Understanding AuDHD

Autism and ADHD are both common neurodevelopmental disorders.

While they were once considered mutually exclusive, we now know they often overlap — with some studies estimating that 50% to 70% of autistic people also have ADHD. This connection has led to the rise of the term “AuDHD,” which is used to describe life with both autism and ADHD.

But AuDHD isn’t a diagnosis according to the DSM-5, the reference book used to define and diagnose mental health and brain-related conditions.

“They’re separate conditions that can co-occur, and AuDHD is the term used to describe the experience of living in that overlap,” says developmental pediatrician Carrie Cuffman, MD.

What’s it like to live with AuDHD, and how is it managed? Dr. Cuffman sheds some light.

AuDHD symptoms

The symptoms of AuDHD can vary greatly from person to person, Dr. Cuffman says. People with AuDHD will have symptoms of both autism and ADHD conditions. Here are just a few examples of what that might look like:

But again, these aren’t hard and fast rules. AuDHDers (as some autistic people with ADHD choose to call themselves) can be affected very differently depending on:

• The severity of each condition
• The type of ADHD they live with (inattentive, hyperactive-impulsive or combined)
• Coping strategies they’ve developed
• Medications they take

AuDHD vs. ADHD

In short, having ADHD means it’s harder for you to direct your attention to certain tasks. Autism is more a matter of how you behave and socialize.

So, having ADHD alone doesn’t impact your interactions with the world in the same way as having AuDHD. And ADHD doesn’t affect speech development in the way that AuDHD can for some people.

Coping with AuDHD

Managing AuDHD can also look different for different people.

“What matters most is looking at where you’re struggling and why,” Dr. Cuffman says. “That’s what guides diagnosis and treatment.”

There’s no one specific treatment for AuDHD. Your providers will instead look to understand how AuDHD is affecting your life and tailor treatment accordingly. Care usually involves treatments for both ADHD and autism — but it may take some fine-tuning.

For example, medications are often a first-line treatment for ADHD for those age 6 and older. But the side effects of those medications can be tougher for AuDHDers.

That can include:

• Decreased appetite: Autistic people may have strong food preferences due to sensory sensitivities. So, if ADHD medication suppresses your appetite (which it often does), it can lead to more issues with eating.
• Worsened sleep: Trouble sleeping is common in autistic people, and ADHD medication can make sleep even harder to come by.
• Irritability: ADHD medications can be associated with more frustration, anger and irritability. For autistic people, that can be more intense. “Increased irritability is a common reason I’ll look to change or stop ADHD medication for kids who also have autism,” Dr. Cuffman relates.

Like autism and ADHD alone, AuDHD treatment often involves additional supports, like:

• Cognitive behavioral therapy to help set goals and practice new ways of thinking and behaving.
• Speech therapy to address any speech delays or trouble communicating, which are common with autism.
• Educational supports to advise and advocate for classroom accommodations, if needed.

AuDHD: Impact on daily life

Living with AuDHD can be very different from having ADHD or autism alone — and come with more challenges.

“We often see more difficulties at school and in relationships when you have both conditions,” Dr. Cuffman explains. “It’s not just the autism causing challenges, but the inattention and hyperactivity layered on top of it.”

AuDHD can cause intense internal struggles, too, because the traits of autism and ADHD are often at odds.

People with ADHD, for example, can be impulsive — changing plans at the drop of a hat. But having autism often means preferring a reliable routine. Those desires can fight for your attention, like a tug-of-war between seeking new experiences and treasuring a set schedule.

The challenges of living with or caring for someone with AuDHD can be tough — and confusing. But you don’t have to navigate it alone. If you suspect you or a loved one is living with ADHD, autism or both, talk with a healthcare provider. Treatment and support can help you live your best life.