Approximately 50-70% of persons with autism spectrum disorders (ASD) also have attention-deficit hyperactivity disorder (ADHD) according to the scientific literature meta-analyses. In addition, up to 84% of people with autism have some form of anxiety and as much as 17% specifically may have OCD obsessive-compulsive disorder.

As a mental health specialist who works with children, teens, and adults with autism, anxiety, and ADHD I have also noticed significant overall. During my involvement with a group of parents seeking support for their children with autism, one thing that I found fascinating is that EVERY parent in the room had a child who also was diagnosed with ADHD and an anxiety disorder such as generalized anxiety, social anxiety, or obsessive-compulsive disorder. This was a “common trio” in addition to other concerns that were unique to each family such as specific developmental delays and behavioral or learning challenges.

Children with autism and ADHD often have additional mental health conditions such as anxiety, depression, behavioral problems, developmental delay or intellectual impairment, speech, or language disorders, and/or learning disabilities. These overlaps can complicate the diagnostic process depending on the scope of practice of the specialist seen. For example, comprehensive testing may be recommended after an initial diagnostic evaluation for mental health and behavioral difficulties to specifically confirm a diagnosis such as Autism and ADHD. Since these are neurodevelopmental, it is important to have data from multiple settings and specific diagnostic tools including ones that focus on attention, memory, learning, and social communication to help inform diagnosis and recommendations.

Researchers have found that autism and ADHD both have significant symptom overlaps. One of the findings is that there were increased difficulties with behavioral self-regulation for children with both autism and ADHD than for children with a primary diagnosis of autism or ADHD alone. While studies have found that children with ASD and ADHD have different behavioral and neuro-cognitive profiles, there are some similarities. For example, children with ADHD commonly struggle with behavioral self-regulation, impulsivity, and hyperactivity as primary diagnostic features. For children with autism, behaviors are related to social communication and “quirky” or “odd” behavior but also display self-regulation difficulties. Also, both groups struggle with executive functioning such as planning and attention, which have some variation in how these present.

Since there is an overlap of some of the symptoms of autism, anxiety, and ADHD, it can be challenging to know where to start and what to address. Many times, this includes a multi-disciplinary team of professionals who can help meet the unique needs and impairment levels at various stages of development from childhood to adulthood.

Here are 5 strategies that can be a starting point for diagnosis and treatment interventions:

1. Talk to your pediatrician or primary care doctor about your concerns. Screening and early intervention are so important, and a medical diagnosis can help with support in other settings such as school. Your doctor can assist with referral options for other specialists.
2. Talk to your school social worker or counselor about services and supports available through the school. This includes exploring eligibility for evaluation as part of an individualized education plan (IEP). The evaluation process often includes testing in areas such as a child’s overall cognitive ability, performance in academic areas, speech-language, motor developmental, and emotional/behavioral concerns. Another option is to seek outside evaluation for children who receive services in a non-public school setting.
3. Talk to a mental health specialist about therapy options. A generalist therapist such as the providers at CARE Counseling can assist with therapeutic strategies to help with emotional and behavioral symptoms and can offer resource and referral options if additional comprehensive testing is needed to clarify a neurodevelopmental diagnosis.
4. Connect with other parents/ caregivers, and individuals for support. This can be a helpful environment to learn from each other, share challenges and successes, connect to resources, and find a sense of community.
5. Focus on strategies that can be helpful for multiple diagnoses. Examples include improving behavioral self-regulation, improving social communication skills, increasing tolerance of uncertainty, and developing routines that balance planning ahead, time management, flexibility, and behavioral management.

Written By: Charlotte Johnson, MA, LPCC