ADHD and autism in adults

Despite the fact that there is limited study on autism and ADHD in adults, some studies suggest that the diseases coexist at a rate of 20 to 37 percent.

Inattention, hyperactivity, and/or impulsivity are symptoms of ADHD, which differ from the social communication symptoms and restricted behaviors associated with autism.

Nonetheless, some ADHD symptoms are linked to autism diagnosis criteria. When you don't listen when you're talked to directly, for example, it's a sign of inattention, which is a common ADHD symptom. However, considering the high social demands associated with assessing a person on this symptom, it could also be a sign of autism. When an adult does not make eye contact during a conversation, it may look that they are "not listening when directly spoken to." Differential psychiatric tests, as well as other diagnostic techniques, can assist clinicians in determining whether this symptom is caused by distractibility (which implies ADHD) or by social-emotional reciprocity and nonverbal communication deficiencies (which indicate autism).

Clinicians must assess whether an ADHD symptom manifests itself in non-social contexts. If a patient feels distracted when working alone and without social obligations, it's more likely that they have ADHD rather than autism. Distractions should be investigated further - is the patient daydreaming, or is he or she being drawn into a sound that is troubling them? The latter could be a sign of autism-related sensory sensitivity.

Outcomes of ADHD in Autistic Adults

Autistic adults have more functional deficits as a result of their ADHD symptoms. According to a recent study, 724 autistic individuals were asked about the frequency and severity of behaviors linked with autism and ADHD, as well as their quality of life and other elements of their lives. When compared to controls, comorbid ADHD explained measurable differences in adaptive behaviors in all cases. 3

Treatment & Interventions for Adults with Autism and ADHD

There are presently no studies on the usage of ADHD medications in persons who have both ADHD and autism. The majority of adult therapy suggestions are based on research on autistic children.

As emphasized in a recent report produced by ASD and ADHD researchers, clinicians usually agree on the supports and therapy interventions that matter most to autistic individuals with ADHD — and which ones boost independence and improve quality of life. In employment and higher education, the recommendations span pharmaceutical and non-pharmacological therapies, as well as behavioral and environmental methods. They include, but are not limited to, the following:

Interventions that aren't pharmacological

  • Individuals with social communication and intellectual difficulties may require unique modifications to cognitive behavioral treatment (CBT), cognitive remediation therapy, and related techniques. Adults, rather than children, may respond better to group-delivered therapy.

  • Executive function therapies; Flexible Futures is a new program that focuses on these skills in autistic adults with ADHD (a children's version, Unstuck and On Target, is also available and has evidence to back it up).

  • Many patients and families benefit from psychoeducation.

Supports for Educators and Workers

  • Identifying attainable career objectives

  • Looking for volunteer opportunities to learn more about the workplace

  • Using assistive technology to complete applications and job interviews

  • Identifying and requesting work or school changes and accommodations (Standardized accommodations like extended time on tests, for example, may not be suitable for autistic adults with an ADHD diagnosis, who may benefit more from a mid-point break)

  • Coaching to help you achieve your long-term objectives

  • Using focus and anxiety-reduction techniques

  • Adoption of assistive technology

  • Utilizing organizational resources (peer systems, skills training)

Interventions with pharmaceuticals

In adults, pharmacological treatments for co-occurring ASD and ADHD are not significantly different from treatments for each illness alone. ADHD is routinely treated with stimulant and non-stimulant medicines. Antipsychotics like risperidone and aripiprazole are frequently used to alleviate anger and irritability, despite the fact that there are no FDA-approved pharmacological drugs to address fundamental symptoms of ASD. However, behavioral and environmental therapies are more prevalent and effective first-line treatments for core autism characteristics.

Experts agree, however, that prescribers should start with low doses and go slowly through treatment because individuals with both diseases may be more resistant to treatment and sensitive to medicine. Medication goals and targets (as with any intervention) should be established from the start, as should measures of effectiveness.

Other good practices include:

  • Due to sensory concerns and/or physical limitations, adults with ASD and ADHD may be unable to swallow drugs in pill or tablet form. Liquid formulations and alternate preparations should be considered by clinicians.

  • Some individuals may have difficulties expressing their thoughts, feelings, and sensations, which may have an impact on treatment feedback. Clinicians should employ visual tools to facilitate reporting, such as mood scales and drawings.