Understanding the "AuDHD" Phenomenon: When Autism and ADHD Coexist

Sabrina B.
Aug 31
5 min read

This article is based on analyses of recent scientific journals concerning the functioning of the brain and therapies that aim to remodel it to treat mental disorders.

The increasingly common term "AuDHD" is not an official medical diagnosis, but a neologism coined by the neurodivergent community. It refers to the co-occurrence, or comorbidity, of Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD). This concept, which falls within the neurodiversity paradigm, suggests that the traits of each condition are not simply superimposed, but interact, overlap, and, in some cases, come into direct conflict. AuDHD thus represents a unique life experience, which has long been misunderstood due to evolving diagnostic frameworks.

Therapy for Autism, ADHD and Autism — **Le terme "AuDHD" n'est pas un diagnostic, mais une réalité clinique qui révèle une interaction complexe et souvent contradictoire entre deux profils neurodéveloppementaux.**

Terminological Foundations and Evolution of Diagnosis: A Historical Shift

Formal recognition of the co-occurrence of ADHD and ASD is a recent phenomenon. Until 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) prevented the dual diagnosis of ADHD and ASD, considering one to be an exclusion criterion for the other. This rule not only hindered accurate diagnosis but also limited research on this population.

The publication of the DSM-5 in 2013 marked a historic shift by removing this exclusion and allowing dual diagnosis for the first time. This change acted as a catalyst for research and clinical practice. In reality, it is not the condition that is new, but its formal recognition that has allowed the phenomenon to become visible. In the French-speaking scientific literature, the preferred term remains "comorbidity" or "co-occurrence," while the community uses the term AuDHD to name this reality and forge a distinct identity.

Clinical Presentation and Life Experience: The "Living Contradiction"

The AuDHD experience is not simply the addition of ADHD symptoms to autism traits. It is defined by a complex and often contradictory interaction of the two conditions, generating constant internal tension and a high risk of burnout.

Shared traits: Many symptoms overlap, making diagnosis complex. Both populations may have difficulties with
executive functions (planning, organizing), emotional dysregulation , and sensory sensitivities . Social communication challenges are also a common trait, although their origins differ (inattention and impulsivity of ADHD vs. difficulties decoding social cues of ASD).
Conflicting Traits: The core of the AuDHD experience lies in the coexistence of traits that seem opposite.
- Routine vs. Novelty: The need for routine and predictability associated with ASD clashes with the desire for impulsivity and novelty of ADHD.
- Hyperfocus vs. Inattention: A person with AuDHD may hyperfocus intensely on one subject, while having difficulty maintaining attention on non-stimulating tasks, leading to forgetting responsibilities.
- Social Interaction: ADHD's desire for social stimulation can conflict with the fatigue and sensory overload it generates for the autistic part of the individual.
- Perfectionism vs. Procrastination: ASD's attention to detail can clash with ADHD's difficulty initiating a task, creating a cycle of procrastination and failure.

Recognition of these contradictory features is essential for an accurate diagnosis.

Epidemiological and Neurobiological Foundations: The Why of Co-Occurrence

The high co-occurrence of autism and ADHD is supported by numerous studies, suggesting a link beyond mere chance.

Statistics: Estimates of co-occurrence vary, but they are consistently higher than expected. One meta-analysis found that between
Between 50% and 70% of autistic people also have ADHD, while a rate of 21% is observed in children and adolescents with ADHD.
Genetics and neuroimaging: The connection has both genetic and neurobiological bases. Studies have identified partially shared genetic factors, and neuroimaging has revealed shared abnormalities in brain regions crucial for cognitive and social functions, such as the prefrontal cortex and amygdala.

These findings demonstrate that the internal tension specific to AuDHD is not simply a feeling, but may be rooted in the complex interaction of brain circuits.

Assessment and Management Strategies: An Individualized Approach

The unique profile of AuDHD requires a tailored diagnostic and therapeutic approach.

Diagnosis: Diagnosis is a comprehensive, multidisciplinary clinical process. It should be conducted by professionals with expertise in both conditions, as symptoms of one can mask those of the other. The individual's developmental history is also crucial, as symptoms must be present from early childhood.
Therapies and support: Multifactorial management is recommended.
- CBT: Helps with emotional regulation and burnout management.
- Occupational Therapy: Develops time management and organizational skills, targeting the executive challenges of both conditions.
- Psychoeducation: Fundamental for the individual and those around them to understand the interaction of the two disorders and use the strengths of one to compensate for the challenges of the other.

Conclusion on AuDHD: A distinct identity, unique needs

AuDHD is not a passing concept. It is a clinical reality that has long been ignored. It is more than just the addition of two diagnoses; it is a distinct neurocognitive profile, with its own challenges and strengths. Recognizing this condition is an essential step in providing tailored and affirming support, which focuses on supporting the individual rather than suppressing their intrinsic traits.

The goal of care is not to "normalize" the individual but to provide them with the tools and accommodations necessary for them to flourish by harnessing their unique strengths, such as creativity, empathy, and resilience, which often emerge from this complex experience.

Do you recognize yourself in these contradictory traits? How does the conflict between the need for routine and novelty influence your daily life? If you would like to explore these questions and receive support in navigating the complexity of AuDHD, I offer online coaching sessions from Monaco to guide you on this journey.

Sabrina Beloufa, Psychologist, Couples Therapist, Sex Therapist

Individual Psychotherapy

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