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Comorbidity

ADHD and Autism (ASD)

Research shows that 30 to 50% of autistic people also have ADHD — and about 20 to 30% of people with ADHD are on the autism spectrum. It is no coincidence: the two conditions share neurological underpinnings and frequently coexist.

30–50%
of autistic people also have ADHD
1 in 100
people are on the autism spectrum (WHO)
+5 years
average diagnostic delay for autistic women

ADHD vs. autism: key differences

They are distinct conditions — but with many points of overlap, which makes diagnosis challenging when the two coexist.

AspectADHDAutism (ASD)
AttentionHard to regulate — jumps between stimuli or gets stuck in hyperfocusIntense, sustained hyperfocus on specific interests
CommunicationVerbal impulsivity, interrupts, talks too much or at the wrong timeDifferent processing of social communication; literalness; may dislike small talk
RoutineDifficulty creating and maintaining routine; procrastinationNeed for routine, predictability and consistency; changes cause stress
Sensory processingSeeks stimulation and noveltyHyper- or hyposensitivity to sound, light, touch, texture, smell
SociabilityWants to interact, but has difficulty with attention and impulsivityA distinct way of processing social interactions; may prefer structured interactions
Emotional regulationIntense, fast reactions; rejection sensitive dysphoriaMeltdowns or shutdowns under overload; may have alexithymia (difficulty naming emotions)

Symptoms shared by both

These symptoms show up in both conditions — which complicates the differential diagnosis and leads many people to be treated for only one of them for years:

Difficulty sustaining attention
Hyperfocus on specific interests
Difficulty with organization and planning
Difficult emotional regulation
Frequent anxiety
Difficulty sleeping
Sensitivity to criticism and rejection
Difficulty with transitions
Social fatigue

When ADHD and autism are both present

The presence of both — sometimes called twice-exceptionality or "AuDHD" — creates a specific profile that can be harder to identify. Symptoms of one condition can mask the other: ADHD's impulsivity and restlessness can obscure autistic traits, while autistic masking can make ADHD look less intense than it actually is.

Many people discover they are autistic only after an ADHD diagnosis — or the other way around. Professionals unfamiliar with the comorbidity tend to stop at the first diagnosis and not investigate the second.

What is masking (camouflaging)?

Masking is the — usually unconscious — process of learning to imitate neurotypical behaviors to blend in socially. It is especially common in autistic women and autistic people with high cognitive ability. Decades of masking cause chronic exhaustion, loss of identity, and increase the risk of autistic burnout.

How ASD diagnosis works in adults

An autism diagnosis in adults is clinical — made by a psychiatrist or neuropsychologist experienced in the area, based on detailed interviews, validated scales (such as the ADOS-2 or ADI-R) and a lifelong history. There is no imaging or blood test that diagnoses autism.

In adults, the process is more complex because the person has developed coping strategies over the years. Ideally, the clinician also screens for ADHD, anxiety and other commonly associated conditions.

Treatment when both conditions are present

When ADHD and autism coexist, treatment needs to be planned for both conditions. ADHD medication (methylphenidate or lisdexamfetamine) can be effective, but requires more careful adjustment. Therapy needs to address both the executive-function difficulties and the aspects of autism.

Environmental adaptations are especially important: structured routines, reduced sensory overload, clear and predictable communication. Many autistic people with ADHD benefit from visual organization strategies, alarms and tools that support executive function — also available in the Balanced Mind app.

Balanced Mind can help

The app's tools — routines, task management, mood check-ins, an emotional journal and crisis mode — are designed to support people with executive and emotional difficulties, benefiting both people with ADHD and people on the autism spectrum.

Frequently asked questions

Can I have ADHD and autism at the same time?

Yes. Research shows that 30 to 50% of autistic people also have ADHD. The two conditions share neurological underpinnings and coexist frequently.

Are ADHD and autism the same thing?

No. They are distinct neurological conditions. ADHD mainly involves difficulty regulating attention and impulsivity. Autism (ASD) involves a broader pattern of different neurological processing, including distinct ways of processing social, sensory and emotional information.

How do I pursue an autism diagnosis?

Diagnosis is made by a psychiatrist or neuropsychologist trained in ASD. Through public health systems, this typically means a referral from a primary care physician or a community mental health center. Privately, psychiatrists with experience in neurodiversity are the most suitable professionals.

Is there a treatment for autism?

Autism is not a disease to be cured — it is a different way of neurological functioning. Support focuses on helping the person live well with their characteristics: occupational therapy, speech therapy, psychotherapy and, when ADHD is also present, medication. The goal is quality of life and autonomy, not "normalization."

Note: The content on this page is informational and based on recognized scientific sources. It does not replace a professional clinical evaluation. If you suspect autism or ADHD, see a psychiatrist or neuropsychologist experienced in neurodiversity.