Autism and ADHD Together

Until 2013, you were not allowed to be both

This is the fact that explains a great deal, and almost nobody is told it.

The fifth edition of the DSM appeared in 2013. Before that, no assessor was permitted to diagnose autism and ADHD in the same person. The manual forbade it.

One review of the field puts it plainly:

With the DSM-5, clinicians are permitted to make an ASD diagnosis in the context of ADHD. In earlier versions of the DSM, this was not acceptable.

So you may have been assessed as a child, or as an adult before the mid 2010s. If so, the assessment was carried out under rules that forced a choice. Whichever was more visible on the day tended to win.

That is not a failure on your part and it is not really a failure on the assessor's part either. It is a rule that has since been recognised as wrong.

Source: Antshel et al. 2016

How often the two occur together

The estimates vary, and the reason they vary is worth understanding.

A meta-analysis puts current ADHD in autistic people at around 38.5 per cent. Lifetime ADHD comes out at around 40.2 per cent.

A separate analysis, counting only confirmed clinical diagnoses, puts it at 28 per cent.

The difference is mostly about what is being counted. The higher figures include people who meet the criteria; the lower figure includes only people who were formally diagnosed. Both are useful and neither is wrong.

Two honest caveats. There is no UK-specific estimate for this at all. And the samples behind the higher figures lean towards children and adolescents, so applying them directly to adults stretches them.

Sources: Rong et al. 2021, Lai et al. 2019

The part that is hard to explain to people

The word AuDHD is not a clinical term. It is a word the community made because it needed one.

What people most often describe is a set of needs that pull against each other.

• A deep need for routine, alongside a mind that goes flat without novelty
• Wanting plans made well in advance, then finding the plan unbearable when the day arrives
• Sensory overwhelm and understimulation, sometimes within the same hour

We should be careful here. The research base on that internal conflict is thin, so we are reporting what people describe rather than something established. It is described often enough, and consistently enough, to be worth naming.

The practical consequence is real though. Advice built for one can work directly against the other. Rigid structure can steady the autism and leave the ADHD restless and miserable.

Holding both fronts up all day is its own kind of effort. We cover masking and burnout separately.

Loosening it can do exactly the reverse. Strategies that assume only one of the two often fail. From the outside, that failure looks like a lack of effort.

What to look for in a professional

Someone who is comfortable with both, and who is not trying to resolve the tension.

In practice, that means someone who does not treat your need for structure as rigidity. Nor your need for change as inconsistency. Someone who will build something with you that flexes.

Not a system that only works on a good week.

If you have a diagnosis for one and suspect the other, say so. You do not need a second diagnosis to be connected with someone here, and we neither assess nor diagnose anyone.

A note on symbols

You may have seen an infinity loop merged with a butterfly used for AuDHD. There is no agreed version of it, and no organisation has made one official. We draw our own rather than copy anyone else's.