Introduction
ADHD and autism are often discussed in the same breath—both are neurodevelopmental conditions, both affect how the brain processes information, and both can significantly impact daily life. But are they related? Can you have both? And if so, how do you distinguish between them?
Here's what you need to know: ADHD and autism are distinct conditions, but they frequently co-occur and share some overlapping symptoms. In fact, research suggests that 30-80% of autistic individuals also have ADHD, and many people with ADHD have autistic traits even if they don't meet full diagnostic criteria for autism.
Understanding the overlap—and the crucial differences—is essential for getting accurate diagnosis and effective treatment.
Can You Have Both ADHD and Autism?
Absolutely yes.
Until 2013, the DSM (Diagnostic and Statistical Manual) didn't allow for dual diagnosis—you could have one or the other, but not both. This has changed.
Current understanding:
- ADHD and autism commonly co-occur
- Estimates suggest 30-80% of autistic people also have ADHD
- Approximately 20-50% of people with ADHD have significant autistic traits
- Co-occurrence is the rule rather than the exception
- Shared genetic factors
- Both involve altered brain development
- Similar neurotransmitter systems affected
- Both impact executive function (though differently)
- Planning and organization
- Time management
- Task initiation and completion
- Working memory
- Cognitive flexibility (shifting between tasks)
- ADHD: Difficulty is primarily with attention control and impulse regulation
- Autism: Difficulty is often related to need for routine and resistance to change
- Sensitivity to sounds, lights, textures, or smells
- Sensory overload in busy environments
- Seeking or avoiding certain sensory inputs
- ADHD: Sensory issues relate to filtering irrelevant stimuli (everything demands attention equally)
- Autism: Sensory processing differences are more fundamental; certain sensations may be physically painful or overwhelming
- Trouble reading social cues
- Interrupting or talking over others
- Difficulty maintaining friendships
- Social awkwardness
- ADHD: Challenges stem from impulsivity and inattention (not listening, interrupting, forgetting social norms)
- Autism: Challenges stem from different social processing (difficulty understanding unwritten rules, reading body language, interpreting social context)
- Intense emotional reactions
- Difficulty managing frustration
- Meltdowns or outbursts
- Rejection sensitivity
- ADHD: Emotional dysregulation is about impulse control and intensity
- Autism: Emotional responses often relate to overwhelm, change, or sensory issues
- Intense focus on topics of interest
- Difficulty shifting attention away from preferred activities
- Deep knowledge in specific areas
- ADHD: Hyperfocus is inconsistent, interest-driven, and not fully controllable
- Autism: Special interests are often sustained, deeply absorbing, and central to identity
- Wants social connection but struggles with execution
- Interrupts because excited, not reading cues
- Forgets to listen due to attention difficulties
- Can read emotions but may miss them due to inattention
- Social skills improve with reminders and practice
- May or may not desire social interaction (varies widely)
- Different social communication style (not wrong, different)
- May not instinctively understand unwritten social rules
- Facial expressions and body language less intuitive
- Social interaction can be exhausting (masking)
- Talks excessively when interested
- Interrupts frequently
- Loses train of thought mid-sentence
- May be tangential or disorganized in speech
- May be very verbal or minimally verbal
- Often literal interpretation of language
- May miss sarcasm, idioms, implied meaning
- May have unusual speech patterns (formal, scripted, echolalia)
- Difficulty with back-and-forth conversation flow
- Inconsistent behaviors (varies with interest/stimulation)
- Difficulty with routines (hard to maintain them)
- Impulsive actions without planning
- Constantly seeking novelty
- Consistent behavioral patterns
- Strong adherence to routines (distress when disrupted)
- Repetitive movements or behaviors (stimming)
- Preference for sameness and predictability
- May struggle with transitions (task-switching difficulty)
- Often adapts quickly once change happens
- Craves novelty but struggles with follow-through
- Significant distress from unexpected changes
- Needs preparation and warning for transitions
- Prefers predictability and routine
- May have rigid thinking patterns
- The autism part craves predictability and sameness
- The ADHD part struggles to follow through on routines
- Result: Constant frustration and self-criticism
- Can get lost in special interests for hours
- But also can't filter out irrelevant stimuli
- Result: Unpredictable productivity
- May want connection but not understand social rules
- Impulsivity makes social missteps worse
- Result: Loneliness and confusion
- May seek stimulation (ADHD) while being overwhelmed by it (autism)
- Hard to find the right sensory environment
- Result: Constant adjustment and discomfort
- Intense passion combined with bursts of productivity
- Creative problem-solving from different perspectives
- Deep knowledge in areas of interest
- Ability to notice details others miss
- Strong pattern recognition
- Unique insights and innovations
- Treatment may only address one condition
- Strategies might work against the other condition
- Medication may have unexpected effects
- Self-understanding remains incomplete
- Accommodations may be insufficient
- Social motivation may hide autistic traits
- Hyperactivity can overshadow repetitive behaviors
- Impulsivity might be mistaken for social difficulties
- Routine-seeking may hide organizational struggles
- Special interests can look like hyperfocus
- Social withdrawal might hide attention problems
- Experience with BOTH ADHD and autism in adults
- Understanding of how conditions present differently by gender
- Willingness to consider dual diagnosis
- Comprehensive assessment approach
- Their experience with co-occurring conditions
- Assessment tools they use
- How long the evaluation takes
- Whether they consider developmental history
- Stimulants can still be effective
- May need lower doses due to sensory sensitivities
- Side effects might be experienced more intensely
- Anxiety may increase (monitor closely)
- Non-stimulants sometimes better tolerated
- Cognitive Behavioral Therapy (modified for neurodivergent brains)
- Occupational therapy for sensory and executive function
- Social skills training (appropriate to actual needs)
- ADHD coaching combined with autism-informed strategies
- Therapies that try to "normalize" autistic behaviors
- Approaches that don't account for executive function challenges
- One-size-fits-all social skills programs
- Sensory-friendly workspace (lighting, sound, textures)
- Clear routines with flexibility built in
- Visual schedules and reminders
- Reduced social demands when needed
- Accommodations at work/school for both conditions
- Neither condition is a flaw to fix
- Both come with genuine strengths
- Understanding yourself leads to better strategies
- Community with other neurodivergent people helps
- Online communities for ADHD and autism
- Therapists experienced with neurodivergence
- Friends who accept your differences
- Accommodations at work and school
- Experiment with different approaches
- Honor your sensory needs
- Build routines that work WITH your brain
- Use your strengths to compensate for challenges
- Accurate diagnosis
- Effective treatment
- Self-understanding and acceptance
- Building strategies that actually work
Why the high overlap?
Overlapping Symptoms: What ADHD and Autism Share
Executive Function Challenges
Both conditions affect:
Sensory Sensitivities
Both can involve:
Social Difficulties
Both can experience:
Emotional Regulation Challenges
Both can have:
Hyperfocus and Special Interests
Both can demonstrate:
Key Differences Between ADHD and Autism
| Feature | ADHD | Autism |
| :---- | :---- | :---- |
| Attention | Difficulty sustaining attention across tasks | Can hyperfocus intensely on interests |
| Social challenges | From impulsivity and inattention | From different social processing and communication style |
| Communication | Interrupting, excessive talking | Literal interpretation, difficulty with nonverbal cues |
| Routines | Difficulty maintaining routines | Strong need for routines and sameness |
| Flexibility | Impulsive, often too flexible | Difficulty with unexpected changes |
| Sensory | Distracted by stimuli | Fundamental processing differences, may be painful |
| Interests | Shift frequently | Deep, sustained, often unusual |
| Eye contact | May forget to make eye contact | Often uncomfortable or effortful |
| Emotional regulation | Impulsive emotional reactions | Overwhelm-based reactions |
Distinguishing ADHD from Autism: The Nuances
Social Interaction Differences
In ADHD:
In Autism:
Communication Style
In ADHD:
In Autism:
Behavioral Patterns
In ADHD:
In Autism:
Response to Change
In ADHD:
In Autism:
What It Looks Like to Have Both ADHD and Autism
Having both conditions creates unique challenges:
The Paradoxes
Needing routine but unable to maintain it
Wanting deep focus but being easily distracted
Social desire without social skills
Sensory needs that conflict
Strengths of Having Both
When ADHD and autism combine, you may have:
Getting Diagnosed: What to Know
Why Accurate Diagnosis Matters
Without proper diagnosis:
Diagnostic Challenges
ADHD can mask autism:
Autism can mask ADHD:
Finding the Right Professional
Look for:
Ask about:
Treatment Considerations for Both Conditions
Medication
ADHD medication with autism:
Therapy Approaches
Beneficial for both:
Be cautious of:
Environmental Supports
Helpful modifications:
Living Well with ADHD and Autism
Self-Acceptance is Key
Embrace your neurodivergent brain:
Build Your Support System
Find people who understand:
Develop Personalized Strategies
What works for you might not be standard advice:
Frequently Asked Questions
Is ADHD on the autism spectrum?
No, they are separate conditions with different diagnostic criteria. However, they share some symptoms and frequently co-occur.
Can you develop autism if you have ADHD?
No. Autism is a developmental condition present from birth (though it may not be diagnosed until later). You cannot develop autism from ADHD or anything else.
Does everyone with ADHD have some autism?
No, though many people with ADHD have some autistic traits without meeting diagnostic criteria for autism. They are distinct conditions.
Why wasn't I diagnosed with both as a child?
Until 2013, official guidelines prevented dual diagnosis. Also, autism can be harder to recognize in people who also have ADHD, and vice versa.
Can ADHD medication help with autism?
ADHD medication treats ADHD symptoms specifically. It won't directly help autistic traits, though reducing ADHD symptoms may make some things easier overall.
Should I pursue dual diagnosis?
If you suspect you have both conditions, getting accurate diagnosis can help you understand yourself better, access appropriate treatment, and get accommodations.
The Bottom Line
ADHD and autism are distinct but related conditions that frequently co-occur. Understanding the overlap and differences between them is crucial for:
If you think you might have both conditions, seek evaluation from a professional experienced with neurodevelopmental conditions. Understanding your unique brain is the first step toward living well with it.
** Connect with specialists experienced in both through our provider directory.