilizes the interventions and treatments associated with ASD. This may be because treatment measures associated with ADHD have not yet been fully researched for efficacy with individuals with AuDHD.

However, it’s important to take the individual’s specific needs into account when devising AuDHD interventions and treatment; recursiveness may be needed to ensure the “best fit.”

The following methods (or combination of methods) are commonly used in the treatment of AuDHD.

Psychosocial Interventions for AuDHD

Psychosocial measures aim to induce change in psychological, cognitive, behavioral, biological, and social factors that contribute to the symptoms of AuDHD. Psychosocial interventions for AuDHD may include:

- Therapy: Therapies, such as Cognitive Behavioral Therapy (CBT), can help devise strategies for challenging the difficult emotions associated with AuDHD. Moreover, CBT can highlight strengths such as creativity and help the individual use these strengths to improve focus and attention. However, it’s important to account for the individual’s social and communicative abilities when choosing a suitable therapeutic approach.
- Psychoeducation: Understanding the reasons behind the symptoms and difficulties associated with AuDHD can help an individual and their families adopt a more empathetic approach. Plus, there are various support groups depending on your region which aim to empower success through knowledge and support.
- Executive functioning techniques: Specific therapies (such as EFT) and groups that target executive functioning skills can help alleviate the difficulties associated with ASD and therefore ease AuDHD symptoms. These approaches improve cognitive, time management, organizational, and attentional skills.
- Support groups: There are multiple support options available for people who struggle with specific symptoms of AuDHD. For example, vocational support exists where people will assist with CVs or preparing for a job interview. Alternatively, assistance is available for issues such as improving concentration and reducing distress. Make sure to consult your local ASD and ADHD advice groups for further information.

Pharmacological Interventions for AuDHD

Pharmacological interventions for AuDHD, if necessary, should be done in conjunction with psychosocial methods. Strategies that focus on the behavioral, psychological, and social components of AuDHD should be the first line of call. After which, if the individual still struggles to cope, they can speak to their GP about pharmacological approaches. These approaches do not differ much from those used to treat individual ASD and ADHD.

Typically, a GP will choose to put someone on the lowest dose of medication possible for treating AuDHD and track their progress to determine whether it needs to be increased over time. Such medications may include stimulants and non-stimulants for ADHD symptoms. However, treating ASD symptoms with medication may be more complicated as there are no current FDA-approved medications for this neurotype. Instead, medications used to treat emotional dysregulation, such as antipsychotics, may be considered.

Final Thoughts on AuDHD

AuDHD is a comorbidity of the developmental neurotypes ASD and ADHD. People with AuDHD may lead a life of conflicting needs: one in which they require strict routines and schedules, but also struggle to adhere to these. Up until recent years, both ASD and ADHD were seen as distinct conditions, but recent research indicates that approximately 70% of people with ASD have ADHD. As of yet, there is still not a singular AuDHD diagnosis – instead, professionals may give separate diagnoses of ASD and ADHD.

If you’re concerned about whether you have comorbid ASD and ADHD, speak to your GP about referral for appropriate diagnoses. Professionals in the area will be able to cater to your unique needs, as well as help alleviate any distress you may be experiencing around them.

As a final note, remember that you can be an active participant in this process and you don’t have to go the journey alone. Although life might seem like a battle at times, there is help available: professionals, support groups, and social circles can help you develop personalized strategies that focus on your goals, strengths, and creativity.