If you’ve ever felt like you’re two contradictory people sharing one body — craving routine but getting bored by it, wanting connection but finding it exhausting — you’re not imagining things. You might be one of the many people living with autism and ADHD together, a combination sometimes called AuDHD.
Yes, you can have both. And it’s more common than most people realize.
This article explains what it means to have autism and ADHD together, how the two conditions interact, and what the path to getting evaluated actually looks like. If you’re looking for an autism evaluation or an ADHD evaluation, understanding how they can co-occur is a useful starting point.
- AuDHD is the informal term for co-occurring autism spectrum disorder (ASD) and ADHD.
- Research suggests that 50–70% of autistic people also have ADHD.
- Before 2013, clinicians were not allowed to diagnose both at the same time — DSM-5 changed that.
- AuDHD often creates internal contradictions: seeking novelty vs. needing sameness, craving connection vs. finding it overwhelming.
- A comprehensive evaluation by a licensed psychologist can assess for both conditions simultaneously.
What Does “AuDHD” Mean?
AuDHD — pronounced “aw-dee-aitch-dee” — is an informal term used by the neurodivergent community to describe people who are autistic and have ADHD. It’s not a clinical diagnosis; rather, it’s a way of naming the experience of having both conditions at once.
Clinically, both conditions fall under the umbrella of neurodevelopmental disorders — conditions that affect how the brain develops and processes information. The National Institute of Mental Health describes autism spectrum disorder as characterized by differences in social communication, restricted interests, and repetitive behaviors. ADHD involves difficulties with attention, impulse control, and activity regulation.
When both are present, the picture becomes more complex — not simply the sum of two separate conditions.
How Common Is It?
More common than most clinicians used to think. According to a review in PubMed, 50 to 70% of autistic individuals also have ADHD. A 2021 meta-analysis of more than 50 studies cited by the American Psychiatric Association found that among people with autism, 39% also had ADHD.
CHADD, the national organization for ADHD, notes that more than half of individuals diagnosed with ASD also show signs of ADHD, making ADHD the most common co-occurring condition in autism.
What’s striking is how often this dual presentation goes unrecognized. A 2024 study referenced by the APA found that only 16% of children with both conditions had been previously diagnosed with both. Adults fare even worse — many reach their 30s, 40s, or beyond having received only one diagnosis, or none at all.
Key Takeaway: Co-occurring autism and ADHD is the norm, not the exception. If you’ve been told you have one, it’s worth asking whether the other might also be present.
Why Was This Overlooked for So Long?
For decades, the clinical community was actually prohibited from diagnosing both. A 2017 review in PMC notes that the previous DSM-IV diagnostic criteria explicitly prohibited the simultaneous diagnosis of both ADHD and autism. The logic at the time was that attention difficulties in autistic people were simply part of autism itself — not a separate condition.
The DSM-5, published in 2013, removed this exclusion. Clinicians could finally recognize and document what they had been observing clinically all along: that autism and ADHD genuinely co-occur, and that treating them as one explains the other does a disservice to the people who have both.
This history matters because many adults who were evaluated before 2013 — especially those who received an ADHD diagnosis as children — may never have been assessed for autism. The reverse is also true.
What Autism and ADHD Have in Common
Understanding how autism and ADHD differ starts with recognizing their considerable overlap. Both conditions share several features:
- Executive function difficulties. Both affect the brain’s capacity for planning, organizing, shifting attention, and regulating emotions. The American Psychiatric Association notes that executive functioning challenges are present in both autism and ADHD.
- Attention differences. Both can involve difficulty sustaining or directing attention — though the mechanisms differ.
- Social communication challenges. Both can affect how people read social cues, maintain conversations, and navigate unspoken social rules.
- Sensory sensitivities. While more closely associated with autism, sensory sensitivities also appear in ADHD.
- Higher rates of anxiety and depression. A 2024 review in PMC found that approximately 75% of people with autism have at least one comorbid psychiatric condition, with ADHD being the most common — followed by anxiety, depression, and OCD.
Key Takeaway: Shared characteristics between autism and ADHD are part of why both conditions are often missed, misdiagnosed, or attributed entirely to one when both are present.
Where Autism and ADHD Pull in Opposite Directions
Here’s what makes AuDHD uniquely challenging: the two conditions don’t just overlap — they sometimes conflict. The APA describes several contradictory experiences common in AuDHD:
- Routine vs. novelty. Autism often drives a strong need for sameness and predictability. ADHD drives boredom and novelty-seeking. AuDHD people can feel trapped between these pulls — frustrated by change and suffocated by sameness.
- Stimulation. People with ADHD often seek constant stimulation. People with autism are often easily overstimulated. AuDHD individuals may crave stimulation while being quickly overwhelmed by it.
- Social connection. ADHD can drive impulsive social engagement; autism can make social situations exhausting and difficult to navigate. The result is wanting connection while struggling to sustain it.
- Overwhelming but unable to stop. Many AuDHD people describe feeling flooded by too much input but unable to slow themselves down — a state that can look like chaos from the outside and feel like it from the inside.
CHADD notes that while ADHD and ASD are both more common in males, they exist across all genders. Late-diagnosed autistic women and nonbinary individuals are increasingly recognized as a population where AuDHD often goes unidentified — in part because masking the more visible symptoms delays recognition.
Key Takeaway: The internal contradictions of AuDHD aren’t character flaws or inconsistency. They’re the result of two neurological systems with genuinely opposing tendencies operating in the same person.
Why AuDHD Is Frequently Missed in Adults
Late-diagnosed adults with AuDHD often describe years of partial explanations. They got an ADHD diagnosis in childhood that explained some things but not others. Or they were told they had anxiety, when the anxiety was actually a downstream effect of unrecognized autism. Or they were high-masking — performing neurotypicality well enough to slip through every evaluation.
Several factors make AuDHD particularly difficult to identify:
Symptoms mask each other. A clinical review in PMC notes that distinguishing between autism and ADHD-specific attention difficulties is inherently challenging — some attention differences in autistic people may be features of autism itself, while others genuinely reflect ADHD. Without a comprehensive evaluation, these nuances get lost.
Standard evaluations often test for one at a time. Many clinicians still screen for autism or ADHD separately, rather than approaching the evaluation with both in mind simultaneously. A provider trained in dual assessment is essential.
The pre-2013 diagnostic blind spot. Anyone evaluated before 2013 was working under criteria that prevented a dual diagnosis. Adults in their 30s or older who received any prior evaluation may never have had the benefit of current understanding.
Gender and presentation bias. Women, girls, and nonbinary people with AuDHD are significantly underdiagnosed. The CDC reports that autism is identified more than 3 times more often in boys than girls — a disparity driven in part by the fact that assessment criteria were developed based on male presentations.
Key Takeaway: If you received a partial explanation that never quite fit — or no diagnosis at all — a comprehensive dual evaluation may finally provide the full picture.
What Does Evaluation for AuDHD Look Like?
Getting evaluated for both autism and ADHD simultaneously is possible, and increasingly common. A comprehensive evaluation by a licensed psychologist includes:
- Clinical interview. A detailed history of your development, current challenges, and functioning across different environments (work, relationships, home).
- Standardized rating scales. Questionnaires for both autism and ADHD that capture your self-report alongside responses from people who know you well.
- Cognitive and neuropsychological testing. Assessments of attention, executive function, and processing speed.
- Behavioral observation. The psychologist observes social communication patterns during the evaluation itself.
The CDC notes that ADHD diagnosis is made by a mental health professional, such as a psychologist or psychiatrist. The same is true for autism. When both are being assessed together, a licensed psychologist with experience in dual evaluation is the most appropriate provider.
At Josi Health, our autism evaluation and ADHD evaluation processes are designed to assess the full picture — including the possibility that both are present. If you’re looking for answers, you have options. Explore how our online assessments work and what your comprehensive report includes.
Key Takeaway: Evaluation for AuDHD doesn’t require two separate appointments. A thorough assessment by a qualified psychologist can evaluate for both conditions in one comprehensive process.
Support and Treatment for AuDHD
Once you have a dual diagnosis, the path forward becomes clearer — even if it’s not simple. A few important points:
Treatment approaches may need adjustment. CHADD cautions that stimulant medications commonly used for ADHD may be less effective and cause more side effects in people who also have autism — including social withdrawal and irritability. A prescribing provider should know about both diagnoses before recommending medication.
Therapy benefits from a dual lens. Psychotherapy, particularly cognitive-behavioral approaches adapted for neurodivergent people, can address executive function challenges, emotional regulation, and sensory management in ways that honor both the autism and ADHD components.
Understanding your own contradictions is the starting point. Many AuDHD adults report that the diagnosis itself was transformative — not because it changed who they were, but because it explained experiences that had seemed inexplicable. Knowing that the push-pull between routine and novelty is neurological rather than personal failure is genuinely useful.
Accommodations can address both. Workplace and educational accommodations can be written to address the combined needs of both conditions. For guidance on navigating next steps after diagnosis, including accommodation requests, Josi Health’s post-evaluation support can help.
A Note on Complexity
AuDHD is real. It’s well-documented in research, increasingly recognized in clinical practice, and deeply resonant for the adults who finally receive a dual evaluation and understand what they’ve been navigating. The 2024 research published in PMC confirms that people with co-occurring ASD and ADHD experience significantly higher rates of additional comorbidities than people with either condition alone — underscoring the importance of a complete evaluation rather than a partial one.
If you’ve been wondering whether your experience fits the AuDHD profile — or if a previous diagnosis explained some things but left others unaccounted for — that wondering is worth taking seriously. You can learn more about both processes and what to expect by visiting our FAQs or reading about the evaluation experience directly.
Answers are available. You don’t have to keep working with incomplete information.
Reviewed by the Josi Health Clinical Team, Licensed Psychologists.