AuDHD, ADHD, and Autism Acceptance Month
Rachel Feldman, LCSW, ADHD-CCSP, ASDCS, a member of CHADD’s board of directors, shares her lived experience as an autistic person with ADHD (AuDHD).
Recognizing individuals who have autism, appreciating their contributions, and celebrating the diverse ways they enrich our communities, is a driving goal of April’s Autism Appreciation Month.
Along with this recognition is the growing social and therapeutic understanding of AuDHD–the name given to the co-occurrence of ADHD and autism spectrum disorder—and the individuals who navigate the world while experiencing the sometime conflicting characteristics of both conditions.
“Living with AuDHD is not a simple equation,” says Rachel Feldman, LCSW, a member of CHADD’s board of directors. She is an ADHD-certified clinical services provider and a certified autism spectrum disorder clinical specialist.
“It is layered, complex, and deeply individual,” she says. “Here is what I want you to take away: AuDHD not a contradiction. It’s a whole valid neurotype that deserves to be understood on its own terms.”
Autism and ADHD share similar traits
On the surface, ADHD and autism seem to have similarities, but a deeper comparison shows they are quite different developmental disorders. Autism spectrum disorder (ASD) is typically diagnosed in early childhood. If you think your child has ASD, look for signs that they are having social interaction and communication difficulties, not just repetitive behaviors or restrictive interests. Other indications may include when your child takes longer to reach developmental milestones, generally no response to you or other family members, or has difficulty making eye contact. If you notice these behaviors, discuss them with your child’s medical practitioner.
A child with ASD can display ADHD-like symptoms. ADHD by itself is different, however. Your child may have ADHD if he talks nonstop, blurts out answers, has trouble sitting still, struggles with focusing, or difficulty paying attention.
This may mean that if a child has communication difficulties and engages in restrictive, repetitive behaviors, it’s more likely the child has ASD rather than ADHD. However, making that formal determination would require a medical provider.
Medical specialists are now better screening for ASD and ADHD using patterns from information shared or observed during the patient’s previous medical visits. A Duke University study found children who were later diagnosed with ASD or ADHD had more medical visits during their first year of life.
“We are hopeful that these early utilization patterns can eventually be combined with other sources of data… to help parents and pediatricians identify which kids will benefit most from early assessment and treatment,” says Scott Kollins, PhD, one of the study authors and a former member of CHADD’s professional advisory board.
AuDHD—Experiencing co-occurring ADHD and ASD
Until 2013, an individual would be diagnosed with either ADHD or ASD—not both. That changed with the updates included in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, acknowledging the experiences of many people and their healthcare providers.
Now, research is demonstrating that 50%-70% (or higher) of individuals with ASD likely also have ADHD. This co-occurrence has taken on the portmanteau “AuDHD” and this new word has quickly become recognizable in both the ASD and ADHD communities.
A person who has AuDHD, as described by many but not all people, has symptoms of both ADHD and ASD, not necessary in even amounts. These symptoms are frequently at odds within the person and can make them feel like they are being pulled toward two extremes.
“I’ve spent most of my life feeling like I contradict myself in ways that don’t make sense,” wrote one member of a popular online forum. “I crave structure. I feel calmer when my days have some kind of shape. And then the moment that structure settles in, I start feeling boxed in. Even when the routine is something I chose. Even when it’s helping.”
Addressing AuDHD symptoms requires combining parts of ADHD and ASD treatment plans and then tailoring those approaches to that person’s needs. Combinations of behavioral treatment, medication management, and lifestyle supports are most common. Some people include coaching or meeting with a therapist in their support plans.
Just like creating an ADHD treatment and support plan, an AuDHD treatment and support plan is often highly personalized to best meet that person’s needs. Finding and getting to know other people in the AuDHD, ADHD, and ASD communities is often an important part of most support plans.
AuDHD acceptance
In the years since the change in the DSM-5, more people have learned about the dual diagnosis of ADHD and ASD. Social media has also helped to share information and connect people with AuDHD. Most people report feeling relieved to have a phrase that explains how they navigate the world.
“Over time, I’ve realized I’m not broken,” shared another forum writer. “I’m just living in the middle of two competing needs. My brain wants safety and freedom at the same time. Now I try to build flexible structure instead of rigid rules. I give myself options instead of demands. Some days I follow my routine beautifully. Other days I ignore every plan I made the night before. Both versions of me are valid.”
Learn more about ADHD and autism:
- ADHD and Autism Spectrum Disorder
- Autism Acceptance Month Highlights Connection Between ASD and ADHD
- ADHD, Autism, and More: What Goes into Getting a Diagnosis?
- A Better Understanding of ADHD & Autism
- Vaccines Have No Role in ADHD
- Coexisting ADHD, Autism, and Anxiety: Understanding and Treating Complicated Problems