Neurodiversity: Autism + ADHD Dual Diagnosis

by | Oct 27, 2025 | Blog

When Autism and ADHD Overlap: Understanding Dual Diagnosis

It’s not uncommon for families to notice that their child doesn’t quite fit neatly into one diagnostic box. Maybe a child who has an autism diagnosis also struggles to sit still, finish tasks, or stay focused on conversations. Or perhaps a student identified with ADHD also finds social situations confusing, or gets deeply attached to routines. More and more, we’re learning that autism and ADHD often coexist—and that understanding this overlap can change how we support kids at home and in school.

How Often Do Autism and ADHD Occur Together?

For a long time, professionals weren’t even allowed to diagnose both. Before 2013, the diagnostic manual (DSM-IV) treated autism and ADHD as mutually exclusive. That changed with the DSM-5, which recognized that the two conditions can—and often do—appear together.

Now that clinicians can name both, we’re seeing how common this really is. Studies vary, but most find that 30% to 80% of autistic children also meet criteria for ADHD, and about 20% to 50% of children with ADHD also meet criteria for autism. The overlap is large enough that many researchers now consider them to be part of the same broader family of neurodevelopmental conditions, sharing differences in how the brain manages attention, motivation, and social processing.

How the Two Diagnoses Are Made

Getting both diagnoses usually involves a comprehensive evaluation—and, ideally, a team that understands neurodiversity.
That evaluation often includes:

  • Developmental history and interviews with caregivers and teachers

  • Behavioral rating scales to look at attention, focus, and impulse control

  • Direct observation or play-based assessments (for autism, this might include tools like the ADOS-2)

  • Cognitive, speech-language, and occupational therapy testing to see the full picture of a child’s strengths and needs

It takes some clinical finesse to tell where one condition ends and the other begins. For example, both can involve social challenges—but for different reasons. A child with ADHD might interrupt or talk over others because of impulsivity, while a child with autism might miss subtle cues about when it’s their turn to speak. A skilled evaluator looks beyond surface behaviors to understand why something is happening.

What It Means When a Child Has Both

A dual diagnosis doesn’t mean something is “worse.” It simply means that the child’s brain is wired in a way that includes characteristics of both profiles.

A child with autism and ADHD might:

  • Have intense interests and big bursts of creativity,

  • But find transitions or organization hard;

  • Be deeply empathetic, yet easily overstimulated;

  • Thrive in structure, but need help with flexibility.

When families understand both parts of the picture, they can make sense of behaviors that once seemed confusing or contradictory. It also helps teachers and therapists choose supports that actually fit the child, rather than forcing them into a single mold.

Helpful Treatments and Supports

Because each child is unique, treatment plans look different from family to family. Still, several approaches tend to help kids with both autism and ADHD.

1. Behavioral and Cognitive Supports

Therapies like Cognitive Behavioral Therapy (CBT), Applied Behavior Analysis (ABA), and structured social skills groups can be tailored for children with overlapping needs. Parent-coaching programs can also teach practical tools for managing routines, meltdowns, and homework battles in a calmer way.

2. Medication

Many children with dual diagnoses benefit from ADHD medications—often stimulants like methylphenidate or amphetamine salts. Some children respond better to non-stimulants (like guanfacine or atomoxetine), especially if they have sensory sensitivities or anxiety.
Medication isn’t the answer for everyone, but for many families, it opens the door to learning and focus.

3. The Right School Environment

Schools that understand neurodiversity can make an enormous difference.
Children with both autism and ADHD usually do best in environments that are:

  • Predictable and structured,

  • Visually clear, with schedules and cues,

  • Flexible with movement and sensory needs,

  • And emotionally supportive, where differences are accepted rather than corrected.

Some specialized schools—like City Elementary and others built on neurodiversity-affirming principles—are intentionally designed for this. They use smaller class sizes, sensory-friendly classrooms, and individualized goals that focus on emotional growth alongside academics.

4. Therapies That Build Regulation

Occupational therapy can help with sensory processing and emotional regulation. Speech-language therapy can target social communication—understanding tone, turn-taking, and perspective-taking in real conversations. These supports build the skills that sit beneath both conditions.

The Bigger Picture

Recognizing both autism and ADHD in a child isn’t about collecting labels. It’s about understanding how their mind works so adults can meet them where they are.

When parents, teachers, and clinicians see a child through a lens of curiosity rather than comparison, they open doors to growth. A dual diagnosis can be a starting point for self-understanding—a way for children to realize, “My brain just works differently, and that’s okay.”

With the right support, these children often grow into inventive thinkers, loyal friends, and problem-solvers who see the world from fresh angles. The goal isn’t to make them “less autistic” or “less ADHD,” but to help them build the tools they need to thrive as themselves.