Autism Spectrum Condition and ADHD - “AuDHD”

Autism Spectrum Disorder (ASD) is a complex condition related to brain development which impacts social interaction, communication, and relationships and sometimes may occur with repetitive behaviours. While often diagnosed in childhood, ASD can present with challenges for adults who may not been assessed and diagnosed earlier in life.

“According to the scientific literature 50 to 70% of individuals with autism spectrum disorder (ASD) also present with comorbid attention deficit hyperactivity disorder (ADHD).” AuDHD is an informal term used by the neurodiverse community to refer to having both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).

With the rapid increase in ADHD awareness, do not have up to date information about the percentage of adults first diagnosed with ADHD who may also be suffering from autistic spectrum disorder. However, we are aware there is a strong link between the two diagnoses. During our comprehensive ADHD assessment, we screen for autistic traits in adults using the Autism Spectrum Quotient.
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What is Autism Spectrum Disorder (ASD)?

ASD is a lifelong neurodevelopmental condition that affects how a person perceives emotions, feelings, communication and interactions around them. This can be described by a combination of challenges:

Social communication and interaction: People with ASD may struggle with starting and maintaining a conversation, understanding nonverbal language, and interpreting social gatherings.

Sensory sensitivities: Individuals with ASD might be hyper-sensitive to certain food textures, sounds, smells, and tastes. While others might have a diminished, indifferent response to sensory stimuli.

Restricted and repetitive behaviours: Individuals have certain interests, activities, or patterns of behaviour: This can manifest in adults by excessively collecting certain niche material items, certain information and facts about types of planes, cars, and railways with little or no interest in any other categories.

Undiagnosed adults with ADHD may not display the classic signs of repetitive movements as often. However, their specific interests or lack of interest in social activities can create challenges in establishing and maintaining relationships.

Not everyone is the same

Mental health and autism are not a one-size-fits-all, and this also applies to ASD which is a condition on a spectrum. This means the severity and the symptoms are different from one individual to another. Despite some appearing functioning well in daily life, undiagnosed adults may experience significant difficulties in relationships and teamwork environments.

Signs and Symptoms of ASD

While the specific symptoms of ASD can vary considerably, here are some of the more common symptoms in adults:

Difficulty understanding social cues and unspoken rules

Misinterpreting body language, and facial expressions, they might miss subtle signs of emotions like sarcasm, annoyance, or excitement in non-verbal communication. Adults may develop and compensate with masking behaviours and having a standard set of tools: mirroring tone and body language, and persistent eye contact despite feeling uncomfortable.

Taking things literally: They might interpret language at face value, missing the intended meaning. Instead prefer clear and consistent communication, and find it difficult to adjust to sudden changes.

Difficulty with humour: sarcasm, teasing, with double meanings can be challenging due to a combination of literal interpretation, abstract language or social context understanding.

Preference for routine and difficulty adapting to change

Challenges making new friendships, but strong loyalty to existing friendships. People with ASD may take longer to open up to new people, but they are capable of establishing lasting friendships.

Fixated interests that may interfere with daily life. Some examples of fixated interests might include collecting trains, little dolls, video game characters, number plates or specific information in certain niche topics.

ASD and co-occurring conditions

Individuals with autistic spectrum disorder are more likely to experience symptoms or co-occurring conditions such as:

  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Anxiety and depression
  • Addiction e.g. gaming addiction
  • Eating disorders, ARFID
  • Autistic fatigue and burnout
  • Obsessive-compulsive disorder (OCD)

Diagnosis of ASD

At the ADHD Specialist, we offer ASD assessments for our patients diagnosed with Attention Deficit Hyperactivity Disorder. However, in complex cases, we recommend a collaborative approach with a separate ASD service.

Our assessment process follows the Royal College of Psychiatrists autism diagnostic interview guide. This involves:

Screening tools: We may utilise standardised screening tools such as the Autism Spectrum Quotient (AQ-50), The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R), Camouflaging Autistic Traits Questionnaire (CAT-Q).

In-depth clinical interview: We may already have detailed information from the ADHD assessment about your individual developmental history. We may need to expand in gathering additional information specific to ASD and further understand the current challenges.

Parent or caregiver interview: Insights from a parent or caregiver are often invaluable. However, we understand this information may not be always accurate or accessible due to various reasons. Depending on your specific case and complexity, we may conduct an ADI-R (autism diagnostic interview revised).

Report writing: involves information about the ASD diagnosis and provides a detailed picture of an individual's strengths and challenges - forming the foundation for recommended interventions.

Support for Autism Spectrum Disorder

When a diagnosis is established, it provides a framework for understanding the individual's experiences. Behaviours previously seen as "different" can be recognised as symptoms of ASD, leading to greater support.

ASD manifests differently in each adult. Our approach focuses on creating a personalized treatment plan tailored to the individual's specific strengths, challenges, and goals. Some of the interventions may be accessed from different services:

Therapy options

Cognitive Behavioral Therapy (CBT): CBT can address co-existing conditions like anxiety or depression, develop coping mechanisms for managing challenging behaviours, and promote emotional regulation.

Psychodynamic Interpersonal Therapy: suitable for individuals with an interest in self-exploration and with issues that are deeply rooted in past. This helps those seeking to understand and change repetitive relationships or outcomes. Although this type of therapy is less researched in ASD, it may be a useful tool for the curious individual where other therapies such as CBT have limitations

Social Skills Training: helps individuals develop the skills needed to establish and maintain relationships, understand non-verbal language, and navigate social situations more effectively.

Speech and Language Therapy: For adults with speech and language challenges, tailored support can improve communication skills, fluency, and confidence.

Family Support

Educating and supporting families is important. Guidance on understanding ASD, promoting communication, and implementing effective strategies at home or in the workplace. With the patient's consent, family members are welcome to attend the consultation and receive guidance.

Medication

Medication alone is not considered a first-line treatment for ASD. We take a cautious approach to recommendations, as this option may exacerbate existing autism symptoms and compared with the general population carries a higher risk of side effects.

In some cases, medication (when appropriate) might be used to manage co-occurring conditions like:

  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Anxiety
  • Depression

Many patients prioritise managing co-existing symptoms first and often prefer a medication-free approach if possible. We understand this choice and can offer a range of non-medication interventions.

Our approach to diagnosing Adult ASD

ASD assessments are comprehensive evaluations tailored to each individual. The complexity of the case and the information available from the informant will determine the specific length, costs and depth of the assessment process.

If you decide to take our private adhd assessment, we utilise the information we already have towards your ASD diagnosis. With this approach, we can complete your autistic spectrum disorder assessment within a separate 3-hour consultation which may be split into two separate appointments.

Our ASD assessment fee starts with the cost of a 3 hour consultation.

*This includes report writing and applies to patients open to our service and diagnosed with Attention Deficit Hyperactivity Disorder (ADHD).

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Are you diagnosed with Adult ADHD and suspect you may have undiagnosed autistic spectrum disorder (ASD)? We offer comprehensive assessments for our patients diagnosed by Dr Ivantu.
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