Can You Have Both ADHD and Autism?

Yes, and it is more common than most people realize. Research shows that 30 to
80 percent of children with autism also meet the criteria for ADHD, and 20 to
50 percent of children with ADHD meet the criteria for autism. These are not
rare edge cases. Co-occurring ADHD and autism is one of the most frequently
seen combinations in neurodevelopmental assessments.

Understanding the overlap, and where the two conditions genuinely differ,
helps families pursue accurate diagnosis and more effective support.

What Do ADHD and Autism Have in Common?

Shared Symptoms

Both conditions affect how the brain processes information, regulates
attention, and handles social interactions. The overlap includes:

• Difficulty with sustained attention and focus
• Challenges in social situations (though for different reasons)
• Sensory sensitivities
• Executive functioning deficits (planning, organization, task-switching)
• Emotional regulation difficulties
• Impulsivity

Children with ADHD are frequently rejected by peers and have fewer friends, a
social difficulty typically associated with autism. Meanwhile, up to a quarter
of children with ADHD exhibit low-level signs of ASD, such as sensory
sensitivities or challenges with social pragmatics.

Shared Genetic and Neurological Roots

The overlap is not coincidental. Approximately 50 to 72 percent of the genetic
factors contributing to ADHD and autism overlap. Both conditions involve
multiple genes, each with individually small effects. Individuals with autism
and their extended family members have elevated rates of ADHD, and vice versa.
This shared genetic architecture explains why the two conditions frequently
appear in the same person and across family members.

Neuroimaging studies show shared and distinct brain alterations. Both
conditions involve subcortical volume decreases and differences in cortical
thickness. White matter abnormalities appear in both, with reduced fractional
anisotropy in the corpus callosum common across ASD and ADHD.

Environmental Risk Factors

Prenatal exposure to toxins, tobacco use, alcohol consumption during
pregnancy, premature birth, and low birth weight are associated with increased
risk of both conditions. These environmental factors interact with genetic
predisposition and do not cause either condition in isolation.

How Are ADHD and Autism Different?

Despite significant overlap, the two conditions have distinct diagnostic
criteria and different underlying profiles.

Autism (ASD) is primarily a social communication and
behavioral disorder. Core features include difficulties with communication,
social interaction, repetitive behaviors, and restricted interests. ASD is
classified as a developmental disability.

ADHD is primarily an attention and impulse regulation
disorder. Core features include inattention, hyperactivity, and impulsivity.
ADHD is classified as a neurological disorder.

Key behavioral differences:

• A child with ADHD may struggle to focus on tasks they find uninteresting,
  but can hyperfocus briefly. A child with autism may hyperfocus intensely on
  specific topics for extended periods.
• Children with autism often have a strong need for repetition and sameness.
  Children with ADHD typically do not exhibit this pattern.
• ADHD is often not diagnosed until school age when attention demands
  increase. Autism symptoms are usually apparent earlier, often by 18 to 24
  months.
• People with autism may struggle with understanding nonverbal communication,
  sarcasm, and social cues. People with ADHD more commonly struggle with
  following through on tasks and impulse control.

Can Autism Be Mistaken for ADHD?

Yes, particularly in early childhood and in girls. The attention difficulties
associated with autism can look like ADHD inattentive type. Social struggles
common in ADHD can resemble mild autism. When a child’s most visible
challenges are attention and behavior rather than communication, ADHD may be
diagnosed first and autism missed entirely.

Studies suggest 30 percent of individuals with ADHD may also meet criteria for
ASD. Without a comprehensive evaluation, the second diagnosis is often
delayed.

Gender Differences in Diagnosis

Both ADHD and autism are diagnosed later and less frequently in girls than in
boys. Girls with either condition often mask more effectively, presenting with
internalized symptoms like anxiety or depression rather than the more visible
hyperactivity or social rigidity. This delays diagnosis and intervention for
many female children.

In adults, diagnosis is further complicated because ADHD symptoms overlap with
anxiety and mood disorders, and autism symptoms may be masked by years of
learned coping mechanisms.

What Does Co-Occurring ADHD and Autism Look Like?

When both conditions are present, the challenges are compounded. Individuals
with co-occurring ADHD and ASD tend to have:

• Greater difficulty with executive functioning than either condition alone
• More significant social challenges
• Higher rates of anxiety and depression
• More difficulty with daily living and adaptive functioning
• Lower quality of life scores compared to either diagnosis alone

About 70 percent of people with an intellectual disability and ADHD also have
ASD, making this population particularly complex to assess and treat.

Unique strengths can also emerge. Some individuals with both conditions show
an ability to hyperfocus on areas of interest combined with the creative,
lateral thinking often associated with autism. These strengths are worth
identifying and building on.

How Is Co-Occurring ADHD and Autism Diagnosed?

Before 2013, the DSM did not allow dual diagnosis of ASD and ADHD. The DSM-5
changed this, explicitly permitting both diagnoses to be assigned. This was a
significant shift that opened the door to more accurate, complete diagnoses.

Diagnosis involves a comprehensive evaluation including:

• Developmental history and parent interview
• Standardized cognitive and behavioral assessments
• Social communication assessment
• Direct observation across settings
• Rating scales from parents and teachers

Some specialists use quantitative electroencephalogram (qEEG) brain mapping to
identify dysregulated neural networks. This technology can help distinguish
ADHD-related patterns from ASD-related patterns, though it is not required for
diagnosis.

Accurate diagnosis requires professionals with experience in both conditions.
A general pediatrician alone may not be sufficient for a complex
dual-diagnosis evaluation. Referral to a developmental pediatrician, pediatric
neuropsychologist, or child psychiatrist is often warranted.

What Treatments Work for Both?

Behavioral Interventions

Behavioral approaches are first-line treatment for both conditions. Applied
Behavior Analysis (ABA) therapy is the most evidence-based intervention for
autism, with a strong track record for improving communication, social skills,
and reducing maladaptive behaviors. Behavioral interventions for ADHD focus on
executive function skills, impulse control, and organizational strategies.

Parent education and behavioral training are important components for both.
Teaching parents to implement consistent strategies at home significantly
improves outcomes, particularly for younger children.

Social Skills Training

Social Skills Training (SST) addresses the social difficulties common to both
conditions. Effective programs combine direct instruction with real-world
practice. The PEERS program at UCLA, a 16-week evidence-based curriculum, has
shown strong results for adolescents with ASD and can benefit those with
co-occurring ADHD.

Occupational Therapy and Speech Therapy

Occupational therapy addresses sensory processing challenges and daily living
skills relevant to both ASD and ADHD. Speech therapy targets communication and
social language skills, particularly important for ASD.

Medication

Stimulant medications (methylphenidate and amphetamine salts) and
non-stimulants (atomoxetine) are effective for ADHD core symptoms. In
individuals with co-occurring ASD, response rates may be lower and side
effects more pronounced. About half of children with both conditions show
significant improvement on stimulants, with a higher rate of adverse effects
than in ADHD-only populations.

Medication decisions should always be made with a physician experienced in
managing both conditions. No medication treats the core features of autism
directly, though co-occurring anxiety, depression, and irritability may
respond to pharmacological intervention.

How Does This Affect Daily Life?

At School

Children with co-occurring ADHD and ASD face challenges with academic focus,
peer relationships, and sensory demands of the classroom environment. An IEP
or 504 plan should address both sets of needs, not just one diagnosis.
Strategies include visual schedules, reduced sensory distractions, structured
transitions, and regular movement breaks.

At Home

Predictable routines reduce anxiety associated with ASD while also providing
the structure that helps ADHD. Clear expectations, visual reminders, and
consistent consequences support both conditions. Parent stress is real, and
connecting with support groups or parent training programs makes a meaningful
difference.

Long-Term

Up to two-thirds of children with ADHD continue to experience symptoms into
adulthood. ASD is a lifelong condition. Early intervention and consistent
support improve adaptive functioning and quality of life over time. With the
right combination of therapies, educational support, and sometimes medication,
most individuals with co-occurring ASD and ADHD can reach meaningful
independence.

Frequently Asked Questions

Is co-occurring ADHD and autism common?

Yes. Research consistently shows 30 to 80 percent of autistic individuals also
have ADHD, and 20 to 50 percent of those with ADHD meet autism criteria. It is
one of the most common co-occurring combinations in neurodevelopmental
conditions.

Can my child be diagnosed with both at the same time?

Yes. The DSM-5 (2013) explicitly allows dual diagnosis of ASD and ADHD. Before
that, clinicians were not permitted to diagnose both. Many adults are now
getting both diagnoses as a result of this change.

Which diagnosis should come first?

Whichever is most impairing should be the primary focus of treatment, but both
should be addressed. Treating only ADHD when autism is present, or vice versa,
leaves significant challenges unaddressed.

Does ADHD medication make autism worse?

Some children with autism experience increased irritability or worsened
emotional regulation on stimulants. This is more common than in ADHD-only
populations. It is not universal, and many children tolerate medication well.
Start low and go slow is the typical guidance, with close monitoring.

What is the best therapy for a child with both ADHD and autism?

ABA therapy combined with social skills training and parent education is
typically the strongest foundation. Occupational therapy and speech therapy
are often added based on the child’s specific profile. Medication may be added
if behavioral approaches alone are insufficient.

How do I know if my child needs an evaluation?

If your child has significant attention challenges alongside social
communication difficulties, repetitive behaviors, or sensory sensitivities, a
comprehensive evaluation is warranted. Talk to your pediatrician about a
referral to a specialist in neurodevelopmental disorders.

Where can I find ABA therapy for my child?

Treetop ABA provides clinic-based, in-home, and school-based therapy across 11
states. Most families pay $0 out of pocket. Start with our
free autism screening or
contact us directly. You can also find a
location near you.

For more on what ABA therapy involves, visit our
services page or read our
what to expect guide.