Understanding AuDHD: What is AuDHD, and what support is available?

The term AuDHD has come into increasingly popular use in recent years. Rates of new autism and ADHD diagnoses have grown since the turn of the century, likely in response to growing awareness around ADHD and autism, as well as changes to diagnostic criteria for both. As these rates have risen, an increasing proportion of people have received both diagnoses. AuDHD, the term coined to describe this dual diagnosis, represents a unique set of experiences, strengths and challenges. Understanding these nuances is key to supporting neurodivergent people in our lives, and making truly holistic, neurodiversity-affirming mental health care more widely available.

AuDHD (pronounced awe-D-H-D) describes individuals who are both autistic and have ADHD. AuDHD is not an official medical term or a diagnosis per se, but a shorthand adopted by the neurodivergent community. AuDHD individuals experience unique intersections of ADHD and autistic traits.

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Autism and ADHD are both neurodevelopmental disabilities associated with differences in cognitive and sensory processing. 

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Autism, or autism spectrum disorder (ASD), can entail:

• Differences in communication and social approaches
• Specific special interests
• Repetitive behavior
• A strong preference for sameness and repetition
• Heightened sensory sensitivities.

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ADHD, or attention deficit hyperactivity disorder, often presents with differences in attention, hyperactivity, and/or impulsivity. Some symptoms of ADHD include:

• Difficulty maintaining attention
• An ability to hyperfocus
• Restlessness/moving around often
• Acting or speaking quickly and without careful consideration. 

These traits can contribute to executive functioning differences, such as difficulty changing or completing tasks.

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Autistic and ADHD traits overlap in nuanced ways, and both groups share differences from neurotypical people in:

• Thinking style
• Executive function
• Sensory sensitivities
• Social communication. 

Autistic and ADHD individuals tend to differ from each other in a few meaningful ways. While autistic individuals tend to strongly prefer routine and familiarity, ADHDers often crave novel experiences and may find repetition boring or stifling. For this reason, autistic people may also experience less flexible thinking styles than ADHDers. Additionally, though both ADHD and autistic individuals often experience differences in attention, autistics may demonstrate a greater ability to maintain focus than ADHDers. 

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ADHD and autism co-occur fairly regularly. Around 50 to 70% of autistic individuals also have ADHD. Some studies have pointed to shared genetic and biological markers between autism and ADHD, suggesting there is a relationship between the two neurotypes. However, the nature of this relationship is still the subject of speculation. One study from the Netherlands posits that ADHD and autism are distinct subtypes of the same condition. Other scientists suspect the shared biological indicators between the two diagnoses may play a role in the behaviors common to both.

The prevalence of AuDHD and the unique experiences of AuDHDers have yet to be studied at length. This lack of research makes determining how common AuDHD is among adults difficult. Plus, AuDHD may be underdiagnosed, widening this knowledge gap. 

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Autism and ADHD come with many overlapping traits, and some individuals who have been diagnosed with either disorder may not pursue further diagnoses, taking this one diagnosis as a complete explanation for all of their neurodivergent traits.

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While the data is limited, AuDHDers seem to comprise a notable portion of the adult population. An estimated 2.21% of adults in the U.S., or almost five and a half million adults, are autistic, and 6% of U.S. adults, about 15.5 million, have ADHD. It’s worth noting that these estimates were reported six years apart—2017 and 2023, respectively. Adult ADHD and autism diagnosis rates are growing, likely due to increased awareness and understanding of neurodivergence and the diverse ways it can present, as well as changes to the diagnostic criteria for autism and ADHD in 2013. This means updated research is warranted to gain an accurate understanding of how common autism is among U.S. adults. Regardless, among these nearly 20 million adults, AuDHD may be quite common, given the frequency at which autism and ADHD co-occur.

AuDHDers have many traits in common with individuals who are only autistic or only have ADHD, but they also experience the unique blending of ADHD and autistic characteristics. Often, this means that traits common to both diagnoses present with greater intensity in AuDHD individuals. It also means that AuDHDers can experience tension between conflicting autistic and ADHD traits.

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Amplification of shared traits

Autistic people and ADHDers often experience differences in sensory processing. For many, this means heightened sensitivity and strong reactions to certain sensory inputs.  Autistic and ADHD individuals can also experience decreased sensitivity to certain sensations, often ones within the body such as hunger, temperature and pain. In AuDHDers, these differences in sensory response can be even more pronounced.

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AuDHDers may also experience an amplification of executive functioning differences that are common between autism and ADHD. These include differences in visuospatial skills, working memory, time management, attention, response inhibition, speed of processing and planning. Autistic and ADHD individuals are both also more likely to exhibit differences in emotional regulation, which can also be heightened in AuDHDers.

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Both autistic and ADHD individuals may also experience challenges navigating social situations. Autistic individuals tend to communicate differently from neurotypical people and lack an intuitive awareness of social expectations. Many find it difficult and uncomfortable to meet typical social expectations. While individuals with ADHD but not autism don’t necessarily struggle to understand social cues, their social behavior may still diverge from what is expected. ADHDers may change topics quickly, and find their mouths move faster than their brains, leading them to act impulsively or in ways others find unusual. In AuDHDers, these social differences can combine, making social navigation feel even more difficult and tiresome.

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Competition between ADHD and autism traits

Contrasting characteristics between autism and ADHD can present simultaneously in AuDHDers, leading many AuDHD individuals to experience tension between competing traits. For example, AuDHDers may feel a conflict between the autistic preference for sameness and the ADHD desire for novelty. AuDHD individuals may implement routines for themselves, but quickly grow bored of them, and find it difficult to motivate themselves to engage with such structures. They may also seek out new experiences or exhibit impulsive behavior, but find the unpredictability that comes with these scenarios distressing. 

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AuDHDers can also struggle with focus and attention. Both autistic and ADHD individuals tend to independently experience inattention and hyperfocus. In AuDHDers, these traits can be both amplified and complicated by the intense interests common among autistics. While they can exhibit impressive focus on areas of interest, AuDHDers may only be able to maintain attention on these subjects for a short time. AuDHD individuals may enjoy the intense focus they can apply to a new hobby or interest, but become frustrated when they grow bored of it quickly.

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AuDHD strengths

AuDHDers possess many of the strengths autistic and ADHD individuals have, and can benefit from the interplay or amplification of these traits. They can be adept problem solvers, thinking quickly and outside the box. AuDHDers can be flexible in problem-solving, often identifying creative solutions to improve systems. AuDHDers also tend to be highly attentive to detail. Because their perceptual and sensory engagement with the world differs from neurotypical people's, they often notice things others may not. AuDHDers may have strong interests, passions and a heightened ability to focus on areas of interest. As with autism and ADHD alone, AuDHD is an important contributor to neurodiversity and the value it presents to our communities.

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As with each autistic person and ADHDer, every AuDHD individual possesses a unique combination of neurodivergent traits. While these are some common experiences AuDHDers report, they do not make a comprehensive list. Each AuDHD individual also has their own relationship with the intersection of their autistic and ADHD characteristics.

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AuDHD consists of two separate diagnoses, and individuals might be evaluated for autism and ADHD separately. For some people, these diagnoses can come years apart, while others may pursue each diagnosis around the same time. Regardless, being diagnosed with both ADHD and autism can help individuals achieve a much clearer, more nuanced understanding of themselves and the way they move through the world.

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Autism and ADHD are diagnosed through similar processes. For both diagnoses, a clinical interview with the individual being assessed is the primary component. The interview is structured differently depending on which diagnosis is in question, but the focus is generally on an individual’s development, behavior and experiences as they relate to the relevant diagnostic criteria.

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The evaluation process for both ADHD and autism may also incorporate an individual’s loved ones. Because both ADHD and autism are considered developmental disabilities, meaning they are present in early childhood, providers often also interview someone who was present during the individual’s youth, like a parent or caregiver. These individuals are typically asked to describe the individual’s development and behavior during childhood. Sometimes, these individuals complete questionnaires rather than provider interviews.

Therapy is an invaluable resource to support AuDHD individuals with their unique challenges. Many AuDHDers also have co-occuring mental health conditions like anxiety and depression, which can be treated through a variety of therapeutic approaches, such as cognitive behavioral therapy (CBT). Neurodiversity-affirming care is paramount for AuDHDers, whose needs and experiences can be misunderstood by providers who lack experience in supporting neurodivergent patients.

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A psychiatrist may also prescribe certain medications as a tool for AuDHDers. Stimulant medications are the most commonly prescribed ADHD treatment, and some research suggests stimulant medication can help AuDHD individuals with executive functioning differences that are affecting their quality of life. However, research also provides evidence that these medications may be slightly less impactful in AuDHD individuals than in people who only have ADHD.

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AuDHDers may also be prescribed antidepressant medications, though research on these drugs’ impacts on AuDHD adults is limited. Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are often prescribed to autistic individuals. These drugs can treat co-occurring anxiety and depression that many autistics experience. However, researchers are divided on the impact SSRIs can have in ADHDers.

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Different kinds of antidepressants, like tricyclic antidepressants and bupropion (Wellbutrin), are more frequently prescribed to individuals with only ADHD. These drugs may reduce the difficulty many ADHDers face with attention and hyperactivity, but their effects on autistic adults and their mental health have not been studied at length.

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For AuDHD individuals who are considering medication, it’s best to see a mental healthcare provider who has experience supporting AuDHD patients. They can work with you to determine the best treatment plan for your individual needs.

Are you wondering if you might have AuDHD? Prosper Health can help you on your path toward answers.

Prosper Health offers telehealth autism assessments from providers who specialize in working with autistic adults. Prosper Health providers can share resources specific to neurodivergent adults.

Prosper Health can also provide ongoing, individualized support for AuDHDers through neurodiversity-affirming therapy. All of Prosper Health’s therapists specialize in supporting neurodivergent adults and have a range of other specialties. Prosper Health can match you with the right therapist to work with you toward your goals for your mental health, so you can thrive with AuDHD.