AuDHD has become a hot topic. More and more people are discovering that they have behaviors of both attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Until 2013, specialists couldn’t give a dual diagnosis of both ADHD and autism to someone. Revisions to the Diagnostic and Statistical Manual (DSM-5) allowed both conditions to be diagnosed at once. These recent revisions likely contributed to the rise in diagnoses. AuDHD in teens affects every aspect of life, from home routines to schoolwork and social skills.
What Is AuDHD? Overlapping ADHD and Autism
Autism spectrum disorder and attention-deficit/hyperactivity disorder are both neurodevelopmental disorders, meaning they affect how the brain grows and functions. While they are distinct conditions, they share many overlapping traits and frequently occur together. In fact, research shows that 50-70% of autistic people also meet the criteria for ADHD.
Understanding Autism Spectrum Disorder (ASD)
Autism spectrum disorder primarily impacts social communication and interaction. Autistic children and teens struggle with:
- Interpreting social cues, non-literal language (like sarcasm), and body language
- Building and maintaining peer relationships
- Intense, highly focused interests in specific topics
- A strong need for routine and predictability
- Sensory sensitivities, such as being overstimulated by loud noises or certain textures
Understanding Attention-Deficit/Hyperactivity Disorder (ADHD)
An ADHD diagnosis requires people to have patterns of inattention and/or hyperactivity-impulsivity. Teens with ADHD often experience challenges with:
- Sustaining attention, organizing tasks, and managing time
- Forgetfulness and losing important items
- Fidgeting, restlessness, and an inability to stay seated
- Acting impulsively, interrupting others, and making hasty decisions
Comparing AuDHD, Autism, and ADHD
Teens with AuDHD can have symptoms that seem at odds. They might have deep special interests, but struggle to engage with them because of the effort it would take to start. They might crave new experiences but avoid them because they can be overwhelming and out of routine. This internal conflict—the brain’s desire for routine clashing with its inability to stay on task—can be incredibly frustrating and emotionally taxing for your teen.
Characteristic Behaviors | Common in ADHD | Common in Autism | Overlap in AuDHD |
| Attention and Focus | Difficulty sustaining attention on tasks or activities. | Intense focus on specific interests (hyperfocus). | Struggles with focus, alternating between hyperfocus and inattention. |
| Executive Functioning | Poor organizational and time-management skills. | Preference for structured routines and predictability. | Hyperorganizes for fear of forgetting anything that might throw off routines. |
| Social Interaction | Impulsivity, interrupting conversations. | Difficulty interpreting social cues, prefers solitude. | May interrupt others impulsively while struggling to understand or engage in social norms. |
| Sensory Processing | Easily distracted by external stimuli, such as noise. | Sensory sensitivities to light, sound, or texture. | Heightened sensitivity to sensory input, leading to overwhelm in various environments. |
| Behavioral Traits | Frequently acts impulsively and struggles with patience. | Strong resistance to change in routines or schedules. | May resist changes impulsively while also feeling distressed when routines are broken. |
| Interests and Activities | Frustration in following through on tasks despite interest. | Intense focus and knowledge in niche subjects. | Deep passions in specific areas, but struggles with execution due to executive dysfunction. |
| Emotion Regulation | Mood swings and difficulty managing frustration. | Difficulty expressing or recognizing emotions. | Emotional outbursts due to frustration from conflicting neurological tendencies. |
AuDHD Is More Than the Sum of Its Parts
Identifying AuDHD can be tricky because the symptoms of one disorder can mask or amplify the other. A teen with AuDHD isn’t just a little autistic and a little ADHD; the combination creates a more profound impact on their daily life. Key signs of AuDHD in teens include:
- More executive functioning deficits: While both disorders affect executive functions (the brain’s management system), the impairment in AuDHD is often more severe. Your teen may struggle immensely with planning, starting tasks, and staying organized.
- Profound social challenges: Autistic teens may want to socialize but not know how. ADHD teens might understand social rules but be too impulsive to follow them. A teen with AuDHD can experience both, leading to significant peer rejection and isolation.
- Heightened emotional dysregulation: The combination of autistic sensory overload and ADHD-related impulsivity can result in intense emotional outbursts, irritability, and mood swings that are difficult for them to control.
- Being “wired but tired”: They may feel a constant internal restlessness from ADHD, yet at the same time feel completely exhausted from the mental effort of trying to fit in or navigating a neurotypical world.
- Delayed diagnosis: Often, one condition is diagnosed while the other is missed. For instance, a teen’s social difficulties might be incorrectly blamed solely on their ADHD, delaying recognition of their underlying autism.
Masking and Burnout in AuDHD Teens
Autistic teens sometimes “mask” to camouflage their symptoms and appear more neurotypical. But people with ADHD also mask. Being neurodivergent is difficult, and it’s even more difficult when you’re trying to fit in—something teens are always trying to do as they gain more independence. The emotional toll masking takes on an AuDHD teen makes it hard to keep up, and they can quickly face burnout.
Neurodivergent burnout doesn’t just happen because of masking, but it can be a major contributor. The burnout we’re talking about here is similar to the one you experience when you work too long without a break. Crushing mental and physical exhaustion that makes you more prone to being irritable, depressed, and detached.
Getting an Accurate Diagnosis
If you suspect your teen has AuDHD, get a comprehensive evaluation. And, if they already have a diagnosis of ADHD or autism, get an updated assessment or second opinion. A correct diagnosis opens the door to the right interventions and school accommodations, and it provides your teen with the invaluable gift of self-understanding.
An effective diagnostic process should involve:
- A multidisciplinary team: Look for a clinical psychologist, developmental pediatrician, or adolescent psychiatrist with expertise in both autism and ADHD.
- Comprehensive interviews: The evaluation should include a detailed developmental history with you (the parents) to understand when symptoms first appeared.
- Direct observation and standardized tools: Clinicians will use gold-standard assessments like the ADOS-2 for autism and gather information from both you and your teen’s teachers using rating scales like the Conners or Vanderbilt for ADHD.
- Cognitive and adaptive testing: An IQ test and an assessment of adaptive skills (like the Vineland-3) help determine your teen’s support needs and rule out other conditions.
Talk to them about testing for both conditions at once, especially if your teen already has a diagnosis of ADHD or autism. While medications can help manage ADHD symptoms, they don’t really have an impact on autism’s social skills. And, while behavioral practices can help with autism, they might not be effective enough to manage impulsivity or executive functioning issues.
The Best Interventions for AuDHD: An Integrated Approach
There is no single “cure” for AuDHD, but a combination of evidence-based strategies can dramatically improve your teen’s quality of life. The most effective treatment plans are highly personalized and integrated, addressing both the autistic and ADHD components.
Medication Management
While there is no medication for autism’s core symptoms, ADHD medications can be transformative.
- Stimulants (Methylphenidate, Amphetamines): These are often the first-line treatment and can significantly improve focus and reduce impulsivity.
- Non-stimulants (Atomoxetine, Viloxazine, Guanfacine): These are excellent alternatives if stimulants cause side effects like irritability or appetite loss, which can be more common in autistic individuals.
Therapy and Coaching
- Cognitive-behavioral therapy (CBT): CBT can help your teen manage anxiety and depression, which are very common co-occurring mental health conditions.
- Executive function coaching: A coach can teach your teen practical skills for time management, organization, and planning.
- Social skills training: Look for groups that are neurodiversity-affirming and focus on understanding social dynamics rather than memorizing scripts.
Parent Training
Parent-mediated programs equip you with the best tools to manage challenging behaviors, improve communication, and strengthen your relationship with your teen. You’re not always going to have the answers, and that’s okay. Some of the best support you can give your AuDHD teen is being involved in the treatment process, where you can learn alongside them.
Creating Supportive Environments at School and Home
By making adjustments at home and advocating for them at school, you can help your teen feel safe, understood, and capable.
School Accommodations
Your AuDHD teen is likely eligible for support under an individualized education program (IEP) or a 504 Plan. The most effective accommodations are evidence-based and tailored to your teen’s specific needs. Request:
- Movement breaks: Allows them to manage hyperactivity
- Preferential seating: Minimizes distractions
- Visual schedules and checklists: Supports executive functioning
- Extended time on tests: Reduces anxiety and accommodates processing speed
- Access to a quiet space: Helps them decompress from sensory or social overload
- Duplicate notes: Frees them to focus on listening rather than frantic writing
Strategies for Home
- Embrace routine: Predictability is calming for an autistic brain—and can help with ADHD executive functioning. Use shared family calendars and visual schedules.
- Leverage interests: Use your teen’s intense interests as a gateway for learning and connection. Help them become immersed in their hobby while exploring adjacent topics that can help satisfy cravings for new experiences.
- Teach mindfulness: Adapt mindfulness for AuDHD. Use short, 3-5 minute practices, incorporate movement (like a mindful walk), and anchor the practice to their interests (e.g., “focus on your breathing like a video game character powering up”).
- Externalize executive functions: Use timers, phone alarms, and color-coded systems to help them stay on track. Help them manage their executive function until they can build their own skills.
The Nest Program: Specialized Support for AuDHD Teens
For neurodivergent teens navigating the complex challenges of AuDHD, finding the right support can make all the difference. In The Nest, our experts deliver neurodiversity-affirming care that truly works. We recognize the distinct difficulties AuDHD presents in emotional regulation, executive functioning, and social skills.
Features of The Nest Program by Family First Adolescent Services
- A specialized, residential environment: Meticulously designed for neurodivergent boys aged 12-18.
- Empowerment, not “fixing”: Your son doesn’t need to be “fixed”; he needs a supportive space that celebrates neurodiversity and equips him with the skills to thrive.
- Compassionate & expert care: Our mission is to provide a safe, developmentally attuned program that addresses your teen’s unique needs with unwavering compassion and proven expertise.
Our Neurodiversity-Affirming Approach
Our personalized, strength-based approach focuses on what works best for your son. Highly trained clinical specialists create individualized treatment plans that may include:
- Expressive art therapy
- Tailored exercise classes
- Group outings
- Parent coaching
- Parallel process therapy
- Educational classes and retreats
We don’t just help your son learn to cope and navigate the world. We’ll help you understand the unique way his brain works, empowering you to rebuild trust, improve communication, and create a truly supportive home environment. With our expert guidance, your son can transform his challenges into remarkable opportunities and step confidently into adulthood.
Get In Touch Today
Take the next step in improving your teen’s functioning, social skills, and path ahead with support from the experts at Family First. With more than 120 years of combined clinical experience, you can trust that your son is in good hands at our South Florida treatment center. Reach out online or call us at 888.904.5947 today.
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