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Writer's pictureRae'Anne Tan

When Autism meets ADHD

When Autism meets ADHD. What exactly do we know about AuDHD?

AuDHD is an unofficial terminology coined to describe an individual as being both Autistic and ADHD.

In this post, we’ll discover the intricacies of the AuDHD brain, unpack the wonders of the AuDHD experience, and find out what we can do to support the needs of this unique AuDHD community in Singapore.

When Autism meets ADHD  | AUDHD | Autism and ADHD | What do we know about ADHD

AuDHD = Autism + ADHD

The term AuDHD had only been in existence and gained traction, in the last decade or less. Before 2013, a dual diagnosis of both ASD and ADHD was deemed impermissible by medical standards.


The 5th edition of the Diagnostics and Statistics Manual differentiates between Autism and ADHD:


Autism is characterised primarily by

  1. Persistent deficits in social communication and interaction, and

  2. Restricted and repetitive patterns of behaviour, interests, or activities;

ADHD’s core symptoms include

  • Inattention, and/or

  • Hyperactivity and impulsivity

depending on the ADHD subtype.


But when it comes to AuDHD, the neurobiological differences and clinical manifestations of Autism and ADHD can no longer be discussed in silo. Both Autism and ADHD are neurodevelopmental conditions characterised by distinct differences in the individual’s brain structure and function; and in AuDHD, the brain simply looks like a unique mishmash of various Autism and ADHD features.


The AuDHD Experience


How common is it?

The prevalence of Autism and ADHD in Singapore stands at approximately 1% and 5% respectively. Conversely, research has shown that around 30-80% of people with Autism meet the diagnostic criteria for ADHD, and 20-50% of individuals with ADHD meet the diagnostic criteria for Autism.


As you might infer, it is not uncommon for a child to be diagnosed with both Autism and ADHD. And in fact, having ADHD lands you a much higher likelihood of being diagnosed with Autism, compared to someone without ADHD, vice versa!


Getting Diagnosed

Although ADHD and Autism are clinically distinct from one another, they share several observable traits such as attention deficit, behavioural problems, social difficulties, and struggles with executive function (planning, working memory, problem solving, self-control) and emotional regulation. In Singapore, Autism and ADHD are typically diagnosed in the early years, when some of these issues begin to surface and are flagged out by caregivers and educators.


As with Autism and ADHD, AuDHD manifests uniquely in every individual. However, the blurred lines of intersection between Autism and ADHD often lead to overlooked or misunderstood symptoms, posing significant challenges in the attempt to fit into either or both diagnostic criteria.


A Therapist’s Perspective

Many children walk into the doors of therapy centres and schools with a host of behavioural, social-emotional, or academic problems exacerbated by their dual diagnoses of both Autism and ADHD. According to research, individuals with AuDHD tend to have poorer outcomes compared to those with only either one or the other, thus it is of utmost importance to us to support their learning and developmental needs.


What is unique about AuDHD is how trait symptoms sometimes interact and manifest in idiosyncratic behaviours.

  1. ADHD and Autism trait interactions can AMPLIFY certain dysfunctions (e.g., ADHD sensory processing difficulties collide with the sensory sensitivities of Autism, leading to sensory overstimulation in those with AuDHD)

  2. Opposing traits of ADHD and Autism may also interact and BALANCE each other (e.g., Autistic preference for structure and routine supports the ADHD struggle with organisation and initiation of tasks)


Take the Next Step with Us!

The unique combinations of traits of Autism and ADHD must be addressed when implementing treatment, and remediation strategies need to be more nuanced, individualised, and tailored to every individual’s unique needs.


At Total Communication, our team of experienced and licensed therapists are committed to evidence-based practices, to deliver individualised and effective solutions for our clients! We take on a client-centric, family-centered approach, to provide individualised and effective support in the holistic development of our clients.


If you have any questions, or concerns about your child’s development, feel free to contact us at Total Communication, it is our pleasure to support you and your child in this journey!


References

Gargaro, B. A., Rinehart, N. J., Bradshaw, J. L., Tonge, B. J., & Sheppard, D. M. (2011). Autism and ADHD: how far have we come in the comorbidity debate?. Neuroscience & Biobehavioral Reviews, 35(5), 1081-1088.


Mayes, S. D., Calhoun, S. L., Mayes, R. D., & Molitoris, S. (2012). Autism and ADHD: Overlapping and discriminating symptoms. Research in Autism Spectrum Disorders, 6(1), 277-285.


Kernbach, J. M., Satterthwaite, T. D., Bassett, D. S., Smallwood, J., Margulies, D., Krall, S., ... & Bzdok, D. (2018). Shared endo-phenotypes of default mode dysfunction in attention deficit/hyperactivity disorder and autism spectrum disorder. Translational psychiatry, 8(1), 133.


Hours, C., Recasens, C., & Baleyte, J. M. (2022). ASD and ADHD comorbidity: what are we talking about?. Frontiers in Psychiatry, 13, 154.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

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